Having treatment
After your shoulder operation
What to expect in the first days and weeks after shoulder surgery, and how to look after yourself at home.
Prepared by Mr Phil Wright, consultant shoulder and elbow surgeon. For educational purposes only.
The short version
This guide covers the practical side of recovering from keyhole or open shoulder surgery. Your own instructions, given on the day and by your physiotherapist, take priority wherever they differ: how long you wear a sling and when you start moving the arm depend on exactly what was done.
The first 24 hours
The nerve block
Most shoulder operations are done with a nerve block as well as a general anaesthetic. It makes the arm numb and heavy for anything from 8 to 24 hours. While it lasts, keep the arm supported in the sling and protect it from knocks and heat, because you will not feel them.
Start your painkillers before the block wears off, and take them regularly for the first few days whether or not the shoulder hurts at that moment. Pain is much easier to keep under control than to bring back under control. As the block fades, pins and needles in the hand are normal.
Swelling and bruising
Keyhole surgery uses fluid to open up the joint, so the shoulder is often swollen at first and the dressings may leak a little pink fluid. This settles within a day or two. Bruising can track down the arm and onto the chest over the first week.
The sling
The sling protects the repair and makes the arm comfortable. How long you need it varies widely.
| Operation | Typical time in a sling |
|---|---|
| Decompression, AC joint excision, release for frozen shoulder | A few days, for comfort only. Move the arm as soon as you can. |
| Stabilisation for dislocation | About 3 to 4 weeks. |
| Rotator cuff repair | About 4 to 6 weeks. |
| Shoulder replacement | About 4 to 6 weeks. |
While in the sling, take the arm out several times a day to straighten the elbow and to move the wrist and fingers, so they do not stiffen.
Looking after the wound
- Keep the dressings dry and in place until your wound check, usually at 10 to 14 days. If a dressing comes loose, replace it with a clean dry one.
- You may shower with waterproof dressings once you feel steady. Do not soak the shoulder in a bath until the wounds have healed.
- Stitches are often dissolvable. If yours need removing, you will be told.
Sleeping, washing and dressing
- Sleeping. The first few weeks are often easier propped up on pillows or in a reclining chair. A pillow behind the elbow stops the arm dropping back. Keep the sling on at night if you have been told to.
- Washing. Lean forward and let the arm hang to wash under it. Do not lift the arm away from your side using its own muscles if you have had a repair.
- Dressing. Loose, front-opening clothes are easiest. Put the operated arm into the sleeve first, and take it out last.
Exercises
You will be shown what to do before you leave hospital and physiotherapy will be arranged. The exercises are the part of the treatment that you carry out, and the result of the operation depends on them. Little and often works better than long sessions. Some discomfort is expected; sharp or increasing pain is a reason to ease off and ask.
Driving and work
Driving
You should not drive while wearing a sling. After that, the test is whether you can control the car safely, including steering quickly and making an emergency stop, without pain holding you back. For minor keyhole surgery that is often one to two weeks; after a repair or replacement it is usually six to eight weeks. Tell your insurer you have had an operation.
Work
Desk work is often possible within one to two weeks, in a sling if necessary. Light manual work usually needs six to twelve weeks after a repair. Heavy or overhead work can take four to six months. A fit note can be provided.
When to seek help
- increasing redness, heat or swelling around a wound, discharge after the first two days, or a fever
- pain that is getting worse and is not controlled by your painkillers
- numbness or weakness in the arm or hand that is still present 48 hours after surgery
- a hand that is cold, pale or blue
Call 999 for chest pain or sudden breathlessness. A painful, swollen calf needs urgent same-day assessment.
Sources
- Driver and Vehicle Licensing Agency. Driving with medical conditions: you must be able to control the vehicle safely at all times.
This guide is for educational purposes only. It is not to be used in place of consultation with a medical professional, and it cannot take account of your own circumstances.