Rotator Cuff Repair - Royal Bournemouth Hospital

Rotator Cuff Repair - Royal Bournemouth Hospital
Rotator Cuff Repair
Additional Notes
Rotator
Cuff Repair
Please bring this leaflet
into hospital with you
Our Vision
Putting patients first while striving to deliver
the best quality healthcare.
The Royal Bournemouth Hospital,
Castle Lane East, Bournemouth,
Dorset, BH7 7DW
Author: Kim Coles Date: June 2012
Version: Two Review date: June 2015 Ref: 1057/10
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Website: www.rbch.nhs.uk n Tel: 01202 303626
This leaflet from the Orthopaedic Directorate
has been designed to answer any
questions you may have
Website: www.rbch.nhs.uk n Tel: 01202 303626
This booklet tells you about your rotator cuff repair surgery at the
Royal Bournemouth Hospital. It is for people who have decided to
have surgery after discussing the options, benefits and possible
risks with their Consultant.
We have developed this guide to help answer any questions that
you may have about your operation and recovery afterwards. It will
be useful during each of your hospital visits so please bring it with
you.
The booklet is a general guide and there may be alterations in
your management made by your surgeon, anaesthetist, nurse
or therapist. Those instructions should take priority.
All members of the Orthopaedic team are committed to providing
you with the highest standards of care and we look forward to
helping you with your recovery.
What is this operation for?
This surgery aims to reduce your shoulder pain and help increase
the stability of the shoulder joint. The rotator cuff is a group of
muscles which hold the shoulder in the correct position while it
moves. These muscles can become damaged due to wear and tear
or following an accident such as a fall. The damage usually occurs
on the tendon. This can cause reduced movement, loss of strength
and pain.
You should check with your consultant and physiotherapist about
when it is safe to drive. As a guide you should be able to start
driving at about six weeks after the operation. Additionally you must
feel that you have the strength and comfort required to drive safely.
You should check your insurance policy too as you may need to
inform your insurance company of your operation.
When can I return to leisure activities?
This will depend on the size of the rotator cuff tear and the
condition of the tendons. Your surgeon will discuss the operation
findings with you. You should expect to have full movement in your
arm at three months after your operation and good function at six
months. For specific guidance regarding sport please speak to your
physiotherapist.
If I have any questions who should I contact?
If you have any questions about returning to activities you can ask
your surgeon or physiotherapist on the day of the operation.
If anything changes before the operation, or you have any
enquiries about appointment dates you should telephone the
admissions department on 01202 704919
If you have any clinical questions concerning your orthopaedics
operation, please telephone 01202 704693.
If physiotherapy and exercises are not appropriate then an
operation may be needed. The aim is to repair the torn tendon
so that your pain is reduced, you can regain your strength and
movement and so that you can return to normal activities.
If you have any problems following discharge then we advise you
to telephone the ward which you returned to after your surgery.
Sandbourne Day Cases
01202 726104
What happens during the operation?
Ward 9 01202 704724
Ward 12
01202 704770
Anaesthetic
Your surgery is performed under a general anaesthetic. This means
that you will be asleep throughout the operation. A nerve block may
also be used. This is an injection that numbs your shoulder and
arm providing good pain relief for the arm. It also results in a loss
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When can I start driving again?
Rotator Cuff Repair
Rotator Cuff Repair
Introduction
Exercise pictures copied from Tools RG PhysioTools
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Exercise 1. Elbow flexion/extension
You should take your arm out of the sling every hour to
bend and straighten your elbow fully 10 times. This will
stop it from becoming stiff whilst you wear the sling.
Exercise 2. Wrist and hand
Make a fist with your fingers
and then open up your hand.
Repeat 10 times every hour.
Keep your wrist moving also.
Exercise 3. Shoulder shrugs
Gently bring both shoulders up towards your ears
then slowly return them back to their relaxed
position. Repeat this 10 times.
What happens when I go home?
Rest
It is important that you have a balance between exercise and rest.
You will be expected to complete your exercises 3 to 4 times a day.
However you will need to ensure that you spend some of the day
resting your shoulder.
Pain Relief
As the nerve block wears off and the feeling returns to your arm
and shoulder, it may feel uncomfortable therefore you should take
painkillers as advised by the nursing staff. This will allow you to
move your arm comfortably and complete the exercises.
Will I have a sling?
You should wear your sling for as long as your consultant and
physiotherapist instruct you to. This is usually for approximately
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6 weeks. When you are wearing the sling ensure your forearm is
well supported and do not allow your hand to be lower than your
elbow. You may take it off for washing and dressing and to do your
exercises. The sling will support the weight of your arm and prevent
you from moving your shoulder too much. When your arm is out of
the sling, ensure it remains by your side.
Sleeping
Lying on your back or on the opposite side will be most
comfortable. A pillow can be used for additional support.
You should wear your sling at night time also.
Rotator Cuff Repair
Rotator Cuff Repair
You will be shown these exercises by the
physiotherapist when you are in hospital.
Dressings and stitches
You will have stitches to close the wounds on your shoulder and
these will be covered by waterproof dressings. This means that you
can have a shower but you should not use soap or rub over the
area. This will cause the dressing to peel off.
District Nurse
You may be contacted by the district nurse after your operation.
They can check the sensation in your arm, your wound and your
pain control. Two weeks after your operation you will need to see
the practice nurse. They will remove the stitches and check the
wound.
Outpatient physiotherapy
We will arrange your outpatient physiotherapy appointment at the
hospital closest to where you live. The physiotherapist will progress
your exercises and assist you in your recovery. You will be required
to attend a few physiotherapy appointments and continue your
exercises regularly between these sessions. Your first appointment
is likely to be around 2 weeks after surgery.
Clinic review
You will also receive an appointment through the post for a review
with your consultant or a member of their team. This will be for
about 6 weeks after your operation. They will be able to monitor
your progress and answer any questions you may have.
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Depending on the type of surgery, you may have restricted
movement in your shoulder. You will also have a sling for the first
few days. Before you come into hospital think about and practice
how you will manage everyday tasks when you return home after
your operation. Examples of activities which you may find difficult
are:
Mobility: If you currently depend on a walking aid which requires
you to use your operated shoulder you need to consider whether
you could use your walking aid in the other hand. However if you
cannot, an alternative walking aid may be required. You may need
to discuss this with the physiotherapist on your admission.
You will need to be able to stand up from a chair without using
your operated arm. You may need to place an extra cushion on
the chair, to sit on. This may make it easier to stand up.
Personal Care: Getting washed and dressed needs to be done
carefully. Sitting down is usually best as you can support your arm
on a pillow while it is out of the sling. Loose clothing with front
fastenings is usually easiest to put on. When getting dressed, dress
your operated arm first. When getting undressed this arm comes
out last.
Food preparation and cooking: Freezing some meals or stocking
up on ready meals is a good idea as food preparation and cooking
will be difficult following your operation.
Returning to activities
It is important to consider that the tendon repair needs to be
protected. It is particularly vulnerable for the first two to six weeks.
You should be very careful about the combined movements of
lifting your arm out to the side and behind you.
When can I return to work?
Returning to work depends upon the nature of your job. Manual
workers may not be able to return to lifting duties for 26 weeks.
Please ask the physiotherapist or your surgeon if you are unsure
when you can start.
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of sensation and movement in the arm. This will gradually wear off
over the next 24 to 48 hours.
Surgical Procedure
This operation can either be performed arthroscopically (this is
another word for ’key hole’ surgery, where two or three very small
incisions are made to access the shoulder joint) or by using a short
incision through the skin over the shoulder. If the tendon can be
repaired the surgeon will stitch it back together. Sometimes a small
piece of bone is also removed from the shoulder to prevent further
damage to the rotator cuff tendons.
Rotator Cuff Repair
Rotator Cuff Repair
Managing everyday activities
Closure and Dressing
The small incisions will be closed with stitches. These will be
covered with dressings. When you wake up from the anaesthetic
your arm will normally be in a sling.
What happens after the operation ?
(While I am in hospital)
How long will I stay in hospital for?
We hope that you will be able to go home on the same day as your
procedure, however depending on your recovery or home situation
you may be required to stay overnight.
Nurses
You may feel tired after the operation. You can rest in bed for
the first few hours and also have something to eat. If you are
uncomfortable, the nursing staff will provide you with painkillers;
please do not be afraid to ask for them if you are in pain.
Physiotherapy
The next page shows the exercises you should complete. These
should be started immediately after your operation. You should
complete all of the exercises three times each day until you attend
for your outpatient physiotherapy appointment.
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