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BEFORE SHOULDER SURGERY
AFTER SHOULDER SURGERY

ANATOMY OF THE SHOULDER

SHOULDER SURGERY GLOSSARY

 

 

 

After Shoulder Surgery

 

Rotator Cuff Surgery:

Rotator cuff surgery is an outpatient procedure. Overnight stays in the hospital are generally unnecessary. The surgical procedure usually takes a few hours, depending on the extent of work needed to repair the torn tendons.

After surgery your arm will be placed into a sling. A sling that holds the arm slightly away from the side (an abduction sling) is generally recommended for rotator cuff repair surgery, as these hold the tendons in a more relaxed position. You will remain at the hospital until your pain is adequately controlled.

The First Days After Rotator Cuff Surgery:

The first days after rotator cuff surgery are focused on ensuring that your pain control is adequate. Your doctor will prescribe medications to help with discomfort. Always try to prevent the pain from becoming severe by taking smaller doses of pain medication at the early signs of discomfort, rather than large doses when the pain is more severe. Trying different types of medication can also be helpful; many doctor recommend alternating prescribed narcotic medications with an anti-inflammatory medication. And don't forget about icing the shoulder. Ice application may be the most important part of pain control.

Rehabilitation after Rotator Cuff Surgery

The type of rehabilitation and physical therapy that is prescribed after rotator cuff surgery depends upon the size of tear, how securely the tear was repaired, the age of the patient, and how well they are able to tolerate physical therapy. While each program is slightly different, there are some general guidelines for rehabilitation after fixing tears in the rotator cuff. For example, in this program for rehabilitation, there are four phases of physical therapy, as follows:

Phase 1 (0 to 6 weeks)
  • Passive range of motion exercises only for almost all tears.
  • Active-assisted range of motion for very small tears or repairs with exceptionally good tissue
Phase 2 (6 to 12 weeks)
  • Full passive motion
  • Begin active-assisted motion
  • Strengthen intact cuff muscles
  • Begin to strengthen the muscles that stabilize the shoulder blade
Phase 3 (12 to 16 weeks)
  • Passive stretching beyond the patient's own range of motion
  • Strengthening the repaired cuff muscles
  • More strengthening of the stabilizers of the shoulder blade
Phase 4 IV (> 16 weeks)
  • Functional strengthening
  • Rehabilitation for sports

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.

 

 

 

 

   

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