Subacromial Impingement: Recovery

Follow-up appointments

After about 2-4 weeks you will be asked to return so that Mr. Cole can check on your progress following your operation. Your wounds will be examined and Mr. Cole will check on your range of motion to ensure that you are not getting stiff. You may discuss any concerns you have during this appointment. Alternatively, should you have a concern, you may telephone Mr. Cole's clinic at any time following your operation.

The wound

Arthroscopic subacromial decompression is completed by keyhole surgery. This means you will only have two to three small puncture wounds. You will not have any stitches, only small sticking plaster strips. Keep the wounds dry until they are healed, which is normally within five to seven days. You can wash or shower and use ice packs, but protect the wounds with waterproof dressings which will be provided to you on your discharge. Avoid using spray deodorant, talcum powder or perfumes near or on the wounds until they are well healed.

The sling

You will be given a sling to wear immediately following the operation. This is for your comfort and can be discarded within a few days. You can take the sling on and off as you wish, although you might find it more comfortable to wear your sling at night.

Sleeping

Sleeping may be uncomfortable for a while. It's best to avoid sleeping on the side of your operation. If you choose to lie on the other side, you can rest your arm on pillows placed in front of you. A pillow placed behind your back can help prevent you from rolling onto your operated shoulder during the night. If you are lying on your back to sleep you may find placing a thin pillow or small rolled towel under your upper arm or elbow will enhance your comfort.

Your recovery

Different people recover at different rates. However, by about three weeks following your operation you should find that movement below shoulder height becomes more comfortable. You should also be able to move your arm into most positions, including above shoulder height, although this might still be a little painful.

By three months you should feel a lot better, although it can take from six to nine months to fully recover. You will continue to improve for up to a year following the procedure.

Things to avoid

There are no restrictions (other than the pain). Start moving the arm as much as you can and gradually it should become much less painful. Avoid heavy lifting for the first 4 weeks. You need to be aware that activities at or above shoulder height stress the area that has been operated on. Try not to do these activities unnecessarily. Try to keep your arm in a range of movement which is not overly painful.

Driving

You may begin driving one week after your operation or when you feel comfortable. Check you can manage all the controls and it is advisable to start with short journeys.

In addition, it is a good idea to check your insurance policy. Many insurers will require you to inform them of your operation.
Returning to work

The best time for you to return to work depends on how you feel following the operation and on the type of work you do. If your job is largely sedentary with minimal arm movements close to your body, you may be able to return within a week. Most people are able to return to work within a month at most. However, if you have a heavy lifting job or one with sustained overhead arm movements you may require a longer period of rehabilitation. It is best to discuss this with Mr. Cole and with your physiotherapy team.

Returning to sport and leisure activities

Your ability to start these activities will be dependent on pain, range of movement and strength that you have in your shoulder. It is wise to avoid sustained or powerful overhead movements (such as trimming a hedge, some DIY, racket sports, front crawl) for a few months. These types of movement will put stress on the subacromial area and may take longer to become comfortable. It is best to start with short sessions involving little effort and then gradually increase the effort or time for the activity. Your physiotherapy team will be able to give advice tailored to you and your situation.

Physiotherapy

You will be shown exercises by the physiotherapist and you will need to continue with the exercises once you go home. They aim to stop your shoulder getting stiff and to strengthen the muscles around your shoulder. We have outlined these early exercises here. Your physiotherapy team will also devise a longer term programme tailored for you and your situation.
Use pain-killers, ice packs or both to reduce any pain before you begin exercise. It is better to do short frequent sessions of physiotherapy several times a day, rather than one long session. Aim to exercise for five to ten minutes, four times a day.

It is normal for you to feel aching, discomfort or stretching sensations when doing these exercises. However, if you experience intense or lasting pain (such as pain that lasts for more than 30 minutes) you should change the exercise by doing it less forcefully or less often.