Transdermal patches (adhesive patches placed on the skin) may also be used to deliver a steady dose through the skin and into the bloodstream. Testosterone-containing creams and gels that are applied daily to the skin are also available, but absorption is inefficient (roughly 10%, varying between individuals) and these treatments tend to be more expensive. Individuals who are especially physically active and/or bathe often may not be good candidates, since the medication can be washed off and may take up to six hours to be fully absorbed. There is also the risk that an intimate partner or child may come in contact with the application site and inadvertently dose himself or herself; children and women are highly sensitive to testosterone and can suffer unintended masculinization and health effects, even from small doses. Injection is the most common method used by individuals administering AAS for non-medical purposes. 
If non-surgical treatments do not ease symptoms or the shoulder joint is severely worn causing parts of the joint to become loose, a procedure called an arthroplasty may be recommended. This is a joint replacement treatment which involves replacing the ball with a synthetic ball and placing a cap for the scapula (known as a glenoid). After surgery passive shoulder exercises will be carried out and involve another person moving the joint. After 3-6 weeks patients are advised to start exercising the joint independently. Exercises and stretches are an important part of recovery and help to increase strength, flexibility and mobility in the joint. The success of surgery is dependent on the state of the rotator cuff muscles before surgery and the patient’s commitment to the exercise regime.