Shoulder Arthroscopy Rotator Cuff Repair Post Op Instructions

Michael E. Higgins, M.D.

Shoulder Immobilizer

  • You will need to wear the shoulder sling to protect the surgery unless otherwise instructed by Dr. Higgins.  You may adjust the sling if it is too tight or too loose. 
  • You may take your arm out of the sling to stretch your elbow several times per day.
  • You will need to remove the sling to dress.

 

Ice

  • Ice will be your friend for the first several days after surgery.  Icing you shoulder will help to minimize swelling and help relieve pain or discomfort.  A bag of ice, or frozen vegetables wrapped in a towel works well.  Apply ice to the shoulder and replace as needed.  If your shoulder is too cold take a break, but otherwise don’t bother with the 20 minutes on 20 minutes off routine.

 

Pain Medication/Prescriptions

  • If you were given a block before surgery you will feel little pain until it wears off.  Despite the lack of discomfort it is important to take the pain medication every 4 or 5 hrs until the block wears off.  Failure to do so can cause the rapid onset of significant pain that will be hard to control because you will be trying to “catch up with the pain”.
  • A narcotic pain medication will be prescribed for pain control at home, usually oxycodone.  Take as needed for pain control.  In the first 3-4 days after surgery it is usually best to take the medicine if you start to have pain to “stay in front of the pain”.  If you are not in pain do not take the medicine.  Beyond the first few days after surgery most patients are able to significantly decrease their use of narcotic pain medications.
  • A non-narcotic pain medicine will be prescribed, usually Ultram.  This medication will help with pain and will make the narcotic pain medication work better
  • If you are prone to constipation or have experienced constipation with pain medication in the past over the counter stool softeners and or milk of magnesia should be started with pain medication after surgery and taken as needed to avoid constipation.
  • An anti-nausea medicine is prescribed, usually Phenergan. Take this medication if the pain medicine makes you nauseous
  • An anti-inflammatory medication is prescribed, usually Meloxicam or Mobic.  This medication is for both relieving inflammation as a bonus it helps with pain although it is not a narcotic.  This medication should be taken for 30 days after surgery, a refill is provided on the script to be used if you notice increased pain after completing the first 30 days. 

 

 

Dressing

  • The dressing should be changed 2 days after surgery. 
  • The incisions can be cleaned gently with antibacterial soap and water or hydrogen peroxide.  You can apply a small amount of Neosporin or its generic equivalent to the incisions daily if you wish but this is not necessary.

 

  • The incisions may be kept open to air as long as they are dry (no drainage).
  • There will likely be some drainage on the dressing when it is changed and a small amount of drainage for a day or two after the first dressing change is normal.  If the incisions are draining beyond 5 days after surgery call the office Dr. Higgins will want it to be evaluated.

 

Bruising

  • Bruising may occur on your chest or shoulder.  This is normal, ice these areas as needed.

 

 

Showering

  • You may shower on the 4th day after surgery as long as the incisions are dry (no drainage).  The incisions should be covered/kept dry while in the shower.  Waterproof band aids work well for this.  Do not submerge your knee under water until your stiches are removed.

 

Fevers

  • Low grade fevers (less than 101) are common after surgery and generally last only a short period of time.  These fevers are most often caused by mucus in your lungs.  Deep breaths, coughing, and moving around a bit are usually all that is needed.  If you are having fevers shortly after surgery the chances of that fever coming from an infection at the surgical site is very low.

 

 

 

 

 

 

Driving

  • If you are in a sling driving is not safe to drive, so most patients will not be ready to drive for 4-6 weeks.   To drive you need to be able to operate the vehicle safely.  That means you should not take narcotic pain medicine and drive. You need to be comfortable and confident you can control the car (ie slam on the brakes in an emergency).  If you are not sure you are ready to drive go to an empty parking lot and practice first.

 

Exercises

  • Physical therapy should be scheduled to begin 2-3 days after surgery and you will be given a home routine from your therapist
  • Exercises you can do before PT
    • Pendulum: remove sling and point your straightened arm to the floor move your arm in small circular motions like a pendulum.  This gently modes the shoulder joint.
    • Flex and extend your elbow and wrist to prevent stiffness.

 

Please Call the Office with Significant Concerns

757 827-2480