Advice on dominating surgical rehab.

November 13, 2012 7:25 PM

Shoulder surgery rehab tips, hints and recommendations

The closest I could find via search was this:

http://ask.metafilter.com/189689/Help-me-hack-my-postshoulder-surgery-recuperation

which provided practical advice about getting around and about after a shoulder surgery.

I am having my labrum operated on in a few days and was looking for advice regarding the best rehab instructions? I'm hoping to be back and active come the spring next year and will take physical therapy very seriously, but any specifics, hints, tips and recommendations would be extremely appreciated. I'm particularly inspired by athletes that have rebounded from serious surgery in record time (e.g. Adrian Peterson post ACL surgery).

Thanks so much in advance.

posted by Hurst to Health & Fitness (10 answers total)

I've had both rotator cuffs repaired and am currently typing with a broken collarbone.

Day of surgery you will be wiped out. Pain + doped to the gills + intubation after effects is no fun. Take the pain medication and try to sleep/zone out.

Next couple days are tough since the surgical dressing will likely still be in place. Nothing much to do but eat & sleep. Sleeping in bed was tough for me and I spent the first week or so sleeping in a recliner.

After the dressings are off, you can shower which is great.

Have loose clothing like sweats ready. My wife would cut open the should of old t-shirts so I could in/out of them easily without raising my arm.

Use the special sling they will give you. Don't try to use the arm at all. AT ALL. You want the healing to happen here. Take the pain pills. Don't be active. Rest as much as you can.

Accept all the help you can with simple things like making food, getting dressed, etc. Don't be macho, be humble and let people help you.

After a couple days you can try walking around a bit to get the blood flowing, but don't try to use the arm. Getting the swelling & inflammation down is job one. I use a special ice pack for the shoulder to help reduce the pain & inflammation. The icing makes a big difference for me.

Wait until you get the go ahead for therapy. If you start too early, you can reinjure yourself. When you start therapy, do the exercises at home. Also, walking for cardio promotes healing.

After the second surgery, it was about a month until I was back on the bike, being very careful. Two months till I felt about normal. About 6 months, until most all pain/soreness was gone.

Let me know if you have specific questions.

Good luck.
posted by Argyle at 7:48 PM on November 13, 2012 [1 favorite]

Response by poster: Thanks Argyle. Looks like I'm in for a battle.
posted by Hurst at 8:12 PM on November 13, 2012

Hope I didn't scare you. The main issue is letting yourself heal at first. I find it real tough to sit still, nap, and simply watch TV. Let alone let my wife do all the household stuff and baby me.

If you can be humble and accept some help, you'll do great.
posted by Argyle at 9:42 PM on November 13, 2012

Mine was fine. Did rehab. Really did not have a ton of pain at all. My doctor was great. Don't worry, and do what they say. I had a torn labrum.
posted by Ironmouth at 10:12 PM on November 13, 2012 [1 favorite]

I had SLAP and Bankart procedures that came out totally successful.

The earlier thread has my general advice but here's some specific to PT:

1. Do not trust the surgeon's assistant to know what is what. Mine was a nitwit. Get thee to a good, reputable PT house post haste. So much the better if they are fascinated by pitchers. Pitchers thrash their shoulders and they're the most intense challenge for shoulder reconstruction.

2. Be careful with your shoulder. Don't do stuff unless they say you can. Most importantly, driving. When you are driving you are apt to make a sudden movement if you think something is going wrong and those can be reflex. You do -not- want to provoke reflex reactions because a) they won't work and b) you will do yourself harm particularly in the first couple weeks.

3. Take your pain killers. Do not think tough guys / cowgirls can do without. They make the musculature around your surgery settle down and that is good for healing. They might make you cross-eyed and bored. Have a lot of music to listen to. If you react like I do you won't be able to focus on a book or a television.

4. If you get a Polartec or similar cold-water recirculation system as part of your insurance package, use it! They're wonderful. I still have mine and if that is *not* part of your package I can send it to you.

You'll probably be appalled that the whole limb is not under command. It will flop around and be heavy and useless. It's OK if it's like that. The sensations will come back and your arm will be under command of the wheelhouse after a few weeks. Treat it as a sweet miscreant, tenderly. Be patient. I had my procedure at age 51 and it took a whole year before I was climbing at my previous level.
posted by jet_silver at 10:15 PM on November 13, 2012 [1 favorite]

Hey, that was my question you linked to!

I believe that this piece of advice from jet_silver made a tremendous difference in my healing and recovery:

First - get the chilling device that is like an ice chest with a pump, that connects to a pad that fits over your shoulder. It keeps the swelling down and promotes healing. Get a lot of ice, many pounds, and be ready to open the bags one-handed (drop on floor, cut open, bail ice into ice chest).

The machine was not covered by my insurance, but it was inexpensive enough that I decided to rent it just for the weekend; I ended up keeping it an additional week (at least) because it was so helpful. I cannot overstate how glad I am that I listened to that advice.

I didn't do anything special other than follow my rehab and PT instructions faithfully and take great caution in keeping my arm immobile. I also wore the brace exactly as I was told, from 24 hours a day, to just sleeping with it, to just wearing it when I went outside.

On preview: Thanks again, jet_silver!
posted by Room 641-A at 10:34 PM on November 13, 2012

Ask the surgeon what kind of pain is to be expected, and what should be avoided. Something like "I know the rehab is going to hurt. How do I know when to push it, and when to back off?"
posted by gjc at 5:19 AM on November 14, 2012

I had this SLAP lesion surgery three years ago. Spent about a month recovering/wearing the triangular pillow-sling. Do take the pain pills, but I'd also recommend a fiber supplement. (If you've never had a painkiller rX, constipation is REAL.)

After I got rid of the sling, I was taking inventory of every slight movement I could/couldn't make without twinges of pain. So, be wary of sudden movements beyond the axis of stiffness.

I'm not a religious man, but I found it in PT. Do it multiple times a day. The most helpful/fun part of my PT regiment was this pulley system that attached to the top of a door. Doc should be giving you one of these, and sending you to PT (if it's covered). Be patient, but also vigilant. If you're doing it right, PT ≠ pain.

Lastly, I could not have fully recovered without great help from my yoga teacher, whom I'll plug here. She literally wrote the book on neck and shoulder problems and recovery (she also had this surgery), and the exercises in this book (with help from a qualified yoga teacher) got my full range of motion back.
posted by obscurator at 7:59 AM on November 14, 2012

The most helpful/fun part of my PT regiment was this pulley system that attached to the top of a door.

Oh yes, and this is really tangible way to mark you progress! I was told to wait a few days or a week to begin this (I had other, passive exercises to do) and it was remarkable to go from barely being able to raise my arm a few inches to raising it all the way up. It was an encouraging incentive to do the other exercises when I didn't want to.
posted by Room 641-A at 11:32 AM on November 14, 2012

Response by poster: Just to provide some color for those that may be searching this thread:

Had the arthroscopic procedure last Monday. The anesthesiologist applied a nerve block on my neck and then I had general anesth. after. Three incisions, had a bandage over the wound site for about 48 hours. Given a sling and was home after about 3 hours.

First day the nerve block held up. As it faded, I began to take a few percocet but my arm was generally good. Some slight throbbing at the incision sites, but over time I've began to regain some basic range of motion (enough to struggle to put a shirt on).

I have my first PT session on Wednesday and will have the stitches out next Monday or so.

It should be a few months of hard work, but this has been better than the horror stories had me concerned about.

Thanks for all of the helpful feedback.
posted by Hurst at 10:12 AM on November 27, 2012