Postoperative Care

  1. Sling instructions.  After surgery your shoulder will be placed in a sling.  The sling should  be worn as directed by your doctor.  The sling is used to limit motion of your shoulder. In some cases where the repair must be carefully protected, your arm may be placed in a sling with a pillow that is attached around your waist.  It is very important to wear your sling as directed by your doctor after surgery. You may remove your arm from the sling to bend and straighten your elbow and to move your fingers several times a day.  You may remove the sling to bathe, dress, and perform elbow range of motion several times a day.  In some cases where no soft tissue repairs are performed your surgeon may ask you to discontinue sling use as soon as possible to prevent stiffness of the shoulder.

 

  1. Diet.  We recommend that you eat a light diet the evening of surgery and the next day but you may resume eating a regular diet as soon as you tolerate it.

 

  1. Pain control.  When you are discharged from the hospital you will be given a prescription for pain medicine.  You may take this medicine as prescribed.  You will be given the option to purchase a cold pack machine.  This machine has a sleeve which is attached to an ice cooler.  You place ice and some water in the cooler and plug this in to a regular outlet.  This circulates cold water through the shoulder sleeve providing relief of pain and swelling after surgery.  You should keep ice on the shoulder frequently for the first 48-72 hours after surgery. We recommend icing 2-3 times pre day for the first week especially before sleep.  We do recommend that you put a t-shirt or a thin towel between you and the sleeve so that it doesn’t injure your skin.

 

  1. Wound care.  You may remove your dressing and shower 48 hours after surgery if your surgery was performed arthroscopically and you do not have a pain catheter. If you have a pain catheter, this should be removed by a family member 72 hours after surgery along with the shoulder dressing.  If your surgery was performed with an open incision, you may remove your dressing 5 days after surgery. After the dressing is removed you may then shower.   You may not get in a hot tub or pool and immerse the incisions underwater for six weeks but you may get in the shower and let the water run over them.  Pat the incisions dry afterwards, and place band-aids over the incisions.  There is no need to place any ointment over the incisions. Sometimes significant bruising is seen in the front of the shoulder or along the biceps muscle.  This is normal and is related to mild internal bleeding after surgery. It is better to keep them dry.  If you notice drainage from the incisions, swelling or increased pain 5 days after surgery please call the office.  Redness around the incision is very common and should not be a concern unless it is associated with drainage 5 days after surgery, redness spreading away from the incision or fevers.

 

  1. Sleep.  It is often very difficult to sleep in the week or two following shoulder surgery.  The surgery itself may interfere with your sleep-wake cycle.   In addition, many patients have increased shoulder pain lying flat on their back.  We recommend that you try sleeping in a recliner or in a reclined position in bed.  This is often much more comfortable.  You may place a pillow between your body and your arm and also behind your elbow in order to move your arm away from your body slightly.   This often helps with the pain.  You should wear your sling when you sleep.

 

  1. Driving.  Operating a motor vehicle may be difficult due to you inability to use your operative arm.  If you should have an accident or get pulled over while wearing a sling, the authorities may consider that driving while impaired.  The decision to drive is based on your comfort level with driving essentially one-handed.  If you need to drive you should wait at least until you have seen your doctor at the first postoperative visit. Once you are out of your sling you may drive once you feel safe operating a vehicle.  No one should operate a motor vehicle while taking narcotic medications.  Please limit car driving until you are off narcotics.

 

  1. Physical therapy.  The decision to prescribe physical therapy and when to start these        activities is made on a case by case basis.  This will be discussed with you on your first postoperative visit.  It is rare that you surgeon will prescribe therapy before your first postoperative visit.  You may be instructed by your surgeon /recovery room nurse to begin gentle range of motion exercises on the day of surgery.  These will be self directed exercises that you start on your own.

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