Rotator Cuff Repair Post Operative Instructions

Your procedure may have been done arthroscopically, "open", or by a combination of the two. The degree of swelling and discomfort you experience may vary depending on how your procedure was performed and exactly what was done to your shoulder. The following guidelines will help you during the post-operative period. If you have any questions, please call the office.

1. ICE
   We suggest that you apply ice to the top of the shoulder as much as possible for the first few days following surgery (20-30 minutes every two hours). This will help limit swelling. The ice should be placed in a plastic bag and the bag placed in a towel to avoid wetting the dressing, If you have a cold therapy device (cryocuff) it should be used as much as you tolerate and can be used continuously.
    
2. DRESSINGS
   The shoulder may have been filled with sterile fluid with a pump during the operation. The shoulder, there fore, will be very swollen and there will likely be some drainage from the wounds. You may change the dressings as necessary. Expect the shoulder and arm to become discolored a few days after surgery. If the dressing becomes loosened or soiled, apply new ones (you may use small band aids on the scope incisions and larger ones to cover any larger incisions). You should not allow the wounds to get wet until the 4th post-operative day, thereafter you may shower as long as the wounds are dry, without any drainage on the bandages.
    
3. ACTIVITY - SLING
   You were given a sling to use to immobilize and unload the shoulder. You should remove the sling periodically to move the elbow. Unless instructed otherwise, the sling may be removed when sitting in a chair or lying in bed, when up and around you should always wear the sling until instructed otherwise. Don't let the arm hang.
    
4. EXERCISE - DO NOT ACTIVELY LIFT THE ARM UNTIL INSTRUCTED TO DO SO
   
   1. Range of motion of the elbow-begin immediately
   2. Posture and cervical flexibility exercises begin first post-op day as tolerated.
   3. Pendulum shoulder and isometrics- as instructed by your surgeon or will be discussed at your first post-operative visit.
   
   See Diagrams
   
5. MEDICATIONS
   You were given a prescription for a strong pain killer. Use it as prescribed during the post-operative period After several days, Tylenol, aspirin or Advil may provide you with enough pain relief. Different people respond differently to medication, If your prescription fails to control your pain or causes side effects, call us.
    
6. POTENTIAL PROBLEMS
   A range of surgical procedures done arthroscopically or open makes the recovery course and improvement times variable. You should not compare your course with that of other individuals. There are certain potential "deviations"' from the routine course that you should be aware of.
   
   1. BLEEDING OR DRAINAGE
      Drainage is expected. A large amount of fluid is used during the procedure and this will drain out of the scope portals. If the dressing becomes saturated, apply another one. If drainage continues after 24 hours or you think the drainage is excessive...... Call the office.
   2. FEVER
      If you have a temperature greater than 101 degrees on more than one reading 48 hours or more after surgery......Call the office.
   3. SWELLING
      A large amount of fluid is used during the procedure and there is often significant swelling in the shoulder and upper extremity. This should resolve over three to four days. If swelling increases or you develop any persistent numbness in the hand...... Call the office.
   4. UNRELENTING PAIN
      If severe pain remains 48 hours after surgery...... Call the office.

If you have not yet made your follow up appolntment, please call the office and do so.

If any problems arise please call the doctor at (518) 587-0845
The phone will be answered 24 hours a day, 7 days a week.

Diagrams

POSTURE Shoulder Shrugs Shrug shoulders backward, pinching shoulder blades together. Hold position 10 seconds. Repeat 5 Times Do 4-6 sessions per day.
CERVICAL FLEXIBILITY Upper Trapezius Stretch Gently grasp side of head with uninvolved hand/arm. Tilt head away until a gentle stretch is felt. Hold 10 - 15 seconds. Repeat 5 times to each side. Do 4-6 sessions per day.
Shoulder Pendulum (Clockwise/counterclockwise) Let arm move in a circle clockwise, then counterclockwise by rocking body weight in a circular pattern Repeat 5 times. Do 3 - 4 sessions per day.

Shoulder Strengthening Isometric Flexion Using a wall to provide resistance, press fist into light moderate maximal resistance. Hold 10 seconds. Repeat 5 times. Do 3 - 4 sessions per day.				Shoulder Strengthening Isometric Extension Press back of arm into wall using light moderate maximal resistance. Hold 10 seconds Repeat 5 times. Do 3 - 4 sessions per day.
Shoulder Strengthening Isometric Internal Rotation Using door frame to provide resistance, press palm of hand into door frame as shown using light moderate maximal resistance, Be sure to keep elbow in at your side Hold 10 seconds. Repeat 5 times. Do 3 - 4 sessions per day.				Shoulder Strengthening Isometric External Rotation Keeping arm tucked in at side, press back of hand into wall. Hold 10 seconds. Repeat 5 times. Do 3 - 4 sessions per day.