Frequently Asked Questions

Pain

What type of pain should I expect, and for how long should I expect it?
Each person experiences pain differently. Pain is common and normal following surgery. Your pain will get dramatically better after the first several days. I prescribe medications for you to help with the first several days, after that you may need only Tylenol and ibuprofen. A sleeping medication such as Ambien may help your pain at night. Pain is commonly worse at night because there are fewer distractions than during the day. Icing the surgery site before bed frequently helps. If you have an accidental injury to the surgery site you may have increased pain that lasts a day or so, this is normal. If the pain persists call the office for an appointment.

What if I have very little pain, or it goes away soon after surgery?
You might feel better quickly, but most people require a full 12 weeks for tendons and ligaments to heal, regardless of the level of pain, so you will want to continue taking care of your healing tendon.

What if it has been six weeks after my surgery and I still have pain?
This is still often normal, especially at night. Overall, your pain should decrease over time, even with some possible daily fluctuations.

Medication

What do I do if my medication makes me nauseated?
It is common for narcotics to cause nausea. Try taking your narcotics with food, it sometimes helps. Dehydration also causes nausea, so ensure you are drinking enough fluids. If your nausea persists and is intolerable, contact the office to try a different narcotic, however, it is possible that you will react to other narcotics in the same way.

What do I do if my medication makes me constipated?
It is common for narcotics to cause constipation. Make sure you are drinking plenty of fluids to stay hydrated. You can also try a fiber supplement like Metamucil. If neither cause relief, you can purchase a Fleet enema from your pharmacy.

When can I stop taking my medications?
Always finish your complete antibiotic prescription. You should gradually wean yourself from pain medication and take an anti-inflammatory if you experience mild pain or soreness. Take sleeping pills only if you are having trouble sleeping.

For how long should I take anti-inflammatory medications? What if they upset my stomach?
You should take them as prescribed for the first several days to weeks after surgery because they reduce pain and inflammation. After that you may take them as needed. You should generally take your anti-inflammatories with food if possible or with Pepcid Complete, Mylanta, or a similar over-the-counter antacid.

What are some alternatives to narcotics if I want to avoid them?
Some people experience side effects like dizziness, drowsiness, and constipation with the use of narcotics. Instead, you can take anti-inflammatories (ibuprofen), Tylenol, or use ice.

 

Shoulder Limitations (activities)

What are some general things to do and avoid doing after surgery?

To do: Take all your medications as prescribed, keep all post-operative appointments, rest from normal activities and work so that you can heal, take care moving around to avoid tripping and falling and causing re-injury.

Avoid: avoid situations that you cannot control, like walking your dog, or driving. Do not immerse your wound in water for at least 10 days after surgery.

How much should I limit my travel?
It is best for you to be in town for 7-10 days after surgery because if there is a complication, it will generally happen in this time period. After a recent surgery you are at an increased risk for blood clots while flying and should take precautions to avoid this. You may need a medication called Lovenox to inject under the skin on the day you travel on longer flights. You should get up and walk around as much as the Air Marshal will let you. Do not attempt to fly the plane.

How much should I limit driving?
You can return to driving when you can safely turn the wheel and brake. Please keep in mind you might have to stop or turn suddenly as if a child has run out in front of your car. You cannot take narcotics and drive. If you drive a stick shift, this period may be extended. You can consider renting or borrowing an automatic.

How long should I wait before getting in a hot tub or steam room? Why?
You should wait at least 10 days. Your incisions should be fully healed to avoid bacteria coming into your wound. Steam rooms also cause increased sweating which also increases bacteria and infection risk.

Can I sleep on my shoulder?
You may find this difficult for several weeks because laying flat pulls on the shoulder and causes pain. You can instead choose to sleep in a recliner or in bed with pillows propping you up.

Can I remove my sling if it is uncomfortable while sleeping and rubbing against my skin while awake?

If your sling is rubbing, try to wrap your arm in a cloth to protect your skin. While sleeping you should wear your sling in order to keep it still and prevent further injury or the repairs from being undone.

When can I expect to resume work?
It depends on your type of work. If your work is primarily stationary at a desk, then you may be able to return within about a week. If your work requires manual labor or significant driving it will likely be much longer.

When can I expect daily activities?
Shoulder surgery: Generally, you can get back to your regular routine that does not involve lifting anything heavier than a coffee cup or where your elbow does not leave your side as soon as it is comfortable to do so. Many people can type at a computer the day after a surgery. Activities with your operative arm that are overhead, like washing your hair should not be resumed for several weeks. To wash your hair lean forward with your neck rather than reaching up with your shoulder.

For how long should I limit running, biking, climbing stairs, etc?
For shoulder surgery: It depends on the type of surgical repair you had. If you had a rotator cuff repair, labral repair, or Bankart repair you should not run, bike outside, or climb for 12 weeks because the pressure it could cause the repair to fail. After 7-10 days you may ride a stationary bike. A recumbent stationary bike is ideal because there is no pressure on the shoulder. If your surgery was for a calcium excision, to remove bursa (subacromial decompression), or a biceps tenodesis you may start exercise in 7-10 days and ice after exercise. If you become sore reduce your activity and try the stationary or recumbent bicycle.

How much and for how long should I limit lifting and overhead activities?
Consider visiting the section on [insert link] rehabilitation on our website to see a specific timeline for certain activities. It takes tendons and ligaments approximately 12 weeks to heal because of how they grow. If the growing fibers of the tendons and ligaments are disrupted while healing, they will not grow properly and the repair will fail.

How frequently should I ice?
You should ice 25 minutes on and 25 minutes off. If you ice for longer you risk giving yourself frostbite. Use a cloth between the ice and your skin.
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Recovery/Rehabilitation

What is the full timeline for rehabilitation?
For shoulder surgery: It depends on the type of surgical repair you had. If you had a rotator cuff repair, labral repair, or Bankart repair the healing time will be about 12 weeks; this is how long tendons and ligaments reconnected to bone take to take root. Healing time is longer in people with diabetes or who smoke. If your surgery was for a calcium exision, to remove bursa (subacromial decompression), or a biceps tenodesis the healing time is 4-6 weeks.

When can I begin physical therapy?
After a rotator cuff, labral, or Bankart repair we will evaluate your healing one month after surgery. Your formal physical therapy should begin 4-6 weeks after surgery, but you will engage in activities almost immediately, like arm circles called Codman’s exercises and passive pulley exercises. However, if you had a subacromial decompression, biceps tenodesis, or calcium excision, you can begin formal physical therapy the first week.

Who should I see for physical therapy?
We have recommendations at the office of excellent physical therapists who are qualified to treat your exact injury.

What if I am confused about the exercises to do after surgery? Can someone help me?
Please visit our website for explanations and images that can help you but if you still need help you can call our office and we will either recommend you visit us or a local physical therapist to help with this.

How long should I expect to wear my sling?
Shoulder surgery: with a Bankart, rotator cuff, or labral repair, you must wear the sling at all times except when showering for one week and at night for an additional four weeks.

Post surgery

How do I know if I have an infection?
The clearest signs of infection are abnormal redness and abnormal swelling (there is always some redness and swelling after surgery), increased temperature, discharge from the wound (sometimes it has an unpleasant odor), and high fever (above 101.5). Before surgery you are given antibiotics in your IV and you are prescribed antibiotics to take for several days afterwards. Infections are very rare. It is common in the first several days to see a small amount of drainage from your wound, however, if it starts after that contact the office.

How do I know it is time to remove my bandage?
In many cases you will visit the office a few days to a week after surgery for a dressing change. At that point we may put a waterproof dressing on your wound, depending on the type of surgery, and if that is the case it can be removed 7 days later.

How high should my temperature be for it to prompt me to call the doctor about?
You should expect an elevated temperature after surgery because it is common. Until a temperature reaches above 101.5 we do not worry. Please call the office if you have taken your temperature with a thermometer and it reads above 101.5.

Other FAQ- General, Office and Surgery

How do I make an appointment?
Please call the office during regular business hours at (415) 610-2702

What insurance do you take?
Please call the office to check, although we take most insurance. We do not accept MediCal.

I don’t have insurance, can I pay in cash?
Yes, you may pay in cash and we will try to help you arrange any other supplies, imaging, or surgeries that you may need.

How soon after surgery can I shower?
Typically you can shower after your first post-operative visit, which is typically after your first dressing change

What do I do if I need a medication refill?
Please call the office during regular business hours. We do not refill medications after regular business hours except in emergencies.

What do I do if my (knee, back, leg, arm, toe, etc) hurts?
Please call the office during regular business hours and we will schedule an appointment. If it is an emergency, please go to an urgent care center or emergency room. If you have a new injury consider calling (415)776-7878 ext. 142 or visiting www.immediateorthopedics.com

I recently had surgery and my ___ is swollen, what do I do?
Because swelling is normal after surgery, do not be overly concerned. Elevate your injured limb above your eyes and apply ice as directed.

Where do I find good information on my injuries, treatment, and rehabilitation?
Please visit our website for information on injuries and rehabilitation. Be wary of information on the internet from a non-credible source, it is often incomplete or inaccurate.

What is the timeline I should expect to get my surgery scheduled?
You can usually be scheduled to a week or two depending on availability. We want to ensure that you have had a chance to be evaluated by your primary care doctor and arrange for coverage from your insurance.