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ORTHOPEDIC SURGERY:

Immediate Post-Operative Shoulder Surgery Guidelines

Sling use and wear

The sling should be worn at all times after surgery. The arm may be taken out of the sling for prescribed exercises. Any overhead arm motion should be avoided until your doctor says you may do so.

Approximate sling use time for...

Subacromial decompression is 24-48 hours.

Inferior capsular shift is 3-4 weeks.

Rotator cuff repair is 4 weeks (can depend on extent of tear and repair).

Electrothermal assisted capsulorraphy (ETAC) is 3-4 weeks.

 

Proper sling use

Have the elbow bent to about 90 degrees to allow the forearm and elbow to rest comfortably in the sling. The elbow should also be slightly in front of the torso. Have the sling adjusted so that the hand is level with or above the elbow.

 

Bathing

You may bathe 48 hours after surgery. Be careful not to slip and fall, as any sudden movement may cause injury. Also, the anesthesia may have a residual effect and make you somewhat clumsy and/or drowsy. Do not soak in a bathtub, hot tub, or pool until your doctor says you may do so. After bathing, pat the wound dry and apply a Band-Aid to the surgical site(s). If you had an open procedure and the dressing falls off, leave the small white paper tape (steristrips) on. No additional dressing is required.

 

Dressing

Remove all cotton and yellow gauze 48 hours after the surgery. No new dressings are required for the wounds at this time. Instead, place Band-Aid(s) over your surgical sites. If you had an open procedure, leave the small white paper tape (steristrips) on. No additional dressing is required.

 

Icing

If you experience swelling and/or discomfort in your shoulder, you may apply ice to relieve these symptoms. Do not ice your shoulder more than 20 minutes at a time, do not place ice directly on your skin, and avoid getting your surgical sites wet. Finally, let your shoulder "warm-up" before re-icing it.

 

Exercise

There are 5 stages associated with post-operative care of your shoulder. They begin on post-op day 1 and progress 4-6 months after the procedure. Listed are some exercises to do during the first stage of healing...

Pendulums or Codman's

(See Shoulder Range of Motion Exercises in Patients)

Wrist flexion and extension strengthening

(See the wrist flexion and extension section of our Tennis Shoulder page.)

Elbow active range of motion

With the arm at your side, bring the elbow up so that your fist is almost touching your shoulder. Then slowly allow your elbow to relax so that your arm, from the elbow down, lowers towards the floor.

Hand gripping exercises

Using putty, and squeeze it in your hand while doing any activity such as watching TV, reading, etc.

Spread a towel, stack of newspapers, or a sheet out on a table. Place your palm face down at the end of the towel/papers/sheet. While keeping contact by the heel of your hand, crumple up the object into a ball inside your hand.

Neck active range of motion

Standing or sitting, slowly bend your neck so that your chin goes down toward your chest. Then slowly raise your head and allow it to go backwards, as if looking up towards the ceiling. Next, with your head in a neutral position, bend at the neck to allow your head to lower to one side with your ear going toward your shoulder. Repeat this activity toward the opposite side. Last, rotate your head as if looking over your shoulder and repeat toward opposite side. (See the page on Neck Pain in Injury Evaluation & Treatment).

 

Common Concerns

You may experience bruising and/or swelling of the shoulder region. The cause of this is bleeding from the bone and soft tissue in the area underneath the skin (which is cut during the surgery). Ice may be applied to lessen these symptoms (see above).

You need to see your doctor about 1 week after the surgery so he/she may assess your progress and your stitches may be removed. You will be given an exercise prescription to begin exercises at home or in physical therapy.

Call your doctor if:

1. You experience any oozing or redness of the wound, fevers (greater than 101.3 degrees), or

    chills.

2. You experience any difficulty in breathing or heaviness in the chest.

 

Other frequently asked questions

I am experiencing swelling in my hand. Is that normal?

Yes, this is normal and is not a matter of concern.

Sometimes after coming from a lying down position to a sitting position, I feel a sudden rush of pain and swelling in my shoulder. Is that supposed to happen?

Yes, this is common after surgery. If the pain is unbearable, ice your shoulder (see above).

I have been to the doctor for my one-week follow up visit and I have lost my home exercise prescription sheet. What are the exercises I should be doing until I begin physical therapy?

See post-op exercises above.

Are there any lifting precautions and motions I should avoid after surgery?

Refer to sling wear and usage above. In addition, do not attempt to lift anything heavier than a pencil in your hand and any overhead activities until your doctor says it is okay to do so.

If you do not understand any of the above information, you still have questions, and/or are concerned about any complications, please call your doctor as soon as possible.