1. ICE
   We suggest that you apply ice to the top and back part of the shoulder as much as possible (at least 30 minutes every hour) during the first 24 to 48 hours after surgery (if a cyrocuff was prescribed, it should be used continuously during this period. Make sure that the cuff remains cold). This will help limit swelling. After the first few days use the ice/cyrocuff as you feel necessary. The ice should be placed in a sealed plastic bag to keep the surgical dressing from getting wet.
    
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 then: 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 bandaids 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
   You were given a sling to use to im mobilize and unload the shoulder. You should remove it periodically to move the elbow. This will help avoid cramping pain and stiffness. Unless instructed otherwise the sling may be removed when sitting in a chair, eating, or lying in bed.
    
4. EXERCISE  See Diagrams
   
   1. Elbow range of motion - begin immediately.
   2. Posture and cervical spine flexibility exercises- begin first post-op day as tolerated.
   3. Shoulder pendulum exercises - begin in 24 to 48 hours as tolerated.
   4. Isometric strengthening exercises - begin within 24 to 48 hours as tolerated.
   
    
5. MEDICATIONS
   You were given a prescription for a strong painkiller. Use it as prescribed during the post-operative period. After several days, Tylenol or Ibuprofen may provide you with enough pain relief and we encourage you to try and transition to these alternative medications as soon as you are able.
    
6. POTENTIAL PROBLEMS
   A range of surgical procedures done arthroscopically 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.