Most people we interviewed were very happy with the information they’d been given by health professionals before and at the pre-operative assessment, particularly about the operation (see Sources of information on shoulder surgery). They also praised the information on the technology-enhanced patient information (TEPI) videos about the surgery, pre-operative assessment, what happens on the day of the operation, and recovery.
Many people said they had all the information they needed, though a few looked at websites such as YouTube to watch videos of the actual surgery. Information that participants would have liked from health professionals but felt was missing from leaflets or the TEPI videos focussed on:
- the risks of surgery
- managing at home and exercising
- recovery time
- the follow-up appointment
Risks of surgery
A few people had had problems after surgery and wished they’d been warned more about these. Jenny developed a nerve problem and said the possibility of having this hadn’t been mentioned before surgery. She felt she’d been told about the advantages of surgery but not the risks.
Patricia was very disappointed because she was still having lots of shoulder pain after surgery and limited arm movement. She felt the surgery had made no difference and was waiting to see a consultant to find out why she still had pain and limited movement.
Patricia was interviewed about 8 weeks after surgery. Many patients still have problems at this early stage and doctors suggest that with physiotherapy and more time, the shoulder is likely to improve.
Patricia would have liked to know before surgery that the operation might not work and about the type of operation shed be having and why.
Subacromial shoulder surgery is relatively straightforward. Patients are usually fully mobile within an hour or two and able to go home the same day, with some simple painkillers to take during recovery. Full recovery, however, can take many weeks or months and physiotherapy exercises are an important part of getting the best results. Complications are quite rare and include infection, stiffness/frozen shoulder, no improvement, and recurrence of pain.
A doctor talks about the risks of subacromial shoulder surgery.
Beverley had had shoulder surgery before and wondered if she’d get calcium build-up again. She wanted to find out more about this at the follow-up appointment. Mary had two “episodes” after surgery, where she had very bad pain triggered by certain movements, and wondered if her shoulder would completely recover with time.
Managing at home and exercising
A few people would have liked to know more about managing when back at home.
Alan would have liked advice on getting in and out of the bath. Jenny, who lives alone, had a lot of pain after the operation and found it hard to shower, wash her hair, and garden. She would have liked more information on managing in the early stages of recovery.
Doing everything with one arm was hard in the first few days. This included going to the toilet, getting out of the bath and reaching things in high places.
Mary’s only question when she was recovering was about when to have the stitches removed:
The discharge letter, leaflet and TEPI video gave different information about when to get stitches removed. Mary should have had them removed earlier.
Exercising was a key factor in recovery, discussed by many participants. Most were pleased to have a TEPI video they could watch at home to guide them, refresh their memory, and help them do the exercises correctly. Sue said the TEPI videos were “absolutely brilliant” but she would have liked a set of exercises that people could do later into their recovery.
The TEPI exercises are good for the early stages of recovery. Five weeks after surgery Sue would have liked to know about exercises to do after 6 weeks.
Ken also would have liked more challenging exercises on the TEPI video and looked on YouTube and other websites to find these:
Ken would like the TEPI exercises to be tailored for use by different age groups and fitness levels. He found them easy and had done them all by the first week.
David said he didn’t know that patients are advised to rest after keyhole surgery, which he assumed was minor surgery. Although he’d been given lots of information, he hadn’t read through it. He watched the videos 4 or 5 times before surgery and showed them to his wife and sons. He went back to work 2 days after the operation and wished he’d been told more about recovery time, the importance of exercising, and that he’d read through the leaflets:
David didn’t realise that keyhole surgery takes time to recover from. Going back to work too soon slowed his recovery down.
David didn’t do the exercises because he was active at work 2 days after surgery. Nicola also didn’t do the exercises recommended by the physio because she “just got up and got on with it”. She felt that she was “doing exercises anyway, every day all day. I lift my arms up to make the beds, to do the sheets and, sometimes when I lift up to the cupboard, it hurts. But I’d keep doing it. So I’m gradually doing things, so I think I’m exercising.”
Many people we spoke to wanted to know how long they’d take to recover, often saying that it was taking longer than they’d been told by doctors or longer than they’d expected. Taking time off work had been an important consideration in deciding to have the operation and when to have it, so knowing about recovery time was crucial.
A doctors talks about recovering from subacromial shoulder surgery.
It usually takes between 2 and 6 months to make a full recovery from subacromial decompression surgery but it can take longer. How long it takes depends on a number of things, including how healthy a person is before the operation and how well they keep up with the exercises after the operation. Returning to work depends on the type of work a person does. Most people return within 4 weeks.
This video explains more about recovery and returning to work:
Rosemary expected to recover in 6 weeks and felt that recovery was taking longer than she’d expected. Had she known this could happen, she might not have agreed to have the operation. Jasmine also wondered how long recovery would take. She was recovering well and wanted to see a physio about more advanced exercises so she could improve further.
Jenny thought she’d be back to work after 3 weeks but felt upset that the pain was still affecting her everyday life. Having surgery was having a financial and emotional impact as she was still not well enough go to back work:
Jenny has had problems since having surgery. She expected to go to work soon after the operation and is finding it hard to live on statutory sick pay.
Taking time off to recover had to come second to earning a living for Nicola, a single mum. She would have liked to take more time off to recover properly but had had to go back to work:
Nicola could only have sick pay for 2 weeks. Advice on managing financially would have been helpful.
Recovering from shoulder surgery was taking Rosemary longer than from the hip replacement operation she’d had 2 years earlier. 9 weeks after surgery she still felt very bruised and had another follow-up appointment lined up with the physio.
Ken felt he had full arm movement but still had pain more than 2 months after surgery when he did things that required a bit more strength, including playing badminton.
Rosemary thought shed recover in 6 weeks. Nine weeks after surgery, her arm muscle feels bruised. The physio strapped her shoulder up and wants to see her again.
The follow-up appointment
Most people knew little or nothing about what the follow-up appointment would involve and who they’d be seen by. Mary realised at follow-up that she’d done one of the exercises wrong and felt that an appointment with a physio sooner would have been helpful. She saw the physio at her follow-up appointment, around 6 weeks after surgery but, like many people we interviewed, hadn’t known what the appointment would involve (see The follow-up appointment for shoulder surgery).