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What to Expect on the Day of Arthroscopic Shoulder Surgery and Recovery

As a baseball pitcher, I suffered multiple shoulder injuries over the years. Finally, I opted to get arthroscopic shoulder surgery.

So you're getting shoulder surgery...

I wrote this article to provide a patient's perspective on what it is like to get arthroscopic shoulder surgery. Not every injury, surgeon, or patient is alike—but I hope this article will nonetheless be useful as you mentally prepare yourself for the big day.

My experience goes like this: as a baseball pitcher, I had a torn labrum, rotator cuff, and biceps tendinitis from my years of play. After over a year of trying non-surgical alternatives, we opted to repair all of these injuries.

Most people who choose arthroscopic shoulder surgery will be getting one or more of these three injuries repaired. Other reasons for undergoing this surgery may include general shoulder instability, arthritis inflammation, or bone spurs.

This article is not intended diagnose or cure any of these illnesses; it is just one person's experience, along with anecdotes from others. If you find the following information to be useful, or even if you don't, please let me know in the comments section, below. Maybe I can add information to make things more accurate.

Note: I will not be addressing total shoulder replacements, or injuries so severe that they require "open surgery," because I haven't experienced those procedures.

Read on if you are interested in how the days before, during, and after your surgery will go.

What is arthroscopic surgery?

The arthroscope is the instrument used to see inside your shoulder without literally peeling back the muscle to look. The benefit of using the arthroscope is that quite a bit of repair can be done via one or more small incisions which reduces infection risk and decreases recovery time. Your surgeon will be trained to know how to interpret what is seen on the camera, which will be fairly hard to understand for a novice.

In rotator cuff and labral repairs, the surgeon will first clean up the area with suction. The tear often ends up with a fair amount of fraying, which itself can cause pain. The surgeon will clean out these loose parts, which sometimes is all that has to be done. This is called debridement. If the tear is significant enough that the surgeon believes debridement is not enough, he or she will then suture the tear. They will basically sew the tear back together.

Biceps tendonesis, a common part of labral repairs, involves detaching your biceps tendon from the labrum. Sometimes it has begun to detach already and other times it is the underlying cause of labrum injury. They will quite literally cut it off and reattach to your humerus bone, instead.

I won't attempt to cover other, less common injuries here, but they will all have similar procedures in terms of how the surgeon will look at your injury. Anything that is arthroscopic will be minimally invasive, relative to open surgery.

Below is a "highlight" tape of sorts of an arthroscopic labrum repair. Be warned though: it is a look at the inside of a shoulder as well as some shots of what the surgeon is doing from the outside. Some folks would be put off by this, but I found it very interesting and informative.

WARNING: Graphic!

Not even water is okay to consume on the morning of your surgery!

Not even water is okay to consume on the morning of your surgery!

The day before your surgery...

Most surgeons will not give you an exact time of day for your surgery. If this is the case, they will call you on the day before your surgery to tell you exactly when to come. Expect it to be in the morning.

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There are not too many special directions before your surgery. The most important thing, though, is that you cannot eat or drink anything starting at midnight before your surgery! This shouldn't be too hard since you probably will be going to sleep by then anyway, but you cannot eat the next morning either. Even water can be a problem. The anesthesia will make you vomit, a lot, if there is anything left in your stomach. That is the last thing you want to be doing after your surgery.

Your doctor will also probably ask you to shower once or twice with Hibiclens. This is more to prevent you from bringing infections into the hospital than anything else. Don't put it near your face, hair, or genitals because it is fairly harsh.

Other than that, just try to have a good day!

Time for surgery!

This will actually be one of the simplest times of the process. Since you can't eat or drink, there's no use in getting up extra early that day. Do arrive in time, though. You will have to do a little paperwork and put on gowns, which I think is a little confusing. Do not be afraid to ask questions, though, and make sure you answer all of their questions.

They will ask you which shoulder is being operated on a lot. Don't get annoyed! They don't want to screw up. They'll ask you your information a few times too for the same reasons.

You won't have much to do before anesthesia begins. First, you'll get an IV. They will probably put this in your off-hand and they will put a mild sedative in first. This should calm you down, but not knock you out. While you are awake, they will put in the "nerve block." This is a local anesthetic that will leave your arm without feeling for the next 6-12 hours. Seriously, no feeling at all! You might feel a little silly as this is all going on because of that sedative. With that said, I thought the nerve block was the most painful thing I felt all day; it still wasn't too bad, though. They will put a long-ish needle in near your collarbone and release the anesthetic several different times while they use an ultrasound to make sure the needle is where it belongs.

You may be left to sit for a few minutes while this sets in. The only sensation you will have left is in the top of your hand and even your thumb and pointer finger will remain numb for most of the rest of the day. Biology and stuff.

Soon, you will be wheeled into the operating room. It will be cold. I know I asked someone why, but I can't remember the answer. You may or may not remember them giving you an oxygen mask, but soon...

...you're in the recovery room.

Just like that, surgery is over. It may have taken a couple of hours, but it's all a blink of an eye to you.

You will probably feel SUPER groggy at first. You are by no means required to wake up right away. If you still feel out of it, just lay back and nap. My first reaction was to try to get out of bed like a lunatic, but you don't want to do that. They will take care of you. You should not have any pain because of the nerve block.

At this point, if you are going to have a negative response to the anesthetic, you'll know it. Nausea is definitely possible and you'll be feeling it now. Most people do not get it or do not get it much, though. Usually you'll be given an anti-nausea patch before surgery and an anti-nausea shot during surgery. My main issue at this stage was dry mouth, which is a side effect of the anti-nausea patch.

Depending on the hospital, your loved ones may be there with you when you wake up. At others, they will let you wake up in a recovery room before wheeling you to a different room with privacy to see your loved ones and get a little more personalized attention from an RN.

Once you feel able, you'll be able to leave. You will have the challenges of putting on your clothes and standing on your feet to overcome. Obviously, you can't drive. Putting on your shirt will be hard to do as you leave, but with the nerve block it shouldn't hurt. I was recommended to bring a button up shirt, but in the end a t-shirt would have been fine. Most doctors will also give you a very cool ice machine to take home.

You can eat, drink, and do whatever else you feel like on the way home. You may or may not feel groggy. Be mindful that you can hurt yourself while the nerve block is still on though and you will want to start your painkillers before the nerve block wears off!

Your sling will look something like this.

Your sling will look something like this.

The days afterward

Eventually, probably before you go to sleep the day of surgery, the nerve block will wear off. It is both very sensitive and probably not quite as bad as you might have imagined. You will want your sling on basically all the time and putting on clothes won't be something to look forward to. You can't get your stitches wet, so you may not want to bother with showering and changing clothes if you can help it.

You should be told to "stay ahead" with your painkillers. This is true. Don't wait for pain to set in to use them. Don't overuse them, but try to use them in such a way that you don't have any pain when you're just sitting. It will of course hurt if you move it, but it should not hurt when you are stationary. They can help you sleep, too.

Your sling will be very neat. It will have a pad to keep your arm a little further from your body, a nice padded strap for over your shoulder, a ball for your hand to squeeze, and another strap around your waist to really keep the arm from moving unintentionally. Use this absolutely as directed or else you will have a lot of pain.

Most doctors will give an ice machine with a fitted attachment that goes over your shoulder. For the first two days, ice an hour on/hour off whenever you are awake or able. You will obviously need a friend to help set this up. Be careful when the nerve block is still on, because you can get frostbite.

You shouldn't have a bad time in the first few days so long as you have reacted okay to the anesthetic and you use the painkillers properly.

Home Exercises

These may vary some depending on your injury, but you will be given a set of a few home exercises to do in the very early days of your recovery, usually starting two days post-surgery. These are very easy to do, usually some combination of letting your arm hang straight down and using your off-hand to assist you in simple movements. You won't feel like doing them, but they turn out to not be so bad and you will feel better after doing them.

These are very important for your recovery! It gets the blood flowing and gets the process of making your shoulder normal again started.

Narcotic Painkillers

These must be used with caution. Many people use these with no event, but these can be addictive. Don't use these longer than needed and don't give them to anyone else. If you have side effects or think you're having trouble discontinuing use, talk to your doctor. Each doctor will have a different preference for narcotic, so I won't comment on dosing for now. With that said, they will probably make you not very productive while you use them. You may find yourself dozing off with little warning while you use them. Do not drive or do anything important while you're on these. You shouldn't need them longer than two weeks, if that long.

You may also be given another once/day pain pill, go ahead and take that but be aware it will make you drowsy too. I ended up taking it at nighttime. Tramadol, which is another narcotic, is what I'm thinking of here; it will be an extended release version. Discontinue this at the same time that you quit your primary narcotic pinkillers.

If you need extra pain support, take ibuprofen or aspirin. Extra acetaminophen (Tylenol) will put your liver at risk.

The post-surgical wounds are not very flashy.

The post-surgical wounds are not very flashy.

Changing your dressing, stitch removal

After a couple of days, you will need to remove the original bandaging you received after your surgery. You can try to clean with just water, but it probably won't be easy to do and you don't really need it to look nice. Do not use alcohol or any ointments on the area!

You will expect it to be gory, but it isn't much. I attached a picture of what a normal post-surgery shoulder looks like.

You need not apply so much gauze like the surgeon did, because you should be done bleeding. If there is pus, a lot of swelling or bruising, or anything else that concerns you, call your doctor.

After a week to two weeks, you'll need your stitches removed. Either your surgeon or your primary care physician can do this. He or she will give you further directions about dressing the wound after that. You'll be starting physical therapy after the stitches are removed.

Long-term outlook?

Most surgeries have positive outlook and are completely done within a year, with much of the hard part done far sooner than that. I won't even try to guess how yours will be, so I'll leave that to the doctor.

If you have questions or feedback, I'd be happy to respond in the comments. I hope this helps alleviate any fears or anxieties about your surgery. While it is super inconvenient, it's really not that bad. You should never feel a ton of pain, and you're asleep for the worst part of it. Hopefully yours goes as smoothly as most!

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Comments

Rebecca on June 20, 2018:

best advise if the surgery is in your dominant arm -- Buy an electric toothbrush. Good luck!

Judy bergado on April 21, 2018:

I am scheduled for arthroscopic surgery to repair bone spur in shoulder on April 25. Have a cruise scheduled for May 18 and was wonding if will be able to go on cruise and enjoy it? I am 70 years old and in pretty good health,.

Chelsi on March 16, 2018:

I had the same surgery. Personally, I had to have it 2x in 6 months on the same shoulder. Both times I refused pain medication to go home with. When the block wore off it was very painful, and sleeping upright was best. But after the block wearing off the pain wasnt that bad! I didnt think anyway!

Diane on February 12, 2018:

Thank you writing about your experience. There is not much info coming out of my surgeon's office about what to expect.

George Johnson on August 06, 2017:

I am having 2 or possibly 3 torn tendons repaired 10 days from today and my pre-op meeting on Tuesday next week. I will be in a sling for 6 weeks and cannot start physical therapy until the end of 6 weeks. I am to sleep in a recliner which I am shopping for. At 6'2" I am too long for a normal recliner which is 67 inches. My feet hang off the end and I will not be able to sleep.

If I am in the sling for 6 weeks day and night I am concerned about how long it may be to take a shower, put on clothes,etc.

I cannot drive for 6 weeks. I am conserned about all of this but feel better after reading your post. Thank you.

Blakely on August 03, 2017:

I'm going in for labrum surgery tomorrow morning on my left shoulder. This helped me a lot! Thank you for writing this. I have been so nervous and this makes me feel a lot better.

Eddie on July 19, 2017:

Going for my second surgery on my right shoulder. Going to fix my labrum again and to see what else they can find. Still lots of pain in my right shoulder. The first surgery didn't work. I had pain the hole time. Hope this time it works.

Naomi on July 06, 2017:

Hi.

Thankyou for this, very interesting read.

I am 3 months into recovery from labrum and bicep tear repairs.

I am quite concerned about my recovery though...

Is it normal to, at this stage, still be very stiff and unflexible on external rotations and reaches.

I find it so difficult and very painful and in those areas have noted no difference over the last month, no matter the excersise's or putting heat on, massaging. My shoulder's external rotation and reach still only go so far and it feels like it locks and cripple's (strange description i know) and to ease it i just need to basically flop it and stop moving for abit.

Im worried something is wrong. But are you aware, that at this stage, it is normal recovery time scale?

Kindest regards

Naomi

Amruta Mahamuni on June 26, 2017:

Thanks for sharing.This information found very helpful.

Laura on June 13, 2017:

I'm having labrum surgery in 5 weeks in the UK... I'm absolutely terrified and extremely anxious

Cindy on May 16, 2017:

Responding to Kevin's note from 5 months ago. I so related to all you had done I literally laughed and cried so hard! I only JUST had my surgery and 3 days later still feel like they used a jackhammer on mine. My right shoulder had a mild Rotator cuff tear, but the surgeon had to literally cut my bicep clean off and reattach it and told my hubby no WONDER I hurt so much in that arm. I also had a bone spur. Two more days to my first week and already getting mentally and emotionally frustrated at how little I can do with my arm.

Kevin, I'm so sorry for your accident and the excruciating pain you are suffering. Best I can offer is I'm biting my lip and hoping we both heal well by obeying Dr.'s orders. Understand your frustration with meds! I'm told 2 weeks in a sling period, and 9 months recoop - all I can say is I'm glad I got my fishing all in before surgery because there won't BE any the rest of the season. Wishing everyone the best on their individual recovery, but having been operated on numerous times, PLEASE follow your doctor's orders, and if that fails, go to Hallmark and read funny cards until you can laugh - it really is best medicine.

Sisie on February 21, 2017:

I am going to have surgery 2-28-17. I have 2 bone spurs, one of which is cutting into my rotator cuff. Also a torn Labrum. Your post really helped me to understand the process!!! Thank you for sharing your story !!!!

jackie on January 29, 2017:

Having surgery on right shoulder, just fixing a bone spur, there is a slight tear in cuff, but dr isn't too worried about it. I actually plan on going back to my desk job 3 days later. any thoughts?

KEVIN on November 27, 2016:

On 23 November I had surgery torn rotator cup, bicep tendon and labium tender repaired due to auto accident the accident was August 31 after 3 months of pain and limited use I said ok the block wore of around 2 am they gave me Percocet it made me really really really itchy looks like a crazy man when the are active that was most of the time I stopped that drug after 3 Pills the side affects was worse then the surgery I opted for medical Canabis it worked amazing and no side effects I'm not sure what to tell the surgeon when I give him back the Percocet other then I told care of the pain it's still feels like I got hit buy a baseball bat from MLB. It's a long recovery and really hard the sholder that was repaired is my right dominant arm now a lefty need more practice at it the Dr S. Tradonsky was amazing but his office is a very large one with a dozen MDs so your just a # there this has been an eye opening experience sleeping really sucks I wish everyone well who gets the operation done

Tasha on October 23, 2016:

I had the tendon moved and a labrum tear fixed and two pinch points ground off in July 2016 and I had complete ROM by 4 weeks

Sage on October 20, 2016:

I keep spraining my low back and I'm scheduled for surgery in a week. I think I'm going to cancel again for another year or so, as I have a two year old and I just can't imagine getting through two weeks without re-injury due to parenting demands. I'm freaked about the potential length of recovery time and I see no need to rush into surgery (though it's been 1.5 years since injury due to being hit by a car as a pedestrian in a x-walk) even though I still have discomfort, some pain and popping, I am thinking maybe I can try to rehab with PT and always have the surgery when my child is older and a bit more self-sufficient & understanding of how to be careful with Mommy's body. Any downsides to outcomes at risk due to waiting?

Ynendine on August 19, 2016:

Rotator cuff surg coming up soon..any suggestions for me in what to wear as a women to hospital? Bring a front close bra or bandeau? Front button tank top and stretchy shorts? my dr is not using a nerve block...I am very concerned about pain. I was given 7.5 hydrocodone..how do u avoid nausea a constipation? Should I take stool softener or laxatives. I did purchase a Breg glacier ice machine

Denise Jackson on August 02, 2016:

I am getting surgery in September and am scared because physical therapy injured my shoulder and do not want them to injure it again

Sherry on July 20, 2016:

All of this information is GREAT. Thank you all. It made me feel a lot more optimistic. I am having the bicep tendosis in a few weeks.

Ali on June 25, 2016:

Another perspective for others: I had rotator cuff surgery in late Dec 2016, just over six months ago. My supraspinatus was a mess, so the doc had to trim quite a bit and then reattach.

I was lightly put under for the nerve block insertion, so no pain there, and it stayed in for three days after the surgery. I carried a small ball around that contained the drug and a pump --- it got in the way, but was SO worth it.

My surgery was in the ortho facility's outpatient clinic. An amazing experience, way better than a hospital.

This was my first experience with anesthesia and opiods, and I have to say I didn't like it at all. Necessary b/c of the pain, but I weaned myself off the opioids within about a week and switched to Alleve and Extended Relief Tylenol (taken every 12 hrs and 8 hrs respectively on the dot using alarms on my phone). I still experienced a foggy and slow brain for months.

One other fun thing with the opioids was the constipation. Start a stool softener the night before the surgery and take more as soon as you can.

The surgery was on my right/dominant side, so not only was I encumbered by the worthless arm and the sling, but I had to learn how to do a lot with my left hand and learned some lessons worth sharing:

► An electric toothbrush was a must! No need to a fancy expensive one, just a $10 one will do fine.

► A seatbelt extender, when inserted into the end where you connect the belt (essentially raising it up to be more accessible), made it easier to fasten my driver's seatbelt with my left hand.

► I ate a lot of meals out of 24 oz cottage cheese containers. I could hold them reasonably well with my right arm, even in a sling, and the high walls made it easier for my clumsy left hand to maneuver.

► Slip-on shoes!! You wont' be able to tie your shoes for a while, regardless of which arm is repaired.

As others have noted, sleeping is no fun at all, for much longer than expected. If you don't have a recliner, borrow one. It doesn't have to be fancy, but you'll live in it for the first week. I eventually moved to the couch for sleeping at night, propping my self up a lot. Slept there for several weeks because it kept me still (I move around a lot at night). It was so lovely when I could move to my bed!

Women: If you are well-endowed, think about your bra the day of surgery and for the first few weeks after. For the day of, I bought a slightly loose front-fastening sports bra where I could run the one strap under my shoulder. The nurse who helped me dress was confused at first, but figured it out. You won't shower for at least three days and no bra isn't a comfortable option for me for that long. For the next couple months, I bought a few more supportive but still front-fastening sports bras. You won't be able to put a back-fastening bra on (at least by yourself) until a few weeks after the sling comes off.

As for recovery - go to PT at least 2x a week and DO YOUR HOME EXERCISES. I was pretty consistent but at 6 months I still don't quite have full range of motion.

It's a long process, y'all. If it's in your future, best wishes.

Matt M on October 14, 2015:

Seems like this is a relatively old post, but maybe you'll see this...at what point post-op would you say you could swing a bat? Similar to others on this thread, I scheduled surgery long enough away to terrify myself in the iterim - watching videos, reading horror story reviews, etc. I play A LOT of softball. Suffered a grade 3 AC separation, SLAP tear, and I'm told I have an uncharacteristically high amount of arthritis in my right/throwing shoulder. After reading all the bad stories, I'd love to hear just one good one! If you see this, would love to know how your recovery has come along. If you don't, I hope you're on a mound somewhere blowing a heater past someone. Thanks for the intel bud, big help. -4

J. Plowman on July 25, 2014:

I'm a real SUSIE! I've never had a nerve block before. I've had a lot of surgery but never a nerve block. Can you relate the pain to any other type of procedure? I've had a lot, including a spinal tap. Thanks for info.

Madhav Poudel Nepal !!!!! on July 12, 2014:

i had shoulder arthoscopy surgery on may last week 2014 and now its 6 weeks but i don`t have energy in my hand i can`t move it freely and main thing is that i am having physo therapy daily visiting hospital .I had 5 dislocation already .I was waiting to get proper reply how much time it will take for fully recover my shoulder .Any one can reply me on that on !!!

Madhav Poudel Nepal !!! on July 12, 2014:

i had shoulder arthoscopy surgery on may last week 2014 and now its 6 weeks but i don`t have energy in my hand i can`t move it freely and main thing is that i am having physo therapy daily visiting hospital .I had 5 dislocation already .I was waiting to get proper reply how much time it will take for fully recover my shoulder .Any one can reply me on that on !!!

denise on June 27, 2014:

I had surgery in April and I have very little RIM. I just went to the doctor yesterday and he told me that I have frozen shoulder. How does this happen when I do my home exercises and go to physical therapy 3 times a week? Is it possible the tendon was reattached to tight?

Caroline on June 20, 2014:

Thanks for the response! Further complicating this, I have Driver's Ed behind-the-wheel (6 days of driving instruction) scheduled for mid-August. If the surgery was sometime mid-to-late July, would driving be possible by this time period?

Jacob Long (author) from Memphis, TN on June 18, 2014:

While I can't be certain how softball recovery compares to baseball recovery, I doubt you could recover fully from arthroscopic surgery in that time span. When mine was done in early May, I was told March would be a time where I'd be 100%. With that said, I'd have been throwing a ball after 3 or 4 months, just not at a very high intensity. I would discuss this with your doctor.

Of course, chances are you'll never be as good as you ought to be if you put off the surgery.

Caroline on June 15, 2014:

I'm a teenage softball player debating if I should have this surgery (already had a steroid injection, pt to no effect). If I had the surgery in July could I be 100% by January?

Chris on June 12, 2014:

Were you able to throw a baseball again. Like a fast ball. When after surgery were you able to did physical activities?

Jimmy on June 07, 2014:

Thank you for all of this. I am scheduled to have labral repair done in a week. Super nervous but this has eased my mind significantly

honeyinajar on May 21, 2014:

I wish I knew you in person. This information was so helpful and a little scary. I am scheduled for my surgery on 20 June 2014. At first I was not sure what to expect, but I thank you very much for putting up this info. I am still a little afraid, but like my surgeon told me it has to be done. I guess of afraid of the pain after surgery. Well, thanks again for posting this.

Jacob Long (author) from Memphis, TN on April 01, 2014:

You probably had bicep tenodesis in addition to the RC repair and grinding. Tenodesis involves detaching, trimming, and then re-attaching the biceps tendon. Sounds gruesome, and it kind of is, and it is something that will delay your recovery a little bit compared to typical rotator cuff, labral, and bone spur surgeries. More so than the other parts, the biceps tenodesis probably is having an effect on your ROM. It literally shortens the tendon that allows your arm to reach backwards. I struggled with the part of ROM that you are talking about and I didn't even have the tenodesis! At 7 weeks, you shouldn't be too worried about where you are but your PT is right to focus on improving ROM. This has the biggest effect on your day-to-day activities and failing to fix it is the most likely thing to cause reinjury.

As far as the unevenness issue, I'm not as familiar with it. I have a feeling it won't last, at least not to the extent you're describing it. I'm guessing it is in part a product of how tight everything is up there. Dedicated work on ROM may allow things to get back into balance. I would guess that a more realistic outcome is that you may have that unevenness in the long run, but to an extent that only you would notice because you are looking for it. I know that my shoulder is still not "the same" as the other one, but for the most part only I notice the differences in my abilities.