What not to do after rotator cuff surgery

You had surgery on your shoulder to repair a muscle, tendon, or cartilage tear. The surgeon may have removed damaged tissue. You will need to know how to take care of your shoulder as it heals, and how to make it stronger.

You will need to wear a sling when you leave the hospital. You may also need to wear a shoulder immobilizer. This keeps your shoulder from moving. How long you need to wear the sling or immobilizer depends on the type of surgery you had.

Follow your surgeon's instructions for how to take care of your shoulder at home. Use the information below as a reminder.

Wear the sling or immobilizer at all times, unless the surgeon says you do not have to.

• It is OK to straighten your arm below your elbow and move your wrist and hand. But try to move your arm as little as possible.
• Your arm should bend at a 90° angle (a right angle) at your elbow. The sling should support your wrist and hand so that they do not extend past the sling.
• Move your fingers, hand, and wrist around 3 to 4 times during the day while they are in the sling. Each time, do this 10 to 15 times.
• When the surgeon tells you to, begin taking your arm out of the sling and let it hang loosely by your side. Do this for longer periods each day.

If you wear a shoulder immobilizer, you can loosen it only at the wrist strap and straighten your arm at your elbow. Be careful not to move your shoulder when you do this. Do not take off the immobilizer all the way unless the surgeon tells you it is OK.

If you had rotator cuff surgery or other ligament or labral surgery, you need to be careful with your shoulder. Ask the surgeon what arm movements are safe to do.

• Do not move your arm away from your body or over your head.
• When you sleep, raise your upper body up on pillows. Do not lie flat as it can hurt the shoulder more. You can also try sleeping on a reclining chair. Ask your surgeon how long you need to sleep this way.

You may also be told not to use your or hand on the side that had surgery. For example, do not:

• Lift anything with this arm or hand.
• Lean on the arm or put any weight on it.
• Bring objects toward your stomach by pulling in with this arm and hand.
• Move or twist your elbow behind your body to reach for anything.

Your surgeon will refer you to a physical therapist to learn exercises for your shoulder.

• You will probably start with passive exercises. These are exercises the therapist will do with your arm. They help get the full movement back in your shoulder.
• After that you will do exercises the therapist teaches you at home. These will help increase the strength in your shoulder and the muscles around your shoulder.

Consider making some changes around your home so it is easier for you to take care of yourself. Store everyday items you use in places you can reach easily. Keep things with you that you use a lot (such as your phone).

Call your surgeon or nurse if you have any of the following:

• Bleeding that soaks through your dressing and does not stop when you place pressure over the area
• Pain that does not go away when you take your pain medicine
• Swelling in your arm
• Your hand or fingers are darker in color or feel cool to the touch
• Numbness or tingling in your fingers or hand
• Redness, pain, swelling, or a yellowish discharge from any of the wounds
• Fever of 101°F (38.3°C), or higher
• Shortness of breath and chest pain

Shoulder surgery - using your shoulder; Shoulder surgery - after

Cordasco FA. Shoulder arthroscopy. In: Rockwood CA, Matsen FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW, eds. Rockwood and Matsen's The Shoulder. 5th ed. Philadelphia, PA: Elsevier; 2017:chap 15.

Throckmorton TW. Shoulder and elbow arthroplasty. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

Wilk KE, Macrina LC, Arrigo C. Shoulder rehabilitation. In: Andrews JR, Harrelson GL, Wilk KE, eds. Physical Rehabilitation of the Injured Athlete. 4th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 12.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

From throwing a baseball to waving hello to lifting heavy objects, shoulders make it possible to perform a wide variety of tasks. Sometimes, however, a sudden injury or repetitive movement can damage the muscles and tendons in your shoulder, resulting in a torn rotator cuff.

In many cases, these issues respond to treatment at home, but when pain continues over a prolonged period, it's time to see a specialist. At Orthocenter, the largest orthopedic group in New Jersey’s, Monmouth/Ocean County areas, our specially trained physicians begin with reviewing your symptoms and conducting an exam. Diagnostic imaging like X-rays and MRIs may help gather more information, and exploring the rotator cuff arthroscopically is another option.

We offer several types of surgery, including minimally invasive arthroscopic rotator cuff repair and superior capsular reconstruction when necessary. Any procedure involves recovery time, but these eight tips can help make it as quick and pain-free as possible.

Wear a sling

To speed recovery, it is important to keep your shoulder immobilized initially after surgery so your tendon can heal. A sling provides stability and support and serves as a good reminder not to move your arm in its entirety (rotating your wrist and wiggling your fingers are OK).

Sleep carefully

Sleeping in a somewhat upright position is often most comfortable following rotator cuff surgery and has the added benefit of helping you avoid the extra pressure on your shoulder that can result when lying flat. Use pillows to help prop you up, or place something under the mattress to raise it slightly. Some people find sleeping in a recliner or wide armchair is a good solution.

Wear a sling even when you sleep to prevent too much movement, and consider propping up your arm on pillows to help reduce swelling.

Ask for help

Accept offers of assistance from family and friends. Especially in the initial recovery period, you may need help with daily activities like showering and dressing, cooking, and other chores. Arrange for rides while your driving is restricted.

Watch for complications

Complications are rare, but it's important to know the signs just in case. Call your doctor if you experience a fever of 101 degrees or more, redness or discharge from the incision, sudden and severe pain, or numbness or tingling in your fingers or hand.

Do the physical therapy

Physical therapy exercises help improve the stability, range of motion, and strength in your shoulder. Attending sessions with the physical therapist as part of your accelerated rehab program and doing the exercises at home is crucial to a successful recovery.

Keep comfortable

Rest is key to recuperation, so try to stay as comfortable as possible. Use an ice pack (or bag of frozen peas wrapped in a light cloth) to help reduce inflammation during the first three to five days after surgery. After that period, heat can provide some relief for pain and stiffness.

Take medication as directed. Anti-inflammatories also help you successfully complete your physical therapy exercises.

Be mindful of your movement

While certain motions — particularly with the wrist and fingers — are safe to perform during recovery, avoid putting stress on your shoulder as it can delay healing. This includes such movements as reaching behind you, raising your arm overhead or out to the side, lifting anything heavy, and placing weight on your shoulder. Wearing a sling can help discourage you from making these motions inadvertently.

Pace yourself

It's easy to think your shoulder is feeling better and then start to do too much too soon. Don't. Anything from resuming sports to challenging yourself with more difficult exercises without doctor approval runs the risk of causing re-injury to your shoulder.

If you’re experiencing shoulder pain that time hasn't healed or other treatments haven’t helped, the Orthocenter team can provide a proper diagnosis and treatment plan. To make an appointment, call one of our offices in Red Bank, Morganville, or Marlboro Township, New Jersey, or click to book it online.

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