Post Operative Instructions After for Rotator Cuff Repair
Now that your surgery is over, it’s time to start healing ! There is a lot to know and understand, but it is rather simple. Don’t make it harder than you need to.
Comfort and medications after Surgery
Many of you will have had a nerve block for the surgery. Your anesthesiologist is in charge of this and performs the blocks. When it works as it should, you may have no pain at all for the first 24 hours. You also may not be able to feel your fingers ! Don’t worry – the block will wear off. Call me if the block lasts more than two days. I’ve seen them last three days.
Aspirin: I typically suggest 81mg of aspirin for the first 10 days to decrease the risk of blood clots. Symptoms to watch for are worsening calf pain, or leg swelling that seems unrelated to the swelling from the surgery. Let me know right away about this. I’ll send you for a simple painless ultrasound of the leg to check.
Ibuprofen: This medicine helps with pain and inflammation. It works in your shoulder. I typically will suggest 600-800mg three times a day unless it bothers your stomach. This will help reduce swelling, inflammation and pain.
Vicodin / Percocet / ?: A strong narcotic. This does nothing for your shoulder, but tells your brain you don’t have pain. You are not required to take this, but may use it as needed. If it is not working, call me right away. You will not get addicted to a medication if taken for the right reasons.
Sleep sitting up
No one really knows why, but most people seem to be happiest sleeping in a sitting position. It’s hard and painful to lay flat, so just don’t do it. A recliner chair may be your best bet. This may go on for a week or two.
Wear the sling
The sling with the bump (abduction sling) is important to keep the repair of the tendons relaxed and the bump cushion does this for you. Stay in your sling unless you are doing your exercises or letting your arm rest on pillows away from your body.
Don’t use your arm!
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This seems so simple, but I have seen a handful of patients–who don’t listen well–try to use their arm after the surgery. It’s not ready for it. If you do try to raise your arm on your own, you are using the stitches I put in to move it, and they WILL tear out and your surgery will fail quickly. Pretend your arm is dead to you. You may type on a computer keyboard but beyond that you should not use it at ll for the first few weeks unless I’ve told you otherwise.
Movement is good for your shoulder in most cases. Start with pendulum exercises. You can watch them here. Let your arm hang down like a pendulum or trunk of an elephant, and make small circles.
Ice your shoulder for about 20 minutes on, then give it a break for another 20-30 minutes. You can do this throughout the day to help keep the swelling to a minimum. Never put ice directly on your skin – it can give you frostbite. This is especially true if you have an ‘ice machine’ as they get extremely cold. Always keep a layer of material between you and the cold pad.
Leave the dressing in place until the 2nd day after surgery. On day 2, remove the tape, gauze and non-stick dressing on your shoulder. Leave the steri-strips in place – these are used as the stitches. Don’t remove them. Recover your incisions with gauze and tape or band-aids.
You may shower, but keep the wounds covered until I see you back in the office in 7-10 days. After that visit, and if given the green light, you may get the wounds wet in the shower. No hot tubs, spas, bathtubs, or time in the ocean until the wounds are completely healed – usually by week 3.
For many of you, physical therapy is a part of the recovery plan. Be sure this is set up with my assistant. We will set this up close to your home or work with someone that I trust.