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Shoulder Arthroscopy: Rotator Cuff Repair

Dr. Timothy S. Petsche, sports medicine orthopedic surgeon

Message from Dr. Petsche…

Whether you or one of your family members or friends is considering shoulder rotator cuff repair, or are scheduled for surgery, I understand this can be a stressful time. And you may have forgotten some of the information we discussed during our last visit, or forgot to ask me a specific question about what to expect. This site is designed to help us stay connected, and to answer some of the most common questions patients ask me about shoulder rotator cuff repair.

If you’re scheduled for surgery, please sign up below to receive pertinent post surgical and recovery information from me via text message or email. I want to make sure that both you and your family members have timely information at your fingertips during the days, weeks, and months following your surgery…so you can get back to enjoying the activities you love.

Do you have a surgery date?

Click below to sign up for our post surgery and recovery information program.
SIGN UP HERE

POST-OPERATIVE INSTRUCTIONS

PAIN MEDICATION
ICE
MILD PAIN
DRESSINGS
STIM MACHINE
BATHING
PHYSICAL THERAPY
WHEN TO CALL
AFTER SURGERY
PREVENTION OF BLOOD CLOTS
OFFICE VISIT
DRIVING
SLING
MOTIONS TO AVOID
SLEEPING
RETURN TO WORK
DOWNLOAD POST-OP INSTRUCTIONS
PAIN MEDICATION

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.  

MEDICATION REFILL POLICY: Refills on prescription medications are processed Monday through Friday 8:30am-5pm. New prescriptions or refills cannot be issued after hours, on weekends or holidays.

Please request refill through the patient portal on www.fvortho.com. If you are not currently registered on our portal, please stop at the front desk for assistance or contact the portal help desk at 630-524-0140

After requesting the refill, please allow 24-48 hours for your request to be processed. It may be wise to contact your pharmacy to ensure that the prescription is ready.

ICE

Use ice or a cold therapy unit as much as possible for the first 48 hours, then as frequently as needed.  For example, 20 minutes of ice to shoulder 5 times daily after the first 48 hours would be a good amount.

Iceman Cold Therapy Unit- click to learn more

MILD PAIN

If you are 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.  Try to avoid medications such as Advil, Aleve, Motrin, or Ibuprofen for about 3 months after surgery- some studies show that these medications could slow healing of your surgical repair.

DRESSINGS

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.

STIM MACHINE

A stim machine may be ordered for you to be used post-operatively.  If so, the stim pads will be placed under your dressing.  The purpose of the machine is to help gently stimulate the muscles to bring blood flow to the shoulder to help with healing and help relieve post-operative pain.  You will be instructed on proper use and operation of the machine.

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 6 weeks after surgery. The timing for when you begin physical therapy will be individualized based on your surgery.

WHEN TO CALL

Please call our office at (630) 584-1400 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, the answering service will contact the physician assistant 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.

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.

PREVENTION OF BLOOD CLOTS

DVT information sheet

Please click on this document to learn more about deep vein thrombosis (DVT) and prevention

OFFICE VISIT

Your first post-op visit will be scheduled 7-10 days after surgery. At this visit, we’ll check your incisions and answer any questions you may have.

DRIVING

Please do not attempt driving for about 6 weeks after surgery.  This is for your safety, as well as other drivers- please do not attempt to drive with only one hand.  Reasons for no driving post operatively: A quick, reactive motion of the shoulder while driving could damage your surgical repair.  Secondly, you should not drive while taking any narcotic pain medications.

SLING

The “arc” sling has 2 components: Hinged waist strap and sling.  The 2 components should be worn at all times when you are up and walking around.  While you are sitting/resting, you may remove the sling occasionally as long as your shoulder stays near your body.  

The purpose of the waist strap (with the small bar that extends) is to hold the shoulder in a slightly “abducted” position, which allows for less tension on the rotator cuff during the healing process.
A few times daily you may remove the sling and gently bend and straighten your elbow, keeping your shoulder near the body.  Typically the sling will be worn for 6 weeks.  However, the use of the sling may be individualized based on your surgery.  

MOTIONS TO AVOID

Do not lift shoulder out in front of body, out to your side, or reach behind your back until your physical therapist has progressed you to that point in therapy. Usually, it is 4-6 weeks before you’ll be moving the shoulder on your own.  It is ok to bend/straighten your elbow and use your hand to do things like typing (as long as your shoulder stays near your body).  For example, you should put a computer keyboard in your lap instead of reaching out on a table for your keyboard). Initially in therapy, your therapist will do “passive motions,” which means your muscles won’t be doing the work.  This protects your surgical repair and allows your body to heal.

SLEEPING

Please try to wear the sling while you are sleeping for 6 weeks after surgery- this protects the repair and provides good support to the shoulder.

Some people find it more comfortable to sleep upright (in a recliner chair) for a few days to weeks after surgery- this is optional.

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 job, or job that requires heavy lifting/repetitive use of your shoulder, you may need to be off work for months. You will have restrictions for up to 6 months after your rotator cuff repair. Some employers allow light-duty, and we can give you work restriction notes at each post operative visit if necessary.

DOWNLOAD POST-OP INSTRUCTIONS

DR. PETSCHE ROTATOR CUFF REPAIR

RECOVERY TIME POINTS

7-10 days
6 weeks post-op
3 months post-op
3-4 months post-op
6 months post-op
7-10 days

You will have your first office visit. You will review surgical pictures and discuss the procedures. Please feel free to ask any questions.

6 weeks post-op

You will be able to discontinue your sling/immobilizer around this time. You may begin to use your arm for daily activities, but should not lift more than a few pounds. For exercise, you may do a stationary bike, walking, and some lower-body exercises but should avoid running or elliptical machines (this will cause too much jostling of the shoulder).

3 months post-op

You may continue to use your arm for daily activities, but should avoid any aggressive lifting or throwing motions. You should have very good motion of your shoulder at this time. For exercise, you may stationary bike, light jog, elliptical machine, and continue doing your physical therapy strengthening exercises.

3-4 months post-op

You will likely be finished with physical therapy by now.  Please continue with your home exercise program! Keep in mind you still have some restrictions for your shoulder (until the 6 month point).

6 months post-op

If things have progressed as expected, you will likely be able to resume all activities as tolerated. Congrats- you no longer have any restrictions for your shoulder! Understand that full strength may still take a few more months.

MOST COMMON QUESTIONS

How should I be using my sling?
What motions should I avoid?
When can I drive?
How should I be sleeping?
What about pain medications?
How can I learn more about rotator cuff tears?
How should I be using my sling?

The sling should be worn at all times when you are up and walking around.  While you are sitting/resting, you may remove the sling occasionally as long as your upper arm/shoulder stays near your body.  You may gently bend and straighten your elbow, keeping your upper arm near the body.  Typically the sling will be worn for 6 weeks to protect your surgical repair.  However, the use of the sling may be individualized based on your surgery.

If you have an “arc” sling (with waist portion): The waist strap should be on to hold the shoulder in a slightly “abducted” position, which allows for less tension on the rotator cuff during the healing process.

What motions should I avoid?

Do not lift shoulder out in front of body, out to your side, or reach behind your back until your doctor or PA has told you to.  Usually, it is 6 weeks before you’ll be moving the shoulder on your own.  It is ok to bend/straighten your elbow and use your hand to do things like typing (as long as your shoulder stays near your body).  For example, you should put a computer keyboard in your lap instead of reaching out on a table for your keyboard).

Initially in therapy, your therapist will do “passive motions,” which means your muscles won’t be doing the work.  This protects your rotator cuff/labrum repair and allows your body to heal.

When can I drive?

Please do not attempt driving for 6 weeks after surgery.  This is for your safety, as well as other drivers- please do not attempt to drive with only one hand.  Reasons for no driving post operatively: A quick, reactive motion of the shoulder while driving could damage your surgical repair.  Secondly, you should not drive while taking any narcotic pain medications.

How should I be sleeping?

Please try to wear the entire sling while you are sleeping for 6 weeks after surgery- this provides good support to the shoulder.  Some people find it more comfortable to sleep upright (in a recliner chair) for a few days to weeks after surgery- this is optional.  

What about pain 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.  After your rotator cuff repair/labral repair, try to avoid taking NSAID anti-inflammatories such as Advil (Ibuprofen), Motrin, and Aleve (Naproxen)- there are studies that show these anti-inflammatories may slow healing of your repair.  If, for example, you get a headache and would like to take an occasional anti-inflammatory that is fine.

How can I learn more about rotator cuff tears?

Visit AAOS site

Surgery for rotator cuff tears

SPORTS SPECIFICS

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
BASKETBALL
FOOTBALL
WRESTLING
BASEBALL/SOFTBALL
WEIGHT LIFTING
GOLF

8 weeks post-op: Putting

3-6 months post-op: Chipping

5-6 months post-op: Pitching, and half-swings with your short irons

6 months post-op: Full but gentle swings, slow and gradual return to play.  Avoid bad lies.  Avoid hitting too much of a divot.

8-12 months: Normal activity

BASKETBALL

3 months post-op: jogging, light dribbling drills

4-5 months post-op: Free-throws, light passing drills,  light “shooting around,” but no contact

6 months post-op: Cautious return to play with less contact as you gain strength

8-12 months post-op: Normal activity

FOOTBALL

3 months post-op: Jogging.

4-5 months post-op: Agility/plyometric training with the guidance of a professional.

6 months post-op: Cautious return to play.

8-12 months:  Normal activity.

WRESTLING

3 months post-op: Jogging

4-5 months post-op: Agility/plyometric training with the guidance of a professional

6 months post-op: Cautious return to play.

8-12 months:  Normal activity.

BASEBALL/SOFTBALL

3 months post-op: Jogging

4-5 months post-op: light throwing drills (with guidance of physical therapist)

6 months post-op: Cautious return to play.

8-12 months:  Normal activity.

WEIGHT LIFTING

Please follow the instructions of your physical therapist.

Once you are nearing the end of physical therapy (typically 3 months post-op), your therapist can create a safe “return-to-lifting” program.  Physical Therapists and Athletic Trainers can outline a specific plan for you.

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