Total Shoulder Replacement

After the first few days, 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; I recommend using Senokot-S, an over-the-counter stool softener, 1 tab twice a day to help prevent this.  You can increase to 2 tabs twice a day as needed.  In addition Miralax or Milk of Magnesia can be used if no results with the Senokot-S.

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.

Use ice or a cold therapy unit constantly for the first 48 hours, then as frequently as needed. After 48 hours, it is recommended to ice at least 3 times daily for 20 minutes each time. The ice will will help with post-operative pain and swelling.

You will have a soft dressing applied over your incision. 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 and blood 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.

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 will have steri-strips over your incision (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. There are no sutures to be removed- sutures are absorbable under the skin. You may let soap and water gently wash over your incision, but do not scrub. Pat the incision dry with a towel. Generally, there is no need to re-apply a bandage over the steri-strips. You may not soak your shoulder in a bathtub or go into a pool or hot tub until incisions are well healed (wait about 1 month to be safe).

Therapy typically starts 1-2 weeks after surgery. The timing for when you begin physical therapy will be individualized based on your surgery.

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. A few x-rays of the shoulder will be obtained at this first post-op visit.

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.

Please do not attempt driving for at least 4 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.

The abduction sling has 2 components: Sling and waist portion. The entire sling should be worn at all times when you are up and walking around.  A few times/day, while you are sitting/resting, you may remove the sling as long as your upper arm/shoulder stays near your body.  You may take off the entire sling up to 3 times daily to gently bend and straighten your elbow while keeping your shoulder near your body.  

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 doing some motion of the shoulder on your own. Immediately after surgery, 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.

Please try to wear the sling while you are sleeping for 4-6 weeks after surgery- this provides good support to the shoulder.  You may remove the waist portion of the sling to sleep if you are too uncomfortable, but try to keep your shoulder near your body (placing pillows around and behind the shoulder may help).   Some people find it more comfortable to sleep upright (in a recliner chair) for a few days to weeks after surgery- this is optional.  

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. However, you may not drive yourself to work for at least 4 weeks.

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 months. You will have restrictions for up to 6 months after your shoulder replacement. Some employers allow light-duty, and we can give you work restriction notes at each post operative visit if necessary.

Dr. Sostak Total Shoulder Replacement