First 2 weeks:
Keep the arm in the sling with the belt around the waist. You also need to sleep with the sling on. Apply ice packs during the first few days for 15-20 minutes at a time. Hand and wrist exercises should be done with the arm in the sling. The sling can be carefully removed when changing clothes or going for a shower, but keep the operated shoulder completely relaxed. Do not try to lift your arm up by yourself, as this will place stress on the rotator cuff repair. To wash your armpit, bend forward while keeping your arm and shoulder relaxed. Gravity will cause your arm to go away from your body, allowing easy access to your armpit. Keep your dressings as dry as possible. If they become soaked they should be replaced.
2 – 6 weeks:
Continue with the sling. If you received a sling with a cushion you can normally remove the cushion at 3 weeks, unless instructed otherwise. The waist belt can also normally be removed after 3 weeks but re-apply it at night when going to sleep. Physiotherapy can be commenced. The physiotherapist will start with gentle passive range of motion within your pain threshold. After 4 weeks you can use your opposite arm to lift up your operated arm (active assisted range of motion). I can also supply you with a pulley system to help with an active-assisted range of motion. I will see you again at 6 weeks to do an ultrasound examination of the shoulder and assess the rotator cuff repair.
After 6 weeks:
The sling is normally removed at 6 weeks (4 weeks for smaller tears) and you can start lifting up your arm without assistance. Start each exercise period with pendulum exercises to loosen up the shoulder first. Then progress to active assisted exercises as previously described and finally move on to an active range of motion exercises. Rotator cuff strengthening exercises are only done after 8 – 10 weeks. You can start driving at 6 weeks. People in sedentary occupations can return to work at 6 weeks (earlier if it is not the dominant arm involved), but manual laborers should only return to normal duty at about 3-4 months. Sportsmen will have individualized rehab programs depending on their sport and types of tears.
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