Shoulder Therapy

Dr. Koo’s Post-Op Instructions

Reverse and Total Shoulder Replacement Patients

Rest but Walk: Plan to rest from your normal activity for 1-2 weeks following surgery. You must be off all narcotics before you return to work, drive a car, or operate machinery. Walk every hour to prevent blood clots. 

Physical Therapy: Starts after your first post-op visit when you will receive a prescription for PT and get a list of recommended therapists who specialize in shoulder rehabilitation.

Take Pain Medication as directed: This is a painful surgery. Pain pills should be taken with food to prevent nausea. We recommend fluids, fruits, and Miralax over the counter for constipation. 

Plan Ahead: Prescriptions can take 24 hours to process and have ready for you to pick up. Narcotics, by law, must be written prescriptions- no refills, no calling it in for faxing to pharmacy. 

Start taking the pain medication as soon as you get home. If given Oxycodone, you can take up to three tablets every 4-6 hours for severe pain, then taper down slowly over the next few days. You can take Tylenol with Oxycodone. Do no exceed six 500mg tablets in a 24 hour period. Do not take Tylenol if given Percocet; Percocet has Tylenol in it.

You Medication: You can go back on all your previous medications when you get home from the hospital, unless otherwise instructed.

No Blood Thinners (Aspirin, Advil, Ibuprofen, Aleve, Fish or Flaxseed Oil) for 5-7 days before surgery. If taking Coumadin/Warfarin, or Plavix – please get recommendations from your cardiologist to assist us in making a safe plan for you.

Ice the shoulder as much as possible to decrease pain and inflammation. Ice 30 minutes each hour while awake and resting. Do not fall asleep with ice.

Sleeping is difficult the first month. We recommend sleeping in a recliner.

Sling: You will be given a sling for 3-4 weeks depending on your surgery. Please talk with Dr. Koo or Claudia to discuss when to wear it. Generally, we want you to sleep in it and remove the sling during part of the day to extend the elbow and rotate shoulder while keeping the elbow by your side. 

No lifting anything more than 2 pounds. No pushing yourself up off the chair or bed with the affected arm.

Bandages: Keep incisions dry for 7 days, then okay to remove the bulky dressing and shower. Do not re-apply a dressing. Keep steri-strips in place until your post-op appointment. Steri-strips can get wet in the shower. Do not soak wound in a tub for a month. Do not apply Band-Aids, ointments, or creams.

Arthroscopy Post-Operative Protocol

Bowel Post-Operative Protocol

Total and Reverse Shoulder Replacement Post-Operative Instructions


Call the doctor (425) 216-4220 if:

Severe, unrelenting pain in your shoulder

Swelling, that does not get better with ice after 24 hours

Fever of over 101 degrees, chills, or flu-like symptom, or problems urinating