Shoulder pain can impact your daily life, limiting your ability to perform tasks, enjoy hobbies, and even get a good night’s sleep. If you’re experiencing persistent shoulder discomfort, reduced range of motion, or weakness, you’re not alone.

Fortunately, advancements in orthopedic surgery offer possible solutions, and one of the most common and successful is shoulder arthroscopy. In this post, we’ll explore the shoulder arthroscopy procedure, including conditions it may help treat and what the recovery process looks like.

• Minimally Invasive Approach: Shoulder arthroscopy uses small incisions, a tiny camera (arthroscope), and specialized instruments to diagnose and treat shoulder conditions.
• Wide Range of Conditions Treated: It can be used for issues like rotator cuff tears, labral tears, bone spurs, shoulder impingement, bursitis, AC arthritis, biceps tendinitis, and shoulder instability.
• Faster Recovery: Patients often experience less pain and quicker recovery times than with open surgery.

Shoulder arthroscopy is a minimally invasive surgical procedure that allows orthopedic surgeons to visualize, diagnose, and treat problems inside the shoulder joint without making large incisions. This technique involves inserting a small camera, called an arthroscope, into the shoulder through tiny incisions.

The arthroscope transmits real-time images of the joint’s interior to a video monitor, providing the surgeon with a clear, magnified view of the bones, cartilage, ligaments, and tendons. Once the problem is identified, specialized miniature surgical instruments are inserted through additional small incisions to perform necessary repairs or procedures.

The potential advantages of arthroscopic surgery are numerous:

• Minimally Invasive: Arthroscopy involves much smaller incisions. In open surgery, a larger incision is made, often requiring muscles to be cut or detached to access the joint, which may prolong recovery and increase pain.
• Reduced Pain and Swelling: Smaller incisions and less tissue disruption may translate to less post-operative pain and swelling.
• Faster Recovery Time: With less tissue damage, the body may heal more quickly.
• Minimized Scarring: The small incisions result in minimal scarring, which is an advantage for many patients.

Shoulder arthroscopy is not the first line of treatment for all shoulder problems. Often, conservative treatments such as rest, ice, physical therapy, anti-inflammatory medications, or PRP injections are attempted first.

However, when these non-surgical approaches fail to provide adequate relief, or when the nature of the injury necessitates surgical intervention, in many cases, shoulder arthroscopy becomes a recommended option. An experienced shoulder specialist can evaluate the injury and help guide if shoulder arthroscopy may be the best option for you.

Patients who may benefit from shoulder arthroscopy often present with a combination of symptoms that impact their quality of life. These may include persistent shoulder pain, weakness, instability, or crepitus (clicking, grinding, or popping sounds or sensations).

Shoulder arthroscopy is a versatile procedure capable of addressing a wide array of conditions affecting the shoulder joint and its surrounding soft tissues. Some of the most common conditions treated include:

• Rotator Cuff Tears
• Bursitis/Subacromial Impingement
• Labral Tears
• AC Arthritis
• Biceps Tendinitis
• Shoulder Dislocation or Instability

Understanding what to expect on the day of surgery can help alleviate anxiety and ensure you are well-prepared.

Proper preparation is key to a successful outcome and a smooth recovery. Your medical team will provide you with specific instructions, but general preparations include:

• Medical Evaluation: You may need to undergo a pre-operative medical evaluation to ensure you are healthy enough for surgery.
• Medication Review: It is important to inform your surgeon of all medications and supplements you are taking. You may be advised to stop taking certain medications, such as blood thinners or some supplements, for a period before surgery.
• Fasting: You will typically be instructed to pause eating or drinking after midnight the night before surgery.
• Arranging for Assistance: It is important to arrange for someone to drive you home following the procedure.
• Home Preparation: Prepare your home for your return. This might include having loose-fitting clothing (like button-down shirts and elastic-waist pants) readily available, preparing meals in advance, and setting up a comfortable resting area.

On the day of your surgery, you will arrive at the surgical facility, where you will be checked in and prepared for the procedure. This typically includes changing into a hospital gown and having your vital signs checked. The anesthesiologist will meet with you to discuss the anesthesia plan.

1. Incisions: Your surgeon will make a few small incisions around your shoulder. These incisions are typically less than half an inch long.
2. Arthroscope Insertion: The arthroscope camera is inserted through one of the incisions. The camera on its tip sends a live video feed to a monitor.
3. Joint Inflation: A sterile fluid (saline) may be pumped into the joint to expand it. This creates more room for the surgeon to work and helps to keep the view clear.
4. Diagnosis and Treatment: With the arthroscope, your surgeon will thoroughly examine the joint to confirm the diagnosis and identify any other issues. Then, specialized surgical instruments are inserted through the other incisions to perform the necessary repairs.
5. Closure: Once the repair is complete, the instruments are removed, the fluid is drained from the joint, and the small incisions are closed with sutures or surgical tape and covered with a sterile dressing.

After the procedure, you will be moved to a recovery room where you will be monitored as you wake up from the anesthesia. Your arm will likely be in a sling to protect the shoulder and keep it in a comfortable position. For the first 12-24 hours after surgery, you may have limited control of the operated arm due to the regional anesthesia or “block” used for initial pain control.

Once you are stable and awake, you will be given post-operative instructions, and your pre-arranged ride will be able to take you home. Shoulder arthroscopy is typically an outpatient procedure, meaning you will not need to stay in the hospital overnight.

The recovery process after shoulder arthroscopy is a gradual one, and it is essential to follow your surgeon’s instructions carefully to ensure the best possible outcome. The timeline and specifics of your recovery will depend on the complexity of your procedure and your individual healing process.

In the immediate aftermath of your surgery, your primary focus will be on managing pain and protecting your shoulder. Your arm may be in a sling to immobilize and protect the surgical site. You will need to wear the sling as instructed, often even while sleeping, to prevent accidental movements that could compromise the surgical repair. Swelling is also common, and applying ice or taking medications may be recommended to reduce both pain and swelling.

Physical therapy is often a key part of recovery after shoulder arthroscopy. The goal of physical therapy is to restore range of motion, strength, and function. The timing and intensity of your physical therapy program will be tailored to your specific procedure.

• Passive Motion: In the early stages, especially after a repair, your physical therapist will generally guide your arm through gentle, passive range-of-motion exercises. This means the therapist moves your arm for you, without you using your own muscles. This helps to prevent stiffness without stressing the healing tissues.
• Active Motion: As you heal, you may progress to active range-of-motion exercises, where you use your own muscles to move your arm. These exercises are gradually introduced to improve your mobility and control.
• Strengthening: Once your range of motion has improved and the surgical repair is strong enough, you may begin strengthening exercises. These exercises are designed to rebuild the muscles around your shoulder, providing stability and support to the joint.

The timeline for returning to your normal activities varies from person to person and depends on the nature of the surgery.

• Driving: Patients generally should not drive as long as they are taking prescription pain medication, or if they do not yet feel safe to drive. Most patients are able to return to driving as soon as two weeks following the procedure.
• Work: If working a desk job, patients may be able to return to work within a few days to a week. For those with more physically demanding jobs that involve lifting or overhead movements, it may take several months before returning to full duties.
• Sports and Recreation: Returning to sports and recreational activities requires patience. For arthroscopy without repair, many patients may return to athletic activity at 6 to 8 weeks, though timelines vary. However, for more complex repairs, it can take around 4 to 6 months.

Recovery can be a gradual process. By following your post-operative instructions, actively participating in physical therapy, and communicating with your medical team, you can support a successful recovery.

Shoulder arthroscopy offers a minimally invasive approach with numerous potential benefits over traditional open surgery. From diagnosing complex issues to repairing damaged tissues, this procedure may provide a pathway to pain relief, improved function, and a faster return to activities.

If you are experiencing persistent shoulder pain or dysfunction, seeking expert medical advice is the first step. By understanding what shoulder arthroscopy entails, when it is recommended, and what to expect during recovery, you can make informed decisions about your health and take proactive steps toward regaining full shoulder health and mobility.

The duration of sling use depends on the type of procedure performed. For minor debridement, it might be a few days to a week. For rotator cuff repairs or other more complex procedures, you may need to wear the sling for around six weeks to protect the healing tissues.

This varies greatly. For some procedures, light activities might resume in a few weeks to months. For more complex repairs, it can take six months for a gradual return to athletic activities, with full recovery sometimes taking up to a year. Your surgeon can provide a personalized timeline based on your specific surgery and recovery progress.

Many patients benefit significantly from physical therapy. It aims to help restore range of motion, strength, and overall function. Your physical therapy program will be tailored to your individual needs and the specifics of your surgery.