Frequently Asked Questions

For the majority of surgeries, regional anesthesia is performed by giving a nerve block prior to surgery, which allows for better pain control after surgery. Most surgeries require you to be asleep during the whole procedure whether you get a regional block or not, therefore general anesthesia is used during surgery.

Specific medications to stop will be discussed in clinic, but you should stop taking any anti-inflammatory medications at least a week before surgery. Blood thinners will need to be stopped as well and this will be discussed in clinic. Stop all herbal medications (including gingko, fish oil, ginseng) or over the counter medications as some of these have been known to increase bleeding risks.

You will need someone to drive you home after surgery as the medications you are given during surgery will make it unsafe for you to drive yourself home.

We use a multi-modal approach to help manage your pain after surgery. This often times begins with taking certain non-narcotic medications prior to surgery. Often times, a nerve block is administered for surgery, which will help numb the operative extremity and aid in initial pain control. We use non-narcotic medications like strong anti-inflammatories and Tylenol (acetaminophen) to manage your pain. Narcotics are given as well, but due to this approach, we like to use these on a limited basis.

Swelling is very common after surgery. Initial swelling after surgery can be expected to go down in the first few weeks, however, swelling is one of the last things to resolve and can remain to a degree for months after surgery.

Although narcotics are used commonly after surgery for initial acute pain management, it is ok to instead use anti-inflammatories like Aleve or ibuprofen. Tylenol (acetaminophen) can also be used together with anti-inflammatories (Aleve or ibuprofen), but should not be used at high doses with narcotics as most narcotic pain medications have Tylenol already added.

For the first 2 weeks after surgery, we want you to use ice 4-5 times a day for 20 minutes at a time. There is no limit to how many times a day you can ice; it will only help with the pain and keep the inflammation down to a minimum. However, you want to limit icing to no more than 20 minutes at a time to prevent damage to the skin, and also, do not ice when you go to sleep. If you have a splint or larger dressing on, you can still place ice over these and still get a benefit, but make sure not to get them wet.

After 2 weeks, you can ice as often as you want, but you don’t need to do it as often. Commonly, you will ice at the end of a long day or after physical therapy.

Constipation is a common side effect of many narcotic-based pain medications such as Norco or Percocet. You may increase your fiber intake to counteract this effect, or you may purchase an over-the-counter stool softener, such as Colace or Senokot, to alleviate the constipation. If you continue to experience constipation with your medication, you may stop taking it and begin taking Motrin, Aleve and/or Tylenol for your pain. Do not combine Tylenol with your narcotic as these medications have Tylenol (acetaminophen) already added to them.

Nausea is a common side effect of many narcotic-based pain medications such as Norco or Percocet. We recommend that you eat prior to taking these medications. If you experience nausea with your medication, you may stop taking it and begin taking Motrin, Aleve and/or Tylenol for your pain. Do not combine Tylenol with your narcotic as these medications have Tylenol (acetaminophen) already added to them. If you need to continue the pain medication, please contact our office and we will call in a prescription to your pharmacy for an anti-nausea medication.

For most procedures, physical therapy begins 1-2 weeks after surgery.

For most arthroscopic procedures, physical therapy will begin 1 week after surgery. You will be given a physical therapy prescription at your first post-operative appointment.

Post-operative infections are not common; however, it is important to be aware of the signs and symptoms of an infection. If you experience any of the below signs/symptoms, please contact our office to speak with the physician:
• Fever (>100.5° F or >38.0° C) and/or chills
• Sudden increase in pain
• Redness around your incisions that is expanding (with increased • warmth to the touch)
• Thick, yellow/white/grey discharge from incisions
• Incisions appear open and/or sutures are not intact

Bruising is a common postoperative finding after most surgical procedures. You may have bruising around your surgical site that can track down your arm/leg. If you notice that there is bruising and you don’t have pain in these places, then don’t worry, this is normal.

Please ask the physician, as this will vary greatly based on the type of procedure.

In general, you may return to work as soon as you feel able. There are many variables to consider outside of the type of procedure you have done including how labor intensive your work is and the amount of time you are required to be on your feet at your job. Commonly for arthroscopic surgery this is 1-2 weeks, but depending on your job, can be over 6 weeks

You may begin to travel and/or fly on an airplane at 1-2 weeks after your surgery.

If you had a total joint replacement (hip or knee), we advise you to walk up and down the aisle for a couple of minutes at least once every hour you are on the airplane. This will help keep blood from pooling in your legs and prevent a clot from developing. These same patients will also need to take one tablet of full strength aspirin (Ecotrin/ASA 325 mg) twice a day on the day before, day of, and day after travel. This should be done for the first 6 weeks after surgery.

In general, you may not drive if you are still taking pain medication. For surgery specific instructions, see below.

Hip/Knee Arthroscopy: You may drive 3 to 5 days after your surgery. If your right leg is the operative side, then you must have good control of your leg prior to driving, so this may be at least 1-2 weeks after surgery and even longer with any knee reconstruction (ACL).

If you were given a knee brace after surgery it is to give added protection to the knee to protect the surgery that was performed and/or give more stability until your thigh is strong again. You will need to wear this at all times after surgery, except to shower, and the total duration you will need to wear the brace will be discussed at your first post-operative visit. There are different settings on the brace that will be changed at your office visits as well.

For knee arthroscopy patients, you can shower 2 days after surgery once you remove your bandages.

Patients who had a reconstruction procedure (i.e. ACL reconstruction) or fracture fixation, you can shower after bandages are removed, or after 2 days, if bandages can be covered to ensure they don’t get wet. However, most patients will need assistance getting in and out of the shower.

If you had either of the above procedures, please avoid submerging your knee in water (i.e. bathtub, pool, Jacuzzi) until after your sutures/bandages are removed in the office at your first post-operative appointment.

You may resume exercise for you upper body as soon as you would like following all knee procedures.

Following a knee arthroscopy, you are not permitted to do any running, jumping, or any lower body impact exercises outside of the ones deemed appropriate by your physical therapist until 6-12 weeks after surgery. These restrictions will be modified by Dr. Marshall as he reevaluates you at each post operative appointment.

You will be able to walk with the use of crutches for stability after most arthroscopic procedures (partial meniscectomy, debridement, ACL reconstruction without meniscus repair) unless told otherwise by Dr. Marshall. You would be told to not put weight on your leg if you had a meniscus repair, cartilage reconstruction procedure (including microfracture), or fracture fixation.

If you had a hip arthroscopy, you may remove your dressing 2 days after the surgery. Just put band-aids over the incisions until your sutures are removed at your first post-operative appointment.

If you had a hip fracture, your dressing needs to remain on until you have your first post-operative appointment. It is water-resistant, so you can get it wet in the shower two days after surgery.

Please avoid submerging your hip in water (i.e. bathtub, pool, Jacuzzi, lake) until after your bandages are removed in the office at your first post-operative appointment.

For hip arthroscopy patients, you can shower 2 days after surgery once you remove your bandages.

Patients who had a hip fracture may shower 2 days after surgery; however, most people will require assistance getting in and out of the shower.

If you had either of the above procedures, please avoid submerging your hip in water (i.e. bathtub, pool, Jacuzzi, lake) until after your sutures/bandages are removed in the office at your first post-operative appointment.

Yes! This is very normal. The muscles, tendons, and ligaments surrounding the hip joint get very tight after a hip arthroscopy and will make popping and clicking sounds occasionally. This will resolve over time as you continue with physical therapy and continue to heal.

You may resume exercise for you upper body as soon as you would like following all hip procedures. Avoid abdominal exercises (sit ups, crunches, etc.) though until 6 weeks after surgery, as this may aggravate your hip.

Following a hip arthroscopy, you are not permitted to do any running, jumping, or any lower body impact exercises outside of the ones deemed appropriate by your physical therapist until at least 3 months after surgery. This is to protect the repair of your labrum.

Following fracture fixation, you will be able to put full weight on your leg after surgery, but will require assistive devices (crutches, walker, cane) as the fracture heals and you regain full strength.

This will depend largely on if your right or left foot was operated on. If it was your left foot, you can drive once you are off narcotics. If it is your right foot, it will depend on the procedure performed and how long you are required to put no weight on the foot, as your reaction time is not appropriate for driving during this period.

You will be in a splint/soft cast for 1 week after your surgery, which will be removed at your first post operative visit.

You may resume exercise for your lower body (i.e. walking, running, elliptical, etc.) as soon as you would like following your elbow surgery. However, depending on your procedure, we need to limit your activity on that side. Depending on your progress with healing, physical therapy and evaluation by Dr. Marshall, this will determine the optimal time to begin full activity to your arm.

If you had a shoulder arthroscopy, you may remove your dressing 2 days after the surgery. Just put band-aids over the incisions until your sutures are removed at your first post-operative appointment.

If you had shoulder replacement surgery, your dressing needs to remain on until you have your first post-operative appointment. It is water-resistant, so you can get it wet in the shower.

If you have had a rotator cuff repair or labral repair, you must wear the sling at all times (even while sleeping) until your first post-operative visit. You will be allowed to remove to sling to perform initial range of motion exercises. After your first visit, you will need to wear the sling at all times including sleep, but can remove to shower, keeping your arm close to your side. Slings are commonly discontinued after 6 weeks for rotator cuff repair and 4 weeks for labral repairs.

For total shoulder replacements, you will typically use your sling for at least 4-6 weeks.

You may resume exercise for your lower body (i.e. walking, running, elliptical, etc.) as soon as you would like following your shoulder surgery. However, depending on your procedure, we need to limit your activity on that side. Depending on your progress with healing, physical therapy and evaluation by Dr. Marshall, this will determine the optimal time to begin full activity to your arm.

Yes! Swelling is common in your arm and hand after shoulder surgery. This happens because swelling will commonly follow in line with gravity. This can occur as early as the day after surgery, but more commonly 2-3 days after surgery. To help prevent this or alleviate the swelling, try to keep your hand and elbow elevated above your heart (which is best achieved while lying down); also, you can keep your fingers moving by flexing and extending your fingers by making a fist or squeezing a ball, icing can also be helpful.