Labral or Bankart Lesion Repair
and/or Capsular Shift

Bankart or Labral Repair Recovery Plan - Part Two

Patient's Recovery Plan

Maintain dressing. You may add 4x4 bandages if needed for drainage through dressing. Use ice pack for 20 minute periods throughout today. KEEP SLING ON AT ALL TIMES.

Move fingers and wrist often. Expect some swelling. If you have skin color changes or changes in sensation in your arm, notify the doctor.

When sleeping, place 1 or 2 pillows under the operative side elbow to keep arm in place. Begin grip strengthening and wrist range of motion exercises tonight. (See exercise list below.)

** Most patients find sleeping in a semi-upright position is more comfortable for the first few days after shoulder surgery. A reclining chair is often most comfortable.

Follow the same instructions as for the day of surgery noted above.

Day 2: (48 hours post-operatively):

Remove the dressing. The Xeroform gauze strips (small yellow ‘tapes’) can be removed at the time of your first dressing change. You can shower with the dressing off. Do the elbow exercises and shoulder pendulum motion in the shower (see the exercises below.) Support the affected arm with the opposite hand. You may wash under the arm, but do not use a large amount of soap. Too much soap may dry out the skin and cause a rash. After a short shower, dry the shoulder well. Pat the incisions dry, don’t rub the scabs off. Cover each incision with a plain Band-Aid. Do not use and creams or ointments on the incisions.

Resume same activities as surgical day; use ice for 20 min. periods as needed.

Exercise: Once a day, in the shower, you may begin to flex and extend your elbow, keep your arm close to your body, rub palm over stomach, keep palm facing inward. Do your elbow, wrist, and hand exercises at least 2 other times each day. 

**The arm sling must remain on at all other times, including bedtime.

Day 3 - 4: 

Start formal physical therapy program.  Continue home exercise as listed below (adjust exercises as per therapist’s instructions. 

Day 4 – 10:

Change Band-aids daily or as needed. Maintain sling use. Continue exercises as directed under Day 3.

Day 7 – 10: 

The first post-op visit: see Dr Reznik in the office. He will review your surgery with you and further instructions will be given for your rehabilitation and recovery.

Exercises: Do three times each day as directed

Starting Day 1:

Hand Squeezes or Grip Strengthening: Using a small soft rubber ball or soft sponge, squeeze your hand. When in the shower, you can use a sponge filled with water. Do this for 3-5 sets of 10-20 repetitions each day. If this is too easy, later in the rehab course you can use a grip strengthener.

Wrist Range of Motion: Roll your wrist in circles for 30 seconds after each round of grip exercises.

On Day 3 add:

Elbow Range of Motion: Turning your palm inward, towards your stomach, flex and extend the elbow as comfort allows.  This will decrease pain and prevent elbow stiffness.

On Day 4 add:

Pendulum Exercise: Holding the side of a table with your good arm, bend over at the waist, and let the affected arm hang down.  Swing the arm back and forth like a pendulum. Then swing in small circles and slowly make them larger. Do this for a minute or two at a time, rest, then repeat for a total of 5 minutes, 3 times per day.

Not before Day 7-10 add:

Wall Walking: Stand facing a blank wall with your feet about 12 inches away.  “Walk” the fingers of the affected hand up the wall as high as comfort allows. Mark the spot and try to go higher next time. Do at least 10 repetitions, 3 times per day.  When more comfortable and stronger (not before three weeks) do these exercise sideways, with the affected side facing the wall. Walk your finders down the wall as well as up. If you will have weakness on the way down, so use the other arm to help. 

Important: Do not let the hand drop down from the wall—this will be painful and strain the repair.

Biceps Curls: Curl the arm up and down 12 times; rest for one minute and repeat for a total of 3 sets of 12. When comfortable, try it holding a very small can.In a few days you can increase can size only as comfort allows. This exercise should not be painful. If painful decrease or eliminate the weight.

General Instructions for Labral Repair Patients

You may resume a regular diet when you return home. Start with tea or broth and advance slowly with crackers or toast, then a non-spicy sandwich. If you become nauseated, return to clear liquids. You can also try Tums, Zantac or Pepcid AC to help settle your stomach.

After surgery you are encouraged to deep breathe and cough frequently (at lease 3-4 times per day). This will reduce mucous from building up in your lungs, and will reduce the risk of developing pneumonia.

Pain Control: Take medication as prescribed by Dr. Reznik. Do not take all your meds at the same time. Take anti-inflammatory medication with food to avoid stomach upset.    Please call our office with any questions regarding your medication.  After surgery, some patients will see some swelling. Use an ice pack for 20 minutes periods throughout the first 24 hours after surgery and then as needed for comfort and to reduce swelling,

Blood Clots: Patients at high risk: These patients should be taking 1 aspirin per day for 6 weeks after surgery unless allergic to aspirin.

• Those with long car or train commutes

• May be overweight: BMI> 30 *

• Have a history of having cancer

• Females on birth control pills

• Males over the age of 40 

(*BMI or Body Mass Index is a number calculated from a person’s weight and height. BMI provides a reliable indicator of body composition.  A muscle/ fat ratio if you will. The index is used to screen for weight categories that may lead to health problems. For more info and how to calculate or figure out your own BMI click on this link: BMI)

Sling: Patients are to wear the pillow sling at all times (including while at sleep) for the first 3 weeks. Then, it is recommended that patients wear the sling with the pillow removed when going out for the next 3 weeks.This will help to alert others to avoid the affected arm during this important healing period. Move fingers and wrist often. Expect some swelling.

Dressing: The Xeroform gauze strips (small yellow ‘tapes’) can be removed after 48 hours. At this time you may shower with the dressing off. Do the elbow exercises and shoulder pendulum motion in the shower (see the exercises below). Pat the incisions dry, using care not to rub the scabs off and cover each incision with a plain Band-Aid. Do not use and creams or ointments on the incisions.

Exercise: You will begin simple exercises the day of surgery.  They should be done every day for the first week post-op, to maintain blood flow and help prevent blood clots.

Your physical therapy will begin 3-4 days after surgery.  The physical therapist will guide you in your shoulder rehabilitation program. It is very important for you to start therapy when recommended.

Physical Therapy: Vital to your recovery of good shoulder function is a graduated activity and exercise program to increase muscle strength and motion.

To avoid complications, postoperative follow up appointments with your physician are also required to monitor your progress.

Driving:  Patient cannot drive until they are off all pain medications, completely out of the sling, and can easily place hands at 12:00 position on the steering wheel and can move hands freely from the 9:00 – 3:00 position.

Airline Flights: Patients may fly 2-3 weeks after surgery on short flights (up to 2 hours) but should in general wait 6-8 weeks for longer flights. You should get up and walk frequently to avoid blood clots and take an aspirin (unless allergic.)

Returning to Work:  Patients with a small tear, and/or low demand work, can usually return to work within 3 weeks. They will still have restrictions on lifting and overhead use. Patients with higher demand jobs or repetitive arm use need at least 6 weeks. Any heavy labor with overhead lifting can take at least 4-6 months. 

**Dental Work: You cannot have any routine dental work (including cleaning) for at least 3 months after your surgery, or you risk infecting the suture anchors. After 3 months, you may see the dentist, but for one year from date of surgery, you will need to take antibiotics before and after dental work. Call our office, and Dr. Reznik will give you a prescription.

Back to Part One

Revised 1/2/09