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Shoulder Surgery (non-immobilised)

Introduction

This webpage will provide you with some information and exercises for you to follow after your shoulder surgery. This page is for rehabilitation following surgeries that do not involve immobilisation which means you will not have your arm in a sling for longer than one day. These include:

  • Subacromial decompression
  • Capsular release
  • Acromio-clavicular joint resection

If you have been told after surgery you will be in a sling for a longer than one day then this is not the correct information and you should refer to the Shoulder Surgery: immobilised information .

What Surgery Involves

Your keyhole surgery (arthroscopy) involves the surgeon making small incisions around your shoulder and using a tiny camera to look inside your shoulder joint. They will look for any areas of possible damage and undertake any necessary treatment. Sometimes the treatment required can be more or less than anticipated prior to surgery. 

You will have a general anaesthetic which means you will be asleep. In some cases, we may use a nerve block to numb the area.

After surgery your arm may be in a sling. This is for initial support, as after your procedure there will be little to no movement in the arm and hand. This should not last for longer than 24 hours.  Once you have regained full sensation and movement of your arm it is safe to take the sling off and discard it. You will probably get home on the day of your surgery or on the day after. 

The ward physiotherapist will see you on the ward after your surgery to provide advice and complete exercises with you. They will refer you for further physiotherapy as an outpatient. You will be contacted with an appointment by telephone or letter with your outpatient physiotherapy appointment.

Post Operative Advice

Pain:

There will be some pain and discomfort after your surgery. You should take painkillers as prescribed, do not wait for your pain to worsen prior to taking pain relief.

Wound:

You will go home from the ward with a dressing over your wound. The nursing staff will give you dressings to use at home and tell you about when and where to get your stitches out. This is usually about ten days after your surgery. However, you will be left with small scars around the shoulder

Sleeping:

We advise you to sleep in any comfortable position. However, sleeping on your operated shoulder will probably increase your pain.

Washing and dressing:

Avoid getting your wound dressing very wet.

When dressing your upper body place your operated arm into your clothes first for comfort. When undressing remove your operated arm last.

Are there things I should avoid after my surgery?

There are no movements of the shoulder that you need to avoid unless we tell you otherwise. You can expect your arm to be uncomfortable when moving. Do not be frightened to start moving your arm and start the exercises.

We recommend you start light activities when you feel able this should be in the days following surgery. Do not lift anything heavy with your operated arm for at least 6 weeks.

If your arm is painful on certain movements then it is best not to force or push these movements and speak with your physiotherapist.

When can I start to drive again?

You should not drive for 2 weeks after your surgery. Do not drive until you have regained full control and movement of your arm. Before driving sit in your car and try using all of your controls to make sure you are able to do so comfortably. When you return to driving, start with a short journey to ensure you are comfortable and in control.

We also recommend that you speak with your insurance company before you start to drive. The law states you should be in complete control of a car to drive.

When Can I Return to Work?

This depends on your occupation, most people can return to work within 6 weeks of their surgery. If your job involves only small movements of your operated arm you may be able to return to work within 1 week.

Please discuss this with your surgeon, doctor or physiotherapist.

When Can I Return to Hobbies and Sport?

This depends on your pain, shoulder movement and strength. Pain would be a sign that you are not ready to return to a specific activity.

Your physiotherapist will guide your return to heavy activities and sport. We normally recommend that you avoid specific sporting activities that involve the operated arm, such as golf and racquet sports for 3 months.

Physiotherapy

The exercises included in this booklet are safe to start once you have the feeling back in your arm, normally the same day or the day after your surgery. It is important that you attempt to do these exercises as instructed to regain the movement and strength of your shoulder.

You will be referred for physiotherapy by the ward physiotherapist – this will usually be within a few weeks of your surgery. You will need to attend physiotherapy to continue your rehabilitation.

Exercises

It is normal to feel aching, discomfort or stretching sensations when doing your exercises. We recommend that you do each exercise 15 – 20 times and repeat this three times per day with at least 2 – 3 hours in between.

  • Pendular: Allow your operated arm to hang by your side and allow it to swing gently forward and backward.
  • Posture: It is important not to slump or have round shoulder posture after your operation. You should practise correct posture regularly.
  • Shoulder Raising: Hold a stick in both hands and slowly raise this upwards, your non-operated arm should help assist movement of your operated arm.
  • Shoulder Side Movements: Hold a stick in both arms at waist level. Gently push your operated arm up and outwards, using your operated arm to assist the movement.
  • Shoulder Rotation: Hold a stick in both hands with your elbows at waist height. Push your operated arm out to the side using your non operated arm to help. You should keep your elbows at your waist, only your hand should move out.
  •  Wall slide: Place your hand flat on wall in front of you at waist or chest height, which ever you are comfortable with. Slide your operated arm up the wall. As your arm raises you may need to step closer to the wall.
  • Table Flexion: place your hands onto flat surface or table. Slowly step backwards keeping your hands on the table bringing your head and shoulders forward into flexion.
Follow Up

All patients will attend follow up appointment but trauma and elective patients will be seen at different clinic types and at different timescales post-operatively.

You will be given your first return appointment by the nursing staff prior to discharge from the ward.

If you have any concerns following surgery please contact your follow up clinic, your GP or physiotherapist for advice.

If you have any urgent concerns please call NHS 24 on 111.