What Should You Expect
Surgery is a stressful experience for many people, but knowing what to expect can alleviate some of that worry. Here are the necessary steps to know.
- Preoperative clearance: Before undergoing surgery, your doctor will perform an exam to ensure you are healthy enough for surgery. Depending on your overall conditions, additional tests may be necessary. Your doctor will discuss any risks associated with the surgery and give you all the preoperative instructions you need, such as what medications you can and cannot take before the procedure.
- The day of the surgery: The day of your scheduled surgery, you will need to avoid eating or drinking anything after midnight. When you arrive at the hospital, you will change into a surgical gown and wait to go to the operating room.
- Anesthesia: Once you are in the operating room, an anesthesiologist will administer general anesthesia, a combination of medications that will put you to sleep for the duration of the surgery. You will not feel anything. The anesthesiologist may also administer a nerve block, which will numb the shoulder. Nerve blocks last after you wake up, so you will likely feel very little pain when you first wake up from the surgery.
The Rotator Cuff And Shoulder Joint
Rotator cuff tears and disease are very common. They often result from ageing and wear and tear. They can also occur as a result of a fall or sporting injury. Impingement of the front of the scapula , where bone rubs into the tendon is believed to be a major cause of cuff tears in individuals older than 40 years of age.
The rotator cuff is important in stabilising the shoulder joint, enabling shoulder movement, and giving the shoulder and arm power and strength. Four muscles and their tendons constitute the rotator cuff. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm.
Subscapularis is the muscle at the front of the shoulder which helps rotate the arm inwards. Over the top of the shoulder are supraspinatus and infraspinatus, which help elevate or lift the arm. Teres minor is the muscle at the back of the shoulder, which helps rotate the arm outwards.
There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder . The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are damaged or injured, the bursa can become inflamed and painful.
Obtain Tools For Bathroom Access And Safety
Stock a big supply of waterproof bandages or plastic bags and tape in the bathroom so youre prepared to shower without getting your incision wet. A detachable showerhead helps keep water away from your shoulder, and pump soap makes bathing easier when you can use only one arm.
Place non-slip bath mats in the shower and on the floor outside your bathtub or shower. A shower chair is also great for safety because you may tire easily during your recovery.
If your dominant hand and arm are immobilized, practice activities like brushing your teeth with your other arm. If its too difficult, look for hacks. For example, you can get powdered toothpaste that you can pour into a bowl and then dip a wet toothbrush in the powder.
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What Is A Typical Shoulder Surgery Recovery Timeline
Your shoulder is a complicated joint that can move in multiple directions. Because of this, it performs in almost all of your typical daily activities, including reaching for food on shelves, brushing your teeth, and getting dressed.
When shoulder surgery puts you out of the game for a while, recovery is essential for getting back to normal as soon as possible. Knowing what to expect, how long each step may take, and what you can do to help support the healing process may make surgery and recovery seem less daunting.
How Long Does It Take To Recover From Reverse Shoulder Replacement
In this medical replacement, the surgeons and medical professionals reverse the very relationships between a ball and a socket within the glenohumeral joint. Studies show that there are thousands of patients who have successfully done these surgeries.
So, it is necessary to know how long does it take to recover from a reverse shoulder replacement. We would like you to be with us and go through the full details that we have included with the recovery period of reverse shoulder replacement.
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What Should You Expect From Postoperative Physical Therapy
Physical therapy is a big part of postoperative rotator cuff treatment. Your physical therapist will start by introducing passive motion to the shoulder. He or she will carefully move your arm for you to ensure the recovering muscles and tendons are not under excessive strain. When you are ready, your physical therapy will progress to active motion, which means your therapist will instruct you how to move your arm. Finally, you will begin to work on strengthening the shoulder with resistance exercises. Rotator cuff tear rehab will usually last at least a few months after the surgery. While you will have regularly scheduled physical therapy appointments, your therapist will likely give you daily at-home exercises to do. As guided by your therapist, sometimes a shoulder pulley system will be able to aid in keeping up with your shoulder therapy exercises at home.
A few recommended shoulder pulleys include:
- Fanwer Shoulder Pulley – Multi-Use Pulleys for Shoulder Rehab Over Door –>
- Fanwer Exercise Pulley Device for Rotator Cuff Recovery –>
Another important aspect of postoperative recovery is dressing care. A few recommended waterproof dressing solutions include:
- Houseables Waterproof Bandages Film, Transparent Dressing for Post Surgical 10 Pack –>
- All Health Waterproof Transparent Dressing & Pad, Dressings, 2.375 in X 4 in 10 Count –>
Avoid Some Shoulder Positions And Arm Movements
Avoid doing everyday movements that might involve lifting or leaning on your arm.
Doing unnecessary movements outside your exercise program can aggravate the repaired tendon and create scar tissue.
Recovering might be a primary concern if youve undergone rotator cuff repair.
With your arm immobilized, it feels like theres not much you can do around the house or at work. So make sure you ask for help whenever you need it.
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How Much Does Rotator Cuff Surgery Cost
The price of rotator cuff surgery will depend on several factors. Estimates range from $6,628 to $11,180, but talking to your insurance carrier is the best way to get an accurate estimate for you. The price of the surgery will hinge on variables such as your insurance coverage, your annual deductible, your coinsurance and your out-of-pocket maximum. The cost of the surgery will include the surgeon, anesthesia, imaging, lab tests and the hospital. You could receive separate bills for each of these services. When talking to your insurance company, it can be helpful to reference specific codes related to shoulder arthroscopy. Commonly used codes for arthroscopic rotator cuff repair include:
- 29821: Shoulder arthroscopy
Are You At Risk Of A Rotator Cuff Tear
The rotator cuff is a collection of tendons and muscles that connects to the shoulder. Without the rotator cuff, shoulder movement and strength are near impossible. Rotator cuffs are also at risk of injury, particularly in athletes and workers who lift or move heavy equipment. Sometimes, a full-thickness tear requires rotator cuff surgery, which means the patient will be out of commission for some time. Understanding the recovery timeline can make the process easier and more successful.
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Phase : 8 Weeks Onwards
The goals during this phase include:
- Restore full range of movement
- Establish optimal neuromuscular control of shoulder girdle musculature
- Restore optimal cuff and scapular control through range and under load
- Optimise function specific power, strength and endurance
- Transference movement pattern correction and cuff/scapula control to functional tasks
- Return to work, sports and recreational activities
More importantly, once you have enough strength and movement you can return to physical movement at your job, sporting, and recreational activities.
Frequently Asked Questions About Arthroscopic Rotator Cuff Surgery
Is my rotator tear “too big” to be fixed using arthroscopy?
The primary advantage of all-arthroscopic repair is that it allows a surgeon “global” access to the rotator cuff and tear for adequate cuff evaluation, repair and fixation to bone. For this reason, the LARGEST tears are often that require the greatest degree of skill and familiarity with arthroscopic techniques. Surgeons who are facile with arthroscopic techniques actually prefer to prepare and evaluate the cuff using the arthorscope, as this allows better visualization.
Will I recover or “heal” faster after arthroscopic rotator cuff repair?
Are the results as good as with “mini-open” techniques?
Most of the recent studies show that in the hands of surgeons who are expert in all-arthroscopic rotator cuff repair, the results are comparable to open techniques. Specifically, the best results reported for open repairs are as high as 97% success.1,7,11,142-6,8-10,12,13 Reports of the traditional open fixation tend to demonstrate that the success rates are less favorable for larger tears. Interestingly, the studies of arthroscopic repairs show otherwise: the results do not appear to be significantly worse with larger tear sizes.4 This is probably due to the global access to larger tears with the arthroscopic techniques. Recent articles reported on arthroscopic fixation using the latest instruments and techniques demonstrate 93% to 95% good and excellent results.
What happens without surgery?
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What To Expect After Shoulder Replacement Surgery
Shoulder replacement surgery is a major operation, but it does not have to be painful. The day after your procedure, you will likely experience pain at your incision site. Your doctor/nurse will give you oral medication, which will help alleviate discomfort at this time. However, if anything else happens other than what was originally planned, dont hesitate to ask about switching over to post-op care where they provide more rigorous therapy programs tailored specifically towards shoulder rehabilitation goals.
Your doctor will recommend you to take a rest for about six weeks after undergoing shoulder replacement surgery. Avoid activities such as lifting heavy objects in this time duration because your arm needs some time to heal properly. If necessary, pain medication will help you lessen the discomfort experienced due to inflammation and swelling in the area around your joints. Your doctor may also prescribe certain antibiotics if there are signs of infection near or at your incision sitethis usually occurs.
Final Thoughts On Rotator Cuff Surgery Recovery Tips
A torn tendon between your shoulder blade and upper arm bone is an acute injury that will take time to heal.
Focus on working towards regaining the strength to perform passive motions, and your active motions will soon return after your shoulder surgery.
Get in touch with Georgia Hand, Shoulder & Elbow today to schedule an appointment for fast recovery.
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Caring For Your Incision
You will have stitches running along your wound on the front of your shoulder. These will be removed one week after your surgery, at your first follow-up appointment. Call your surgeon immediately if your incision swells, drains, becomes red or painful, or if you develop a temperature over 101 degrees Fahrenheit.
Before leaving the hospital, your incision will be covered with a dry bandage. Please do not get the incision wet or dirty. The dressing can be changed daily and it is not uncommon to have a small amount of blood on the dressing. Do not shower or go in the bath until you return for your follow-up appointment. The incision has not healed yet and getting the incision wet puts the shoulder at risk of infection. After the stitches are removed and if the doctor allows you to, you can take a shower and let the water run over the wound. Do not go into a tub or Jacuzzi to soak the wound. Pat the wound dry after you finish showering.
What Is Arthroscopic Shoulder Surgery
Arthroscopic shoulder surgery uses tiny instruments and a miniature camera to assess, diagnose and treat conditions of the shoulder joint. Arthroscopic surgery is preferred over traditional open shoulder surgery because it uses very small incisions to access the interior of the joint, which leads to less pain and a faster recovery time for patients.Arthroscopic shoulder surgery is typically used by surgeons to repair torn or damaged rotator cuffs, repair shoulder ligaments, remove damaged or inflamed cartilage, and treat recurring shoulder dislocation.
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Dr Soffer: Committed To Providing The Highest Level Of Orthopedic Care
If shoulder pain is disrupting your life, it may be time to explore treatment options with an experienced orthopedic surgeon such as Dr. Stephen Soffer. Proudly providing his orthopedic expertise to patients in and around Reading, PA, Dr. Soffer offers a full range of surgical and nonsurgical treatment options for shoulder problems.
If surgery is needed to restore shoulder function and alleviate a patients symptoms, Dr. Soffer prioritizes arthroscopic surgery whenever possible. As compared to traditional open procedures, shoulder arthroscopy generally offers the benefits of minimal trauma, less damage to surrounding tissue and, in turn, a shorter recovery time. To schedule an appointment to explore cutting-edge shoulder treatment options with Dr. Soffer, call our office at 610-375-4949.
What Is A Shoulder Replacement
A shoulder replacement is a procedure that tries to eliminate the source of pain and dysfunction by replacing damaged parts of the shoulder joint with artificial components called prostheses. The most common reasons for a shoulder replacement surgery are osteoarthritis, rotator cuff tear arthropathy, avascular necrosis or rheumatoid arthritis. The procedure is meant to relieve your pain, improve your strength, increase your range of motion and enable you to use your shoulder and arm.
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How Do I Treat The Stiffness
You should always follow the directions of your surgeon after surgery, since some tears need more time to heal than other tears. The best thing is to listen to your doctor as well as the physical therapist involved in your care. We tell our patients that ice is helpful for the pain, along with pain medicine of some sort, such as acetaminophen , anti-inflammatory medications , pain relievers and even prednisone by mouth . You should take these medications only at the direction of your doctor. We usually recommend that during the first three months the emphasis in physical therapy and with your home program should be on regaining motion in your fingers, wrist, elbow and shoulder. We tell patients they have the rest of their lives to get strong, but during the first four months after rotator cuff surgery, the major goal should be largely to regain motion in the shoulder. Stiffness in the shoulder can be the cause of pain months after the surgical repair, so it is important that stiffness be addressed even months or years after the surgery.
Rotator Cuff Tear Surgery
Surgical repair of torn rotator cuff tendons helps alleviate pain and restore shoulder movement and strength.
This surgery is done as a day procedure. Being prepared for the day of the surgery and what to expect can by read in my rotator cuff surgery recovery tips guide.
The surgery is performed with a general anaesthetic, however before you are put to sleep, the anaesthetic specialist will perform a nerve block that numbs the entire arm.
This is performed by finding the nerves that supply the shoulder and arm with an ultrasound machine and introducing local anaesthetic around the nerves using a small needle. This means that you require less medications during your anaesthetic to combat pain, which means waking up less nauseous and groggy.
The shoulder should be pain free for a period afterwards. As the block wears off and some pain develops in the shoulder, we can manage this comfortably with tablets. It is common to require some pain relief for about a week after surgery.
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What Are The Risks Of Shoulder Replacement Surgery
Like any surgery, there are some risks associated with shoulder replacement surgery as well. However, the risk of a complication will vary from person to person, so these may not apply to everyone undergoing shoulder replacement surgery.
One of the other major concerns for shoulder replacement surgery is the risk of infection. The shoulder joint contains many blood vessels which can increase your chance of getting an infection if proper precautions are not taken during and after the surgery. Infections that occur in shoulder replacement surgeries vary from mild skin infections to damaging symptoms like septicemia . So, to reduce your risk of developing any type of severe infection, make sure you practice good hygiene by washing yourself regularly with soap and water while also paying close attention when shaving around the surgical site before going into surgery.
Moreover, some surgeons may use cement when installing the artificial shoulder through keyhole techniques . In contrast, others inject bone marrow into the shoulder socket during the installation of the implant. Cement can irritate around where it attaches to tendons and ligaments near surrounding areas like muscles on shoulders, causing pain. So, make sure you discuss all potential risks and benefits with your surgeon before your surgery.
So What Do I Do If A Rotator Cuff Tear Fails
Usually a tendon repair fails because it was going to fail and not because of a bad surgery or bad therapy. The reality is that rotator cuff surgery is not perfect, and not all tendons will heal completely with surgery. Once a tendon has failed an attempted surgical repair, the odds are that it will be difficult to repair again and to get it to heal. In some cases, the tear may be small enough after a failed repair to be successfully repaired, but the exact risk of failure with further surgery is related to how large the tear is at that time. The larger the tear, the less likely it can be successfully repaired a second time. In most cases a second attempt at repairing the tendon is not going to be successful unless the tear is small.
The second myth about have a rotator cuff tear that is too large to repair is that the shoulder is doomed to get arthritis or to gradually lose function. There is no way to predict what rate the shoulder will have any problems or if it will have any problems at all. There is only one study which has suggested that the shoulder with no rotator cuff tendons may develop arthritis over time . This study was not conclusive, so it is currently believed that being active does not lead to degeneration of the shoulder when there are irreparable tears. We encourage people with torn rotator cuff tendons that cannot be repaired to be as active as possible within the limits of their pain and weakness.
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