The first evening: Swelling during the first evening is normal especially if you underwent shoulder arthroscopy. The swelling will decrease naturally and the dressing re-inforcements will absorb excessive liquid. Prior to your discharge your dressing will be debulked on the ward. During the first days after surgery rest at home. The operated arm must stay in the sling provided to you. You can remove the sling for showering ensuring to keep your arm by your side. Your sling must be placed back on after you get dressed. Ice can be used over the surgery site but not directly on the skin.
If you received a regional block from the anaethetist, the effect of the of the block will fade over the course of the first evening . It is necessary to anticipate this and begin your prescribed medication as the block wears off before pain is felt. Usually you will be prescribed simple analgesia such as paracetemol +/- an anti-inflammatory. In addition to this most people will need stronger medication for up to 14 days post surgery. Please follow the instructions you are getting carefully and do not let pain get in front of you by staying on top of your medications. Also use ice regularly (on the shoulder or the arm, alternately) for a period of 20 minutes.
Dr McBride will see you the day following your surgery to discuss the findings and procedure. A follow up wound review is usually arranged by the ward nursing team for 10 to 14 days after your surgery in Dr McBride's rooms.
Dr McBride works with a network of experienced physiotherapist who have specialised skills and knowledge in the rehabilitation of shoulder and other upper limb conditions. He will help arrange rehabilitation with an appropriate practitioner for you or contact your regular physiotherapist to ensure a complete understanding of the surgery and post surgical protocol. For rehabilitation protocols relating to specific surgeries see below.
Recovery from shoulder replacement surgery requires rest, restoration of range of movement then progression of strengthening and return to functional activities.
The rotator cuff tendons need to be protected after rotator cuff surgery to allow healing before active range of movement, strengthening and functional drills can commence.
Achieving full power and function after shoulder instability surgery requires a rehabilitation program that meets the functional requirements of your sport or occupation.
Stabilisation of the ac joint is important to facilitate normal scapulohumeral rythm and stabilise the shoulder to the axial skeleton to allow it to perform with control and strength.
The key to achieving maximal pain free range of movement and over head strength following shoulder impingement surgery is to retrain the stabilisers around your shoulder blade to coordinate with the rotator cuff muscles.
Overcoming shoulder apprehension can be a a major challenge for patients who have had shoulder dislocations. Functional plyometric exercise directed by an experienced supportive physiotherapist can help achieve this goal.
Recovery from Elbow stifness requires analgesia, restoration of range of movement and return to functional activities.
The rehabilitation of the elbow after dislocation should commence in a supine position to minimise the effect of gravity and allow the triceps to stabilise the elbow through range of motion
Early elbow rotation range of motion following radial head replacement is important to restore function
Rehabilitation following distal biceps tendon repair can commence the day after surgery with progressive range of motion exercises.
Continuous passive range of motion and/or early active assisted movement with pain relief will help maintain the range of movement that has been regained after elbow surgery
Cartilage in the elbow joint recieves nutrition from synovial fluid in the joint. Movement helps with the production of synovial fluid and should be commenced early after surgery