Thank you for choosing Palm Beach Hand to Shoulder for your care. I have put this information together with the patient scheduled for shoulder arthroscopy in mind. Please review carefully to ensure the best possible outcome.
Shoulder arthroscopy is a minimally invasive procedure performed through several small incisions around the shoulder using a camera to visualize structures and special instruments to clean out, repair, or reconstruct injured or worn out structures.
Make alternative arrangements for transportation, dog walking, meal preparation, house cleaning, and heavy chores. Pick out clothes that are easy to take on and off with limited use of one arm: an oversized shirt that buttons down the front, pants with an elastic waist, and shoes that are supportive and preferably without laces.
Unless otherwise instructed, hold any blood thinning medications for 5 days prior to surgery.Do not eat or drink anything after midnight the night before surgery.
Take a shower the night before surgery and scrub your operative shoulder, neck, upper back, underarm, and chest wall with surgical soap (4% chlorhexidine gluconate) followed by wiping the same area with a cloth soaked in 3% hydrogen peroxide.
You will wake up from surgery with a sling on your operated arm. For the first 12-24 hours after surgery, you may have limited control of the operated arm owing to the regional anesthesia or “block” that temporarily numbs and paralyzes the arm for pain control.
Getting comfortable for sleeping can be challenging after shoulder surgery. Most patients recovering from shoulder surgery find it easiest to sleep in a recliner chair for up to several weeks after surgery. An alternative is to sleep propped up in bed with multiple supportive pillows. The sling should be on for sleeping.
Most patients will require prescription medication for a few days after the regional anesthetic block wears off. You should discontinue the prescription pain medication as soon as your symptoms allow you to do so, with a goal of discontinuing them at 2 weeks. Opioid medication can cause constipation.
Walk in a climate-controlled environment, stay hydrated, and eat a fiber-rich diet to avoid this problem. If not medically contraindicated, taking an anti-inflammatory such as ibuprofen or naproxen in conjunction with or as a substitute for the prescription pain medication can be very effective for controlling pain with fewer side effects than the prescription medication.
The answer to this depends on whether you are having a “clean up” or whether structures have to be repaired and/or reconstructed. Patients just having a debridement or “clean up” will be allowed gentle use of their shoulder within a few days of surgery.
If you are having surgery for rotator cuff repair, do not move your shoulder or discontinue the sling until I have instructed you to do so. Remain in the sling at all times except to shower or to periodically bring your hand to your face for eating, brushing teeth, shaving, typing, etc. (i.e. “hand-to-face” or tabletop activity).
Your hand on the surgery side should remain in front of your face until instructed (wait for clearance from me before reaching out to the side or behind your back). When you are bathing you can bend forward at the hips and lower back and dangle your arm out of the sling to straighten out the elbow so it doesn't stiffen up on you and so that you can access your underarm while bathing.
The surgical bandage should be kept in place for at least 3 days after surgery. Each small incision should then be kept covered with fabric band aids. Do not get the incisions wet until you see Dr. Diaz at 2 weeks after surgery. Avoid sweating as this can lead to wound infection.
If you are interested in renting an ice machine that circulates ice water around your shoulder, please let my office know. Whether you use an ice machine or a reusable pack/gel pad, ice is an excellent means of reducing pain and swelling in the shoulder.
Most people undergoing shoulder arthroscopy benefit from physical therapy. If you had a repair or reconstruction, the start of therapy will usually be 4-6 weeks after surgery.
Criteria for resuming driving include no requirement for narcotic medication and discontinuation of the sling. You should ask Dr. Diaz before resuming driving after shoulder surgery.
Patients with sedentary jobs may return to work as early as a few days after surgery with some modifications. Patients whose job entails heavy lifting, repetitive loading, or above-eye-level activity with the operated shoulder will require anywhere from 3-4 months off from work unless arrangements can be made for modified job responsibilities (i.e. supervisory, desk/office work).
This depends largely on the procedure performed and the type of sport. For arthroscopy without repair, I clear most patients for full athletic activity at 4-6 weeks, depending on the circumstances. If I performed a rotator cuff repair or other soft tissue reconstruction, it will be 3-5 months before you are allowed full athletic activity.
Please call the office or use the Patient Messaging Portal should you have any further questions.