Raising Your Arms Post Top Surgery
We understand that minimizing scarring is a top priority for many of our patients. In this article, we discuss the importance of limiting certain arm movement in improving the outcome of your top surgery scars. We also recognize that certain individuals may need to prioritze their shoulder mobility over following traditional shoulder limitation guidelines that seek to reduce scarring. As a result, we have included post-surgical instructions that can help patients avoid shoulder injuries during top surgery recovery. Here we provide our recommendations for shoulder mobility as well as ways to assess your shoulder range of motion before and during your recovery period.
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In addition to following our scar prevention guidelines, which include wearing sunscreen and using a silicone-based scar gel, we often advise patients to not raise their elbows above their shoulders for the first 3 months of healing. Image 1 depicts the typical maximum height for arms and elbows for the first 3 months of healing: just under shoulder height, no matter the orientation of the arms (in front, out to the side, etc.). However, some patients have reported shoulder tightness and a decrease in mobility after the 3-month recovery milestone, especially those over 50 years of age or those with a history of shoulder injuries. As a result, we are revising this instruction for certain patients.
Image 1
Shifting your post-op recovery priorities to shoulder mobility may result in wider and darker top surgery scars. Therefore, we only recommend shoulder mobility exercise for patients who have had a previous shoulder injury, anyone who experiences shoulder tightness, or patients undergoing physical therapy for their shoulders.
One way to assess shoulder mobility before surgery is to lift your elbows above your shoulder and point them straight up, as seen in Image 2. This can also be done at most once a month during your recovery to periodically check on shoulder mobility. Obviously, this violates the general post-op movement restriction, so one should do this if they know they are prone to shoulder tightness or experienced shoulder pain before surgery.
Image 2
If this exercise causes pain or tension, we will need to order physical therapy for your shoulder either through our office or your primary care provider. If you experience pain or tightness, do not push yourself to reach your arms all the way up.
If you have an adequate range of motion and do not experience tightness or pain in your shoulders, then you can continue the activity restriction of having the elbows below the shoulders at all times.
As always, the more information you are able to provide regarding pre-existing shoulder injuries with us during your virtual and/or in-person consultations, the better we will be to help tailor a recovery plan to fit your needs. While physical therapy may cause your scars to widen or darken while healing, it is important to have your full range of motion without pain or tightness, and we can work with you to ensure your scars heal as well as possible.
