This is one of the most frequent questions that I get from patients. And it’s not an easy one to answer.
Recently a team at The Hospital for Joint Diseases led by one of my shoulder fellowship mentors Dr. Laith Jazrawi produced a study that makes some recommendations about safe driving after labrum and rotator cuff repair surgery.
The study concluded that one should wait at least six weeks before considering driving after rotator cuff or labrum repair surgery.
There are not a lot of good studies on this topic. This is because it is a difficult topic to study. If we studied patients who recently had surgery in an actual driving situation, the risk for shoulder injury and for a life threatening accident would just be too great to make that study ethical.
But just as pilots use flight simulators to train, we now have reliable driving simulators that can help us answer some of these questions in a low risk environment.
Dr. Jazrawi’s study examined total number of collisions, centerline crossings and road edge excursions at preoperative baseline, 6 weeks and 12 weeks postoperatively. The study compared the patients to simulator results of a healthy group with both arms available who had first the dominant then non-dominant arm placed in a sling.
The study found that collision rates nearly doubled at 6 weeks for patients who had surgery on their dominant arm and increased by about ¼ for those who had surgery on the non-dominant arm compared to the pre operative scenario. The rates returned to normal by 12 weeks.
Interestingly the findings agree with the practices to which I have always adhered: no driving while in a sling or until at least 6 weeks after rotator cuff or labrum repair surgery.
My rule of thumb has always been that you are not allowed to drive until you can comfortably raise both arms to at least shoulder level. This rule of thumb seems to correlate well with their more formalized data.
I know as a patient this is not easy advice to follow. It restricts your mobility and makes you dependent on other people in the early period after surgery. But if I’m going to ask you to wear a sling for about 6 weeks then I can’t in good conscience let you drive a car.
Aside from the fact that your rotator cuff is still healing early after surgery, the other reason why we must limit peoples driving is because technically it is necessary to have two hands to drive. Sure some people skirt the rules and will drive only with one hand. But as your surgeon it is my job to protect you in case of the worst-case scenario. The worst-case scenario would be when you have to react quickly to avoid a pedestrian or oncoming traffic.
Take-home message for patients: you should restrict driving after shoulder repairs for at least 6 weeks. For me this includes shoulder stabilization procedures, rotator cuff repairs and shoulder replacements to name a few.
Not all rotator cuff or labrum surgeries are “repairs,” however. This can create some confusion. Sometimes your surgeon only needs to smooth the rough edges of labrum of rotator cuff. And this does NOT require the same level of restriction with driving. Remember to clarify this with your surgeon.
This is obviously one of the more difficult aspects of having shoulder surgery and this is why having a good social support network is so important after an operation.