Six Months After Surgery
Once six months have passed, patients are ready to graduate. At this point, the majority of patients are pain-free; however, some patients do experience aches related to the weather.
Individuals suffering from shoulder pain who reside in the Pensacola area should contact OGrady Orthopaedics today. Dr. Christopher OGrady is an Orthopaedic Surgeon who is dedicated to helping those experiencing shoulder pain. Seeking treatment is critical to ensuring the damage occurring to the shoulder is addressed. at OGrady Orthopaedics.
How Can You Manage Any Postoperative Pain And Discomfort
Pain management is one of patients’ most significant concerns following surgery. Anesthesia and a nerve block will help with pain the day of the surgery, but once you go home, you will be responsible for managing your pain. Your care team will help prepare you to return home to begin your recovery process. Here are some things you can do to stay comfortable after surgery.
- Ice:;Intermittently;placing an ice pack on your shoulder will help alleviate some pain and reduce swelling. While you ice, be sure you do not get the incision area wet. Place a thin towel around the ice and apply it to your shoulder for approximately 20 minutes at a time.
- Medications:;Your doctor may prescribe you a pain reliever. You may also try different over-the-counter medications to help manage any pain. It is a good idea to check with your doctor before taking any pain medication. Some medications can have an impact on bleeding, while others might interact with what your doctor has prescribed. Always follow instructions carefully when taking any medication.
- Sleeping:;Sleeping is a vital part of recovery, but it may be a challenge immediately after the surgery. It can take;up to six weeks after surgery;to sleep comfortably in a horizontal position. You may find it easier to sleep in a reclining chair. Alternatively, you can prop yourself up on a bed using pillows. Be careful to prop the affected arm up and away from your body. If you prefer sleeping on your side, you can sleep on your other shoulder.;
The Anatomy Of The Shoulder
The shoulder is a complex joint capable of more movement than other joints in the body. Its made up of several bones.
Besides bones, other components are responsible for function and movement.
- Ball and socket:;Your upper arm bone head fits into your shoulder blade through a rounded socket known as your glenoid. Your articular cartilage, which is a slippery tissue, covers the surface of your ball and socket, creating a frictionless, smooth surface that helps your bones easily glide across one another.;Strong fibrous cartilage rings your glenoid, which creates a gasket around your socket, adding stability and cushioning the joint.
- Shoulder capsule:;Bands of tissue called ligaments surround your joint, forming a capsule that holds it together. Your synovium, which is a thin membrane, lines the capsules undersurface. It makes synovial fluid that provides lubrication for your shoulder joint.
- Rotator cuff:;You have four tendons surrounding your shoulder capsule that help center your arm bone in your shoulder socket. This is your rotator cuff and is a thick tendon material. Your rotator cuff covers your humerus head, attaching it to your shoulder blade.
- Bursa:;Your bursa is a lubricating sac between the bone on top of the shoulder and your rotator cuff. Your bursa helps your rotator cuff tendons smoothly glide when youre moving your arm.
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When Can You Return To Routine Activities
You will be able to use your fingers, wrist and elbow immediately after surgery. You may walk with assistance as soon as you have recovered sufficiently from anesthesia. If you live alone it may be helpful to have someone stay with you for 1-2 days. You may shower or bathe with regular soap and water 48 hours after surgery. Bend from the waist and let your operated arm move away from your side; then use your good arm to wash under your armpit. Some patients find it helpful to put a plastic stool or chair in the shower for a day or two. Remember that you are doing everything with one hand. You may walk outdoors, write, cook, and drive a car within a few days. Connecting the seat belt is awkward. Take your time and move slowly. Do not lift more than 1-2 pounds with your operated arm.
How Is The Shoulder Rehabilitated
The recovery after rotator cuff surgery is complicated, and requires a delicate balance between allowing the shoulder to heal without letting it get too stiff. I have designed recovery protocols based on the latest medical literature and adapted to your tear. There are certain restrictions to be mindful of, and phases of therapy outlined in the protocol.
Because of the complexity of the recovery, I recommend you work with a physical therapist. Typically, physical therapy will start the first week or two after surgery. The first part of rehabilitation labral repair involves letting the labrum heal to the bone. At surgery, we put the labrum back in position against the bone. It is not healed. It requires about 6 to 8 weeks to heal to the bone. During that time the less stress you put across the shoulder, the more likely it is for the labrum to heal.
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Two To Four Weeks After Surgery
Two to four weeks following surgery:
- Dr. OGrady removes the patients sutures two weeks after shoulder surgery; however, for protection and support, the patients arm remains in the sling.
- Patients must avoid lifting anything that weighs more than a few pounds. Individuals with small children and/or pets will need assistance caring for them.
- During this period, formal physical therapy begins.
- As the patient builds strength, he or she will regain independence.
Are There Any Potential Complications
Any surgery comes with the risk of complications. While these are rare, it is essential you become an informed patient before deciding to undergo surgery. The potential complications of shoulder arthroscopy include the following.
- Infection:;Your surgeon will take every precaution to prevent surgical site infection, but bacteria are always present in our environments. Signs of postoperative infection include redness, pain, swelling and drainage at the site of the surgical incision. Infections like these typically need treatment with a long course of antibiotics. While you should be aware of this complication, only;0.16 to 1.9 percent of arthroscopic surgery patients;experience deep infection postoperatively.
- Stiff shoulder:;A stiff shoulder is one of the more common complications of rotator cuff surgery, with one study finding;20 percent of patients;experiencing postoperative stiffness. While this stiffness may be unpleasant, the study found it typically resolved with six to 12 months after the surgery.
- Lack of improvement:;Arthroscopic rotator cuff surgery has a high success rate, but it is not 100 percent. Lack of improvement is not a true complication, but the result can be disappointing for patients. It is possible patients will find they do not regain full motion, strength and function in the shoulder.
- Retears:;While arthroscopic rotator cuff surgery can be successful, there is a risk of retearing the injured tendon. The risk of this is higher with larger tendon tears.
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Why Am I Still Having Symptoms After Rotator Cuff Surgery
The most common causes of pain after rotator cuff surgery are that the shoulder is still recovering from the surgery itself and the shoulder has gotten stiff due to lack of movement. It is well known that rotator cuff surgery is a major operation where the rotator cuff tendons are sewn back to the upper arm bone .
The other major reason patients have pain after rotator cuff surgery is due to stiffness of that shoulder. It is common after rotator cuff surgery to have some stiffness due to the fact that the operation caused the arm to be held without motion for some time. It is important after the surgery to protect the rotator cuff repair for several weeks while it heals, and during this time it is very common for the shoulder to get stiff to a lesser or greater degree. Your doctor and physical therapist can keep an eye on this for you and let you know if your stiffness is the expected amount or too excessive. Often times the stiffness can be treated, and the pain resolves.
Changing Your Dressing And Removing Your Stitches
Right around the time you start your exercises, youll also have to remove the initial bandaging. Its best to clean the area with nothing but water or it will sting. Youll then have to put new bandaging on, but you wont need nearly as much as you had for the first few days as the bleeding should have stopped by now. The incision area shouldnt look too gruesome, so if you see what looks like serious bruising or swelling its a good idea to call your doctor just to be safe.
One to two weeks later, your stitches will need to come out. Your surgeon or primary care doctor can take care of this for you. He or she will give you all the information you need about dressing your shoulder going forward and getting started on physical therapy, the next leg of your recovery.
Looking for a doctor that specializes in shoulder surgery and recovery?
Look no further, contact us today!
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How Much Pain Is Acceptable After Surgery
It’s a common question and a complicated answer: Why won’t my surgeon give me more pain medication?;I’m having pain so why doesnt he just give me better pain medication?
Some pain after surgery is expected. The goal of pain management is to make the pain manageable or to significantly reduce your pain, the goal is not to eliminate pain. This allows you to get through your day, to take care of yourself and continue with the healing process.
There are several reasons that pain medication is given with the intention of reducing pain, not eliminating pain. It is possible to give too much pain medication. It can interfere with your breathing and can cause sedation beyond what is safe . Many pain medications also cause constipation, which can become a major surgical complication, depending upon the type of surgery you have had.;More pain medication can mean more severe constipation.
How Long Will You Stay In The Hospital
Patients enter the hospital in the morning, have the surgery and go home the same day. This is called Outpatient surgery. Will you need to wear a brace? A sling is all that you will use. Patients wear the sling for 4 to 6 weeks but remove it for bathing and dressing. Use of the sling is important to maximize labrum healing. The length of time to wear the sling largely depends on the size of the tear seen during surgery.
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Frequently Asked Questions About Arthroscopic Rotator Cuff Surgery
Is my rotator tear “too big” to be fixed using arthroscopy?
The primary advantage of all-arthroscopic repair is that it allows a surgeon “global” access to the rotator cuff and tear for adequate cuff evaluation, repair and fixation to bone. For this reason, the LARGEST tears are often that require the greatest degree of skill and familiarity with arthroscopic techniques. Surgeons who are facile with arthroscopic techniques actually prefer to prepare and evaluate the cuff using the arthorscope, as this allows better visualization.
Will I recover or “heal” faster after arthroscopic rotator cuff repair?
Are the results as good as with “mini-open” techniques?
Most of the recent studies show that in the hands of surgeons who are expert in all-arthroscopic rotator cuff repair, the results are comparable to open techniques. Specifically, the best results reported for open repairs are as high as 97% success.1,7,11,142-6,8-10,12,13 Reports of the traditional open fixation tend to demonstrate that the success rates are less favorable for larger tears. Interestingly, the studies of arthroscopic repairs show otherwise: the results do not appear to be significantly worse with larger tear sizes.4 This is probably due to the global access to larger tears with the arthroscopic techniques. Recent articles reported on arthroscopic fixation using the latest instruments and techniques demonstrate 93% to 95% good and excellent results.
What happens without surgery?
Rehabilitation After Shoulder Surgery
The rehabilitation of your shoulder depends on the operation you have had. We would have discussed with you the expected post-operative rehabilitation before the operation in clinic and on the ward and we will confirm this with you after your surgery.
Almost all patients having shoulder surgery will require physiotherapy post-operatively. You will need to arrange the physiotherapy to start when we advise you, and will need to get approval from your insurance company to cover the costs of the physiotherapy.
While waiting for your physiotherapy to start, if we give you permission, you can do the exercises in this video for your shoulder, elbow, wrist and hand:
We will give you a copy of your operation note to take to your physiotherapist. If you have had any of the following procedures, we will also give you a rehabilitation protocol to take with the operation note to your physiotherapist:
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Shoulder Surgery Recovery Timeline
Your arm will be placed in a sling to keep it immobilized during the healing process, which takes approximately four to six weeks. This can make some daily activities difficult, but you must wear your sling as instructed by your surgeon. Keeping your shoulder immobilized is a key part of making sure you heal correctly and avoid future stiffness, pain, or failed shoulder surgery syndrome.
During the four to six weeks that you are wearing the sling, youll likely also be working with a physical therapist, who will have you do different exercises and movements to build strength and flexibility in your arm.
What Are The Symptoms Of A Rotator Cuff Tear Or Injury
Rotator cuff tear symptoms include the following.
- Immediate pain:;A single injury causes an acute rotator cuff tear. You will likely be able to pinpoint the exact injury because it will involve a quick, sharp pain in the shoulder. Heavy lifting and falls are common causes of an acute tear.
- Dull pain:;In cases of rotator cuff tears that happen as a result of overuse, you likely won’t be able to isolate one incident that started the pain. Instead, you will probably notice a continuous, dull ache in your shoulder.
- Pain while lying down:;Whether acute or the result of repetitive motion, most rotator cuff injuries come with pain while lying down on the affected shoulder. You may notice this pain while you are trying to fall asleep.
- Weakness and restricted range of motion:;Weakness in the affected arm is another of the common torn rotator cuff symptoms. Injury to the rotator cuff can make it difficult to move your arm in different positions. These muscles and tendons play a significant role in allowing you to move your arms above your head. If you have this type of injury, you may find it difficult to perform simple tasks that involve lifting and rotating the affected arm.
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Stick To The Lowest Dose
If you need opioids, your doctor should prescribe the lowest possible dose. Three days or fewer will often be enough and more than seven days are only rarely needed for urology procedures. According to the Centers for Disease Control and Prevention, taking opioids for more than three days will increase your risk of addiction. If youre still in pain after three days, use over-the-counter medicines as recommended by your doctor. Your doctor or pharmacist can help you take those medicines safely. They may also suggest non-drug ways to ease your pain, such as heat or cold therapy.
The Recovery Journey Begins
After shoulder surgery, the patient needs time for the tendons to heal and fuse back to the bone. While some data reveals a full recovery can take 4-6 months, this timeframe varies. The factors that affect healing time includes the extent of damage, age, current health, and sticking to rehab. After surgery, there will be a limited range of motion in the first 4-6 weeks. The arm should be in a sling, restricting any movement. This gives the shoulder time to heal.
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What Is The Fastest Way To Recover From Shoulder Surgery
Everyone wants to get back to normal as soon as possible after surgery, but rushing to return to your normal activities is a surefire way to extend your recovery time. The fastest way to recover from shoulder surgery is by taking it easy and following your doctors orders. Use these tips to make sure you recover from your shoulder surgery as quickly as possible.
Wear your sling After shoulder surgery, your surgeon will require you to wear a sling to keep your shoulder immobilized as it heals. Dont be tempted to take your sling off more than necessary. Just like getting better from a cold, your shoulder needs rest to heal faster and more completely.
Commit to physical therapy Your physical therapist will work with you to keep your shoulder moving, flexible, and healing properly after surgery. Stick with it! These exercises are specifically prescribed to help you heal on a healthy timeline.
Kick pain medication as soon as youre able By all means, take your meds! But as soon as youre able to wean yourself off of your post-surgery pain medication, do it. Its important for you to feel the sensation in your shoulder to know if youre healing correctly. Ongoing pain can be a sign of a hidden problem.
Avoid certain arm movements Talk to your surgeon about what movements are more likely to re-injure your healing shoulder. In general, lifting heavy objects, raising your arm over your head, or reaching behind you put too much strain on a healing shoulder.