Shoulder Surgeon Archives

How Long Do I Have to Wear A Sling After Rotator Cuff Repair?

Arthroscopy, Rotator Cuff, Shoulder, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Sports Injuries, Uncategorized

Screenshot 2024 02 27 at 11.22.26 AM How long do I have to wear a sling after rotator cuff repair?

You recently discussed rotator cuff repair with your orthopedic shoulder specialist and you are moving forward with repair. Hopefully you are seeing a talented specialist. A talented specialist will spend time with you and discuss the details of the after-surgery healing process.

One of these details is the use of an arm sling after your rotator cuff repair. After rotator cuff repair, your arm will be immobilized in an arm sling, sometimes called a “UltraSling.” It usually consists of a durable, high-quality, well-padded sling. It also has an extra “pillow” piece that will help keep your arm and elbow from moving too much.

For more information on use of your sling, see Dr. Nelson’s YouTube channel. You may also download and print this important document, Shoulder Arthroscopy: What You Need to Know. Or you may visit Dr. Nelson’s main rotator cuff repair page.

After surgery, the rotator cuff repair must be protected. If your arm hangs free, the movement in the early weeks after the surgery will be uncomfortable. However it also places too much stress and tension on the rotator cuff repair. If too much stress and tension is placed on the rotator cuff repair, there is a risk that the repair will come loose and fail.

The sling also serves as an important reminder. It reminds you as a patient that you should not be using the arm, and it reminds others around you that you had surgery and should not be expected to use the arm.

But how long do I have to wear the sling?

The answer to this question is different for different doctors. Dr. Johnny T. Nelson follows a very simple protocol. Rotator cuff repair patients will need to wear their sling full-time for 4 weeks after the procedure. Of course, Dr. Nelson will have you come out of the sling for simple hand, wrist, and elbow exercises and sometimes some very gentle movement exercises of the shoulder. However you will be wearing your sling 24 hours per day, including sleep. After 4 weeks, Dr. Nelson will permit you to remove the sling while at home only and use the arm for very gentle activities

Dr. Johnny T. Nelson will still have you wear the sling when you leave the house up until 6 weeks after surgery. This is because it is important that you do not use the arm to do things like open doors, drive a car, carry grocery bags, etc.

In the first 4 weeks, there are a few reasons to remove your sling.

For example, if you are taking a shower or getting dressed, it is necessary to remove your sling. In these situations, it is still important to be careful with the arm and not use it for grasping, pushing, or pulling, or lifting.

It is also okay to remove your sling if you are sitting or lying down, such as on a sofa or armchair. It is acceptable to remove the straps and remove the sling for comfort, allowing the arm to rest at your side. You may do this only if you are awake. Remember, the sling is a reminder above all else, which is most important when you are up and especially when you are out of the house.

If Dr. Nelson does not perform a rotator cuff repair, and shoulder surgery targets other problems (such as the biceps tendon or bone spurs), he may allow you to remove your sling earlier and begin using your arm earlier.

If you have shoulder pain, if you have a rotator cuff tear, if you are in need of an orthopedic shoulder doctor, call 919-872-5296 today to schedule your visit with Dr. Johnny T. Nelson, MD.

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When Can I Get Back to Work After Rotator Cuff Repair?

Arthroscopy, Rotator Cuff, Shoulder, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Sports Injuries

Image 2 15 24 at 1.25 PM — A rotator cuff tear before repair

Return to work after rotator cuff repair.

You have a painful rotator cuff tear. You try oral medications and anti-inflammatories, physical therapy, chiropractic care, watchful waiting, massage therapy. You change your diet and lower your sugar intake. You try regenerative therapies like PRP injections.

You try everything, and yet still you have pain.

The answer is clear. While discussing with your orthopedic shoulder specialist, rotator cuff repair is your best and only option to get you back to living and loving your life.

Yes, a well-trained shoulder specialist such as Dr. Johnny T. Nelson, MD is able to repair your rotator cuff. But what does this mean for you? How will your life be affected?

One of the most frequent questions that patient’s ask while discussing rotator cuff repair is:

When can I get back to work?

This is not a simple question, and ultimately the answer is usually different for every patient. That is why it is very important to have a personal, one-on-one visit with your orthopedic shoulder specialist.

But if you are alone, searching for guidance and answers to this question, here are some pointers.

Rotator cuff repair procedure is always done as an outpatient, meaning you will go home the same day that the procedure is performed. No lengthy hospitalization is necessary. You will be back home, resting and healing in your home environment on the day of the procedure. More information about the healing process after shoulder arthroscopy can be found here.

But you cannot return to work after rotator cuff repair immediately.

You will need at least one week of strict rest, mostly spent lying down with ice on your shoulder allowing the swelling to subside. While this process under the guidance of Dr. Nelson’s protocol not very painful, it is important that you have at least one week devoted to rest of the shoulder and the entire body. During this time, of course it is okay to get up and walk, go from one room to the other, and go on simple short excursions outside the home. It is also important that you move your hand, wrist, and elbow.

But the first week after the procedure is certainly not a time to return to work, no matter what you do.

After 1 week, most patients are able to sit up comfortably. For some patients, they are comfortable enough to sit at a desk or a computer, answer phone calls, and talk for extended periods on the phone. Therefore, some patients may be able to return to work at 1 week or 2 weeks if they do mostly sitdown, desk type work.

But even in these situations, you may require a shortened shift or periods of rest. So it is very important that your employer is comfortable with you using such accommodations.

Depending on the shoulder procedure that you had done, some patients must keep their arm strictly without movement, such as a rotator cuff repair. For other surgeries on the shoulder where rotator cuff repair is not performed, patients return to using their hand for waist level and gentle activities as soon as they can tolerate it. However, this does not mean that the patient returns to repetitive use or any forceful gripping, pushing, or pulling.

Are you having a rotator cuff repair? Plan out enough time for healing. Many patients are able to return to desk work at 1 to 2 weeks while wearing their sling. But some other patients may not be comfortable enough to do so.

If you work heavy labor, you will not be able to return to full work for 4 to 6 months.

You can probably return to work wearing your sling and without use of the operated arm 4 weeks after surgery. However, the use of the operated arm to push, pull, or perform any heavy lifting or climbing is not allowed for 4 to 6 months. This can be a long time to stay out of work. But it is absolutely essential that you do not perform heavy work with a newly repaired rotator cuff.

Do you have a rotator cuff tear? You need to learn more about your options. You need to discuss the healing process with an experienced shoulder specialist. Dr. Johnny T. Nelson, MD is a shoulder surgeon serving patients in Raleigh, Durham, Chapel Hill, Garner, Knightdale, Cary, and all of North Carolina. Call 919-872-5296 today to schedule a consultation.

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How Do I Know If I Have a Rotator Cuff Tear?

Shoulder, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Ultrasound

US shoulder How do I Know If I Have a Rotator Cuff Tear?

Shoulder pain is very common, and many of those with shoulder pain wonder and worried about why they have pain. They would also like to take steps to figure out the cause of their shoulder pain and ask themselves: how do I know if I have a rotator cuff tear? And most importantly, they want to know what it will take to make their shoulder stop hurting.

If you have shoulder pain, and you are trying to figure out why, seeing a shoulder specialist like Dr. Johnny T. Nelson MD is a great place to start.

Before you start working on trying to make your shoulder feel better, it is usually a good idea to be evaluated by a specialist and make sure that you have the correct “diagnosis” before you start treating the condition. If you do not have a correct diagnosis, sometimes you can be performing the wrong treatment. Think of it like driving a car: if you were trying to get somewhere, you need to know where you are starting, or else, the directions you are, following will not take you to the right place.

Typically it is a good idea to start with simple things like an x-ray, physical examination, and several questions about the history of your pain: When did it start? How bad is it? What movements make the pain worse? Do any movements make the pain better? Have any treatments you tried made it better?

With these pieces of information, a highly trained shoulder specialist like Johnny T. Nelson, MD is able to give you more information about your specific diagnosis, and most importantly, the best treatment for that diagnosis. From there, you might consider anti-inflammatory medicine, physical therapy or chiropractic care, anti-inflammatory injections, simple home exercises or watchful waiting.

Sometimes Dr. Nelson may recommend an MRI of your shoulder. This is if there is more concern for a more major problem, or if you have been having severe pain for a long time and other treatment methods have not helped.

However Dr. Nelson is one of the only orthopedic surgeons in the Raleigh Durham area to offer in-office ultrasound for the evaluation of the rotator cuff.

How is in-office ultrasound helpful?

In office ultrasound is a great way to determine the health of your rotator cuff. While x-rays can be very helpful to shows US RC tear the bones, x-rays do not show us the health of the rotator cuff. Sometimes a specialist can get information on the health of the rotator cuff with a physical exam, but still rotator cuff tears can be missed. In-office ultrasound helps shoulder specialist such as Dr. Johnny T. Nelson see rotator cuff tears quickly and easily. Furthermore, ultrasound gives you and Dr. Nelson peace of mind that you do not have a rotator cuff tear, and performing simple nonsurgical treatment is probably the best way to go.

Ultrasound to check for rotator cuff tears takes only a few minutes, and you are able to see the results as they happen in real-time. Dr. Johnny T. Nelson loves to point out the findings on ultrasound as he sees them, and teaches patients about the anatomy of the rotator cuff.

Sometimes if a rotator cuff tear is found, an MRI examination is ordered to get more information. Because ultrasound is not a perfect tool, if there are signs that there is a tear of the rotator cuff, an MRI is able to give us much more information and confirm the findings on ultrasound.

Do you have shoulder pain? Are you worried that you have a rotator cuff tear? Are you interested in ultrasound examination of your shoulder? Call 919-872-5296 today to schedule an appointment with Dr. Johnny T. Nelson, MD, Raleigh shoulder specialist!

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I Injured my shoulder! Should I rest it?

Rotator Cuff, Shoulder, Shoulder Pain, Shoulder Surgeon, Sports Injuries

I injured my shoulder! Should I stop working out? Should I wear a sling? Should I see an orthopaedic doctor?

Depending on the circumstances surrounding your injury or pain, these questions may be swirling about in your head, and the answer to these questions could vary.

Of course, very mild aches and pains can be a normal part of life.

Illness, exercise, sports, aging…all of these can lead to soreness, mild temporary aches, and fatigue. It would be unusual to pass an entire lifetime without any trace of discomfort in our bones and joints. These types of pains can and should certainly be tolerated and should not cause alarm. When we do experience them, it is best to stay active and not allow these symptoms to affect our active lifestyle.

However, shoulder pain that is more severe, longer-lasting, or accompanied by significant weakness or loss of motion should not be “brushed off.”

An orthopedic shoulder specialist like Johnny T. Nelson, MD is specially trained in diagnosis and treatment of any and all causes of shoulder pain. Based on questions that he will ask you about the type of pain you have, location of the pain, how long the pain has been present, as well as findings on physical examination, x-rays, and possibly ultrasound of your shoulder, he will be able to give you direction on whether or not further treatment is necessary or if it is okay to continue with life as usual.

For example, if your pain began after a more serious accident, for example a car accident or a fall, it is very important to rule out serious problem such as broken bones or torn rotator cuff tendons. This is usually done with a combination of x-rays and physical examination. Dr. Nelson also uses in-office ultrasound to diagnose these conditions as well without having to resort to more costly and time-consuming MRIs.

There are other conditions, such as bursitis, rotator cuff tendinitis and inflammation, and arthritis that are okay to live with, and continuing to workout is usually okay and safe. Of course, some modifications of your workout regimen may be necessary to avoid inflaming or aggravating the shoulder further.

It is almost never necessary or advisable to wear an arm sling or shoulder immobilizer unless a physician recommends it.

Unnecessary sling use can lead to more stiffness and pain, and does not contribute much to healing. Slings are usually only used for short periods of time after either serious shoulder injuries (broken bones or dislocations) or after shoulder surgery.

Sometimes if the patient has very severe pain, it may be a good idea to stop working out for a short whi 6993b le to focus on more basic exercises to rebuild shoulder health, such as strengthening the rotator cuff muscles, stretching out the shoulder blades, and working on posture and core strengthening. This also allows for time for a proper workup to rule out more serious causes of pain (for example, rotator cuff tears).

Also, as we age, some types of exercising, such as very heavy weights and plyometrics, may not be suitable for our level of conditioning and physical activity, so it may be necessary to discontinue some exercises altogether. However, every exercise that is discontinued should be replaced by another because, as Dr. Nelson always says, if you don’t move it, you lose it!

Once a diagnosis is made, Dr. Nelson can then recommend treatment. Very rarely, this includes surgical treatment, but more often it may include watchful waiting, oral anti-inflammatories, physical therapy, injections, a home exercise program, chiropractic care, or possibly even referral to a different physician.

Do you have shoulder pain? Are you unsure of where to go next or who to listen to? Call 919-872-5296 to make a visit with Raleigh’s Shoulder Doctor, Johnny T. Nelson MD.

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How are Shoulder Pain and Neck Pain Related?

Shoulder Pain, Shoulder Surgeon

how are shoulder pain and neck pain related 62767f8e28a61

Patients that have pain in the shoulder often will also have pain in their neck, and vice versa. Patients with neck pain may also have an experience pain in their shoulder.

This highlights the importance of beginning your treatment for musculoskeletal pain with an orthopedic surgeon who is an expert in evaluation and diagnosis of musculoskeletal problems and injuries.

So how exactly are neck pain and shoulder pain related?

The first way that they are related is by something called splinting. Patients that have pain originating in the shoulder joint, whether it is caused by inflammation, biceps tendon problems, arthritis, or rotator cuff conditions, will often perform splinting.

Splinting is an activity that we often perform without even knowing it.

Most people think of a splint as an object that we put on, but is also thing that we do. When we have pain in a certain joint, we can use the muscles that are attached in and around that joint to hold the joint still so that it hurts less. This is called splinting.

When the shoulder is painful, it is not uncommon to use the muscles at the base of the neck, the chest muscles, back muscles, and even muscles in your armpit to hold the shoulder still so that it does not hurt you. In the short-term this may make your shoulder feel better, however in the long-term it can cause harm because those muscles will eventually grow tired, experience spasm, and begin to cause pain themselves.

How else are shoulder and neck pain related?

Another way that neck and shoulder pain are related is that problems in the neck can often mimic shoulder pain. Because the nerves that come out of the neck send signals to and from the shoulder joint, problems such as pinching of those nerves in the neck can often be experienced by the patient as shoulder problems and shoulder pain rather than as nerve problems and nerve pain.

This is why a physical examination by a qualified orthopedic surgeon is of utmost importance.

Orthopedic surgeons are experts at distinguishing between pain that is truly originating in your shoulder and pain that is likely originating at the level of the neck. There are also experts at knowing what the next step is necessary, whether further imaging or surgery is necessary, or whether simple watchful waiting, physical therapy, chiropractic care, and anti-inflammatories is okay.

If you have shoulder pain, even if you have pain radiating into your neck, your back, or numbness and tingling traveling down your arm, a visit with an orthopedic shoulder and upper extremity specialist is a good first starting point to get answers and relief.

Call at 919-872-5296 to book an appointment with Dr. Johnny T. Nelson.

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