Rotator Cuff Repair Instruction Sheet
For a printable version of these instructions click here: PDF link
Dr. Solberg’s Office Number is 213-455-8448.
This information should be useful after your shoulder surgery. Please read this information carefully. You will receive further instructions at your next visit. The following items cover what to expect and what to do for the first week after surgery.
GENERAL EXPECTATIONS
Expect your shoulder to be quite stiff and sore for the first few days. Keep your arm in the sling most of the time. You may take the sling off to wash. Take your arm out of the sling a couple of times a day and bend and straighten your elbow. This will help improve your motion. Squeeze and relax your fist often to improve circulation
Apply ice to your shoulder for the first 48 hours after surgery. Wrap the ice in two bags to avoid getting the bandage wet. You may use ice packs longer if they help the pain. If you have a cold pack set up, make sure it is filled with ice water.
You should expect some swelling in your hand and fingers on the affected side as well as some bruising in the arm and chest area, this is perfectly normal. This will subside when you begin to move your arm more.
PAIN MEDICATION AND PAIN CONTROL
Many patients have a block or regional anesthetic for pain control after surgery. This produces numbness in the involved arm and is very good at relieving pain after surgery. The block often lasts 12-24 hours before it wears off, which can occur fairly quickly. The first sign the block is wearing off is tingling in your fingers, the same type of feeling you have when you lay on your hand and it “falls asleep”. It is very important to have pain medication in your system when the block is wearing off to avoid having excessive pain. I recommend you take an extra dose of the pain medication as soon as you feel tingling in your hand.
Take your pain medication as directed by your prescription. Do not wait until the pain is intolerable to take the medication. It will take between 30-60 minutes to begin working, so take it accordingly. In addition to your prescription, recommend combining it with either Advil or Aleve for an additive or synergistic effect (the effect of the two medications together is more than the effect of the individual medications). Over the counter Advil or Aleve work as well as prescription ibuprofen or naproxen (the generic form) and can be safely taken with your prescription. For Ibuprofen (Advil or Motrin) take 3 tablets (600 mg) every 8 hours as needed and for Naproxen (Aleve) take two tablets (440 mg) every 12 hours. Do not take both ibuprofen and naproxen, rather choose one or the other. Make sure you take these medications with food to avoid stomach upset.
WOUND CARE
Take the bandage off after 3 days. The incisions may continue to ooze a small amount. Leave the tape strips on the wounds.
You may take a shower after 3 days. Take your shower first then remove the bandage. Leave the tape strips on the wounds and don't soak the incisions underwater or swim in a pool for the first 3 weeks.
You may take a shower after 3 days. Take your shower first then remove the bandage. Pat the incisions dry with a towel. If they continue to ooze a small amount, place a small piece of gauze over the wound to catch the drainage. If the incisions are not oozing, leave them open to the air.
ACTIVITY AND REHAB
The first couple of weeks are a balance between protecting the repair of the tendon and preventing your shoulder from stiffening too much. Do not lift anything heavier than a coffee cup with your arm. Do not try to lift your arm higher than your shoulder. You can use your arm for writing, typing and general desk work.
Keep the sling on most of the time. You will need to take it off when you shower and you can take it off when you are sleeping. Whenever you are up and about (walking, going outside) keep the sling on. This will prevent sudden movements that can cause injury.
Begin to gently move your shoulder as soon as you can. Your motion should improve a little bit every day. Start by removing your arm from the sling and leaning over a table, allowing your arm to hang free. Gently begin drawing circles with your arm, first in one direction then the other. Each day try to increase the size of these circles. Do these exercises 2-3 times a day.
CODMAN EXERCISES
You should start doing gentle range of motion (Codman) exercises within the first few days after surgery. Do these exercises 3 times a day for roughly 5 minutes each .
SLEEPING
Many people have difficulty sleeping for the first week. The most comfortable position is often sitting up about half way. If you have a recliner, this is a great way to keep your body partial upright and the armrest prevent you from rolling over. If you are sleeping propped up in a bed, make sure you have some way of staying in this position while you sleep.
If you’re having trouble falling asleep you can take a gentle over the counter sedative such as Benadryl or Unisom. These can be taken safely with your pain medication and help you to fall asleep more quickly.
Don’t drink alcohol with the pain medication or sleep aid as this can be dangerous.
Some people will have a pillow between their arm and chest after surgery to hold their arm away from their body. It is important to have someone help hold your arm in this position when removing the sling and pillow.
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Call Dr. Solberg’s Office if you notice any of the following symptoms. You may be connected with an associate if you are calling in the evening hours. Have your discharge orders and description of your procedure available.
Temperature over 101o Fahrenheit
Persistent numbness in your hand
Increasing, severe pain in the shoulder
Increasing redness around the incisions
You have been prescribed pain medication which has a number of side effects. Most common are drowsiness, nausea and or vomiting, itching, constipation and irritability. If these are prolonged or severe, your pain medication may need to be changed. You must contact our office during business hours to have a prescription refilled or a new prescription dispensed. After hours (after 5:00 pm or weekends), the on call doctor will not give you a refill or a new pain medication prescription.