What to expect about the operation and rehabilitation
Pain:
A supplementary local anaesthetic or nerve block is used during the operation which means that immediately after the operation the shoulder and arm may feel numb. This may last a few hours. After this the shoulder may well be sore and you will be given painkillers to help this whilst in hospital. These can be continued after you are discharged home. Ice packs may also help reduce pain. Wrap frozen peas or crushed ice in a damp, cold cloth and place on the shoulder for up to 15 minutes.
Wearing a Sling:
You will return from theatre wearing a sling. This is for comfort only and should be discarded as soon as possible (usually within the first 1 to 2 days). Some people find it helpful to continue to wear the sling at night for a little longer if the shoulder feels sore. (Please note – If a rotator cuff tear is found and repaired, the sling may be required for 6-8 weeks.)
The Wound:
This is a keyhole operation usually done through two or three 5mm puncture wounds. There will be no stitches only small sticking plaster strips over the wounds. These should be kept dry until healed. This usually takes 5 to 7 days.
Driving:
You may begin driving one week after your operation or when you feel comfortable.
Returning to work:
This will depend on your occupation. If you are in a sedentary job you may return as soon as you feel able usually after one week. If your job involves heavy lifting or using your arm above shoulder height you may require a longer period of absence.
Leisure activities:
You should avoid sustained, repetitive overhead activities for three months. With regard to swimming you may begin breaststroke as soon as you are comfortable but you should wait three months before resuming front crawl. Golf can begin at six weeks. For guidance on DIY and racquet sports you should speak with your physiotherapist
Follow up Appointment:
You will be made a follow up appointment at the Shoulder Unit for around three weeks after your surgery. At this stage you will be reviewed by the specialist physiotherapist or Consultant who will check your progress, make sure you are moving your arm, and give you further exercises as appropriate.
Progression:
This is variable. However experience shows us that by 3 weeks movement below shoulder height becomes more comfortable. By this stage you should have almost full range of movement although there will probably be discomfort when moving the arm above the head. At three months after your surgery your symptoms should be approximately 80% better and you will continue to improve for up to a year following the procedure.
Exercises:
After leaving hospital you should exercise the arm frequently throughout the day. The arm may feel sore whilst you are doing the exercises but there should be no intense or lasting pain. Aim for four exercise sessions per day.
What to expect after surgery
After surgery, there is typically a period of 5-7 days where a dressing is on the shoulder, and the arm is in a sling. After that time, the dressings and sutures are removed, and the sling is discontinued. Typically, physical therapy starts the week after surgery, and will continue for 8-10 weeks. Depending on the type of work patients do, they can return to work 1-2 weeks after surgery if they have a desk job, or 8-12 weeks after surgery for a job that involves a lot of lifting. Full recovery after impingement surgery is common, but takes 3-5 months.