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
|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
|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
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.
You may bathe 48
surgery. Be careful not
to slip and fall,
as any sudden movement
may cause injury. Also,
may have a residual effect
and make you somewhat
clumsy and/or drowsy. Do not
soak in a bathtub,
tub, or pool until
your doctor says
you may do so. After
the wound dry and
apply a Band-Aid to
the surgical site(s).
If you had an open procedure and
falls off, leave the
small white paper
on. No additional
dressing is required.
Remove all cotton
and yellow gauze 48 hours after
the surgery. No
new dressings are required for
the wounds at
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.
If you experience swelling and/or discomfort
in your shoulder, you may apply ice
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.