One-Armed Living: Showering, Dressing, Cooking and Coping After Shoulder Surgery

The operation is over, the sling is on, and you're standing in your own bathroom realising you have no idea how to wash your armpit. Nobody covers this bit. Your discharge letter explains the repair; it doesn't explain how to get a t-shirt on, boil a kettle, or wash your hair with one working arm.

NHS occupational therapists teach all of this, but usually only if you happen to see one. Here's what they'd tell you.

Washing and showering

When can you shower?

The national NHS baseline for surgery generally is that you can usually shower 48 hours afterwards unless told otherwise, and that you shouldn't submerge the wound — no baths or swimming pools — until it's fully healed.

For shoulder surgery specifically, trusts add detail and don't entirely agree with one another. Oxford advises keeping the wound dry until healed, "normally 10-14 days", washing with a flannel in the meantime, and covering the dressing with a plastic bag or cling film. Wrightington, Wigan and Leigh describe a shower-proof dressing and say you "may shower or wash with the dressing in place, but do not run the shower directly over the operated shoulder or soak it in the bath. Pat the area dry and do not rub." Worcestershire is stricter still: "You will not be able to shower or bathe with your sling on and will therefore need to wash around it."

How to wash under the operated arm

This is the question everyone has and nobody asks. The answer is that you never lift the arm — you use gravity. Worcestershire's polysling leaflet describes it precisely:

The Royal Orthopaedic Hospital explains the mechanism: "You must avoid actively moving your shoulder to gain access. If you bend forward gently you will notice gravity assists in opening up the space of your armpit to enable you to wash/dry more easily." If even that isn't possible, North Bristol suggests sliding a thin flannel or a wet wipe under the armpit instead.

• Sit down to wash. Gateshead: "Sitting down is usually best as you can support your arm on a pillow while it is out of the sling." The Royal Orthopaedic Hospital recommends a strip wash specifically to reduce the risk of falls.
• Rest the arm on a table if you're strip-washing at a basin, so nothing is hanging unsupported.
• Dry the armpit thoroughly — Guy's and St Thomas' flag this as a skin-irritation risk, and it's a real one over six weeks in a sling.
• Don't forget the elbow crease. South Tees specifically mentions washing elbow creases as well as the armpit — an easy place to develop soreness.
• Use a pump dispenser and a long-handled sponge. Squeeze bottles need two hands; a long-handled brush reaches your back without twisting the arm out to the side.

Hair washing

North Bristol is blunt about it: "Do not use your operated arm to help wash your hair. You may find that dry shampoo is a useful alternative for a short period," and notes some people simply need help. Oxford recommends "long-handled combs, brushes and sponges" to avoid twisting the arm out to the side. A detachable shower head makes rinsing one-handed far easier — one of the best things to buy before your operation.

Getting dressed

There is one rule, it's universal across UK trusts, and it will save you a great deal of pain: the operated arm goes in first and comes out last. Oxford's wording:

The full sequence

Royal Berkshire's occupational therapy guidance gives the step-by-step, and the pillow detail is the part that makes it work:

1. 1Sit down and put a pillow on your lap, resting the operated arm on it.
2. 2Lay the garment next to that arm, buttons undone and facing you.
3. 3Feed the operated hand into the sleeve and work the fabric up over the elbow and upper arm using your good hand — keeping the arm resting on the pillow throughout.
4. 4Pull the collar around so your good arm can go through its sleeve.
5. 5To undress, reverse it — good arm out first, operated arm last.

What to wear

• Loose, front-fastening tops, a size larger than usual so they'll go over the sling.
• Elasticated waists — Royal Berkshire notes these are much easier one-handed than zips and buttons.
• Slip-on or Velcro shoes. Laces are a two-handed job; a long-handled shoe horn helps.
• Bras: North Bristol suggests a strapless bra fed under the operated arm and fastened with help. Royal Berkshire's one-handed method is to fasten at the front and rotate the band around. Note the constraint — Oxford tells reverse replacement patients to avoid reaching behind the back for six weeks, so any fastening has to happen at the front.

What you're allowed to lift

This is where generic advice becomes genuinely unsafe, because the limits differ enormously by operation. Some examples of what UK trusts actually publish:

Two prohibitions come up again and again regardless of procedure: don't push yourself up out of a chair or bath with the operated arm, and don't reach behind your back. Raising the height of your favourite chair with a firm cushion removes most of the temptation.

Running a kitchen one-handed

Royal Berkshire's occupational therapy guidance is the most practical NHS document we found on this, and its advice is refreshingly unglamorous: sit down, plan ahead, and accept ready meals for a fortnight.

• Keep a perching stool or chair in the kitchen and sit to prepare food wherever possible.
• Fill the kettle with a jug rather than lifting it under the tap, and boil only what you need. A cordless travel kettle is lighter; a kettle tipper removes the lifting entirely.
• Don't carry a pan of boiling water. North Bristol's tip: cook vegetables in a frying basket inside the pan, or lift them out with a slotted spoon and let the water cool before emptying it.
• Leave everyday items out on the worktop so nothing needs reaching for — and leave jars and tins out for visitors to open, since most tin openers need two hands.
• Batch cook before your operation, and lean on ready meals that go straight from packet to oven or microwave.
• Order shopping online. Carrying bags is out for longer than you'd think, and stairs with one hand and a full bag is exactly how people fall.
• Useful one-handed kit: non-slip mat, one-handed jar opener, plate guard, chunky-handled cutlery — the Royal Orthopaedic Hospital lists these specifically for shoulder patients.

Sitting, standing and getting about

• An armchair beats a sofa — you get arm support, and it's easier to stand up from. Raise the seat with a firm cushion if you're struggling.
• Support the arm on your lap or a surface in front of you whenever you're sitting.
• Use your legs, not your arms, to stand. This is the habit that protects the repair more than any other.
• Watch your posture. Guy's and St Thomas' warn against slumping or rounding the shoulders in a sling, and recommend gentle neck exercises — sling wearers very commonly develop neck ache.
• Keep walkways clear and well lit. With one arm you have no way to catch yourself.

When you get your life back

Oxford publishes one of the clearest activity timetables, for reverse shoulder replacement: