Advice following Total Shoulder Replacement

What is Occupational Therapy?

Occupational Therapy provides practical support to empower people to facilitate recovery and overcome barriers preventing them from doing the occupations (or activities) that matter to them. Occupations may include self-care (getting dressed, preparing and eating meals and toileting), being productive (work, studying or caring for others) and leisure activities.

An Occupational Therapist will consider all of the patient’s needs – physical, psychological, social and environmental. This support can make a real difference giving people a renewed sense of purpose, opening up new horizons and changing the way they feel about the future.

What is occupational therapy? (opens in a new tab)

What will the hospital Occupational Therapist do?

Sometimes people find that they are unable to or have difficulty carrying out their occupations (daily activities) following an operation.

Based on our assessment in your pre-operative clinic, the Occupational Therapist may provide:

• Education and advice on how to continue to complete your occupations following your operation.
• Suggestions of minor changes to your home environment for you or your family to put in place on discharge.
• Equipment for your home to support you after your operation.
• Rehabilitation whilst in hospital to work on your agreed treatment goals.
• Working with the multidisciplinary team to coordinate your discharge from hospital including onward referrals to community services if required.

Your Occupational Therapist is:

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Occupational Therapy Team contact information (use this number to provide us with furniture heights or if you have any further queries)

01223 216880

Total Shoulder Replacement pre-operative Clinic (to be completed with your Occupational Therapist):

Recommendations made during your pre-operative clinic appointment:

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Shoulder precautions

After having a shoulder replacement there are certain precautions that you must adhere to in order to help to protect and prolong the life of your new shoulder.

For 6 weeks:

• No heavy lifting (usually no heavier than cup of tea)
• No weight bearing
• Maximum external rotation of 20-30 degrees.
• Do not get dressing wet for 10-14 day
• Use of sling for approximately 3 weeks at home, but for 6 weeks outside the home. (take the sling off for exercises, washing and dressing)
• Do not drive until you can control the steering wheel and complete an emergency stop. This which may be sooner than 6 weeks.

Activities of daily living (ADL)

Getting on and off furniture

• When you stand up or sit down avoid the movement of pushing through your operated arm.
• Avoid sitting on low furniture such as chairs and toilets, that may make it more difficult to get up or avoid the need to push through your operated arm
• When getting out of bed, try not to push through your elbow on your operated side to help sit you up. You may need to sleep higher, using extra pillows to avoid this exertion.

Mobilising

• If you walk with an aid, you will not be able to use your operated arm to hold onto to it post surgery. We will pass this information on to the physio team so they can address this post surgery.
• If you have stairs at home, you will need to avoid using the banister on the side of your operation. When going up or downstairs, you may need to consider going sideways. We will let your physio team know if you might need help with how best to use stair if you have them.

Washing

• You are encouraged to wash yourself as you feel comfortable and are able to use your operated arm to assist with you.
• You are able to shower. If you still have your dressing on it would be beneficial to cover this up. When showering consider if you normally need to hold onto a rail, if this is the case it may be sensible to continue strip washing whilst following shoulder precautions.

Dressing

• Dress your operated arm first and undress it last. It may be worth practising before your surgery to see what clothes feel easy to get on and off.
• You are able to use your operated arm to help dress your lower half also.

Sleeping

· Sleep on your back for two weeks after the surgery. You may wish to wear your sling during the night so it provides support.

Household tasks

• You should avoid heavy housework such as changing bed sheets. As you feel able, you can complete light tasks, for example, dusting. Try to complete any heavier tasks before your surgery.
• You may wish to consider how you will do your shopping after your discharge as you will be unable to drive - can family support you with this or can you do the shopping online? Think about how you will put your shopping away, as you will need to avoid heavy lifting.

Cooking and preparing meals

• Cook simple meals. Consider using ready meals and pre chopped vegetables.
• Before your surgery try to batch cook and stock up your cupboards and freezer.
• Try initially to avoid foods that require a lot of cutting up.
• Before your surgery reorganise your kitchen so items are easy to access
• Practice using your non-operated arm to complete tasks prior to your surgery
• Initially, having a friend or relative to give you a helping hand with these tasks, can be very useful, as you can focus on getting used to your new routine
• If you have any questions or concerns about managing your daily activities, speak to your Occupational Therapist on the ward after your surgery for additional advice.