Shoulder Rotator Cuff Repair Post-op Packet

Transcription

1 L. Ryan Smart, MD Shoulder Rotator Cuff Repair Post-op Packet Contents: Post-op Reference Sheet Exercise Sheet Surgical Pictures Physical Therapy Prescription SOS Fayetteville 4115 Medical Center Drive, Fayetteville, NY Tel: , Fax: SOS Liverpool 5100 West Taft Road, Liverpool, NY Tel: , Fax:

2 L. Ryan Smart, MD Patient Post-op Reference Sheet: Rotator Cuff Repair Pain Control and Ice A pain medication prescription will be provided prior to discharge. You may take the prescribed medication as directed. You should expect to experience moderate shoulder discomfort for several days and even weeks following the surgery. Patients often only need prescription narcotics for a few days following surgery and then can switch to over-the-counter medications Tylenol or Ibuprofen. Ice should be applied to the shoulder up to three times a day for 20 minutes until swelling subsides Wound Care If the bandage is draining, reinforce it with additional dressings for the first 24 hours. After 24 hours, remove the bandage and place band aids over the incision sites. Showering is acceptable after 48 hours, do not submerge the shoulder (ie no bathing) Rehabilitation/ General Post-op Care At the completion of surgery, you will have a sling placed on your arm. Maintain the sling in place at all times with exception of showering Take one 325 mg (full strength) aspirin daily for 14 days (unless otherwise instructed) to prevent blood clots. Follow up with Smart within 2 weeks from the date of surgery. Many times this appointment will be made for you ahead of time. Eat a regular diet as tolerated and please drink plenty of fluids. You are unable to drive a car as long as you need to utilize a sling. For patients who had only a decompression driving may start when they are comfortable, often 3-7 days after surgery. Call office for Temperature >102 degrees, excessive swelling, pain or redness around the incision sites. Plan at least a week away from work or school. Utilize this time to decrease swelling and participate in your home exercise program. You may be able to resume work (depending on type of work and setting; very variable) once the pain and swelling resolves. The above are guidelines and only intended as generalities.

3 Post-operative exercise program prior to the start of traditional physical therapy Pendulum, Circular - Bend forward 90 degrees at the waist, using a table for support. Rock body in a circular pattern to move arm clockwise 10 times, then counterclockwise 10 times. Do 3 sessions a day.

4 Rehabilitation for patients who underwent a rotator cuff repair will vary depending on extent of surgery and pathology, see prescription for specifics. The following are only general recommendations Post-op Rehabilitation Protocol Rotator Cuff Repair Phase 1 (Weeks 0-3): Goals: Minimize effusion, Decrease shoulder pain, utilize sling, and participate in home exercise program Treatment plan: 1) Swelling control with ice 2) Maintain arm in sling to encourage healing 3) Elbow and Wrist motion 4) Participate in exercises in back of packet Phase 2 (Weeks 3-8): Goals: Initiate formal physical therapy, Full passive ROM, remove sling Treatment plan: 1) swelling and pain control 2) Progressive Passive to active assisted range of motion activities 3) Scapulothoracic range of motion and strengthening 4) Wrist and elbow range of motion and strengthening Phase 3 (Weeks 8-12): Goals: Full active range of motion, rotator cuff and shoulder PRE (do not increase inflammation or overwork cuff musculature), aerobic training, Treatment plan: 1) swelling and pain control 2) Progressive active range of motion strengthening exercises 3) Scapulothoracic strengthening exercises Phase 4 (Weeks 12-24): Goals: Home exercise program, rotator cuff and shoulder PRE, aerobic training

5 Do not start Physical Therapy until given instruction to do so This may be 4-6 weeks after surgery. Bring prescription to your first PT session L. Ryan Smart, MD Physical Therapy Prescription Patient Name: Diagnosis: Rotator Cuff Repair Prescription: Passive range of motion (PROM), modalities for edema and pain reduction, Scapulothoracic exercise, Postural education Frequency: 2-3x a week Precautions: Signature SOS Fayetteville 4115 Medical Center Drive, Fayetteville, NY Tel: , Fax: SOS Liverpool 5100 West Taft Road, Liverpool, NY Tel: , Fax: Frequently Asked Questions

6 1) When do I have to use the sling? The sling must be worn at all times except when you are sitting and the arm can be supported with a pillow. The sling should be removed for the pendulum exercises as well as occasional range of motion of elbow, wrist and hand. 2) I have noticed some bruising of the arm by the biceps and triceps muscle, is this normal? It is normal to have bruising throughout the arm. Gravity will move blood ( a normal result of the surgery) down the arm, this results in bruising remote from the direct surgical site. 3) Can I type or write? How much can I lift with the arm You can type and write while the arm is supported in the sling. You can lift no more the 1 lb with the hand during the initial post-operative period. This limits ones activity to tasks such as stirring a coffee or using a remote control. 4) When can I drive? You cannot drive while utilizing a shoulder sling. Local driving comes once confidence is built up. Obviously narcotic pain medication should be completed prior to initiating driving. 5) Can I exercise my legs? You have no restrictions on exercise of the lower extremities. Be careful not to fall with any walking program. For this reason, we do not encourage treadmill use during the initial post-operative period 6) When can I expect to be pain free? This depends on many factors including, extent of tear, presence of osteoarthritis and patient respect for the recovery period. 7) I have become constipated since the surgery, what should I do? Post-operative constipation is often a side effect of the narcotic pain medication. There are numerous over the counter remedies for this problem. Your pharmacist is a great resource for this. Often Colace, a stool softener will do the trick. If you go past 3 days without a bowel movement please call the office or you primary care physician for guidance.