Shoulder Subacromial Decompression

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Message from your doctor…

Dr. Tony Levenda

Dr. Tony Levenda, sports medicine orthopedic surgeon

Thank you for using the Lakeshore Bone & Joint Institute Shoulder Subacromial Decompression Text Messaging System. This system is designed to walk you through the recovery process that follows this procedure. We will send you key tips and pointers at specific time points throughout your recovery. You are, of course, welcome to contact us at any time. We are here for you throughout your recovery in person, by phone, and now via text messaging. Messages contain general information about your recovery.

Please remember that these are guidelines for routine Shoulder Subacromial Decompression. Your doctor may wish to individualize your treatment and rehabilitation in which case you should follow your doctor’s instructions and not the instructions given through the Text Messaging System.

RecoverWell — Post Surgical Shoulder Subacromial Decompression

Pertinent Recovery Information

Shoulder Subacromial Decompression – Post-Operative Instructions

After Surgery

You will be receiving a post-operative phone call from the surgical staff within a few days after surgery to check on you and assist you with any concerns.

When To Call

Please call our office at (219) 395-2109 if you develop a fever greater than 101°F, increasing pain that is not responding to pain medication, redness around incisions or shoulder, increased swelling, persistent bleeding or drainage, or drainage other than clear fluid or blood. If it is after hours, please call (219) 921-1444 and the answering service will contact the physician on call. It is normal to develop bruising to the operative arm. Some people have bruising across the chest all the way down to the hand. It can also be normal to develop swelling to the arm and hand. Gravity tends to pull fluid down the arm- your body will be able to reabsorb this fluid but it may take a few weeks. If the swelling becomes increasingly painful and more tender to the touch, please let our office know.

Pain

Your prescription for pain medication will be given to you before you leave the surgery center.  After the first day or two, as the pain lessens, you may decrease the frequency with which you take the medication. Remember, the medications are not necessarily meant to completely eliminate your pain, only to make it more bearable. Narcotic pain medications can cause constipation; you may wish to use an over-the-counter stool softener to help prevent this. Use ice or a cold therapy unit constantly for the first 48 hours, then as frequently as needed.

Dressing

You will have a soft dressing applied over your incisions. It is meant to absorb any leaking blood or fluid from the joint, and to protect from infection. Leakage immediately after surgery is normal and actually helps to drain some of the fluid that accumulates in the joint during surgery. The dressings may become moist or blood-stained; this is normal and usually not a cause for alarm.

Your dressing will be changed 2- 3 days after surgery. Your dressing will be removed during your first therapy visit. If you plan on going to an outside therapy office that does not offer nursing care, you must call our LBJI’s physical therapy department to get the dressing changed. If there is a clear dressing over the incisions, this should be left along until you follow-up with Dr. Levenda.

We ask that you keep all incision areas free of perfumes, lotions, deodorants, etc. You may develop blisters around your incision due to your skin stretching and swelling. Please refrain from popping the blisters. You may cover them with a Band-Aid free of ointments.

Bathing

You may remove your dressing 48 hours after your surgery to take a shower. For showering, you may remove your entire sling and let your arm rest at your side. Under the surgical dressing, you may have steri-strips over your incisions (small white strips of tape). Please leave them in place until they fall off on their own or until they are removed at your first post-op appointment. You may let soap and water gently wash over your incisions, but do not scrub them. Pat them dry with a towel, then recover each of the incisions with a band-aid if desired. You may not soak your shoulder in a bathtub or go into a pool or hot tub until incisions are well healed (usually takes a few weeks).

Physical Therapy

Therapy typically starts within 2-3 days after surgery. Most patients go to physical therapy 2-3 times per week for about 4-6 weeks.

Driving

You may drive once you have stopped the narcotic pain medication and can comfortably move your shoulder. You should not wear a sling while driving.

Sling

Because your surgery did not require a “repair,” the sling is only for comfort. It may be removed whenever you are comfortable. Most patients wear the sling for 1-2 weeks. Your therapist will let you know when it is safe to wean.  You do not need to wear your sling while sleeping.

Return To Work

This depends on the nature of your job. If you have a desk job or can work from home, you may be able to do computer/phone work within 1 week of surgery. If you have a labor-intense job, or job that requires heavy lifting/repetitive use of your shoulder, you may need to be off work for at least 1 month. We can give you work restriction notes at each post operative visit if necessary

Other Tips

If you are having minimal pain and would like to switch to a milder medication, please take Tylenol/acetaminophen. Do not take Tylenol and Norco together (this would be too much acetaminophen). Do not exceed more than 4000mg of Tylenol/acetaminophen in a 24 hour period

Allow yourself to rest and recover during the weeks following surgery. Even if your shoulder is feeling better/less pain, don’t overdo it.

Plan ahead- if you need a refill on pain medication, our office requires 24-48 hours notice for your request to be processed. We cannot refill medications after hours or on weekends.

Rehabilitation is one of the most important aspect of shoulder surgery. Work hard in therapy to get your motion back!

Sport Specific Guidelines

We know you are eager to return to your sports and hobbies. We want to guide you safely through that process. Please use the following as a guide.

GOLF

1 week post op: Putting
1 month post op: If you have full and comfortable motion, you may take full swings with your irons and may progress to your driver as tolerated

WEIGHT LIFTING

Please follow the instructions of your physical therapist. Once you are nearing the end of physical therapy, your therapist can create a safe “return-to-lifting” program. Physical Therapists and Athletic Trainers can outline a specific plan for you. You may do lower body weight lifting and core exercises within 1-2 weeks after surgery.

SWIMMING

You may get in a pool at 2 weeks post-op, as long as your incisions are well healed. You should wait to swim until you have full and comfortable shoulder motion. For most patients, it will be 1 month post-op before swimming and up to 2-3 months until your stroke returns to normal.

RUNNING

You may use an elliptical machine or treadmill 3 days after your surgery provided your arm is holding a stationary hand rail. You may return to jogging 2-3 weeks after surgery as long as the shoulder is not hurting too much while you run. You may progress to your normal running routine 4-6 weeks after surgery.

OTHER SPORTS

Once you have full and comfortable motion and your physical therapist feels that your strength has progressed well, you may resume sports without restrictions. For most patients, it is 1 month after surgery before return to sports. If surgery is on your throwing arm it may take you 6-12 weeks to return to normal velocity and control of your throwing arm. Please ask us about returning sooner if you’d like.

Recovery Time Points

7-10 days post-op

During your first office visit, we will review surgical pictures and discuss the procedures. Please feel free to ask any questions. Please bring your surgical pictures with you.

4-6 weeks post-op

You will have another office visit to check your range of motion and pain level. Most patients will have full shoulder motion at this time. You may resume any activity that you’d like. If you are happy with how the shoulder feels, you may follow-up as needed after this office visit. You are welcome to make future appointments.

Frequently Asked Questions

When can I drive?

You may drive once you have stopped the narcotic pain medication and can comfortably move your shoulder. You should not wear a sling while driving.

What about medications?

Take the narcotic medication regularly for at least the first few days after surgery. If you have having minimal pain and would like to switch to a milder medication, please take Tylenol/acetaminophen (extra strength or regular). Do not take Tylenol and norco together (this would be too much acetaminophen). Do not exceed more than 4000mg of Tylenol/acetaminophen in a 24 hour period.

What motions should I avoid?

Use pain as your guide, while progressing activities.  Your therapists will begin passive range of motion and progress you to full active motion within a few weeks of your surgery, at that time you will begin strengthening.  Most patients are able to return to full activities in 4-6 weeks.

 

When can I drive?

You may return to driving when you are no longer taking any narcotic pain medications.

 

What about sleeping?

You may remove your sling to sleep even on the first night after surgery. Some people find it more comfortable to sleep upright (in a recliner chair) for a few days to weeks after surgery- this is optional.