Question :

Rehab Post labral tear and capsule shift shoulder surgery

Dear Ask The Doctor:
I recently had shoulder surgery on Dec 16th, 2010 to repair a torn Labrum. I believe the surgery was called "L shoulder scope and capsule shift repair". I recently started therapy on January 31st 2011, but something isn't right. I of course have a weak shoulder and arm, and I constantly have a sharp deep pain in the top of my shoulder, and when I try to follow the therapy diagrams every day, the pain gets worse. To make matters worse, every single muscle in my upper arm (tricep, bicep) and my trap, along with my left back muscle always seem to hurt, feel pulled and strained and I get shots of pain in those muscles randomly. I talked to my doctor and physical therapist and they gave me a STIM unit, and also told me to use a heating pad before therapy and ice after. This is all fine and good, but I am still having annoying pain constantly. I only missed 2 days of work since Dec 16th since I had the surgery and I opted out to take the 6-8 weeks off. I am worried something doesn't feel right here but everyone else seems to think it is normal. I am currently not on any pain medication and have not been since January 10th, but I really think that I should get a script for therapy, but I don't know if this is normal or not. I have been trying to get along with this annoying pain, weak shoulder and arm and have not worn the sling for 2 weeks now. My doctor and therapist suggest I follow through therapy three times a day, but I can only physically manage once with all of the pain and discomfort. My question now, is this normal to experience? How long do I expect to be in this state? Should I be on any anti inflammatory medication or pain medication for therapy? Also, is there something else I can do to get through this misery, yet still be able to function at work? I just feel like everything was going so good until I had to start therapy. Now I feel like my doctor left me in the dust.


Answer :

Dear Patient: 
You only have 3 weeks in rehab therapy and everything that your doctor and therapist have told you to do is right, meaning: using the TENS unit, the hot before and cold after the exercises to control pain and inflammation, which is normal the first weeks of therapy after the suurgery. Of course you could use some anti inflammatory medication to help you with the pain (“Aleve”, “Motrin”).It is very important to complete a intensive and comprehensive Rehabilitation program after the surgery to ensure that you strengthen and balance the muscles around the shoulder joint giving stability, improve range of motion, prevent scarring as the ligaments heal and also teach you which movements and / or activities you should avoid. It is advised that you do the exercises as many times a day as you can tolerate to speed your recovery.


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