For a smooth recovery, do your homework before surgery:

  • Talk to your employer about your plans to return to work with restrictions or part-time at first.
  • Respect the healing process; it takes time. Let the inside of your shoulder settle down while you restore mobility.

For the first 2-3 days:

Controlling the Pain: The novocaine inside your shoulder will keep it numb for 2 days after surgery.

  • Pain Pump: See the attached brochure. The nurses at the surgery center will review details with you.
  • The most important way to control pain is to properly support your arm.
    • Do: Adjust the sling while standing up; gravity will help you and your upper arm will hang comfortably.
    • Wear the sling when up and around, and while sleeping; you can take it off while sitting, resting or showering.
    • Don’t: Wear the sling so tight that it hikes up your shoulder and puts pressure on the surgical site.
    • Don’t be afraid that dressing and repositioning yourself will mess up the shoulder.
  • How to sleep comfortably:
    • Do: Sleep in a reclining chair, or with a large wedge-shaped pillow supporting your whole back.
    • Keep a small pillow behind your upper arm to lift your elbow forward; rest your forearm on your tummy.
    • Don’t: Try to lie flat; it’s not dangerous, but it will hurt. Don’t rest your elbow on an armrest, or anything that pushes up on the shoulder.
  • Place a LARGE ice pack around your shoulder 20 minutes every 3-4 hours. Fill 2 gallon-sized zippered plastic bags with ice cubes, or buy several LARGE gel-packs that you can rotate through the freezer.
  • Medication: Take your pain medicine (usually Hydrocodone [Vicodin] or Oxycodone [Percocet]) as prescribed for the first 2-3 days, then cut back as you feel better.
    Switch to over-the-counter acetaminophen (Tylenol), 500mg, up to 2 tabs, 3 times a day after this runs out.
    Anti-Inflammatories: Along with the pain medicine or acetaminophen, you can also take:

    • Over-the-counter ibuprofen (Advil) OR naproxen (Aleve) according to package instructions.
    • Your prescription anti-inflammatory medication as prescribed:_______________
    • Do NOT take any anti-inflammatory medication because of your other medical issues

Activity:

  • Move your neck, elbows, wrists, fingers 10 times, 3 times a day. Squeeze a rubber ball to pump your hand.
  • You can use your hand for light activities like holding a toothbrush or a pencil, buttering toast or light typing. Lifting 1-2 pounds with your elbow near the body is OK. Don’t overdo it.
  • Gradually increase how much, and for how long, you use your arm…use your symptoms as a guide.
  • Start your exercises on the first day after surgery. Begin slowly and you’ll improve day by day.
  • Wear shirts that button up the front. Treat your shoulder with respect, but realize it’s not fragile.

Care of the dressing:

  • For the first 2 days, leave the dressing in place. Tuck a dry washcloth under your armpit to absorb sweat.
  • The dressing is waterproof, so you can take a shower even with the Pain Pump catheter in place.
  • Some blood and novocaine might leak from the incision for a few days. Don’t be alarmed if it soaks through the bandage. Reinforce the dressing with extra gauze pads or a clean wash cloth if needed.
  • On the second day after surgery, remove the dressing and slip out the Pain Pump tube. You may feel a brief sting; the tube will quickly slip out with a steady tug. Throw it away.
  • Apply a light dressing to absorb any drainage from the hole where the Pain Pump was removed.
  • You can leave the wound open to the air while resting; DO NOT REMOVE THE PAPER TAPES FOR 2 WEEKS. You can get the paper tapes wet in the shower briefly. Pat them dry and apply a light dressing to protect the tapes under your clothes.

For the next 3-14 days:

  • Switch from ice to warm compresses if it feels better.
  • You can cut your pain medication dose as you feel better: cut the pills in half, or take them less often.
  • You might have a lot of bruising around your shoulder and chest. Warm compresses and gentle exercise will help.
  • It’s OK to drive after 1-2 weeks IF you can safely control your car. Use common sense.

The priority is to restore your range-of-motion without resistance.

pendulums1
Pendulums: A relaxing way to keep your shoulder from getting stiff.

  • Bend forward at your hips, use a table for support. Let your arm hang down, relaxed.
  • Gently sway back and forth, then in a circle, to let your arm swing North-South, East-West, Clockwise, Counter-clockwise.
  • Do 10 arcs in each direction, 3 times a day. The arcs will get bigger each day.
forearm-table
  • Rest your forearm on a table; walk your fingers across the tabletop for a slow count of 10 as you bend forward at the hips.
  • Then, sit up and slide your elbow back toward you body.
  • Do 10 repetitions, 3 times a day, to the front and side. You’ll reach further each day.
elbow

Neck Range-of-Motion: Many shoulder muscles also attach to the neck.

  • Sit or stand up straight: head high, shoulders back, stomach in.
  • Slowly lower your chin to your chest, and then tip it back toward the ceiling: 10 times, 3-5 times a day.
  • Tilt your head to the right, then left; Turn your head right, then left:10 times, 3-5 times a day

Keep Everything Limber:

  • Move both elbows, wrists and fingers 10 times, 3-5 times/day.
  • Squeeze a rubber ball gently to pump the swelling out of your hand.
  • Take a walk, ride a stationary bike or do other lower-body exercises for up to 20-30 minutes each day.

At your 2-week postop visit:

  • We’ll check your range-of-motion. You should be able to: lift your arm almost overhead (with help from your other arm!), reach your hand to your back pocket, and be comfortable lifting 3-5 pounds near the body.
  • Most patients start PT at 2-6 weeks postop to add more aggressive exercises to restore function.
  • We’ll talk about your plans to return to work, and what you can expect from your shoulder in the future.

What are some problems to watch out for?

  • Some patients get very constipated after surgery. If you are nauseated and/or don’t have a bowel movement within 2-3 days postop: drink plenty of water or fruit juice, try over-the-counter laxative like Senokot, go for a walk.
  • You’re having extreme pain that’s not relieved with rest, proper positioning or your prescribed medication.
  • You’re having a fever over 101.5, or your arm is hot, red and very painful.
  • You’re having problems with prescribed medications, with the dressing, or with any issue about your recovery that can’t wait until your follow-up visit.
  • Call the office: 585-271-4272 (or for emergencies after-hours: Dr. Siegrist’s cell phone 585-329-3308 or our answering service 585-723-6566).