When can I remove my dressing?
You may remove the dressing 2 days after surgery. Some people like to place a new dry dressing on the wound after taking off the original one. Often staples are used to close the skin. So a dressing can help prevent the wound from being irritated by clothing. However, this is not absolutely necessary unless you notice drainage from the wound. If you do notice drainage, be sure to note the location, quality and amount and keep a dressing on it.
When can I get the incision wet?
You should keep your incision dry for at least 1 week. You may shower in 1 week and allow water to gently run over the wound. DO NOT vigorously scrub the wound in the first 2-3 weeks. And DO NOT soak the wound such as with swimming or tub baths for at least one month after your surgery.
When can I drive?
There is very little good evidence to make truly sound recommendations on when it is ABSOLUTELY safe to drive. However, here are a few rules of thumb:
NEVER drive a vehicle on your own if you have been instructed to wear your sling full time. Safe driving requires 2 hands and it is NOT recommended that you drive while you still are wearing a sling.
DO NOT drive until the doctor has cleared you to do ACTIVE range of motion of your shoulder. Many shoulder procedures require a period of only passive range of motion exercises in the immediate postoperative period. (see question 4 for more details).
You should NOT drive until you can comfortably elevate your arm to at least shoulder level.
Will I do physical therapy after surgery?
You will be given a specific therapy protocol that is tailored to your particular condition. Each condition around the shoulder is different and requires different levels of therapy and activity. You should follow your particular instructions strictly as some surgeries require more therapy than others. Sometimes you will need supervised therapy with a licensed physical therapist. Other times you can do prescribed exercises at home.
Most therapy programs require that you do at least some exercise on your own at home for you to achieve maximum benefit.
There are 2 important facets to every shoulder treatment program:
- The timing of the allowed activity and
- The level of permitted activity.
I will help guide you regarding each for your particular condition.
How often will I have to go to therapy?
Everyone is a little different. The answer to this question may depend on a host of factors:
- what type of surgery you had
- outside time constrains such as your job
- your ability to do exercises properly and independently and
- the stage of your recovery.
I will tailor your protocol specifically to your individual needs. Each person and shoulder case is unique.
Will I get pain medication after the surgery?
Yes. I typically prescribe some form of pain medication in the immediate post operative time period. This along with other methods of pain control (see questions 7) should help to make you more comfortable after the surgery. Understand however, that medications do not completely eliminate all pain, that they do have side effects and can lead to dependency. They should be taken with caution and only as prescribed. Side effects can vary for each person but some of the more common ones are nausea and constipation.
My goal is for you to be comfortable enough to perform your daily living activities and your prescribed therapy.
Should I use ice or heat to help with the pain?
Early on, after you have had your surgery, your shoulder will be swollen and inflamed. Ice helps reduce this inflammation.
As some of the initial discomfort from the surgery subsides, alternating heat and ice has been shown to be a good strategy for some people. Using heat before a therapy session to “warm up” the joint and ice after to help “cool down” may be a good strategy. But each person is different and the above practices may not hold true for everyone.
REMEMBER: never keep ice packs on the shoulder for more than 20-30 minutes at a time. Always allow a period of about 20 minutes between icing sessions so you do not get frostbite. This can happen.
Will I have a lot of pain?
Pain is a very subjective phenomenon. Literally everyone experiences it differently. So it can be hard to give a one-size-fits-all answer to that question.
I can honestly say that I have had some people require no oral pain medication as early as 2 days after surgery and others require it for many weeks after surgery. Here are a few rules of thumb:
- Patients that have used narcotic pain medication (Vicodin and Percocet for example) for any consistent period of time prior to surgery often require higher doses of pain medications to control their pain after surgery. The body gets used to increased doses of narcotic pain medications and requires increased doses to get the same effect.
- This is why I advise patients to wean off of narcotic pain medications as much as possible well in advance before surgery if they are on them chronically.
- Using other treatments such as ice in combination with pain medication may help you lessen the amount of medications that you need to get more comfortable
- Pain can come and go in waves. That is, you may have good days and bad days depending on a host of factors including activity level. However the overall trend should be for the pain to decrease with time. For example some people find that their pain level may increase when they start a new more strenuous phase of a rehab program. This is often normal, as long as the overall decreasing pain trend eventually resumes. If it doesn’t or you have sudden new pain, swelling or signs of infection you should treat that more urgently.
- There is no completely pain free surgery. You will likely have some pain, but with some coaching, a good medication and therapy regimen and some patience, you will likely be able to deal with it well.