Post-Operative Instructions

Once you are discharged, your primary goal is to manage pain and protect the surgical repair during the initial healing phase.

1. Pain & Swelling Management

  • The Nerve Block: Your arm will likely be numb for the first day due to a regional nerve block. It is critical to start your oral pain medication before the block wears off so that it begins working and you don’t need to catch up to your pain.

  • Icing: If you have an ice machine or ice packs, use them for 20–30 minutes every hour while awake. Icing is the most effective way to reduce swelling and deep joint pain. Arthroscopic shoulder surgeries often result in a lot of swelling around the shoulder which is actually the fluid used during the surgery and not swelling because of tissue trauma. This swelling does get better on its own after a day but it can be helped by icing.

  • Sleeping: Most patients with shoulder pain prefer to sleep more upright as this can help diminish that pain. We recommend sleeping in a recliner or with multiple pillows propping you up in bed until your surgical pain begins to subside.

2. Sling & Immobilization

  • Usage: You must wear your sling/immobilizer 24 hours a day, including while sleeping. It should only be removed for showering and your prescribed exercises. Your physical therapy protocol provided to you in clinic will specify if you are allowed to remove your sling/immobilizer at all and when.

  • Duration: Most repairs require 4–6 weeks of strict immobilization.

  • Hygeine: If you are permitted to remove your sling for hygeine purposes, allow your arm to simply dangle straight down and move your body slight away from it so you may wash under your arm. Do not allow your dressings to get wet.

3. Wound Care & Hygiene

The purpose of maintaining good hygiene and wound care after surgery is primarily to reduce the risk of infection. The surgery you undergo (open versus arthroscopic) will determine how long you need to keep your wound covered and how long you need to wait to shower. However, no one may soak in tubs, pools or hot tubs for at least 4 weeks from surgery.

Open Surgery - a larger wound was used for your surgery (examples: fracture fixation, shoulder replacement, etc.)

  • Dressings: Leave your dressing on for two weeks from surgery to allow your skin to heal in as sterile environment as possible. Your dressing will be removed in clinic and your sutures will be under your skin and dissolvable. Oftentimes there will be a layer of skin glue over your wound to help seal it even better. This will dissolve and wear off on its own over time once you begin showering.

  • Showering: You may shower after your dressing is removed at two weeks. Allow warm, soapy water to flow over the incision but do not scrub it aggressively. Pat it dry with a clean towel at the end. Do not pick at the skin glue.

Arthroscopic Surgery - only small “portals” were used for your surgery (examples: rotator cuff repair, biceps tenodesis, etc.)

  • Dressings: You may remove your bulky outer dressing 3 days after surgery. You may have suture outside your skin and/or you may have small adhesive "Steri-Strips" directly on the incisions; these will fall off on their own. If you have external suture, it will be removed in clinic at your two week visit. If the suture tails bother you or catch on your clothing, you may cover them with bandaids.

  • Showering: You may shower 3 days after surgery. Be gentle with the incisions and do not scrub them aggressiely - just allow warm soapy water to flow over them and pat it dry with a clean towel at the end.

4. Warning Signs

If you are having a medical emergency, call 911 or present to your closest emergency room.

Call our office immediately if you experience any of the following. If it is after hours or you are unable to contact a member of our team, call 911 or go to your closest emergency room.

  • Fever above 100.4°F, chills, night sweats

  • Excessive redness, heat, or "pus-like" drainage from the incision.

  • Sudden, severe calf pain or shortness of breath (potential signs of a blood clot). Call 911 immediately.

  • Chest pain or difficulty breathing. Call 911 immediately.

  • Persistent numbness lasting longer than the anesthesia team told you it would

  • Nausea, vomiting, itching, hives

  • Uncontrolled pain

5. Follow-Up Milestones

Recovery is a marathon, not a sprint. We monitor your progress at regular intervals. For many surgeries, we will get new x-rays at each visit to These may be modified slightly depeneding on the type of surgery you have and your progress in recovery, but are overall representative of a typical post-operative course:

  • 2 Weeks: Wound check, review the details of the surgery again

  • 2 Months: Transitioning out of the sling/evaluate motion.

  • 4-6 Months: Motion and strength evaluation

  • 9-12 Months: Strength and functional activity evaluation

  • Annual Checks: Continued monitoring for long-term success.