Physical Therapy at Home After Shoulder Surgery in Los Angeles

Written by Jennifer Chen Wound Care Specialist, CWCN Oct 12, 2026

Coming home after shoulder surgery changes almost everything about your day. With one arm in a sling, getting out of bed, dressing, bathing, and even standing up from a chair can feel new and uncertain. For some patients, physical therapy at home after shoulder surgery is part of a safe recovery, especially when other health problems make it very hard to leave the house. For many others, outpatient therapy at a clinic is the usual and better path.

This guide explains who may qualify for home health physical therapy after a rotator cuff repair, shoulder replacement, or shoulder fracture repair, what a home health therapist may help with, and how to tell which setting fits you. It does not give a rehab protocol. Your surgeon’s protocol always comes first.

Common shoulder surgeries and why recovery takes time

Shoulder surgery covers several different procedures. The most common ones that lead to physical therapy include:

• Rotator cuff repair: the surgeon reattaches one or more torn tendons around the shoulder. The repair needs time to heal, so motion is often limited at first.
• Shoulder replacement: the damaged joint surfaces are replaced. This may be an anatomic replacement or a reverse shoulder replacement, depending on the patient’s shoulder and the surgeon’s judgment.
• Fracture repair: a broken upper arm bone near the shoulder, or another fracture around the joint, is fixed with hardware or, in some cases, replaced.

Each of these comes with its own precautions. Your surgeon decides how long you wear a sling, which motions are allowed and when, whether the arm can be moved by someone else or only by you, and when you can start using the arm for light tasks. These limits protect the repair, and they can be different from one patient to the next even after the same surgery.

That is why this article will not tell you which exercises to do or when. The surgeon’s written protocol and the instructions from your therapist govern your recovery.

Who may qualify for physical therapy at home after shoulder surgery

Home health physical therapy is part of the Medicare home health benefit and similar coverage from other plans. It is designed for patients who are homebound and need intermittent skilled care under a physician-ordered plan of care. Having shoulder surgery does not by itself make someone homebound. Many people walk well after shoulder surgery, get rides to appointments easily, and do well with outpatient PT.

Home health PT is more likely to fit when the shoulder surgery is combined with other problems that make leaving home a considerable and taxing effort. Examples include:

• An older adult with balance problems who normally relies on a walker or cane, and now cannot use it safely with one arm in a sling.
• A patient who had a fall that caused the shoulder fracture and is now weak, unsteady, or afraid of falling again.
• Someone with heart, lung, or other chronic conditions who becomes very short of breath or exhausted with any outing.
• A patient who also has a hip, knee, or leg problem that limits walking.
• Someone with memory problems who needs another person’s help to leave home safely.

If none of this sounds like you, and you can get to a clinic without a taxing effort, outpatient PT is usually the right choice. Outpatient clinics are very familiar with shoulder rehab and often have equipment that helps in later stages of recovery.

The two parts of the homebound definition

Medicare uses two criteria, and a patient needs to meet both. Criterion one: because of illness or injury, the patient needs a supportive device, special transportation, or another person’s help to leave home, or leaving home is medically not recommended. Criterion two: the patient is normally unable to leave home, and leaving requires a considerable and taxing effort.

Homebound does not mean never leaving. Trips for medical care, including your surgeon’s follow-up visits, do not by themselves disqualify you. Adult day care, religious services, and infrequent or short absences such as a haircut or a family event are also generally allowed. You can read more examples in our post on what qualifies as homebound for Medicare.

Other requirements

In addition to being homebound, the patient needs an order from a physician or allowed practitioner, a plan of care, and a need for intermittent skilled services such as physical therapy. A face-to-face encounter related to the reason for home health is also required, within 90 days before or 30 days after the start of care. A recent surgical or follow-up visit may meet that requirement when it is documented and related to the reason for home health.

Medicare may cover home health physical therapy when these conditions are met. Other plans have their own rules and may require in-network agencies or prior approval. Our insurance page explains how intake checks coverage.

What a home health physical therapist may help with

When physical therapy at home after shoulder surgery is ordered, the therapist starts with an evaluation. They review the surgeon’s protocol and precautions, ask about your pain, look at how you move around your home, and check how safely you can walk, transfer, and handle stairs with one arm. Then they recommend a plan that fits the orders.

Depending on the plan of care and your surgeon’s instructions, a home health therapist may help with:

• Following the shoulder protocol: guiding the exercises your surgeon allows at each stage, and making sure you understand which movements to avoid.
• Sling use: checking that the sling fits well, and teaching you and your caregiver how to put it on and take it off when allowed.
• Safe walking and balance: helping you walk safely when you cannot use both arms for support. This may include trying a different device that works one-handed, if appropriate and ordered.
• Transfers: getting in and out of bed, up from a chair, and on and off the toilet without pushing up through the surgical arm.
• Stairs and entrances: working on the actual steps and doorways in your home.
• Fall prevention: looking for hazards such as loose rugs, cords, poor lighting, and clutter in walkways.
• Caregiver teaching: showing family members how to help without pulling on the arm or putting it in an unsafe position.

You can learn more on our rotator cuff rehab at home and shoulder pain physical therapy at home service pages. Because falls are a major concern when one arm is out of use, fall prevention therapy at home is often part of the conversation as well.

How occupational therapy may fit in

After shoulder surgery, daily tasks can be harder than walking. Putting on a shirt, fastening a bra, washing your hair, reaching a cabinet, and cooking a simple meal all use the shoulder. Occupational therapists focus on these activities.

When it is ordered as part of home health, an occupational therapist may teach one-handed techniques for dressing and grooming, recommend adaptive equipment such as a long-handled sponge or reacher, and help you set up the bathroom and kitchen so that what you need is within easy reach of your good arm. Our occupational therapy at home page explains more.

Getting your home ready before surgery

If your surgery is scheduled, you have a chance to prepare the house before you go to the hospital or surgery center. Simple steps can make the first weeks much easier:

• Move everyday items to counter height so you do not need to reach overhead.
• Choose loose, front-opening shirts and slip-on shoes.
• Plan where you will sleep. Many people find a recliner or extra pillows more comfortable at first, but ask your surgeon what is safe for you.
• Clear walkways, remove loose rugs, and add night lights between the bedroom and bathroom.
• Arrange help for meals, shopping, laundry, and rides for the first weeks.
• Ask whether a shower chair or handheld shower head would help, and follow your surgeon’s instructions about keeping the incision dry.

Our guide to preparing your home for post-surgery recovery has a fuller checklist.

Questions to ask your surgeon before discharge

Before you leave the hospital or surgery center, ask the surgical team to explain your precautions in plain words and in writing. Useful questions include:

1. How long should I wear the sling, and can I take it off to bathe, dress, or sleep?
2. Which movements are not allowed yet, and for how long?
3. When should therapy start, and is it outpatient or home health?
4. Who should I call if I have questions about pain, the incision, or the sling?
5. What warning signs should make me call right away?
6. When is my first follow-up appointment?

If you think you may be homebound, ask the surgeon or discharge planner whether a home health referral makes sense. If you are not homebound, ask them to recommend an outpatient clinic that works with shoulder patients.

Once you have these answers, our step-by-step guide on how to get physical therapy at home after a hospital stay explains the order, the face-to-face encounter, and choosing an agency.

The Los Angeles County angle

Some practical features of life in Los Angeles County can make the early weeks after shoulder surgery harder, and they are worth discussing with your care team.

Getting in and out of a car. Even a short drive means getting into a car seat, buckling a seatbelt across the body, and climbing out again without using the surgical arm. For a patient who also has balance problems, this can take real effort and another person’s help. Long drives in heavy traffic to reach a clinic add more time and fatigue.

Stairs, hillsides, and walk-up apartments. Homes on hillside streets in many parts of the county have steep driveways or long staircases. Many older apartment buildings have no elevator. Climbing stairs while holding a railing with only one hand is very different from climbing with two. A home health therapist can practice on your actual stairs, and an outpatient therapist can help you plan for them as well.

Caregivers with jobs and commutes. In many families, the person who helps after surgery also works. If you live alone or your helper is away all day, tell your surgeon and therapist so they can help you plan for safe daily routines.

Language and communication. Los Angeles County families speak many languages. Make sure the patient and the caregiver who helps with exercises both understand the precautions. Ask for written instructions and interpreter support if needed.

HarvardCare Home Health serves homebound patients in communities across the county. You can read about post-surgery rehab at home in Pasadena, and see our pages for home health in Torrance and home health in Sherman Oaks.

When outpatient PT is the better fit

For many people, outpatient physical therapy is the standard and best option after shoulder surgery. If you can walk well, get in and out of a car with little help, and get to appointments without a considerable and taxing effort, outpatient therapy is likely the right setting. Clinics often have pulleys, bands, weights, and other equipment that are useful in later stages of shoulder rehab.

Some patients start with home health PT while they are homebound and then move to outpatient PT once they are stronger and can leave home more easily. That is a common and healthy progression. Your surgeon decides whether more therapy is needed and where.

HarvardCare Home Health can only admit patients who are homebound and meet the other home health requirements. If you are not homebound, we encourage you to work with an outpatient clinic or another therapy provider your surgeon recommends.

For a fuller comparison, read home health PT vs outpatient PT vs mobile PT and which one fits different situations.

Warning signs to report

Call your surgeon’s office promptly if you notice increasing redness, warmth, swelling, or drainage at the incision, a fever, pain that is getting worse instead of better, new numbness or tingling in the arm or hand, or a sudden loss of motion you had before. If you have a fall, contact your surgeon even if you feel all right.

Call 911 for chest pain, trouble breathing, sudden swelling and pain in an arm or leg with shortness of breath, signs of a stroke, or any other emergency. Home health is not an emergency service.

This article is general education and is not medical advice. Always follow your surgeon’s protocol and the orders of your treating provider.

Frequently asked questions about physical therapy at home after shoulder surgery

Does everyone get home health PT after shoulder surgery?

No. Most patients who can get to appointments without a taxing effort go to outpatient PT. Home health PT is for patients who are homebound, such as older adults with balance problems who cannot safely use a walker or cane one-armed, and who have a physician order.

Will the home health therapist give me a different protocol?

No. The surgeon’s protocol governs your recovery, including sling time and range-of-motion limits. The therapist follows those orders and helps you carry them out safely at home.

Can I still go to my surgeon’s follow-up visits if I am homebound?

Yes. Leaving home for medical appointments does not by itself mean you are not homebound. Infrequent or short absences, such as a haircut or a family event, are also generally allowed.

Does Medicare cover physical therapy at home after shoulder surgery?

Medicare may cover home health physical therapy if you are eligible. That generally means you are homebound, need intermittent skilled therapy, have a plan of care and a physician order, and had a related face-to-face encounter. Other plans have their own rules.

Can home health help with dressing and bathing after shoulder surgery?

When ordered, an occupational therapist may teach one-handed techniques and recommend adaptive equipment. A home health aide may also help with personal care when it is part of the plan of care and the patient is receiving skilled services.

How often will the therapist visit?

There is no set number of visits. Visit frequency and length are set by the physician-ordered plan of care, based on the therapist’s evaluation, and they are reviewed as you progress.

What if I start at home and then improve?

That is a good outcome. When you are no longer homebound or your goals are met, home health ends. Your surgeon may then refer you to outpatient PT to continue your recovery.

Ask about home health PT after shoulder surgery