Following surgery most patients will experience a variable amount of pain. Dr. Rajaratnam will give you a prescription for pain medication following surgery to control your pain.
You will be fitted with a Cold Rush Therapy pack after surgery, which will apply intermittent ice to the shoulder to relieve pain.
In addition, you may have a pain pump that provides supplementary local anaesthesia, if so this will remain in place for 48 hrs)
If you feel you are having an extraordinary amount of pain following surgery despite taking medication please contact COG.
Following shoulder arthroscopy there will be a significant amount of swelling in the shoulder. This is due to the surgery itself but mostly due to the arthroscopy fluid, which is used to expand the joint. It is not uncommon for the swelling and bruising to travel down the arm into the forearm and hand and also into the chest and thorax.
To help with the swelling you should perform simple hand, wrist and elbow exercises several times a day. If you feel you are having an extraordinary amount of swelling or bruising following surgery, please contact COG.
Shoulder arthroscopy is performed through small puncture (less than 1 cm) incisions through the skin. Depending on what procedure you have performed you may have anywhere from 2 to 10 small incisions. Most patients have 3 to 6 small puncture incisions.
Since shoulder arthroscopy is performed by expanding the joint using fluid, this fluid must drain out of the shoulder after surgery. After shoulder arthroscopy a bulky dressing will cover the wound to soak up this drainage. It is not uncommon for the dressing to become saturated with fluid. This fluid may be lightly blood tinged but for the most part represents drainage of arthroscopy fluid and not blood.
If the dressing becomes saturated it may be reinforced with more gauze or changed. Otherwise, the dressing will be changed at your follow up with the COG.
It is not uncommon to have a small amount of drainage from the puncture wounds, which may be covered with a small amount of gauze and tape. We will change your dressing as often as necessary, until wounds appears dry and healed (usually 2 weeks). Usually there will be small white tapes across each puncture wound (called SteriStrips), which help keep the wounds clean and opposed. This is usually covered by a waterproof dressing (called Opsite). If you feel you are having any extraordinary amount of drainage, or thick blood is draining from your wound please contact COG.
This depends on what type of surgery you have had. In general, if you have had a repair (e.g. rotator cuff repair, labral repair, instability repair) then the sling is worn all the time for 3 weeks, (including sleeping) unless you are doing your exercises, taking a shower, or sitting comfortably.
For example if you are watching television you may take your sling off and rest your arm in a comfortable position or if your wish to type on a computer or write you may sit at a desk, take your sling off, rest your arm on the desk and type or write. However, when you are up and walking even if in the house, it is safest to use your sling to avoid any inadvertent injury (i.e. fall, sudden motions)
If you have had only a decompression type procedure (e.g. subacromial decompression, acromioplasty, distal clavicle excision) or a procedure to gain motion (e.g. capsular release for frozen shoulder) then your sling is for comfort only. You may take your sling off as soon as possible and begin moving your shoulder.
If you are having trouble wearing your sling please contact COG.
You can use your operated arm to eat. It is easiest to slip your arm out of the sling and use your hand to feed yourself by bending at the elbow. Keep your the elbow at the side and do not reach or do anything away from your body (e.g. picking up a plate, cutting tough meat) or lift anything heavier than a coffee cup.
Generally, you should not take a bath (i.e. soak the wound) until the wound is completely healed which may take up to 2 weeks. However, you may shower 24 hours after surgery (with the waterproof dressing). You may take your arm out of the sling when taking a shower and support the arm and its weight using the opposite arm. After 2 weeks, you can shower by letting the water run over the exposed shoulder. Do not scrub. After taking a shower pat the wounds dry with a clean towel. It is important to keep the axilla (i.e. armpit) of the operated shoulder clean and dry. To clean the axilla, do not try to lift the arm or elbow away from the body using the muscles of the shoulder. Instead it is easier to lean towards the operated side and let the arm gently dangle away from the body supporting the arm. You can then wash and dry the axilla.
Depending on your surgery, this is generally 3 weeks. It is unsafe to drive during this time. After your sling is discontinued it is recommended not to drive a vehicle until your operated arm is consistently and comfortably out of its sling.
Some patients have difficulty finding a comfortable position to sleep. For many patients it is easiest to sleep in a reclining chair or propped up with pillows in bed. This seems to relax the shoulder for many patients and can be easier to position the sling. If you sleep on your back it may help to place a small pillow behind the elbow or shoulder to help support the weight of the shoulder. If you sleep on your side (the operated side up) then it may help to place a pillow between your arms. When you are getting in and out of a bed or chair, try not to use your operated arm to push down.
Dr Rajaratnam will discuss with you when formal physical therapy will be required. In most cases, formal physical therapy will not begin until after your first follow-up visit. However, Dr Rajaratnam will instruct you on your home exercise program to be perform immediately after surgery.
Dr Rajaratnam will instruct you on when and which exercise to specifically perform following shoulder arthroscopy. This will be depend on what type of surgery was performed.
This usually depends on the type of work you do, how much pain you are in, and what type of surgery you have had. In general, most patients do not work until they are seen back in the clinic about 2 to 3 weeks after surgery. After this most patients are able to tolerate either single-handed work (i.e. answering the phone) or light deskwork duties only. After this your ability to work and your specific job duties will depend on your type of surgery and your rehabilitation progress. Please remember that it is unsafe to drive during your period of sling immobilization. However, you can contact COG to ask specifically about your job and when you can return.
Dr Rajaratnam is here to help you. Please contact the COG office if you have any problems, questions or concerns.