Shoulder Replacement: Post-Operative Instructions

Medications

Take all medications exactly as prescribed and follow the instructions on your pharmacy labels.

• Narcotic pain medication (such as oxycodone): take as prescribed, as needed for pain. Try to taper your use as soon as you feel comfortable. You may take Extra Strength Tylenol in place of the narcotic. Do not take additional Tylenol if you are taking Percocet, hydrocodone, or Vicodin, which already contain it.
• Pregabalin: take as prescribed. This is for nerve pain.
• Tylenol (acetaminophen): take as prescribed. You can take it along with your narcotic or in between doses to help manage pain.
• Aspirin: take as prescribed to help prevent blood clots. Continue aspirin for 14 days after surgery.

Diet

Resume a regular diet as soon as possible. It is advisable to start with clear liquids until any nausea is gone.

Sling

• Reverse shoulder replacement: wear the sling at all times for 2 weeks. Do not remove it except to shower or do exercises.
• Anatomic shoulder replacement: wear the sling at all times for 4 weeks. Do not remove it except to shower or do exercises.

Frequently Asked Questions

Is bruising and discoloration normal?

Yes. Some people bruise easily and it can be significant, but this is normal and not a cause for alarm.

When do I start physical therapy?

Physical therapy typically starts between 1 and 2 weeks after surgery.

What exercises can I do right after surgery?

You can do gentle elbow motion starting the day after surgery, and you can start pendulum swings on post-op day 3 (instructions below). Do not actively lift your operative arm away from your body or reach behind your back until cleared by your surgeon.

How do I care for my dressing?

About 1 week after surgery, change your dressing and replace it with a clean bandage over the incision. Your dressing will be removed for good at your first post-op visit. When showering, let water run over the incision without scrubbing, then pat dry. Do not remove the skin glue (Dermabond) or any white strips over the incision.

When should I ice?

Ice is very important after surgery. Use it continuously over the dressing for the first 3 days. After that, ice 3 times a day, especially before bedtime, using a cold therapy unit, an ice pack, or a bag of frozen vegetables.

When is my first post-op appointment?

Your first post-op appointment is typically scheduled before your surgery. If you are unsure of the date, time, or location, contact our office.

When can I start driving?

Driving can begin around 2 weeks after surgery, once you feel safe to do so and are no longer taking narcotic pain medication.

When should I call the office?

Contact our office if you notice excessive drainage or blood on the dressing after 5 days, a fever over 101.5°F, or numbness or tingling in your arm or hand that was not present before surgery.

Pendulum Exercise

1. Stand and lean forward with your non-operative arm resting on a chair or table. Let the operative arm hang relaxed at your side.
2. Gently rock your body forward and back, letting your arm move freely.
3. Keep the shoulder relaxed. Do not actively move the shoulder.
4. Move forward and back for 45–60 seconds, then side to side for 45–60 seconds, then 30 seconds clockwise and 30 seconds counterclockwise.