To prepare for shoulder arthroscopy, find out exactly which procedures are planned, since that decides whether you will use a sling for a few days or for 4 to 6 weeks. Set up your home for some one-handed days, arrange a ride home and to early appointments, and practice the sling and a few one-handed tasks. Write your questions for your surgeon now. Your surgeon’s protocol comes first, and timings vary with what is done and with each surgeon.
Shoulder arthroscopy is keyhole surgery, and the name covers many different operations. Preparing well starts with knowing which one you are having.
Key takeaways
- Know your procedure: decompression alone usually means a short sling time; a repair usually means 4 to 6 weeks or more.
- Home setup: move everyday items to waist or chest height on your other side.
- Rides: you will need a ride home, and driving often waits 2 to 6 weeks, longer after a repair.
- Practice: sling on and off and one-handed dressing before the day.
- Questions: ask what will be done, sling time, movement limits and who to call after hours.
What the operation does
The surgeon makes two to four small cuts around the shoulder and passes a camera (arthroscope) and fine instruments into the joint and the space above it. Common procedures include:
- Subacromial decompression: removing the inflamed bursa above the rotator cuff and sometimes shaving bone from the underside of the acromion.
- Distal clavicle excision: trimming the end of the collarbone where it meets the shoulder blade.
- Biceps procedures: releasing or reattaching the long head of the biceps tendon.
- Repairs: stitching a torn rotator cuff or labrum (the rim of cartilage around the socket) back to bone.
- Capsular release: cutting a tight joint lining, sometimes used for frozen shoulder (adhesive capsulitis).
Your surgeon may decide on the final plan during the operation, once they can see inside. Ask how you will be told what was done.
What to set up at home
- Clothing: loose, front-opening tops, elastic-waist pants and slip-on shoes. A front-fastening bra is easier than a back clasp.
- Sleeping position: plan to sleep propped up for at least the first 1 to 2 weeks, with pillows behind your back and one under the forearm. A reclining chair works for some people.
- Kitchen: put cups, plates and daily food on the counter or at chest height on your other side. Prepare a few days of easy meals.
- Bathroom: pump bottles, a long-handled sponge and a non-slip mat. Keep toiletries within easy reach.
- Driving and help: arrange a ride home, and rides to appointments for at least 2 weeks, or 6 to 8 weeks if a repair is planned.
- Work: ask about lighter or one-handed duties, especially if your job involves lifting or reaching overhead.
What to practice before surgery
- Sling on and off: practice with the sling, or with instructions, and a helper.
- One-handed tasks: dress the operated arm first and undress it last. Practice eating, brushing teeth and toilet hygiene with your other hand.
- Gentle movements your surgeon allows: a shoulder that moves well before surgery can be easier to rehab after. Ask which movements suit your shoulder, and stop anything that sharply increases pain.
- Elbow, wrist and hand movement: learn the simple bending and gripping exercises you will do while the shoulder rests.
Questions to ask your surgeon
- Which procedures are planned, and might that change during the operation?
- Will I have a repair, and how long will I wear the sling?
- What movements are allowed straight away, and which should I avoid?
- When does physical therapy start?
- Will I have a nerve block, and how long will the numbness last?
- Which pain medicines will I take, and when?
- When can I drive and return to my kind of work?
- Who do I call after hours if I am worried?
The first 48 hours
Most people go home the same day. If you had a nerve block, the arm may be numb and heavy for about 12 to 24 hours, sometimes longer, so keep it supported in the sling. Your team may suggest taking pain medicine before the block wears off.
A block given at the side of the neck can briefly cause a hoarse voice, a drooping eyelid or a feeling of not getting a full breath. These usually fade as the block wears off.
The shoulder often looks swollen from fluid used during surgery, and this usually settles in the first few days of recovery. Sleep propped up. Use a wrapped cold pack for 15 to 20 minutes at a time if your team allows, and keep the dressings dry. Move the elbow, wrist and hand gently several times a day. Have an adult with you for the first night.
The word arthroscopy describes how the surgeon gets in, not what they do once inside.
Call your surgeon or emergency number if
- Breathing gets harder: breathlessness that is severe or getting worse, or chest pain. Call your local emergency number.
- Calf swelling or pain: in one leg. Call your local emergency number if you are also breathless.
- Fever: 100.4°F (38°C) or higher, or shaking chills.
- Wound changes: spreading redness, warmth, pus or a bad smell from any of the small cuts.
- Numbness that does not wear off: past the time your team gave you, or a hand that is cold, pale or blue.
- Uncontrolled pain: pain your medicines are not controlling.
More on this area: surgery recovery guides.
Ask what will be done inside your shoulder, then plan your weeks around that answer.
Written by Louise Yow, Neck & Shoulder Physio.