Sling Usage
It is important to wear the sling at all times after the surgery. You can however take the arm out of the sling in order to perform the prescribed exercises. It is advisable to refrain from any overhead arm motion until the doctor deems it fit to do so.
The following are some usage time for slings:
- Subacromial decompression - 24-48 hours
- Inferior capsular shift - 3-4 weeks
- Rotator cuff repair - 4 weeks
- Electrothermal assisted capsulorrhaphy (ETAC) - 3-4 weeks
Your elbow should be bent at about 90 degrees in order to allow the forearm to rest properly in the sling. It is also required to keep the elbow slightly in front of the torso. The hand should be at level or above the elbow.
Bathing
It is possible to take bath two days after the surgery. However, one must be careful not to slip and fall as any sudden movement can result in serious injury to the shoulder. There may be a residual effect from the anaesthesia that can make you clumsy or drowsy. For this reason, it is advisable not to soak in a bathtub, hot tub or pool unless the doctor has said so. Soon after bathing, you must pat the wound dry and apply necessary dressing to the surgical sites.
Dressing
Patients who undergo open procedure should ensure proper care of their dressing to prevent infections. Two days after the surgery, all the cotton and yellow gauze is usually removed and further dressings to the wounds may not be necessary. You should however keep the surgical sites adequately protected.
Icing
If there is a swelling or discomfort in your shoulder, you can place some ice for quick relief. However, you shouldn’t ice your shoulder for over 20 minutes at a time. And you shouldn’t place the ice directly on the skin either. Never get your surgical sites wet and you should wait until the shoulder becomes warm before applying the ice again.
Exercise
Post-operative care of your shoulder begins on the first day after the surgery and can extend up to 6 months. The following are some of the exercises surgeons usually advise to heal the shoulder after the procedure:
- Pendulums or Codman’s exercises
- Wrist flexion and extension strengthening
- Elbow active range of motion - Bring the elbow up to touch the shoulder with the fist. Then allow it to relax until the arm lowers towards the floor
- Hand gripping exercises – Use putty and squeeze it while you watch TV, read etc. You can also crumple cloth spread on a table by keeping the palm heel fixed on the table
- Neck active range of motion - Bend your neck slowly to touch your chest with the chin. Bend it back to look to the ceiling. Do the same to the sides. Lastly, rotate your head.
Common Concerns
Patients have reported experiencing bruising or swelling in the shoulder region. The reason for this is that there is bleeding from the bone and the soft tissue underneath the skin, which were cut during the surgery. You can apply ice to lessen the symptoms in this case as described above.
You should see your doctor 1 week after the procedure so that assessment can be made regarding your progress. Your stitches also need to be removed. The doctor can give you a proper exercise prescription such as the ones mentioned above. These exercises can be performed at home or your physiotherapy center, as per the doctor’s guidlines.
You should call your doctor if:
- You see any oozing or redness around the wound
- Fevers greater than 101.3 degrees or chills.
- You have difficulty breathing or feel heaviness in the chest.
Frequently Asked Questions
- It is normal to experience swelling in the hand?
- Yes, it is quite normal and there is no need to be concerned
- There is a sudden rush of pain and swelling in the shoulder while coming to a sitting position from lying position. Is that okay?
- Yes, it is common after surgery. If the pain is unbearable, you can ice the shoulder.
- I had visited my doctor after one week but I lost my exercise prescription. What are the routines I can do until I start my physical therapy?
- You may refer to the post-op exercises described above
- Are there any precautions regarding lifting and motions?
- Please refer to the sling wear and usage mentioned above. Generally you shouldn’t lift anything heavier than a pencil until the doctor says you can.
