Shoulder Replacement

The procedure that you have just undergone is a Shoulder Replacement. These instructions are intended as general guidelines. They may be modified due to your particular problem by your physician.

It is important, especially in the first 48 hours, that you keep your limb elevated higher than your heart as this helps reduce swelling and speeds recovery. For those who have had an upper extremity procedure, a sling will be provided and tied in such a way that this elevation will be maintained.

Days 1-3: Pain Relief and Wound Care.

1. Keep your arm in the sling with the pillow. You will wear sling for 8 wks.
2. Ice the operated shoulder for 20 minutes every hour, as needed. Or use the ice machine – do not place directly on skin because this can cause an ice burn.
3. Do not use operated arm for driving for 8 weeks. Your surgeon will go over this with you at your follow-up appointment.
4. No lifting anything with the operated arm for 12 weeks.
5. Sleeping in a recliner chair or propped up on pillows may be more comfortable.
6. Please anticipate bruising down your arm, chest wall and even potentially on the back of your shoulder. This is normal but will improve as time goes along.
7. Swelling is expected as well down your arm and to your hand. Please keep your hand elevated as much as possible and have your sling adjusted so your hand is not hanging down or else your hand will swell due to gravity.

Diet

1. Drink plenty of water.
2. Resume regular diet as tolerated.

Medications

1. Resume all of your regular medications as prescribed.
2. Take pain medications prescribed as needed (Tylenol #3, Vicodin). It is fine to add or switch to or add an anti-inflammatory medication (such as Motrin) if this works better for you.
3. Aspirin 81 mg – take once a day for six weeks to help prevent a blood clot.
4. Anti-inflammatories (Aleve, Advil, ibuprofen, Motrin) – if you are able to take these medications, please start them right away and take them with food.

Wound Care

1. Expect some bloody drainage on your surgical dressing. This is normal.
2. If you experience numbness, tingling, pain in your fingers and hand may happen after shoulder surgery. Usually this resolves over time. Please call my office if you experience worsening numbness or tingling in your hand, arm or other part of your body after surgery.
3. It may be helpful to keep a washcloth in your armpit to absorb sweat.

Days 3-10

Wound Care

1. Remove the dressing on post-op day 3. Do not remove the small tapes on the skin until 2 weeks after surgery.
2. It is ok to shower on the third day after surgery and get your incisions wet. Please do not soak the shoulder. After the shower, pat the area dry and cover the incision with Band-Aids. Leave your stitches alone. You only need to cover the incision site if your wound is draining.
3. No baths, pools, or spa for 4 weeks.

Activity – Exercises

1. Do NOT use your shoulder muscles to move your arm.
2. You will begin formal physical therapy after two weeks following your surgery. Please follow the instructions of your therapist closely.
3. Please take your arm out of the sling several times a day to move the elbow, wrist, and hand through a full range of motion.
4. Start working on posture – pinch your shoulder blades together and hold for 5-10 seconds. Repeat 15 times and do 4 sets, three times a day.

2-6 weeks after surgery

Follow Up Appointment Information

You should have a post-op appointment between 10-14 days after surgery for removal of sutures and re-check by your surgeon. If you do not, call 916-732-3005 to schedule one.

Physical Therapy

You should schedule your first physical therapy visit for two weeks after surgery. If you do not have an appointment, please contact our office or the physical therapy office you would like to go to.

Other Special Post-op Instructions

1. Increasing pain or pain not controlled by ice or medications prescribed.
2. Large amounts of bloody drainage.
3. Foul smelling drainage from the surgical site.
4. Swelling in the calf or foot.
5. Fever (over 101F) or chills.
6. Increasing redness/warmth/hardness around wounds.
7. Inability to eat or urinate.
8. Persistent numbness and/or tingling not present before surgery, or by loosening the ACE bandage.
9. Cold or blue toes.
10. Any other signs that concern you.

If you experience any of the above danger signals, please contact the office at 916-732-3005 or 916-732-3000.

You can also contact our office directly by using the Klara texting application. You can respond to the text messages sent by our office or your can initiate a new conversation by clicking on the purple “MESSAGE US” at the bottom of my webpage. www.sacorthosports.com

Please visit www.sacorthosports.com for additional information and for your PT protocol.

Greg Takenishi, MD
Sacramento Orthopedic Sports & Shoulder
Sacramento River Cats Head Team physician
San Francisco Giants Team physician
www.sacorthosports.com