Same day surgeries: You will be discharged home with instructions on how to manage your bandages, sling, ice machine and medications.
Overnight surgeries: You will receive discharge instructions as mentioned above, but will also be seen by our therapy department to review some exercises, as well.
When surgery is completed, you will be placed in a shoulder abduction sling. The purpose of the sling is to keep you comfortable while healing in a supported position. You may adjust the sling to ensure your comfort.
For most rotator cuff repair surgeries, you will remain in a sling for a period of 4-6 weeks to allow the shoulder to heal.
For most shoulder replacement surgeries, you will remain in a sling for a period of 3-4 weeks to allow the shoulder to heal.
You may remove your arm from the sling several times a day to perform some basic exercises for the elbow and wrist (see below). You may remove your arm from the sling to bathe, as well. You may move your arm a small distance away from your body to bathe underneath your armpit, but otherwise, please be sure to keep your arm by your side and use your non-operative arm to help move your arm.
For instructions on how to adjust your sling, please go to the following website:
Click on “View Application Video” to see how to adjust the sling. There is also a tab labelled “Instructions for Use” for written/visual instructions.
We take a multi-modal approach to managing your pain after shoulder surgery. You will be offered an ice machine and a combination of medications to help reduce your pain. Please be aware that you will not be pain-free, but your pain should be reduced with these measures
Ice: Most patients leave the hospital with an ice machine. The ice machine has a sleeve that covers your shoulder. It has tubing that attaches to a cooler that should be filled with ice and water. You may use ice as much as you’d like, but should check your skin every 20 minutes to ensure there is no frostbite. You should always keep a layer (shirt or cloth) between the ice pad and your skin.
Medications: We use a series of medications to help control your pain. Though they may not work when used alone, the combination is very effective. If you undergo surgery with us, these will be prescribed to you.
- All medication regimens are individualized depending on medical conditions and age.
- Tylenol: A pain reducer. We recommend utilizing 1000mg every 8 hours.
- Ibuprofen: A non-steroidal anti-inflammatory medication. We recommend utilizing 800mg every 6 hours.
- Gabapentin: A medication that helps with nerve pain. We recommend taking 300mg every 8 hours as needed.
- Oxycodone: A narcotic pain medication. We recommend taking 5mg every 6 hours as needed for severe pain. This should ONLY be used if the other medications do not work.
- Narcotic pain medications can be addictive. They also have side effects that include constipation, sedation and respiratory depression. Please ensure you drink plenty of water and take stool softeners if needed (Miralax, Colace, Senna). You may be prescribed Narcan (Nalaxone) in case of an accidental overdose depending on what medications you already take.
We encourage you to remove your arm from the sling 3-5 times per day to perform elbow and wrist exercises. Using your non-operative arm, you will help to bend and straighten your elbow 10 times with your arm by your side. Be sure to do this with the help of your non-operative arm.
You may perform wrist range of motion and ball squeezes as much as you’d like throughout the day.
After surgery you will have a series of incisions and bandages around the shoulder. Depending on which surgery you have, your incisions may be slightly different
- There will be 3-4 incisions near the top of the shoulder (each approximately 1 centimeter). These are closed with dissolvable stitches under the skin surface. They are covered with steri-strips in a star pattern. Steri-strips should remain in place for 10-14 days.
- There will be 1 incision near the armpit that is approximately 1 inch long. It will be closed with dissolvable stitches under the skin surface. It will have skin glue over the top and have a clear dressing over the top of it. This dressing can be removed after three days.
- Over the entire shoulder is a bulky gauze bandage covered with pieces of tape. This dressing should remain in place for three days. It cannot get wet. After the bandage is removed, you may shower.
Shoulder replacement surgery
- There will be an incision on the front of the shoulder that is approximately 4-6 inches long. The incision is closed in layers with dissolvable stitches. A device called a zipline is used to close the very top layer of the skin. This is a type of bandage and can be peeled off like a bandaid 14 days after your surgery.
- Over the incision is a clear dressing with gauze underneath. This can be removed after three days.
Normal changes to your body after surgery
- Swelling: You may notice swelling in the arm after surgery. This is normal. Though the surgery was on your shoulder, the swelling can be in the entire arm and go into the hand. Use a stress ball and elevate the arm to try to control the swelling. If you develop chest pain or shortness of breath, please contact a health professional immediately.
- Bruising: You may notice bruising in the arm. It may be a yellow, green or purple color and will change over time.
Rehabilitation (Physical and Occupational Therapy)
- Depending on your surgery, you will remain in a sling and keep your shoulder immobilized for a period of time to allow healing. Around the time you are cleared to remove your sling, you will be instructed to start physical therapy
- Your provider will give you a referral to physical therapy and the protocol that the therapist should use.
Post-operative Physical Therapy
- Physical therapy is a vital part of the post-operative process aimed at helping you achieve a full recovery.
- Specific protocols have been developed for your surgery to ensure that you have an optimal rehab based on the surgery that was performed.
- Arthroscopic Rotator Cuff Repair
- Arthroscopic Biceps Tenodesis, Debridement and Subacromial Decompression
- Anatomic Shoulder Replacement
- Reverse Shoulder Replacement
- Arthroscopic Capsular Release
- Arthroscopic SLAP Repair
- Arthroscopic Anterior Stabilization
- Arthroscopic Superior Capsular Reconstruction
- Anterior Stabilization with Bone Block
- Lower Trapezius Tendon Transfer
- Latissimus Dorsi Tendon Transfer
- Pectoralis Major Tendon Transfer
- Pectoralis Major Repair
- Clavicle Open Reduction and Internal Fixation
- AC Joint Reconstruction
- Triceps Tendon Repair