Shoulder surgery - using your shoulder; Shoulder surgery - after You will need to wear a sling when you leave the hospital. You may also need to wear a shoulder immobilizer. This keeps your shoulder from moving. How long you need to wear the sling or immobilizer depends on the type of surgery you had. Follow your surgeon's
instructions for how to take care of your shoulder at home. Use the information below as a reminder. Wear the sling or immobilizer at all times, unless the surgeon says you do not have to. If you wear a shoulder immobilizer, you can loosen it only at the wrist strap and straighten your arm at your elbow. Be careful not to move your shoulder when you do this. Do not take off the immobilizer all the way unless the surgeon tells you it is OK. If you had rotator cuff surgery or other ligament or labral surgery, you need to be careful with your shoulder. Ask the surgeon what arm movements are safe to do. You may also be told not to use your or hand on the side that had surgery. For example, do not: Your surgeon will refer you to a physical therapist to learn exercises for your shoulder. Consider making some changes around your home so it is easier for you to take care of yourself. Store everyday items you use in places you can reach easily. Keep things with you that you use a lot (such as your phone). Call your surgeon or nurse if you have any of the following:What to Expect at Home
Self-care
When to Call the Doctor
References
Cordasco FA. Shoulder arthroscopy. In: Rockwood CA, Matsen FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW, eds. Rockwood and Matsen's The Shoulder. 5th ed. Philadelphia, PA: Elsevier; 2017:chap 15.
Throckmorton TW. Shoulder and elbow arthroplasty. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 12.
Wilk KE, Macrina LC, Arrigo C. Shoulder rehabilitation. In: Andrews JR, Harrelson GL, Wilk KE, eds. Physical Rehabilitation of the Injured Athlete. 4th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 12.
Version Info
Last reviewed on: 11/12/2020
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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- Rotator Cuff
- Postoperative Care
Sling Instructions
After surgery, your shoulder will be placed in a sling as directed by your doctor. The sling is used to limit motion of your shoulder so that the rotator cuff tendon can incorporate and heal. 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.
- The sling is typically used for 4 to 6 weeks after surgery.
- You should not do any reaching, lifting, pushing, or pulling with your shoulder during the first six weeks after surgery.
- You should not reach behind your back with the operative arm.
- 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.
Watch the video below to see how you should properly wear your sling.
Your Diet
We recommend that you eat a light diet the evening of surgery and the next day. You may resume eating a regular diet as soon as you tolerate it.
Pain Management
When you are discharged from the hospital, you will be given a prescription for pain medicine. You may take this medicine as prescribed.
Ice Therapy
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. If you do not purchase a cold pack, you may use
ice bags or frozen vegetable bags to ice your shoulder.
- You should keep ice on the shoulder for the first 48-72 hours after surgery.
- Ice your shoulder two to three times per 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.
Caring for Your Surgical Incision
- You may remove your dressing and shower 48 hours after surgery if you do not have a pain catheter. If you had a biceps tenodesis surgery, you should leave your dressing on for five days after surgery.
- If you have a pain catheter, this should be removed by a family member 72 hours after surgery along with the shoulder dressing before showering.
- You should not get in a 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 Aid’s over the incisions. There is no need to place any ointment over the incisions.
- If you notice drainage, swelling or increased pain five days after surgery please call the office.
- Redness around the incision is very common and should not be a concern. However, please call our office if you have:
- Redness and drainage five days after surgery
- Redness spreading away from the incision
- Redness and a fever
Sleeping
It is often very difficult to sleep in the week or two following rotator cuff 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. 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. You should wear your sling when you sleep.
Driving
Operating a motor vehicle may be difficult due to your inability to use your operative arm. If you should have an accident or get pulled over while wearing a sling, 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, and a rotator cuff
repair has been performed, you should wait at least until you have
seen your surgeon at the first postoperative visit. No one should operate a motor vehicle while taking narcotic medications.
Healing and Recovery
Tendon tissue heals much more slowly than other tissues in your body. For example, if you cut your skin, it will typically heal in seven to 10 days. Rotator cuff tendon tissue, however, heals over a three month period. After three
months, it typically takes another two to three months to regain good
shoulder strength, depending on the size of the rotator cuff tear. While the goal of surgery is to restore a pain-free and functional shoulder, there may be some limitation based on the age and the size of the tear. In larger tears or tears in older patients, the tendon repair may not heal. In these cases, pain relief and function are usually good; however, some weakness usually remains in the shoulder. In
general, about 90% of patients are satisfied with their shoulders after rotator cuff repair, and have significant improvements in pain and function after surgery.
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. You may be instructed by your surgeon or 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.
Surgical Risks and Complications
The list below includes some of the common possible side effects from this surgery. Fortunately complications are very rare. Please note that this list includes some, but not all, of the possible side effects or complications.
Complications may include: complications from anesthesia, infection (very rare with arthroscopic procedures), nerve injury (extremely rare), blood vessel injury (extremely rare), bleeding (extremely rare), shoulder stiffness, failure of repair (failure of the tendon to completely heal to bone), failure of the anchors or sutures, failure to improve your symptoms as much as you had hoped, a blood clot can form in your arms or legs and very rarely travel to your lungs, complex regional pain syndrome (a painful condition involving the arm).
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