Reverse and Standard Total Shoulder Replacement Post-Operative Patient Instructions
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 sling must be worn at all times for the first 5 weeks following the surgery. It should only be removed while showering and performing your home exercise program. The physical therapist will educate you regarding the appropriate fitting of your sling. 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. To allow for adequate tissue healing and to minimize the risk of a shoulder dislocation, it is important to avoid placing your operated arm behind your torso or neck until you are instructed otherwise. To follow this precaution, always make sure that you are able to visualize your elbow. 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 5 weeks after surgery. Driving may be allowed earlier than 5 weeks, but only with clearance from your physician.
Sleeping During the First 5 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 should both be worn during this time.
Keep this area clean during the first weeks after surgery until all incisions have healed. Do not pull on, or attempt to remove the staples. The physical therapist will remove the staples approximately 12-14 days after your surgery, once sufficient healing of the incision has occurred. 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 appropriate use of pain medications.