Thursday, September 30, 2010

Life after Shoulder Surgery for the Weight-lifter


Message from a reader...

Hey John, I have just recently read your article A 7-Phase Approach to Protecting Your Shoulders on the Muscle & Fitness website.  I have had the procedure called acromioplasty performed. This past March, my orthopedist took off about 5mm off my acromium to reset my ac-joint in my shoulder. From what I understand in your article, it was written from a personal experience. I believe you also had the same procedure completed on one of your shoulders.  I'm a young guy (19 years old) and I am currently 9.5 weeks post op. From my understanding, at 12 weeks "light" lifting can begin and heavy lifting slowly will transition. I have been doing physical therapy right away after my surgery. I am now strengthening my shoulder with band-work, dumbbells (external and internal rotations lying on my side), arm bike, and various other exercises that I am sure you went through.

In your article, you wrote that you "began performing movements that once resulted in pain, now only resulted in oddly enough, unfamiliarity. I was beginning to perform movements that I restricted to avoid feeling pain." 

I was just wondering if you could better describe to me what this means, and what your transition was like getting back to lifting. For instance, can you answer some of my questions below:

At what week post-op did you start lifting again, and at how much weight?
Were there any exercises that you avoided once you started lifting again because it gave you pain in your shoulder? 

How long did it take you before you could lift with the same intensity you had been training with before your injury and surgery? 


Do you have any other suggestions for me on my road to recovery (beside following your advice outlined in the article)?

Thanks in advance for your help John. I have not lifted in over a year because of this injury. As you can imagine I have lost a lot of muscle mass, and I am looking to get it back! I realize that I won't be in the weight room for at least another month, but I want to be smart and ease my transition with care and intelligence. Thanks again John.

Brian
Toledo, OH

My response:
Thanks for the e-mail. I know where you are coming from all too well...

Here are some answers to your questions above:

At what week post-op did you start lifting again, and at how much weight?
My surgery was in November 2002, so my memory is abit vague, but I think I started lifting light weights about 6 weeks after. I remember I got too overzealous and caused some inflammation within the joint capsule that set me back again. At one point, I saw my doctor and thought he messed something up, but he told me I was being too aggressive. "Even though it feels good, doesn't mean its ready"--that was the best advice I was told. So I actually hooked up with a PT friend and we went back to do some serious therapy to calm down the inflammation.

Were there any exercises that you avoided once you started lifting again because it gave you pain in your shoulder?I perform minimal overhead work. Once in a while I will perform a standing push press, but honestly, its been close to 10 years since my surgery that my shoulder feels 99.9% better. I have returned to bench pressing. Although, I have eliminated foolish exercises in my program like: upright rows, trap shrugs, and front raises.  I wrote an article on this here.From time to time, I will include some lateral raise work as a 'finisher exercise'--but thats about it.

How long did it take you before you could lift with the same intensity you had been training with before your injury and surgery?
Good question...my training changed drastically after surgery. I went from benching 315 at 175 and having some serious "imaginary lat syndrome" to thinking about training differently. My intensity now is probably higher than it was when I was lifting "heavier" weights. Now...my rest periods are short (<20 secs.) and I am using alot of compound exercises (chins, DL, squat, DB snatch, etc, etc), so the intensity is there--just not from lifting serious weight. Although my weights are still better than most guys I see at my gym (405 Dead lift, 330 Squat). Plus I make an emphasis to perfect my form. I like to think I have a really, really strong core--much stronger than before my surgery. I think strengthening my "insides" has helped with my recovery and conditioning. I am 35 and feel better than I did when I was 19.  



Do you have any other suggestions for me on my road to recovery (beside following your advice outlined in the article)?
Use this time to really learn how your shoulder works and how alignments within the ankle/hip/lumbar all effect how your shoulders act. Honestly, at 19 I feel your doctor may have hastened to surgery. in my case, I actually sought out 2 different orthopedist to get their opinion. I was 26-27 at my surgery, but I didn't want to live with the pain and I was unsatisfied with physical therapy. Looking back I am content with the outcome as it has made me more aware of my form, strength levels, and has made me a better trainer. today, I really emphasize scapular stabilization exercises like YTWL's or my infamous "Scap Clock Drill":



Here are some more helpful tips to save your shoulders:

1.) Don't shrug during shoulder movements. If you are not meaning to "shrug" or elevate the shoulder blades--then don't. Make a conscious effort to keep those muscles down.

2.) Chest erect and shoulders depressed. Those are the 2 most common cues I use with myself and clients. Optimal posture during lifts is important and definitely something you have to constantly remind yourself to do.

3.) Neutral grip on dumbbell exercises prevail. Anytime you use dumbbells for upper-body exercises, prefer to have the palms facing each other (neutral) to allow more room for movement under your collarbone. Things get tight in the acromium space where your rotator cuff muscles are located.

4.) Massage and flexibility are paramount. I routinely receive massages and foam roll regularly. I always make it a habit to include flexibility exercises in my exercise routines; as this has helped me keep the tissue quality up to par and muscle lengths optimal.

4 comments:

  1. Great advice, John.

    I'd like to add to Brian that acromioplasty is nothing. You'll be good as new in no time. Things like rotator cuff or SLAP tears are what you really should be worried about; all the more reason to strengthen stabilizers, improve posture, and work on scapular positioning.

    -ML

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  2. Thanks ML! and I echo your advice!

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  3. Great information! I was a fitness instructor for 4 years until my shoulder problem. Just had surgery in September. This will definitely help me understand therapy better and make sure that I don't mess things up for myself. I had micro-fracture surgery on my left knee 2 years ago. And the recovery was long and intense. I will never be the same, but I won't make the same mistakes that got me to the operating room.

    Laura

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  4. Best of luck. Take things slow and use progression...not perfection!

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