Rotator cuff surgery repairs the tendons connecting the upper arm bone to the shoulder socket, restoring stability and function. While the procedure is a single event, successful outcomes rely heavily on preparation beginning weeks or months prior to the scheduled date. This proactive approach optimizes the patient’s body, ensures the surgical team has necessary information, and makes the home environment safe for the recovery period.
Required Clinical Clearance and Medication Adjustments
Preparing for surgery requires obtaining medical clearance to confirm the patient is healthy enough for the procedure and anesthesia. This often necessitates a pre-operative physical exam from a primary care physician within 30 days of the surgery date. Patients with existing heart or lung issues will likely require a specialized clearance letter from a cardiologist or pulmonologist. Standard pre-operative testing typically includes blood work and potentially an electrocardiogram (EKG) to assess heart function.
A detailed review of all current medications and supplements is important, as many can increase the risk of bleeding during surgery. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, along with aspirin, are usually discontinued 7 to 10 days before the procedure. Supplements such as high-dose Vitamin E, fish oil, and various herbal remedies must also be stopped approximately one week prior to surgery due to their blood-thinning properties. Individuals taking prescribed anticoagulants like warfarin must obtain specific instructions from their prescribing physician regarding temporary discontinuation or switching to a shorter-acting blood thinner.
Physical Preparation and Pre-Habilitation
The period before surgery offers a window to optimize the physical state of the body, known as pre-habilitation. If prescribed, pre-hab exercises focus on maintaining the existing range of motion and strength in the affected shoulder within a pain-free range. Low-impact movements, such as pendulum exercises where the arm hangs freely and gently swings, promote mobility without stressing the damaged tendons. Strengthening the muscles surrounding the shoulder blade (scapular stabilizers) is also beneficial for supporting the joint before and after the repair.
While the injured shoulder requires careful management, patients should focus on strengthening the core, legs, and especially the unaffected arm. The non-operative arm will bear the burden of nearly all daily tasks for several weeks, making its strength and dexterity important for independence. Patients should practice performing tasks using only that hand, such as opening jars, preparing simple meals, and managing personal hygiene. This rehearsal helps identify potential challenges and develop compensatory strategies needed while the surgical arm is immobilized in a sling.
Logistical and Home Environment Adjustments
Planning the home environment is crucial for safety and comfort, as the surgical arm will be immobilized for several weeks. A designated recovery zone should be established, ideally on the main floor to avoid navigating stairs during the initial phase. A comfortable recliner is often preferred over a bed, as sleeping semi-upright minimizes strain on the repair site. All frequently used items, including the television remote, phone charger, water bottle, and medications, must be placed within easy reach of the non-operative hand.
Accessibility within the home should be maximized to prevent falls, as balance may be compromised when wearing a bulky sling. Tripping hazards must be removed, such as throw rugs and loose wires, and adequate lighting should be ensured, particularly in hallways. In the kitchen, move lightweight dishes and food items from high shelves to lower cabinets to eliminate the need to reach or stretch. Preparing several weeks’ worth of freezer meals or arranging for a meal delivery service is important, as cooking with one hand is difficult.
The post-operative wardrobe requires specific attention to accommodate the immobilized arm. Clothes must be loose-fitting and open in the front, such as button-up shirts or zip-up hoodies. When dressing, the surgical arm should always be inserted into the sleeve first, and then the garment is pulled over the torso. Securing transportation is also important, as driving will be prohibited for an extended period, requiring arrangements for all post-operative appointments and errands.
The Final 24 Hours Before Surgery
The day before surgery focuses on final preparations and strict adherence to the surgeon’s instructions. The most important rule is the fasting requirement: consuming absolutely no food or drink, including water, gum, or hard candy, after midnight. This prevents the risk of aspiration during anesthesia, though the surgical team may provide specific instructions about taking approved medications with a small sip of water.
A pre-operative shower with an antimicrobial soap, if provided, is often required to minimize the risk of infection at the surgical site. Before heading to the facility, all jewelry, body piercings, and makeup must be removed. Nail polish must typically be removed from at least one finger to allow for accurate monitoring of oxygen saturation. The hospital bag should contain identification, insurance information, loose clothing for the return trip, and comfortable slip-on shoes, which are easier to manage with one hand. Confirm the exact arrival time and location with the surgery center, as the schedule can sometimes be adjusted the day before the procedure.