Rotator Cuff Repair Post-Operative Patient Instructions
Rotator cuff repair involves suturing the tendons in the shoulder back into the humerus bone where they have torn. The goal is for the tendon to grow back into the bone and for the blood supply from the bone to grow into the tendon so that there is permanent healing. The sutures are strong but they are temporary, and there is a race between healing to the bone and the sutures wearing out.
It is extremely important during the first 6 weeks after surgery that only passive motion be done with the operated shoulder. This means that the arm should not be lifted independently in any way, even for very mild motions such as getting dressed or shifting the position of the arm. All motions should be done by the therapist or by using your other arm to move it. After 6 weeks, the arm will be able to come out of the sling and active motion can be started. However, it is not until 12 weeks that light resistive motion or strengthening can be started. It is important to give the tear a complete chance to heal.
Below is a list of instructions to follow during the first several weeks after your shoulder surgery. It is extremely important that these instructions are followed in order to maximize your recovery process and avoid complications. The physical therapist or physician will notify you if there are any exceptions to these rules for your case. If you have any questions, please ask the physical therapist or physician.
The padded sling with wedge must be worn at all times for the first 6 weeks following the surgery. It should only be removed only while showering and performing your home exercise program. The physical therapist will educate you regarding the appropriate fitting of your sling. Some patients are permitted to remove the wedge during the daytime after the first 3 weeks. Patients with large tears will continue to wear the wedge at all times for 6 weeks. The physical therapist will instruct you on this. If the sling puts too much pressure on your neck, a facecloth placed under the strap may be helpful.
The first goal is to restore passive motion. It is important to adhere to your home exercise program as instructed by the physical therapist. It is also important to avoid any active lifting of your operated arm during the first 6 weeks following surgery. This includes carrying, pushing, or pulling objects with your operated arm. The therapist will instruct you on appropriate activity progressions after the 6-week point.
Once the physical therapist has removed your bandaging, it is safe to shower. It is important to avoid submerging the operated arm underwater. Your sling may be removed while you are showering. Your operated arm should remain at your side at all times. Use only your non-operated arm to complete washing tasks in order to avoid any active lifting of your operated arm. Avoid scrubbing over the incisions. When drying yourself after a shower, pat the incisional area dry with a towel.
Some patients are not permitted to drive for 6 weeks after surgery. Driving may be allowed earlier than 6 weeks, but only with clearance from your physician.
Sleeping During the First 6 Weeks
You are permitted to lie on your back or non-operated side following surgery, however, many people find this uncomfortable. Rather than lying flat, sleeping can be performed in a semi-reclined position. Many patients sleep in a recliner for a few weeks if one is available. The sling and wedge should both be worn during this time.
Keep this area clean during the first weeks after surgery until all incisions have healed. It is not necessary to remove or replace the white Steri-Strips™. They can be discarded once they fall off. Notify the physician or physical therapist if you notice any drainage or odor coming from your incisions.
Management of Pain
Shoulder pain is expected following your surgery. Do not use NSAIDs such as Motrin, Advil, Nuprin, or Ibuprofen until cleared by the physician. Such use may interfere with proper healing. Application of ice over your operated shoulder may help to manage pain and decrease inflammation. This can be done for 15 minutes at a time, followed by at least 45 minutes without ice.
Initially following your operation, it is appropriate to use ice several times a day. Application of heat over your operated shoulder should be avoided until at least 2 weeks following the operation (after the acute phase of tissue healing is completed).
Speak with the physician regarding the appropriate use of pain medications.