Rotator Cuff Repair
Pre-Op Instructions for Arthroscopic Rotator Cuff and Labrum Shoulder Surgery
Items to bring to surgery: Slingshot, cold therapy cooler, and a large button-up shirt
- Give the above items to the nurse when you get to the bed.
- Once in bed, the anesthesiologist will offer you an interscalene nerve block. This block involves an injection of local anesthetic which will numb your shoulder and arm before surgery so that your brain will not receive any pain signals during or immediately after surgery.
- A block will numb your whole arm and will occasionally make your neck and the side of your face numb.
- The block will last from 6 to 24 hours from the time it is given.
- It is recommended that you take 2 pain pills as soon as the block starts wearing off and you begin to experience feeling in your arm.
- NOTE: If you take 1 pain pill, and it is not enough, it will take longer to control your pain.
Recovery: When you awaken from surgery, your surgical arm will be covered with a thick dressing, a blue surgical towel, a cold therapy pad on your shoulder, and a slingshot. Your arm will be numb.
Getting Dressed: You will need a large button-up shirt to go over your surgical bandages. The nurse will place your non-surgical arm into the sleeve and drape or wrap the rest of the shirt around you.
Once home, you may remove the slingshot and put your clothes on the correct way:
- When putting on a shirt, slide the sleeve onto your surgical arm first, pulling the shirt over your head or put it behind your back, and then put your non-surgical arm in the other sleeve.
- When taking clothes off, you will reverse the order. Remove from non-surgical arm first and then slide off surgical arm.
Sleeping: Dr Todd recommends sleeping in a recliner. If you do not have a recliner, you will need to make a “nest” in your bed. Most people do not feel comfortable sleeping in a flat position and use pillows for elevation. Always keep your pain medication and water close by for easy access.
You may begin your exercises the morning after surgery. You will need to set a timer on your stove or cell phone for 5 minutes.
- Remove the slingshot and drop your arm down to your side.
- Hand, wrist and elbow exercises:
- With open or closed hand, bring your hand up toward your shoulder then back down to your side, like you are doing a curl, for multiple sets. Do not hold a weight in your hand while performing these exercises.
- Open and close your hand and turn your wrist.
- These exercises can be performed in the sling, at any time throughout the day if your hand or wrist becomes stiff.
- The last exercise is called a PENDULUM.
- Bend over and let your arm hang loosely.
- Gently rock your body back and forth to make your arm swing.
- Do not let your arm swing in a circle larger than the size of a large pizza.
- If this is too difficult, (with your arm still hanging down loosely), hold onto the wrist of the surgical arm with your other hand and manually move the surgical arm around in a circle.
- If you continue to have difficulty with this exercise, have someone you love and trust help you with it.
All of the above exercises (performed in any order) should be done for a total period of 5 minutes and should be done 3 times a day, every day.
Note: You can do these exercises more than 3 times a day, but not less than 3 times a day. You will have a 2 pound weight limit for your surgical arm until the therapist tells you to increase the weight.
Sponge baths only for the first few days. The third day after surgery you may take a shower, not a tub bath. To shower:
- Remove the slingshot.
- Remove the surgical dressing completely, all the way until the stitches are visible.
- Shower as usual.
- Pat surgical site dry and apply band aids.
- Do not use any Neosporin or Polysporin.
- Change band aids daily when you shower.
When you are taking your shower or dressing, you can move your arm, not your shoulder. You may move it from your mouth to your zipper with your arm bent at a 90 degree angle at the elbow from your side to across your abdomen.
If you need to apply deodorant or wash under your arm, you will need to lean over like you are doing a pendulum exercise. You will be able to zip your pants, button a shirt, brush your teeth, but you won’t be able to wash your hair with your surgical arm.
- If you continue using the cold therapy, it is important to use a thick hand towel underneath it once the surgical dressing has been removed. Without proper protection, the cold therapy can damage your skin.
- You may use the cold therapy as often as you like. It can run 24 hours per day.
- Ice can be made at home by filling four (4) quart-size freezer bags with water. Freeze solid.
- Put two (2) bags in the cooler and swap them out as they thaw.
Important: Dr Todd prefers that his rotator cuff patients not take any NSAID’s (anti-inflammatory medications) for up to 4 weeks after surgery. NSAID’s inhibit the healing of the rotator cuff.
Driving is an issue due to the taking of narcotic pain medications and wearing of your slingshot immobilizer.
- You will need to be in the immobilizer for varying amounts of time based on your surgery.
- Your first post-op appointment is usually 6-8 days after surgery to remove your stitches.
- The second appointment is usually the time that your pillow is removed from the slingshot.
- You will transition out of the sling over the next 7-10 days, will start outpatient physical therapy, and be able to drive.
Any questions may be addressed by calling the office at 251.625.2663, Monday to Friday, between the hours of 8 am – 4:30 pm.
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