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Rotator cuff surgery

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Swede View Drop Down
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    Posted: 9/16/12 at 9:06am
I just had surgery on Tuesday, my rotator cuff was 90% torn. Talk about hanging on by a thread... Anyway my arm is in a sling and the info on rehab sounds like a long slow road with not much in the way of lifting or throwing. Anyone have any experience/advice going through rehab after rotator cuff surgery and getting back to training? Perhaps Shawn Baker? It has not even been a week and I am going crazy.

Thanks
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AlDargie Quote  Post ReplyReply Direct Link To This Post Posted: 9/16/12 at 9:16am
Don't want to rain on your parade, but you are in for a long recovery.  Have many friends here and elsewhere that have had major shoulder work done and they are almost back to 90-100% a year later.  Take it easy, DO THE REHAB as prescribed and work your way back SLOWLY.  You should be able to work with your other side with dumbbells and your legs with leg presses or hip belt squats.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Swede Quote  Post ReplyReply Direct Link To This Post Posted: 9/16/12 at 9:50am
Thanks for your reply. Everything on this topic seems constant: slow.

The gym I go to is a "Crossfit" type of place, even though I do not participate in the group classes they have lots of open space, medicine balls up to 40 lbs, bumper plates etc...but no leg press or other type machines. The best I can hope for is to specialize in the squat for a couple of months, I just don't even know when to reasonably expect to place a BB across my shoulder/back...?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote K-Monster Quote  Post ReplyReply Direct Link To This Post Posted: 9/16/12 at 8:12pm
Had a complete tear, along with upper bicep reattach done Feb 14. Working up to a 250 seated shoulder press to the front, hopefully by Nov. Rehab aggressively and sensibly, but just be patient. It will come.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Shawn Baker Quote  Post ReplyReply Direct Link To This Post Posted: 9/16/12 at 10:17pm
Dave, sorry to hear about your shoulder, my advice would be to listen to your doc and therapists until they cut you loose (let your therapist and doc know what level of activity your planning once recovered- they probably won't know much about the highland games, but you can probably give them the general idea)

Assuming the high grade partial tear you described was generally a pain issue for you and not a dramatic strength problem, you likely had good cuff tissue to work with during the repair. It generally takes about 6 weeks for the tendon to adhere to the bone so the early focus is going to be a lot of passive motion and isometric periscapular stuff, then progressing to active and active assisted stuff followed finally by some fairly light strengthening (especially compared to what your used to). You'll probably be released from therapy somewhere around this point approximately at the 3 month point.

If you are planning on going back to throwing I would then spend a few months generally bringing up strength with basic relatively slow stuff (pressing, pulling) once finished adding some light speed work progressing to maybe some release stuff (eg med ball) then perhaps some plyo pushups and then finally back to throwing

I fix at least a couple of cuff tears a week but thus far not on any HG guys yet, you might also chat with Don Stewart who was/is coming back to throwing after a shoulder replacement
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TheJeff696 Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 6:40am
I twice tore my labrum and twice had surgery on it (the first one was not good apparently)

I did a lot of biking. The recumbent bike was great because in a sling it is really easy to use and you can do a lot of leg work on it. I used to bike for like an hour to an hour and a half just to make myself feel like I did anything. 

I also religiously did my rehab exercises. They started me doing them the day after my surgery, just moving my arm and what not but whatever the doc says, do it. 

Good luck with everything!!
Jeff Kaste



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Silverback Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 7:45am
Total tear of cuff and total labrum tear at one time my 5th year at age 39.  Get on your door pulley and get your range of motion back.  Find the one groove you can do up and down and then gradualy work out to the sides of that each way, spend an hour doing it at a time, just keep doing it until you get the range back.  Then do a ton of reps very light on bicep and tri to get the blood flowing through the joint and I don't mean 20 or 30 reps, I mean hundreds.  One arm cable push downs so light you can do them forever.  Cable or dumbell curls again forever.   You must wait the 6 weeks for some tissue remodeling before leaning at all on the shoulder.  I competed in a game at 17 weeks and had already practiced enough that I won.  While your habing the hurt delt, work the rest of the body as hard as possible.  Ditch the sling. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote getyoukilt Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 7:46am
I had a right rotator cuff that looked like cotton candy. I was able to get the strength back fairly quickly but ignored the flexibility. I am still paying for that. Make sure you concentrate on the mobility. It will hurt, and it will take time, and your shoulders may never be symetrical again. 5 to 6 months before I threw again, and probably a year before I felt like I wasn't holding back because of the surgery. It is difficult to know if the thing will hold together without actually throwing. My advice in hindsight would be be cables and bands very light and work your way up in weight and speed as the shoulder allows. Use angles that mimic a throw, and take your time. 

Good luck with the recovery, Keep your spirits up, the not being able to will get to your head as much as anything else.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Swede Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 8:38am
Thanks to all for the input and advice on this isue.  It seems I don't have many happy times ahead of me on the rehab.  The mental will no doubt be equally as hard as the physical. 
 
The plan I have come up with involves lots of squats (and front squats when able) to keep strength up, and perhaps even gain, plus obviously lots of specalized shoulder rehab accordingly. 
 
Any guesses on when I could start squating with a BB on my back/shoulder?  Perhaps one month post-surgery?
 
Thanks again!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote old fat guy Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 10:08am
I think that 1 month is pushing it.  But, when you do try to squat, you're going tove yo do a lot of stretching on that shoulder before you back squat, otherwise ....uh oh!Cry
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Post Options Post Options   Thanks (0) Thanks(0)   Quote celtuckian Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 11:31am
SLAP/Bankhart repairs to both shoulders in my forties...
Back squats put a pretty good strain on the shoulder joint, and at one month you're probably not going to have the strength to hold the bar in position, let alone enough ROM to get in position.  I would suggest holding off on the back squats.  It took me a good nine or so months before I could even get under a bar.
 
Take the rehab slow, make sure your PT works the ROM from all angles, that will be your biggest issue post-op.  Otherwise, the shoulder will heal but you won't be able to do anything with it. 
 
Good luck.  Its going to be a slow go, but the strength will eventually return, but I would have to say realistically you are looking at a year.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Sammy68123 Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 11:57am
Originally posted by Swede Swede wrote:

Thanks to all for the input and advice on this isue.  It seems I don't have many happy times ahead of me on the rehab.  The mental will no doubt be equally as hard as the physical. 
 
The plan I have come up with involves lots of squats (and front squats when able) to keep strength up, and perhaps even gain, plus obviously lots of specalized shoulder rehab accordingly. 
 
Any guesses on when I could start squating with a BB on my back/shoulder?  Perhaps one month post-surgery?
No, a month post-surgery for back squats is too soon because of the extreme stretch you'll put on shoulder tissues.  My surgeon made sure to warn me that the tissues at 3-4 weeks are weaker than they were the day of surgery due to all the tissue remodelling going on.  I don't have my exercise log at hand, but figure at least 3 months for a bar on your back--and then keep your ego out of it.
 
A "90% tear" is a little ambiguous--90% through (thickness)? How long was the tear?  I had full-thickness tear, but only about 1-2 cm long.  Once you get a go ahead to get out of the sling from your PT for some time, religiously work those range-of-motion exercises for the involved shoulder--wand exercises, etc. 
 
I went back to gym lifting the week following surgery with the goal of working everything else I could with the arm in sling.  Leg presses, 1-arm DB presses, 1-arm rows, squats with 1 DB.  It felt good to do something and I kept my ego out of it. 
 
Once I could get out of sling (my initial PT at 2 weeks said my status was more what they would see at 3-4 weeks post-surgery), I did Rom DLs and Zercher squats--nowhere close to what I was capable of doing.  Main goal was to keep everything else as strong as possible.  On exercises like step-ups where I might reach reflexively to keep my balance, I wore the sling.  Else, I mirrored exercises like DB presses with no weight on the involved side.  The PT's eyes got a bit big when I described doing the RDLs and Zerchers, but I knew the objective was to keep my shoulder girdle snug--again, keep ego out of it.  Elliptical was good because I could use arm on the moving handle and rest arm on the stationary handle when I needed to.
 
The continuum of rehab is ROM, then strength, then power/speed.  I was able to do state PL championships about 3 weeks before the "magic" 6-month point and my (normally pathetic) BP was only 2.5 kg less than the previous year's (pre-surgery and pre-injury).
 
Remember, keep your ego out of it and be systematic in your return.  Keep us up on your progress!
 
Teresa Merrick, Ph.D./Bellevue, NE
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Swede Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 12:12pm
Thanks for sharing your experience.  There is no way I can make it 9 months before lifting.  I do worry about getting under the bar due to the stress on the shoulder in order to hold the bar in place.  But if this is a static hold position and not a dynamic movement I thought it would be safer...?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote C. Smith Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 12:16pm

Anytime I have shoulder or elbow issues I go to the rackable cambered bar for squats.  Seems like that would be a good alternative in this case, as you would still be able to back squat heavy and not put the shoulder at any additional risk.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Pingleton Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 12:58pm
What about the Saftey Squat Bar?  I do not know, I am just curious about this.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Swede Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 1:23pm
The rackable cambered bar or safety squat bar both seem like good options, unfortunetly I have neither available to me where I train. 
 
This may sound crazy, but would front squats be easier on the shoulder than back squats?  You are racking the BB across the structural bone-on-bone inegrity of the clavical/shoulder joint.  Although load bearing there is no compromised shoulder positions...especially if you start off with the crossed arm bodybuilding style.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote C. Smith Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 1:37pm
I wouldn't want to do any fronts until I was sure my shoulder could take as, cause even with the genie-style hold the compensation is always going to be driving the elbows up.  And as mentioned, just holding the load there may suck in itself.   

If it was me, I'd just find a place nearby with a cambered bar or SSB, as I'm sure there is a place in the area you can use temporarily. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Pingleton Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 1:58pm
Originally posted by C. Smith C. Smith wrote:


If it was me, I'd just find a place nearby with a cambered bar or SSB, as I'm sure there is a place in the area you can use temporarily. 

So a SSB is a viable option for this purpose then?


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Post Options Post Options   Thanks (0) Thanks(0)   Quote C. Smith Quote  Post ReplyReply Direct Link To This Post Posted: 9/17/12 at 2:16pm
It wouldn't be my preference in this situation, but I wouldn't dismiss it either as I think it could work. 

I would try to use long handled version though (to prevent unnecessary rotation of the shoulder). 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Swede Quote  Post ReplyReply Direct Link To This Post Posted: 10/10/12 at 2:21pm
Thanks for the advice on the SSB/Cambered bar.  Not having either I invented my own set-up with a "Manta-Ray" and some straps.  The Manta-Ray shifts the load higher on the back/neck so I needed a slant board to be able to get down low enough.  Just happy to be doing something, it has been one-month since surgery.  Where there is a will, there is a way!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Sammy68123 Quote  Post ReplyReply Direct Link To This Post Posted: 10/10/12 at 4:20pm
You are very creative!!!  Be sure to dump the bar if things start to go bad: don't want to wreck that repair by trying to save the unsaveable.  I hope your recovery is going well!
 
Teresa Merrick, Ph.D./Bellevue, NE
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Post Options Post Options   Thanks (0) Thanks(0)   Quote JSiau10 Quote  Post ReplyReply Direct Link To This Post Posted: 10/10/12 at 11:56pm
Ouch, bummer. Well the only thing I can suggest is don't stop the rehab. My dad did that when he messed up his rotator cuff and it froze up, as he put it "it calcified." 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote S McCracken Quote  Post ReplyReply Direct Link To This Post Posted: 10/11/12 at 9:28am

I had a total 2 years ago, listen to the Mule. his advise helped me then, I am sure it will help you now. I had a bunch of cleanup work in the joint along with the repair, so pain was an issue for almost year for anything over head. squats were hard to do just reaching up to grab the bar was painful for a long time. you just have to push though the pain, and keep focused.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote C. Smith Quote  Post ReplyReply Direct Link To This Post Posted: 10/11/12 at 9:40am
I love the creative set up to still be able to work!

You probably need more ankle, hip, and knee mobility (or perhaps more core strength) as opposed to the slant board imo.  Hbbs is much easier to hit depth than a lbbs.   


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Jeff Ingram Quote  Post ReplyReply Direct Link To This Post Posted: 10/11/12 at 12:45pm
Looks high.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote old fat guy Quote  Post ReplyReply Direct Link To This Post Posted: 10/11/12 at 1:07pm
Yep--nothin' but reds on depthThumbs DownLOL
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Post Options Post Options   Thanks (0) Thanks(0)   Quote rob meulenberg Quote  Post ReplyReply Direct Link To This Post Posted: 10/11/12 at 8:43pm
That is an awesome picture.  Way to go!  Another thought would be buying a hip belt from Ironmind (http://www.ironmind.com/ironmind/opencms/Main/homesweathome4.html).
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dWood Quote  Post ReplyReply Direct Link To This Post Posted: 10/11/12 at 9:26pm
When I tore my bicep in 98.. squatted w/ manta Ray in the smith machine..was the only way to maintain my mental squat sanctity...kudos on the setup! Hit a milestone for myself today..front squat 295 X 3 reps ATG. Felt good and solid not bad for a few years removed by a dual patellar tendon rupture and quad tear ( at that time was hitting 365 X 5 in front squat)
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dWood Quote  Post ReplyReply Direct Link To This Post Posted: 10/11/12 at 9:27pm
Hip belt is ok but never could get the right setup to get good depth
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Post Options Post Options   Thanks (0) Thanks(0)   Quote norkasd Quote  Post ReplyReply Direct Link To This Post Posted: 10/13/12 at 7:50pm
  Maybe learn to throw with the other arm.  I did.  Injured right wrist in the spring on the farm.  Still not healed(tendon).  So, I throw the weight for height and distance and the stones now left handed.  And it makes sense.  I am right handed but my strong leg is my left leg, lead leg for hurdling, jump leg for long jump, high jump and I bat left handed.  After about a month I equaled my throws from the right hand.
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