Post-Surgery Care: Managing Muscle Tension and Wound Healing After Orthopedic Surgery

Postoperative wound and generalized muscle tension?

Hello Doctor: I was involved in a car accident on the night of May 9, resulting in a left clavicle fracture, a mild concussion, and multiple abrasions and contusions.
I underwent plate fixation surgery on the morning of May 11, with the sutures placed on the inner side of the wound, so the skin was secured with cosmetic glue.
I was discharged on the 15th and am scheduled for my first follow-up appointment at the end of the month.
I work in rural education in Hualien, primarily involving desk work and teaching on stage.
Due to uncertainties regarding post-operative care (I was unable to ask for details during my hospitalization as my attending physician was on leave), I would like to ask a few questions:
1.
I have experienced overall weakness except for my left arm due to prolonged bed rest and would like to perform simple stretching exercises, but I am afraid of straining the wound and often cannot complete them.
Is it safe to stretch my back muscles while pressing on the wound and leaning backward?
2.
The on-duty nurse mentioned that I should avoid shrugging my shoulders to prevent incomplete healing, but when I lie flat to sleep, I feel a tendency to shrug my shoulders, which disrupts my sleep.
Could you advise me on other sleeping positions I should be aware of besides lying flat?
3.
Following up on the previous question, since I have only been using the arm sling for less than a week, is it permissible to remove it while sleeping to allow my elbow to straighten? Additionally, when I want to engage in light activity with my left arm, can I remove the arm sling for extended periods (about one to two hours at a time)? Most of the information I found pertains to the first one or two weeks post-surgery, so I would like to know if it is acceptable to alleviate muscle tension and insomnia due to anxiety during this period.
Thank you for your guidance, Doctor!

Jerry, 20~29 year old female. Ask Date: 2023/05/16

Dr. Shi Guozheng reply Orthopedics

1.
The left arm can perform some movements, but it still needs to be supported with a sling.

2.
Avoid putting pressure on the wound; the pain should improve in about one to two weeks.

3.
It is not necessary to use the sling while sleeping, and it can also be occasionally removed during the day.

Reply Date: 2023/05/16

More Info

Post-surgery care is crucial for recovery, especially after orthopedic procedures like your recent clavicle surgery. Managing muscle tension and ensuring proper wound healing are essential components of your rehabilitation process. Here’s a comprehensive response to your questions, along with some additional insights into post-operative care.

1. Stretching and Muscle Tension: It’s understandable that you want to engage in light stretching to alleviate the overall muscle weakness from being bedridden. However, caution is necessary, especially regarding your surgical site. When performing back stretches, it’s advisable to avoid any movements that could place strain on the incision area. Instead of pressing on the wound while leaning back, consider gentle stretches that do not involve the upper body. Focus on lower body stretches or seated stretches that keep your arms stable. Always listen to your body; if you feel discomfort or pain, stop immediately.

2. Sleeping Position and Shoulder Elevation: Sleeping can be challenging post-surgery, especially if you’re concerned about shoulder elevation. While lying flat may cause you to inadvertently elevate your shoulder, you can try using pillows to support your arm and keep it in a neutral position. A reclined position may also help alleviate discomfort and prevent shoulder elevation. If you find that sleeping on your back is uncomfortable, consider side sleeping with a pillow to support your arm, ensuring that it is not elevated too high. It’s essential to find a position that allows you to rest without compromising your healing.

3. Use of Arm Sling: The arm sling is designed to immobilize your shoulder and promote healing. While it’s important to wear it as prescribed, you can take it off for short periods to allow for gentle movement and circulation. However, avoid any activities that could strain your shoulder during these breaks. If you feel comfortable, you can remove the sling for about one to two hours at a time, focusing on light movements that do not cause pain. Gradually increasing your activity level while being mindful of your limits will help prevent muscle stiffness and tension.

Additional Considerations:
- Wound Care: Keep an eye on your surgical site for any signs of infection, such as increased redness, swelling, or discharge. Follow your surgeon's instructions for wound care meticulously, including keeping the area clean and dry.

- Pain Management: If you experience significant pain or discomfort, consult your healthcare provider about appropriate pain management strategies. Over-the-counter pain relievers may be helpful, but always follow your doctor's recommendations.

- Physical Therapy: Once cleared by your physician, consider engaging in physical therapy. A physical therapist can provide tailored exercises to improve strength and mobility while ensuring that you do not overexert yourself.

- Nutrition and Hydration: Proper nutrition and hydration play a vital role in recovery. Ensure you consume a balanced diet rich in vitamins and minerals to support healing, particularly protein, which is essential for tissue repair.

In summary, while it’s natural to feel anxious about your recovery, taking a proactive approach to your rehabilitation can significantly enhance your healing process. Always communicate openly with your healthcare team about any concerns or symptoms you experience. They can provide personalized advice and adjustments to your recovery plan as needed. Remember, recovery is a gradual process, and it’s essential to be patient with yourself as you heal.

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