Shoulder Arthroscopy

Post Operative Instructions for Shoulder Surgery

Following your shoulder surgery you will be allowed to do certain things, but you must understand exactly what NOT to do. It is important that you participate in your post op recovery to avoid injury to the tissues that were repaired. If you are too active or disregard these precautions and instructions, then you may disrupt the work that was done for you. Therefore, it is imperative that you read these instructions carefully, ask questions if things are unclear, and follow these guidelines exactly.

You will be able to follow one of two pathways:

  • Minimal protection – No tissue was repaired and, therefore, strict immobilization is not necessary. You should still use a sling for comfort. Let pain be a guide to what you can and cannot do.
  • Moderate protection – Tissue was repaired. Stitches are holding things together until the tissue heals enough to allow motion of the shoulder. You do need the shoulder immobilizer that was given to you.

One of these two pathways will be identified for you. An explanation of each one will follow. If you are unclear which pathway is correct for you, call us.

Danger signs: Call the office if you notice any of the following!

If your pain is getting worse rather than improving or you start to require more pain medication rather than less, this could mean there is a problem. But it also may be due to being too active at home. Before you call, get off your feet and put some ice on your shoulder. Take a pain pill. Give it a few hours. If you do not feel any better and are concerned, then call the office or answering service 248-988-8085.

If you start having fevers over 101 as measured by a thermometer, this too could mean there is a problem. If you feel like you have a cold or flu, then there is no need for concern. However, if there is no other obvious cause for your fever or if your incision is looking red and angry with pus-like drainage, then this could mean an infection and you should call!!

If you notice rashes, itching, hives or difficulty breathing, then you may be having an allergic reaction to a medication. Call!!

The Minimal Protection Pathway

  • You should use your sling for comfort only.
  • Pain is your guide to what you can and cannot do.
  • Nothing can be undone or ruined by moving your arm around.
  • You may have pain, but will not do any harm to your shoulder.

Functional Activities for Minimal Protection Pathway

  • ¢ Feel free to remove the sling when you are at home and just taking it easy. Put it back on if the arm feels heavy, or if you are uncomfortable.
  • ¢ Remove the sling when you are showering, (anytime after 48 hours after surgery). Remove the whole dressing before you shower. You can get the wound wet, but do not wash it. Do not put any creams, ointments, etc. on the wound. After you are finished showering, put either Band-Aids or gauze pads from the drugstore on your cuts depending on their size. You may lean forward and wash under your arm. You can do the same for using deodorant, or putting on a shirt.
  • You can remove the sling when sleeping. You can sleep in any comfortable position without fear of damaging your shoulder.
  • You can and should bend and straighten your elbow, squeeze a ball or other such device for grip strength, and lean forward making some gentle circles with your arm.
  • Discontinue the sling as soon as you feel ready.
  • Use your operated side for eating, writing, dressing and bathing.
  • Do NOT lift anything heavy until you are moving the arm well. Only lift lightweight objects such as 5 lbs. or so.
  • Practice using your operated arm to touch your hand to your mouth, to the top of your head, to reach behind to touch your bottom, and reach across to touch your other underarm.
  • You may resume driving as soon as you can place two hands on the steering wheel and operate the controls of the vehicle comfortably and safely. Never operate a vehicle while taking narcotic pain medication!!
  • You can return to work as soon as you can resume your normal duties. If your job is physical, and you can return with restrictions, then we can provide you with specific guidelines.
  • You can resume any workout such as health club type activities as soon as you feel ready. Do NOT use the arm for anything strenuous such as: weightlifting, rowing, swimming, pushups, etc. until we discuss this.

The Moderate Protection Pathway

  • You need to wear the sling or immobilizer until you are told otherwise.
  • Pain may not be a reliable indicator that you have done “the wrong thing”.
  • Once you feel any significant pain, you may have already done some damage.
  • There is tissue that was repaired and needs time to heal before you can begin using the arm normally. By doing too much, too soon, you can disrupt these tissues and jeopardize your results.

    • Functional Activities for Moderate Protection Pathway

    • Remove the immobilizer when you are showering, (anytime after 48 hours after surgery).
    • Remove the whole dressing before you shower. You can get the wound wet, but do not wash it. Do not put any creams, ointments, etc. on the wound. After you are finished showering, put either Band-Aids or gauze pads from the drugstore on your cuts depending on their size. You may lean forward and wash under your arm. When you lean forward, keep your finger pointing at the floor. You can do the same for using deodorant, or putting on a shirt. Do NOT move the arm around freely. You can bend and straighten your elbow, squeeze a ball, or other such device for grip strength.
    • You may use your hand on the operative arm to assist in eating, writing, dressing, and bathing. For example, you can use your hand to button shirts, cut food, brush teeth, write, etc. Do NOT use the arm for anything that requires force or power. Do NOT lift anything over 2 lbs.
    • After you finish dressing, eating, bathing, etc., you should put your immobilizer back on. Do NOT go for any length of time without it.
    • Sleep with your immobilizer on.
    • You may use your hand only in front of your body. Use your other hand for personal hygiene.
    • Do NOT use your operated arm to support yourself, or push yourself up from a chair or bed.
    • Do NOT have anybody pull you up by the operated arm.
    • You may find sleeping in a recliner, easy chair, or sofa more comfortable. Put a pillow or cushion behind your elbow of your operated arm to prevent it from falling back.
    • You have significant one-arm restrictions for driving and working. You may be back to work soon if your job is primarily deskwork, and it is your non-dominant arm. You need to get a ride to work. This could be as early as a week or so. It will take longer if your work is strenuous, or requires repetitive or overhead use of the arm.
    • It may be as long as 6-10 weeks before you are able to use the hand normally. Heavy physical work will be even longer closer to 4-6 months
    • You should do nothing more than ride an exercise bike for general exercise. Use the immobilizer when you do so.

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