JSES - 2026-07-01 - Journal Article
Return to weightlifting following anatomic and reverse shoulder arthroplasty.
Abdelshaheed J, Chatterji R, Levy J, Flynn G, Beleckas CM, Levy JC
Topics
Key Takeaway
70.1% of shoulder arthroplasty patients returned to weightlifting without difficulty at mean 66.6 months, with no significant difference between anatomic and reverse cohorts (74.3% vs. 56.8%, p=0.10).
Summary Depth
Choose how much analysis to show on this article page.
Summary
This study examined return-to-weightlifting rates and functional outcomes in 184 self-identified weightlifters following primary shoulder arthroplasty (aTSA, HA, or rTSA) at minimum 2-year follow-up. Overall, 70.1% reported no difficulty with weightlifting, 21.7% reported some difficulty, and only 0.5% were unable to participate. No statistically significant difference in full return rates was found between anatomic and reverse cohorts (74.3% vs. 56.8%, p=0.10), though both achieved substantial improvements in ASES (mean 86.1), SANE (83.4), and VAS pain (1.3).
Key Limitation
The retrospective single-surgeon design with patient self-selection into the weightlifter cohort introduces significant selection bias, as patients who returned to weightlifting were more likely to complete follow-up questionnaires identifying that activity.
Original Abstract
BACKGROUND
Weightlifting is a common form of recreational activity that can place higher levels of stress on the shoulder joint and is of particular interest to many patients undergoing shoulder arthroplasty. Despite the growing number of individuals receiving anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA), recommendations regarding return to weightlifting remain unclear. The purpose of this study was to report the rate of return to weightlifting following primary shoulder arthroplasty and to evaluate postoperative function and performance outcomes.
METHODS
A retrospective review of a single institution's shoulder and elbow surgery repository identified patients who underwent aTSA, hemiarthroplasty (HA), or rTSA by a single fellowship-trained shoulder and elbow surgeon between February 2009 and August 2023. Patients who self-identified "weights" or "weight training" as a usual sport on the American Shoulder and Elbow Surgeons (ASES) questionnaire at a minimum 2-year follow-up were included. Demographics, surgical indications, range of motion, patient-reported outcome measures (ASES, Simple Shoulder Test, Single Assessment Numeric Evaluation, visual analog scale pain/function), and return to weightlifting status were analyzed and compared between anatomic (aTSA/HA) and reverse (rTSA) cohorts.
RESULTS
Of the 200 shoulder arthroplasty patients self-identified as weightlifters, 184 patients (92%) met inclusion criteria with a mean follow-up of 66.6 ± 34.7 months. The mean age was 64.8 ± 8.1 years, and 76.6% were male. Overall, 70.1% of patients reported no difficulty performing their usual weightlifting activities, 21.7% reported some difficulty, 7.6% reported great difficulty, and only 1 patient (0.5%) was unable to participate. There was no statistically significant difference in rates of full return to weightlifting between patients treated with aTSA or HA and those treated with rTSA (74.3% vs. 56.8%, P = .10). Postoperative range of motion only differed for internal rotation (8 vs. 4, P = .001). Both cohorts achieved substantial postoperative improvements in ASES (mean 86.1 ± 16.8), SANE (83.4 ± 21.6), SST (10.3 ± 2.0), and VAS pain (1.3 ± 2.2) scores.
CONCLUSION
Shoulder arthroplasty patients can expect a high likelihood of returning to weightlifting without difficulty, with excellent pain relief and functional improvement.