We had people submit their questions to our Resident Sexual Health Clinician, Dr. Kathryn Ellis, OTR/L, OTD, AASECT-SC, an occupational therapist and American Association of Sexuality Educators, Counselors, and Therapists Certified Sexuality Counselor. 

Shoulder surgery can be a major jam for your sex life. The surgery can cause pain, limited mobility, anxiety, busy rehab schedules, and fatigue. Plus there is typically a “no sex for X amount of weeks” rule from your surgeon (we’ll talk about this one) and multiple medical and rehab appointments is exhausting.

Yet the surgery recovery period can also be a great time to connect and bond with your partners. Oftentimes there is a lot of downtime between medical appointments and partners are providing caregiving which can be comforting and nurturing.

We get a lot of questions about sex after shoulder surgery, so we wanted to address a few pointers.  

Make your doctor blush when they say “no sex for X amount of weeks.” 

Ok, so let’s be real here. Most likely when your doctor says “no sex” they are referring to sex as intercourse. What happens time and time again is that the doctor says “no sex” and the patient abstains from all sexual activity. 

Well, isn’t that a shame when the doctor is likely referring to one of many sexual activities: penetrative activities. So when your doctor says “no sex,” ask them to expand and explain. Ask them if you’re still allowed to masturbate, receive and give handjobs and oral sex.

They will likely expand upon the restrictions to range of motion and weight bearing for your shoulder, which is better information for you to brainstorm the sexual activities you can do versus just “no sex.” You get extra points if your doctor blushes! ;-)  

Talk to your partner about less strenuous sexual activities you want to do and can do.

Based on the information from your doctor, work with your occupational therapist, physical therapist, and/or partner(s) to discuss the sexual activities that fall into the category of “can do.” If your sex life prior to surgery was penetration heavy and didn’t include other sexual activities, then this might be a great time to try out some other ones and add them to your sexual menu.  

Self-pleasure first

Some people find that for the first few times being sexual after a surgery, they prefer solo sex.

It can be a good idea for you to explore what happens in your body during arousal and orgasm without the added element of another person and managing the interaction between the two (or more) of you. You can focus on yourself and what you’re feeling. Is there a little pain during different phases? You can ask yourself if it’s manageable and you can breathe through it.

Sometimes, focusing on yourself can be difficult when you’re also focusing on another person. If your dominant arm is the surgery arm, you may consider using an vibrator, dildo, or masturbatory sleeve to make it easier to self pleasure with your nondominant hand. 

For more strenuous sexual activities choose ones you can protect your shoulder from extended range of motion or weight bearing 

If your precautions involve non-weight bearing and limited shoulder range of motion, here are a few suggestions on modifications to certain sexual activities. 

• Oral sex: This typically requires should extensions and weight bearing.  Consider having the receiving partner in the seated position and the giving partner either kneeling or sitting on a low stool. You’re trying to make the genitals at about face height on the giving partner, so they don’t need to lean over or support themselves with their hands. 
• Penetrative sex: In general, seated and standing positions offer more shoulder protection than laying, leaning over, or side lying positions. The giving (penetrating) partner can stand with the receiving partner bent over the bed (for doggy style modification). For a position that is more similar to missionary in the standing position, the giving partner can stand at the edge of the bed with the receiving partner laying on their side on the bed with their legs over to the side —  think of the body in an L position with the bend at the hips. Additionally, seated positions, especially for the receiving partner, require little use of the arms. 
• Try grinding over thrusting: Thrusting typically is more strenuous and requires weight bearing through the arms to help the legs out. Try a grinding or humping motion which requires much less energy expenditure out of the legs. Not sure how to do this? Turn on some sexy music and sway your hips to the music during penetration. 

Continuing sex through a few modifications or changes to your typical patterns can help you maintain your sex life post-shoulder surgery. Of course, you have to listen to your body and determine what you want, feel comfortable doing, and feel ready for!