12

Author:Lyndsey Smith, Senior Physiotherapist,Therapy Services

© January 2015James Paget University Hospitals NHSFoundation TrustReview Date: January 2018PH 27 version 1

The hospital is able to arrange for an interpreter to assist you in communicating effectively with staff during your stay through INTRAN.

If you need an interpreter or a person to sign,please let us know.

If you require a large print version of this booklet, please contact PALS on

01493 453240

Courtesy and respectA welcoming and positive attitude• Polite, friendly and interested in people• Value and respect people as individuals•

So people feel welcome

Attentively kind and helpfulLook out for dignity, privacy & humanity• Attentive, responsive & take time to help• Visible presence of staff to provide care•

So people feel cared for

Responsive communicationListen to people & answer their questions• Keep people clearly informed• Involve people•

So people feel in control

Effective and professionalSafe, knowledgeable and reassuring• Effective care / services from joined up teams• Organised and timely, looking to improve•

So people feel safe

James Paget University HospitalsNHS Foundation Trust

Courtesy and res

Patient Information

Capsule Release following a Frozen Shoulder

James Paget University HospitalsNHS Foundation Trust

2

IntroductionThis booklet provides information and advice about your shoulder surgery and to aid your recovery and rehabilitation during your stay at the James Paget University Hospital and once you are discharged from hospital.

The aim of your surgery and post-operative advice is to regain as much range of movement of your shoulder as soon as pain allows.

11

What happens when I’m discharged?You are expected to complete your exercises regime on discharge.

On discharge, your physiotherapist from the ward will refer you for outpatient physiotherapy. The location of the outpatient physiotherapist will depend upon you GP address. They will typically contact you within the fi rst four weeks of your surgery. They will aim to improve your shoulder movements and function.

Contact numbers

Ward 7: 01493 452007

Orthopaedic Therapy Offi ce: 01493 453849

10

Exercise 5

Move operated hand up towards your face. Return to start position.

Exercise 6

Open and close your hand as shown.

3

Reasons for your operationThe shoulder is normally a very mobile and fl exible joint.

A frozen shoulder (or adhesive capsulitis) is when the shoulder becomes infl amed and scarred resulting in pain, stiffness and reduced movement.

A capsule release involves removing this scarring and sometimes the infl amed capsule.

This aims to increase your movement and reduce your shoulder pain and stiffness.

4

Post-operative advice

The woundYou will have two to three small puncture wounds which will be closed with small sticking plaster strips. Keep the wounds dry until they are healed, which is normally within eight to ten days. You can wash or shower with your waterproof dressing straight after your operation but do not submerge under water e.g. bath. After 10 days, you may shower without the dressing. Avoid using spray deodorant, talcum powder or perfumes near or on the wounds until they are healed to reduce the risk of infection. The dressing will normally be removed at your GP practice between 10 and 14 days post-surgery.

The slingYou will be provided with a sling to wear for your comfort during the fi rst few days post-operation. After this time you should remove the sling to allow more shoulder movement.

9

Exercise 3

Clasp hands together. Use good arm to move your operated arm out, away from body. Return to start position.

Exercise 4

Holding a stick/pole with both hands, use your un-operated arm to move the stick out away from the body on operated side.

8

Exercise 1

With fi ngers entwined and palms together push away from you as far as pain allows, then return to the start position.

Exercise 2

With fi ngers entwined and palms together push upwards in front of your chin as far as pain allows, then return to the start position.

5

SleepingIt is best to avoid sleeping on the side of your operation. If you choose to lie on the other side, you can rest your arm on pillows placed in front of you. You may fi nd it comfortable to sleep in a more upright position initially.

Movement and functionYou should aim to increase your range of movement immediately after your operation as pain allows. Once full movement has been achieved you may begin to carry out light tasks. It can take from six to nine months to fully recover.

Return to workDiscuss with your consultant in the fi rst instance but expect to return to light work after two to four weeks. Return to heavy lifting and overhead work may require a longer period of rest.

DrivingIt is best to avoid driving after your procedure and for the fi rst few weeks. You must feel comfortable and be able to safely operate the vehicle before returning to driving. Talk with your GP or consultant to discuss this further.

It is advisable to contact your insurance company to inform them of your procedure.

6

Peripheral Nerve BlocksSome patients will have had a peripheral nerve block during the operation. This may result in reduced feeling and movement in your operated arm and shoulder.

This anaesthetic technique is very safe and effective. Serious complications are very rare.

Normal side effects of regional anaesthesia include numbness and heaviness in your limb. These symptoms might still be present when you are discharged home. They should resolve within 48 hours, and strength and feeling in your limbs should return to normal.

Remember to protect your limb from potential hazards while there is still numbness and weakness (for example hot surfaces).

Please call us for advice if you have any concerns regarding your anaesthetic management once you are at home or experience any of the following symptoms within your fi rst week at home.

A • suspicion of infection around the injection site of the nerve block. Signs include a temperature, localized redness, tenderness, swelling or oozing from the wound site.

Any • pain or weakness in your arm which did not exist before your surgery and you do not think was caused by your surgery.

Persisted numbness• or altered sensation in your arm.

Any • new numbness or weakness in your arm which develops after your discharge home.

If you have had a peripheral nerve block and have any queries during the week between 07.00 and 19.00, please contact the Hospital switchboard on 01493 452452 and ask to speak to the ‘Anaesthetist of the Day/Trouble Shooter’.

Out of hours or at weekends please ask to speak to the Anaesthetist-on-call.

7

Physiotherapy shoulder exercisesShoulder exercises should begin straight away following your procedure. Movement in all directions should be as far as your pain allows.

It is important to have a balance between rest and exercising your shoulder. Aim to complete your exercises three to four times daily.

It is important that you have adequate pain relief to allow you to complete your exercises effectively so take the analgesia offered to you and tell your nurse, doctor or physiotherapist if your pain is preventing you from completing your exercises.