Last week I began sharing my story about my left arthroscopic rotator cuff repair. As reminder, I had surgery on May 20. In this post, I will share more about the first week. I get many common questions like: How bad does it hurt? When can you get rid of the sling? How long is the total recovery?

The entire outpatient procedure went well. I barely remember getting an interscalene block (kudos to the anesthesiologist) and the entire operation lasted about 45 minutes. The  oldest feeling is not feeling the left arm and having no control of the arm until the block wears off. The entire arm is essentially paralyzed and numb. Great for pain management to be sure, but not even being able to use the hand is inconvenient for small prehensile tasks.

I was fortunate that I did not have any adverse reaction to the anesthesia itself. I was a bit tired and groggy for the first 4-6 ours after surgery. The biggest adjustment is getting used to the sling and abduction pillow (see below)

Learning how to sit, adjust and take this off/put it on takes some getting used to. However, I quickly learned how valuable and supportive it was once the block wore off. My surgery was at 8:45 AM on a Thursday. The block wore off about 18 hours later at 3 AM. Let’s just say that aha moment was enough to get my attention.


I would say pain level was 7/10 for me. The doctor and his staff had advised me to start taking pain pills ahead of the block wearing off and I had initiated that about 8 hours after surgery. I was alternating ibuprofen every 2 hours while taking oxycodone every 4 hours. I can only imagine how much more it would have hurt if I had waited for the block to wear off.


The first 3-4 days afterward were the worst in terms of pain. Generally, pain at rest was probably 3-4/10, occasionally spiking to 9/10 if I moved the wrong way. Aside from the meds, I used cryotherapy, specifically a Game Ready, extensively (20 minutes on, 40 minutes off) 8-10 times per day the first week. I cannot say enough about how helpful this is in managing pain and inflammation.

This unit provides cold and compression, however, I would recommend low or no compression initially as your incisions will be tender, especially once the surgical dressing is removed at day 3 post-op. I sat upright in a chair and supported the elbow while using this machine. The hospital or outpatient facility will offer a polar care unit for $250, but I opted for this unit as I have used it for years in the clinic, while hearing countless patients tell me how much better it is. A 3-week rental will cost you $300, but it is well worth it.


The biggest milestone the first week was taking a shower on day 3 post-op (72 hours after surgery). My wife helped remove the bulky surgical dressing and tape. The hardest thing is getting your shirt on/off the first week, so I highly recommend button downs or oversized t-shirts, while getting help from someone in your household. This is your first chance to peek at the skin around the incisions to ensure there are no signs of infection. You will also see where the MD identifies anatomical landmarks. Do NOT take the steri-strips off until you go back to the doctor (or unless they fall off).

My shoulder at day 3 is below:

You can see the 3 steri-strips over the portal sites, as well as the surgeon’s markings and our initials. I applied waterproof bandaids before and once again after showering to avoid getting the incision sites too wet. Letting the arm dangle did feel good since it had been in the sling for 72 hours straight. Keep in mind during this early phase you will need to use the unaffected arm to do everything as active movement of the surgical arm will be painful, severely limited and contraindicated the first several weeks to avoid strain on the repair.

Early Rehab Exercises

With respect to exercises, I only worked on the following 2x/day from days 3-7:

  • Small pendulums (front-to-back and side-to-side)
  • Active wrist range of motion (up/down)
  • Active forearm supination/pronation
  • Passive elbow flexion and extension

For the pendulums, it is imperative that the arm moves with the trunk/body, meaning that momentum moves the shoulder/arm. There is minimal stress on the repair provided the arm is not initiating the motion (body movement creates the swing of the arm). Early on the motion should be small to minimize stress. Additionally, I made sure my elbow was supported while keeping the arm stationary when performing the wrist, forearm and elbow range of motion exercises. At this early stage of recovery, gentle movement is helpful for reducing stiffness and ROM loss.

The Inflammatory Process

Keep in mind that inflammation reduction and protecting the repair matters most in this phase. Peak and acute inflammation lasts the first 72 hours. Subacute inflammation lasts from day 4 to day 21 post-op. Managing pain and inflammation properly the fist 7-10 days will set the stage of the early recovery period. Resting and not doing too much in week one is paramount. I am active and have a hard time sitting still, so this has been tough for me lol.


Finally, let’s talk about sleeping, or the lack thereof. I spent the week in a recliner or semi-reclined in our bonus room. I could only sleep for about 2 hours at a time, and got 4-5 hours at most during week one. This was definitely the hardest part for me. I found myself napping at times during the day. I tried laying on my back while propping the arm up, however, I found the abduction pillow in the sling made it very difficult for me to get comfortable. I even had a specific post-surgical pillow, but again the sling was problematic.

Check back next week as I dive into my first week of rehab and share more info on my pain response, progress and the exact exercises I have been doing.