After shoulder arthroscopy

Pain control

• Use Extra-Strength Tylenol 1000 mg every 6 hours on schedule, without exceeding 3,000 mg in 24 hours or double-dosing combination medicines
• Ice 20 minutes on and 20 minutes off as tolerated for the first 72 hours, then as needed during the first week; never place ice directly on skin
• Use narcotic medicine only for breakthrough pain; most patients stop within 5–7 days
• Do not take Advil, Aleve, Motrin, or another NSAID unless Dr. Ramirez specifically approves it because it may slow tendon healing
• Use a stool softener while taking narcotics

Sling, sleep, and hygiene

Wear the sling and bolster at all times, including while sleeping, unless Dr. Ramirez says otherwise. Most repairs require 4–6 weeks. Remove it briefly for hygiene, dressing, and elbow, wrist, and hand exercises while keeping the elbow at your side. A recliner or propped-up position is usually most comfortable for the first 1–2 weeks.

Wound care

After 72 hours, remove the shoulder wrap and leave the Steri-Strips in place. Shower after 72 hours only if the incisions are covered and kept dry; shower with the arm at your side and do not scrub or direct high-pressure water at the sites. Do not soak in a bath, pool, hot tub, lake, or ocean for at least 4 weeks and until the incisions are fully healed.

Weeks 0–2

• Bend and straighten the elbow, wrist, and fingers several times daily
• Squeeze the red ball attached to the sling and perform scapular squeezes
• Perform gentle pendulums only if Dr. Ramirez permits them
• Keep the sling on at all times
• No active lifting of the arm, reaching behind the back, or lifting more than a coffee cup

Weeks 2–6

Formal therapy usually starts after the first postoperative visit at about 14 days. Begin gentle passive range of motion only as directed. Continue to avoid active arm lifting, pushing, pulling, and overhead reaching.

Weeks 6–12 and months 3–6

Active motion begins as directed during weeks 6–12. Light strengthening after a cuff repair usually starts around week 12. Progressive strengthening and return to activity follow during months 3–6. Most patients feel close to normal by 4–6 months, but improvement continues for up to a year. A repaired tendon needs roughly 12 weeks to heal back to bone.

Driving and work

Do not drive while taking narcotic medicine or wearing the sling. Most patients resume driving at 2–4 weeks when they feel safe; first test in an empty parking lot or quiet street. Desk or one-handed work may be possible within 2 weeks. Light-duty restrictions commonly continue through weeks 10–16, and return to full duty is generally expected during weeks 16–24 after a repair, depending on the work and recovery.

Call promptly for

• Fever above 101°F or chills
• Increasing redness, warmth, swelling, or cloudy or foul-smelling drainage
• Pain that is worsening or not controlled by medication
• Numbness or tingling that does not improve 24–48 hours after the block wears off
• Significant hand or forearm swelling or any drainage after the wrap comes off
• Go to the emergency room for chest pain, shortness of breath, calf pain with swelling, or sudden severe arm swelling