Physical Therapy Exercise Videos

Benzoyl Peroxide 5% gel has been shown to reduce the risk of infection following shoulder surgery. The gel is to be applied for 72 hours prior to surgery as outlined below.

Most pharmacies carry this product. It may be found either by the pharmacy or in the health and beauty department. In some instances it may be advertised as “acne medication”.

Warning: It is suggested to wear a cotton t-shirt as the Benzoyl Peroxide may bleach clothing. 5% Benzol Peroxide is less likely to bleach clothing but be cautious to let it dry before putting on anything other than cotton clothing. If you notice any skin irritation or side effects please discontinue use.

Three days prior to surgery:

Twice daily (morning and evening) apply the gel (about a quarter to half size dollop) onto the skin of the operative shoulder. Apply to the side, front, and back of the shoulder and over the armpit area. This should be gently rubbed into the skin, as if you are applying sunscreen lotion. The gel will not be visible.

Morning of Surgery:

If desired, shower with anti-bacterial soap, dry well and apply the gel to the skin and armpit area.

WOUND CARE

• You may remove the Operative Dressing on Post-Op Day #2. You may notice a yellow piece of mesh covering your incisions. You may remove it if it is loose. If it seems stuck then it will loosen up on its own over the next couple of days and you may remove it then.
• KEEP THE INCISIONS CLEAN AND DRY.
• If there are white steri-strips covering any of the incisions leave these in place. If no white strips are present, you may leave the incisions open to the air. If the stitches rub on your clothing you may cover them with a band-aide.
• To decrease pain and swelling use Ice or an icing device if desired. Most current icing devices (ex. Polar Care) are not covered by insurance and the cheapest way to obtain them if desired is online. For the first 3 days apply for 20-30 minutes 4 times per day, and then use it 1-2 times per day as needed. You may increase the frequency as needed if you are having continued pain and swelling. Place a towel or cloth between the skin and the ice to prevent skin injury.
• You may shower on Post-Op Day #1. Please cover the dressing or wounds with plastic wrap and secure it to your skin with tape. Do not get the sutures wet. After you shower remove the plastic wrap and pat the incisions dry. You may remove the sling for showering.

EXERCISES/SLING INSTRUCTIONS

• You may remove the sling for your therapy exercises and showering. To shower let your arm rest at your side or you may keep it held across your belly. It is safe to lean forward to allow cleaning under your arm.
• Several times per day bend your wrist back and forth to maintain flexibility. You should exercise your hand by squeezing a tennis ball or rubber ball.
• Many people have difficulty sleeping after shoulder surgery. If you have difficulty try sleeping in a recliner or propped up on pillows in a semi-reclining position. Also place a pillow under your elbow for support.

ADDITIONAL INSTRUCTIONS

• Prescriptions have been provided for you to use post-operatively:
  • An anti-inflammatory medication (i.e. Naprosyn, Celebrex, Mobic). Take the anti-inflammatory as prescribed with food. **IF YOU HAVE AN ULCER HISTORY OR DIFFICULTY USING ANTI-INFLAMMATORIES OR ASPIRIN USE ONLY THE NARCOTIC MEDICINE PRESCRIBED
  • A Narcotic (Oxycodone, Hydrocodone) is to be used on an “as needed” basis for pain in addition to the anti-inflammatory. Avoid taking this medication on an empty stomach. In general you should try to wean down and transition off the narcotic as soon as pain allows. The goal is not complete elimination of pain but keeping it moderately well managed. Once Tylenol and the anti-inflammatory are managing your pain you should discontinue the narcotic.
  • An anti-nausea medication (Phenergan, Zofran). Narcotic pain medications can sometimes cause nausea and you may use this prescription on an as needed basis.
• If you have any adverse effects with the medications, please call the office.
• If you develop a Fever (101.5), Redness or Drainage from the surgical incision site, please call our office to arrange for an evaluation.
• Do not drink alcoholic beverages or take illicit drugs when taking pain medications.
• Do not drive a car or operate heavy machinery when taking pain medications.
• Pain medication may make you constipated. Below are a few solutions to try in this order:

1. Decrease the amount of pain medication if you aren’t having pain.
2. Get up and walk around several times per day
3. Drink lots of decaffeinated fluids and fruit juice
4. Take Colace or Senokot – over-the-counter stool softeners

FOLLOW-UP

• If not already scheduled please call the office (919-788-8797 or 919-866-4242) to schedule physical therapy and a follow-up appointment for your suture removal in 10-14 days.

WOUND CARE

• You may remove the operative dressing on Post-Op Day #2. You may notice a yellow piece of mesh covering your incisions. You may remove it if it is loose. If it seems stuck then it will loosen up on its own over the next couple of days and then you may remove it then.
• KEEP THE INCISIONS DRY.
• If there are white strips covering the incision leave these in place
• An ACE wrap may be used to help control swelling. Do not wrap the ACE too tight.
• To decrease pain and swelling use Ice or an icing device if desired. Most current icing devices (ex. Polar Care) are not covered by insurance and the cheapest way to obtain them if desired is online. For the first 3 days apply for 20-30 minutes 4 times per day, and then use it 1-2 times per day as needed. You may increase the frequency as needed if you are having continued pain and swelling. Place a towel or cloth between the skin and the ice to prevent skin injury.
• Swelling and bruising is normal after surgery.
• You may shower on Post-Op Day #1. Do not get the surgical wounds wet. Wrap the knee in plastic wrap (press and seal or saran wrap from the kitchen) and secure at the top and bottom with tape. If the site gets damp, gently pat the area dry. You may gently wash the area around the incisions with a washcloth then gently pat the area dry.

AMBULATION

• You may place as much weight on your leg as your pain allows unless otherwise instructed by Dr. Solic.
• Any brace that has been provided is only necessary when you are upright and mobile—it may be removed when you are sitting down/resting.

ADDITIONAL INSTRUCTIONS

• Prescriptions have been provided for you to use post-operatively:
  • An anti-inflammatory medication (i.e. Naprosyn, Celebrex, Mobic). Take the anti-inflammatory as prescribed with food. **IF YOU HAVE AN ULCER HISTORY OR DIFFICULTY USING ANTI-INFLAMMATORIES OR ASPIRIN USE ONLY THE NARCOTIC MEDICINE PRESCRIBED
  • A Narcotic (Oxycodone, Hydrocodone) is to be used on an “as needed” basis for pain in addition to the anti-inflammatory. Avoid taking this medication on an empty stomach. In general you should try to wean down and transition off the narcotic as soon as pain allows. The goal is not complete elimination of pain but keeping it moderately well managed. Once Tylenol and the anti-inflammatory are managing your pain you should discontinue the narcotic.
  • An anti-nausea medication (Phenergan, Zofran). Narcotic pain medications can sometimes cause nausea and you may use this prescription on an as needed basis.
  • Aspirin – Depending on your specific surgical procedure you may be prescribed aspirin for blood clot prevention. Make sure to take this starting the first day after surgery and at a different time of day than the anti-inflammatory medicine.
• If you have any adverse effects with the medications, please call the office.
• If you develop a Fever (101.5), Redness or Drainage from the surgical incision site, please call our office.
• Do not drink alcoholic beverages or take illicit drugs when taking pain medications.
• Do not drive a car or operate heavy machinery when taking pain medications.
• You may return to sedentary work/school in the next couple of days when you feel up to it.
• Pain medication may make you constipated. Below are a few solutions to try in this order:

1. Decrease the amount of pain medication if you aren’t having pain.
2. Get up and walk around several times per day
3. Drink lots of decaffeinated fluids and fruit juice
4. Take Colace or Senokot – over-the-counter stool softeners

FOLLOW-UP

• If not already scheduled please call the office (919-788-8797 or 919-866-4242) to schedule physical therapy and a follow-up appointment for your suture removal in 10-14 days.