Arthroscopy Archives - Johnny Nelson

How Long Do I Have to Wear A Sling After Rotator Cuff Repair?

Arthroscopy, Rotator Cuff, Shoulder, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Sports Injuries, Uncategorized

Screenshot 2024 02 27 at 11.22.26 AM How long do I have to wear a sling after rotator cuff repair?

You recently discussed rotator cuff repair with your orthopedic shoulder specialist and you are moving forward with repair. Hopefully you are seeing a talented specialist. A talented specialist will spend time with you and discuss the details of the after-surgery healing process.

One of these details is the use of an arm sling after your rotator cuff repair. After rotator cuff repair, your arm will be immobilized in an arm sling, sometimes called a “UltraSling.” It usually consists of a durable, high-quality, well-padded sling. It also has an extra “pillow” piece that will help keep your arm and elbow from moving too much.

For more information on use of your sling, see Dr. Nelson’s YouTube channel. You may also download and print this important document, Shoulder Arthroscopy: What You Need to Know. Or you may visit Dr. Nelson’s main rotator cuff repair page.

After surgery, the rotator cuff repair must be protected. If your arm hangs free, the movement in the early weeks after the surgery will be uncomfortable. However it also places too much stress and tension on the rotator cuff repair. If too much stress and tension is placed on the rotator cuff repair, there is a risk that the repair will come loose and fail.

The sling also serves as an important reminder. It reminds you as a patient that you should not be using the arm, and it reminds others around you that you had surgery and should not be expected to use the arm.

But how long do I have to wear the sling?

The answer to this question is different for different doctors. Dr. Johnny T. Nelson follows a very simple protocol. Rotator cuff repair patients will need to wear their sling full-time for 4 weeks after the procedure. Of course, Dr. Nelson will have you come out of the sling for simple hand, wrist, and elbow exercises and sometimes some very gentle movement exercises of the shoulder. However you will be wearing your sling 24 hours per day, including sleep. After 4 weeks, Dr. Nelson will permit you to remove the sling while at home only and use the arm for very gentle activities

Dr. Johnny T. Nelson will still have you wear the sling when you leave the house up until 6 weeks after surgery. This is because it is important that you do not use the arm to do things like open doors, drive a car, carry grocery bags, etc.

In the first 4 weeks, there are a few reasons to remove your sling.

For example, if you are taking a shower or getting dressed, it is necessary to remove your sling. In these situations, it is still important to be careful with the arm and not use it for grasping, pushing, or pulling, or lifting.

It is also okay to remove your sling if you are sitting or lying down, such as on a sofa or armchair. It is acceptable to remove the straps and remove the sling for comfort, allowing the arm to rest at your side. You may do this only if you are awake. Remember, the sling is a reminder above all else, which is most important when you are up and especially when you are out of the house.

If Dr. Nelson does not perform a rotator cuff repair, and shoulder surgery targets other problems (such as the biceps tendon or bone spurs), he may allow you to remove your sling earlier and begin using your arm earlier.

If you have shoulder pain, if you have a rotator cuff tear, if you are in need of an orthopedic shoulder doctor, call 919-872-5296 today to schedule your visit with Dr. Johnny T. Nelson, MD.

How Long Do I Have to Wear A Sling After Rotator Cuff Repair? Read More »

When Can I Get Back to Work After Rotator Cuff Repair?

Arthroscopy, Rotator Cuff, Shoulder, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Sports Injuries

Image 2 15 24 at 1.25 PM — A rotator cuff tear before repair

Return to work after rotator cuff repair.

You have a painful rotator cuff tear. You try oral medications and anti-inflammatories, physical therapy, chiropractic care, watchful waiting, massage therapy. You change your diet and lower your sugar intake. You try regenerative therapies like PRP injections.

You try everything, and yet still you have pain.

The answer is clear. While discussing with your orthopedic shoulder specialist, rotator cuff repair is your best and only option to get you back to living and loving your life.

Yes, a well-trained shoulder specialist such as Dr. Johnny T. Nelson, MD is able to repair your rotator cuff. But what does this mean for you? How will your life be affected?

One of the most frequent questions that patient’s ask while discussing rotator cuff repair is:

When can I get back to work?

This is not a simple question, and ultimately the answer is usually different for every patient. That is why it is very important to have a personal, one-on-one visit with your orthopedic shoulder specialist.

But if you are alone, searching for guidance and answers to this question, here are some pointers.

Rotator cuff repair procedure is always done as an outpatient, meaning you will go home the same day that the procedure is performed. No lengthy hospitalization is necessary. You will be back home, resting and healing in your home environment on the day of the procedure. More information about the healing process after shoulder arthroscopy can be found here.

But you cannot return to work after rotator cuff repair immediately.

You will need at least one week of strict rest, mostly spent lying down with ice on your shoulder allowing the swelling to subside. While this process under the guidance of Dr. Nelson’s protocol not very painful, it is important that you have at least one week devoted to rest of the shoulder and the entire body. During this time, of course it is okay to get up and walk, go from one room to the other, and go on simple short excursions outside the home. It is also important that you move your hand, wrist, and elbow.

But the first week after the procedure is certainly not a time to return to work, no matter what you do.

After 1 week, most patients are able to sit up comfortably. For some patients, they are comfortable enough to sit at a desk or a computer, answer phone calls, and talk for extended periods on the phone. Therefore, some patients may be able to return to work at 1 week or 2 weeks if they do mostly sitdown, desk type work.

But even in these situations, you may require a shortened shift or periods of rest. So it is very important that your employer is comfortable with you using such accommodations.

Depending on the shoulder procedure that you had done, some patients must keep their arm strictly without movement, such as a rotator cuff repair. For other surgeries on the shoulder where rotator cuff repair is not performed, patients return to using their hand for waist level and gentle activities as soon as they can tolerate it. However, this does not mean that the patient returns to repetitive use or any forceful gripping, pushing, or pulling.

Are you having a rotator cuff repair? Plan out enough time for healing. Many patients are able to return to desk work at 1 to 2 weeks while wearing their sling. But some other patients may not be comfortable enough to do so.

If you work heavy labor, you will not be able to return to full work for 4 to 6 months.

You can probably return to work wearing your sling and without use of the operated arm 4 weeks after surgery. However, the use of the operated arm to push, pull, or perform any heavy lifting or climbing is not allowed for 4 to 6 months. This can be a long time to stay out of work. But it is absolutely essential that you do not perform heavy work with a newly repaired rotator cuff.

Do you have a rotator cuff tear? You need to learn more about your options. You need to discuss the healing process with an experienced shoulder specialist. Dr. Johnny T. Nelson, MD is a shoulder surgeon serving patients in Raleigh, Durham, Chapel Hill, Garner, Knightdale, Cary, and all of North Carolina. Call 919-872-5296 today to schedule a consultation.

When Can I Get Back to Work After Rotator Cuff Repair? Read More »

Do I Have to Have Surgery for a Rotator Cuff Tear?

Arthroscopy, Rotator Cuff, Shoulder, Shoulder Surgery

Do I have to have surgery for my rotator cuff tear?

You may have recently been given a diagnosis of rotator cuff tear. Often, this can be given by a surgeon based on physical exam, a physical therapist based on your symptoms, or even based on imaging studies such as x-rays or MRI.

This diagnosis may lead to many questions for you.

Some patients think that just because rotator cuff tear is present, there is an immediate need for surgery. This is not actually true, as rotator cuff tears come in many different “flavors.” That is why it is very important to allow a shoulder expert like Dr. Johnny Nelson to examine your shoulder and discuss your unique situation with you.

It is important and helpful to look at the rotator cuff like a rope made out of a bunch of fibers. Some ropes are extremely new and extremely healthy, completely intact without any tearing or fraying. Other ropes may have some tearing and fraying of the fibers but overall remained intact. Then again other ropes may be completely torn, cut, or snapped and unable to be used.

The rotator cuff tendon is the same way.

Some patients have completely intact rotator cuff, with no tearing or fraying or even inflammation. Some patients have mild tearing of a few of the muscle and tendon fibers, while some patients have complete tears where the muscle is not connected to the bone.

We do have some evidence that smaller rotator cuff tears are less likely to become large tears, possibly scarring in place and healing. We also have evidence that large rotator cuff tears are more likely to get larger over time, and are less likely to be repairable the longer they are left without repair.

As a general rule, younger more active patients with more severe tears are more likely to be offered surgery and are more likely to respond well to that surgery. Patients with small tears are less likely to be offered surgery because there is evidence that these patients will often heal without surgery. However, even for small tears surgery is sometimes offered when treatments such as physical therapy, anti-inflammatory medications, and injections do not bring lasting relief of their pain and weakness.

If you have been told that you have a rotator cuff tear, or if you have been told that you need surgery on your shoulder, do not hesitate to make a visit to see Dr. Johnny Nelson to discuss your shoulder.

Sometimes knowing is half the battle!

Do I Have to Have Surgery for a Rotator Cuff Tear? Read More »