What should I expect after the operation?
After your operation you will be kept in the theatre recovery room before being transferred to the ward. A nurse will check your pulse, blood pressure, and breathing rate regularly. It is important that if you feel any pain you must tell the nursing staff, who can give you painkillers to help. The first time you get out of bed, please make sure you ask a nurse to be with you. This is in case you feel dizzy.
If you have had a regional block, you are likely to feel little pain post operatively. Sometimes the block can be very dense and also lead to weakness in the muscles of the arm and hand and well as numbness. Do not worry, the function does return when the anaesthetic wears off. It is important for you to be particularly careful with your arm and protect it in the sling initially as during this period it will be numb. It is also very important you start taking your pain-killers regularly straight away, despite having little or no pain.
When will I go home?
You will usually be discharged home the same day as your operation. Occasionally you may be kept in hospital overnight. Remember that you have just had an operation. It is normal to feel more tired than usual for a few days after having an operation. Your shoulder is likely to be uncomfortable in the first few days’ post-surgery. This is normal. You may not feel there is a significant improvement in your pre-operative pain until a few weeks after surgery
Will I be in pain?
It is normal to feel some pain following your operation. You will be given some painkillers and/or anti-inflammatory medication to take in the days following the operation. It is vital to begin the tablets prescribed by the surgeon immediately after the operation even if you are pain free because of a very effective nerve block. It is important that you have adequate pain relief for when the block eventually wears off.
Using ice on your shoulder can be helpful in reducing pain. Wrap a bag of crushed ice, or frozen peas in a damp towel. Protect your dressings from getting wet with a layer of cling film, or a plastic bag, before applying the ice pack for 10-15 minutes at a time.
Posture can make a big difference to your pain after surgery. Avoid ‘hitching’ your shoulder or holding it in an elevated position. Also try to avoid slumping or standing/sitting with round shoulders as this puts more stress onto your shoulder.
What do I do about the wound?
You will not have any stitches, only small sticking plaster strips over two or four small wounds. Keep the wounds dry until they are healed, which is normally within seven days. You must keep them covered when showering or bathing for the first week.
Your shoulder is filled with water during the operation and this often will make your shoulder look very swollen initially. The wounds sometimes allow some of this fluid to escape which will be blood stained. Do not be alarmed. If your dressings become soaked following discharge, either attend your GP practice to change them.
Are there things that I should avoid?
Yes, it is very important to protect the repair. You will be advised to wear a sling for three weeks. Do not lift your operated arm without assistance until it is allowed out of the sling. Do not use the un- operated arm for any heavy manual work whilst the operated arm is in the sling.
How long do I need to wear the sling?
Your arm is supported in a sling straight after your operation to protect the repair. If you have had an arthroscopic arthroscopic subacromial decompression, the sling can be removed 1-2 days following surgery. For rotator cuff repairs it must be worn for six weeks. It is essential that you wear the sling as advised by Mr Al-Sabti. This will be explained to you after your surgery. You can remove the sling to carry out your exercises and for washing and dressing only.
Do I need to do exercises?
Yes, you will be shown exercises by the physiotherapist and you will be advised when they can commence. They aim to stop your shoulder, elbow and wrist getting stiff.
How long will it take me to recover?
Rehabilitation varies depending on the type of shoulder surgery carried out.
Physiotherapy helps maintain motion and regain strength of the shoulder.
- Arthroscopic subacromial decompression – 6 Weeks
- Arthroscopic rotator cuff repair – 12 Weeks
Getting back to normal – how you can help yourself to recover
Sleeping can be uncomfortable if you try and lie on your operated arm. We would recommend that initially you lie on your back or on the opposite side. If you lie on your back support the operated arm with a folded pillow under your lower arm. Make sure that your elbow is parallel to your body and avoid it falling backwards.
These techniques have two benefits.
1. Protects the repair.
2. Reduces pain.
What is the long-term prognosis?
You will continue to improve up to two years following the operation, but from six months these improvements are usually much slower. Everybody is individual and makes progress at slightly different rates, but overall more than 85% of patients get a satisfactory result in the first six months.
When can I drive?
You should not drive until you have discussed your progress with Mr Al-Sabti. You must be able to comfortably control your vehicle and perform emergency manoeuvres.
When can I return to work?
The amount of time you have off work depends on your job. If you have a manual job, or one that involves lifting or overhead activities, you will not be able to do this for eight to 12 weeks. Please discuss this with Mr Al-Sabti.
When can I return to sports and leisure activities?
The timescale for which you can go back to any previous sport or activity will depend on your movement and strength and the particular activity you have in mind. Please discuss returning to any activity or sport with your consultant or physiotherapist
Physiotherapy appointments – how often will I have to attend?
You will be referred for outpatient physiotherapy and until you have that appointment you are expected to start the exercises on this sheet as soon as possible after the surgery. You have an important part to play in your own recovery and are expected to follow your home exercise programme as instructed.
Further appointments – when will you back to see Mr Al-Sabti?
You will be seen in outpatient clinic approximately four weeks after your surgery. This appointment will be made and given to you before you are discharged from hospital. Further clinic appointments are made after this as necessary.