Recommend Some Post Labrum Surgery Activities

[GoNiners!]

I appreciate the feedback on the physical therapy or lack thereof. The impression I got from my physical therapist was the real work would begin at 6-8 weeks and that I didn't need to be there to do my passive range of motion stretching. Right or wrong, good or bad, that was the feeling I got. I also think the fact that I am only 29 and relatively fit and very strong also makes them feel that I can do more on my own than their average patient, which judging from the waiting room, are elderly folks.

So here I am at week 5 post op. Looking back at last week, it was a total disaster. I had sever inflamation in my shoulder after my physical therapy session that lasted into Saturday. The joint felt super swollen and I ended up missing two and a half days of work staying home and resting it to no avail.

I iced it on and off for hours on end using the gel ice packs and found that I couldn't get the coldness deep enough into the tissue. I had even asked my doctor for a prescription painkiller just so I could sleep as the extra strength tylenol was having zero effect on me. Feeling desperate, on Saturday morning I took a ziplock bag, filled it with ice cubes added some salt so it would get colder, and put it onto my bare shoulder for 2 hours straight. I finally felt the releif I needed as the whole joint went numb all the way to my neck. I felt intermittent pain in the flesh of my arm and shoulder but it quickly became numb before it registered.

About an hour after I removed the ice bags, the entire area of my arm where they had been resting was blistered and inflamed. I had essentially given myself a really bad case of freezer burn. I'm a smart guy, but sometimes I do some real dumbass stuff. I guess that's what makes me human and not some kind of superbeing. In the future, if I ever feel this desperate for ice, I will wrap the ice bags in a towel so it doesn't have direct contact with my flesh.

Looking forward, I am not sure how much progress I have made. In some ways the freezer burn on my has been a blessing as the pain from the blistering has drowned out anything I feel within the shoulder itself. I am disheartened in that I can't really do the physical things I enjoy. I understand that I can't lift weights, but I also can't go target shooting on the weekends or go hiking as I don't want to jar my arm. Sitting around the house during my free time is really starting to wear on me. After what felt like 2 months of crappy weather, the weather over the last week was really nice and I didn't do anything to enjoy it. I know I can't do anything in the gym for another couple of months at least but I'll be damned if I don't miss it.

 

[SociallyChallenged]

🙁 Sounds like a hard week, man. Honestly, you should be working with a PT starting right out. At 4-6 weeks, you can typically start doing progressive training under the close eye of a PT because amount of force needs to be limited. On top of that, the PT should be doing PROM drills, checking your ROM, applying topical agents that will help reduce pain, etc.

Was it the PT you did by yourself that really flared it up or was that PT in the office? Did you feel pain WHILE doing the exercises?

Also, I want to let you know that you shouldn't ice for longer than 15min at a time. It actually makes things worse, inflammation-wise. There's a phenomenon called reactive hyperemia that increases blood flow when blood has been occluded for a while. Ice 15min on, 15min off, and repeat if you really need to. But never, ever wear it for over that. And don't ever add salt. It's ok if it's directly on your skin, but you gotta be careful, man. I know how hard bad weeks are, but you need to keep at it. Also, I think I'd think about going to a different physical therapist. They are not doing their jobs.

 

[the DRIZZLE]

Like I told you its a long road, but most people have good outcomes. I was still on prescription pain killers at 5 weeks. Have you spoken with your doctor yet? The reason SC and I are pushing the PT issue is because its much easier to get the ROM back now rather than later. You need to someone who will push into the pain on the stretching but knows how far they can safely go. You can't do that yourself.

There are going to be times during the rehab process where the swelling gets worse. How are you using the ice packs? I used a pitchers wrap. The compression helps the joint get colder faster so you don't need to keep the ice on as long.

 

[GoNiners!]

I felt the need to comment on some of my exercizes...

I hope there aren't any issues with imbedding a pic in a post.

 

[Lamont Burns]

I do 3 of those 6 for my rehab along with a long static series of stretches. I feel really manly too.

 

[GoNiners!]

Week 7 progress report.

I managed to use my right arm to shave my head this morning for the first time. I am still having issues with reaching out and picking something up off a table. I can do it but the motion of raising the arm and reaching out is very awkward. I find myself twisting my torso to do something that should be all arm.

My other shoulder (left) has been giving me significant pain over the last 3 weeks.

Outside of that, I think I am falling behind in progress. I am going to have a talk with my physical therapist about my lack of progress.

Emotionally, I was really down all week last week.

 

[GoNiners!]

Week 8 Progress Report:

So I had been pretty down from Week 6 through Week 8 as I felt like I wasn't making much progress and may have even plateaued. The arm pretty much felt the same.

Last Friday I visited my physical therapist and we measured my range of motion and he felt that I was within the proper range as far as rate of recovery was concerned. I mentioned that I had developed an unusual motion when it came to reaching out and grabbing things. He felt that it was a matter of regaining coordination in my arm muscles as the stronger ones were mainly taking over for the weaker muscles from lack of use.

I also discussed the tightness I felt in my shoulder on the outside of the arm. He felt that it was due to scar tissue which had essentially attached my skin to the muscle. He went on to explain that the skin of our bodies ride along the top of our muscles free of any significant attachments. That when they made the incisions and sutured them closed in my arm, a portion of the skin had attached itself to muscle via scar tissue as it healed. He said that I would need to gently pull along my scars to break up the scar tissue and that the tightness would go away as it freed itself from muscle below.

I was shown some different exercises to work on my mobility related to reaching out behind me and also to work on getting that last 5-10 degrees of vertical lift too. He decided that isometric exercises for the rotator cuff were not necessary as I had not injured them and that I was too strong for them to provide me with any real benefit.

I ended the session with clearance to go back to the gym and do back related workouts. I was told to avoid any lifting that caused a downward force on the joint but rows were fine. I still am not allowed to do any pushing type exercises like a bench press. I also don't have enough range of motion yet to do free weight squats so I will leave the legs alone for now.

So I went to the gym this morning for this first time in 8 weeks. I did a very light back workout with a focus on technique and high reps. I got a good sweat going and felt good all around being in the gym again. I don't feel any discomfort or inflamation in the arm. I plan on doing my light back workout on Mon - Wed - Fri until I am allowed to do chest and have enough flexibility in the arm to do free weight squats again.

I have to be honest, I feel like me again.

 

[the DRIZZLE]

Week 8 Progress Report:

So I had been pretty down from Week 6 through Week 8 as I felt like I wasn't making much progress and may have even plateaued. The arm pretty much felt the same.

Last Friday I visited my physical therapist and we measured my range of motion and he felt that I was within the proper range as far as rate of recovery was concerned. I mentioned that I had developed an unusual motion when it came to reaching out and grabbing things. He felt that it was a matter of regaining coordination in my arm muscles as the stronger ones were mainly taking over for the weaker muscles from lack of use.

I also discussed the tightness I felt in my shoulder on the outside of the arm. He felt that it was due to scar tissue which had essentially attached my skin to the muscle. He went on to explain that the skin of our bodies ride along the top of our muscles free of any significant attachments. That when they made the incisions and sutured them closed in my arm, a portion of the skin had attached itself to muscle via scar tissue as it healed. He said that I would need to gently pull along my scars to break up the scar tissue and that the tightness would go away as it freed itself from muscle below.

I was shown some different exercises to work on my mobility related to reaching out behind me and also to work on getting that last 5-10 degrees of vertical lift too. He decided that isometric exercises for the rotator cuff were not necessary as I had not injured them and that I was too strong for them to provide me with any real benefit.

I ended the session with clearance to go back to the gym and do back related workouts. I was told to avoid any lifting that caused a downward force on the joint but rows were fine. I still am not allowed to do any pushing type exercises like a bench press. I also don't have enough range of motion yet to do free weight squats so I will leave the legs alone for now.

So I went to the gym this morning for this first time in 8 weeks. I did a very light back workout with a focus on technique and high reps. I got a good sweat going and felt good all around being in the gym again. I don't feel any discomfort or inflamation in the arm. I plan on doing my light back workout on Mon - Wed - Fri until I am allowed to do chest and have enough flexibility in the arm to do free weight squats again.

I have to be honest, I feel like me again.

Good to hear you're turning the corner. The PT can massage the area to break up scar tissue around the incisions. I never got enough ROM back to squat, but I was barely flexible enough to begin with. I ended up buying an attachment for the bar called a top squat.

Be careful in the gym and up the weight slowly even though the strength might return quickly. My strength came back much faster than my ROM.

 

[GoNiners!]

Good to hear you're turning the corner. The PT can massage the area to break up scar tissue around the incisions. I never got enough ROM back to squat, but I was barely flexible enough to begin with. I ended up buying an attachment for the bar called a top squat.

Be careful in the gym and up the weight slowly even though the strength might return quickly. My strength came back much faster than my ROM.

Thanks for the kind words bro. I feel like I am pretty close as far as ROM needed to support a bar for squats but I don't think I am ready to place any sort of load on the arm when it is in that position. I also don't feel like I am recovered enough to be lifting 45 lbs plates and placing them onto the squat bar.

I am going to have to maintain my discipline while in the gym so I don't overdo things and hurt myself while I am recovering. In all honesty, the weight I was using wasn't very much nor did it feel heavy but my goal for the next couple of weeks is just to work on moving the arm with some resistance so the muscles get a chance to sync up and any kind of awkward motions that I have developed will begin to fade away with use.

I expected to feel pain at the end of the day yesterday as I worked the arm more in the hour in the gym than I had all of the previous times combined. But outside of some swelling late yesterday I didn't feel anything.

The arm actually feels more loose this morning that it has previously with the exception of some pressure in the outer arm at the incision locations.

Now that I am back in the gym, I am going to start a caloric deficit in my diet and begin to cut some weight. I have packed on some pounds over the last 4 weeks that I need to drop and then some.

 

[GoNiners!]

Week 9 Progress report:

So last week, I was in the gym, Monday, Wednesday, Friday doing a very limited and light back type workout that ran along the following lines:

5x20 close grip lateral pulldowns 30, 40, 50, 60, 60 lbs
5x20 cable rows 30, 40, 50, 60, 60 lbs
5x20 cross t-bar 10, 20, 25, 25, 35 lbs
5x20 dumbell rows 20, 20, 25, 25, 30lbs

I had a little inflamation in the shoulder at the end of the day on a workout day but it was gone by morning. I didn't feel much discomfort but I did cut things a little short on Wednesday and only did 4x20 of the dumbell rows. I have also been continuing to do my daily physical therapy exercises.

I have noticed that my shoulder is popping and shifting slightly like it was during the first couple of weeks after surgery. I am assuming this is just the scar tissue breaking up and the capsule continuing to slowly forming itself. I still have tightness on the outer part of my shoulder from the scar tissue and I honestly forget to massage the area on a consistent basis.

I went to the gun range for the first time yesterday and did some pistol shooting. I didn't have any pain issues although the new beretta mags, I brought with me to break in were a real pain in the butt to load as the springs were super stiff. The act of raising and firing the handgun was smooth and fluid. The combat grip I use felt firm without any unusual motions. Overall, I was quite pleased with how I felt and how I performed as I hadn't shot that particular handgun for over a year and hadn't fired any weapons for close to 3 months. I am not sure if I am ready for any off hand rifle shooting yet.

My arm is moving in a more natural motion again without any of the strange twisting I had been experiencing earlier. I think my brain is back to using the arm like it did before surgery as I am engaging in more rotational lifts with something in my hand without experiencing any strange movements.

My range of motion has improved slightly, particularly in my ability to put my hand behind me and walk it up my back. Two weeks ago, that would not have been possible. Last week, it was very awkward, today it feels more natural.

Plank motions are still a little painful for me. I am doing modified pushups at a 45 degree angle off of tables and it is still a bit of challenge. I feel quite a bit of muscle quiver in the shoulder and arm after about 5-7 reps.

I am hoping to develop my gym workouts further after this week if I am given the green light to do so by my physical therapist. I really would like to start into my chest routine as my pecs are no longer symmetrical. My left pec is much larger than the right one.

I'll update the thread again if anything comes up or next Monday. Whichever comes first.

For those following along, I just want to make it clear, that despite everything, I feel like having the surgery was the right choice for me.

 

[the DRIZZLE]

Sounds like you had another good week. You might want to hold off on bench press at least until you can do a few regular push ups. The quivering is because you muscles are having trouble keeping the joint stable. Bench pressing before you have enough stability is risky.

My PT had me do a lot of exercises for stability but they all required another person or equipment that you won't find in a regular gym. Maybe SC can recommend some specific exercises that you could do yourself.

 

[GoNiners!]

Week 10 Progress Report:

I continue to progress in my recovery. At this point I have very few restrictions on my mobility. The only limitations I feel in any way are reaching behind me and even that is pretty small.

My physical therapist was quite pleased with my progress. My light gym workouts and dedication to the physical therapy routine have worked wonders on my recovery. He even said that I could slowly start increasing the weight on my rowing exercises in the gym. I asked my physical therapist about a timeline for a full recovery and he felt that I should be close to fully recovered in another 3 months. So I should be hitting that magical halfway point in recovery in another two weeks barring any sort of unforeseen stupidity on my part.

My surgeon is still adamant about staying away from any sort of bench, deadlift, overhead presses, and shrugs. So I haven't done any. I am still not doing squats as I don't have the flexibility to support the bar and I don't think the joint could handle any sort of real load on it even though it doesn't really handle much of a load during squats.

One interesting tidbit from this last meeting with the physical therapist was the fact that he felt my infraspinatus was pretty weak. It was his opinion that the muscle around the shoulder blade that ran around the ball of the arm bone was not exerting enough force in keeping my ball joint a little further back in position within the shoulder and that it was/would cause me problems in the future.

I am not sure if that is the result of having a massive back that tends to push the shoulders forward a little. But I will focus now on my sidelying and external rotations to build that area up so that it puts everything in a more proper alignment.

On another note, I am turning 30 on May 12th. So it's official, I am now an old fart...lol. My weight has been hovering between 225 - 230 lbs for the last 6 months or so. And while I am beastly in my strength I would be delusional if I tried to tell you guys that it was all muscle. I think it's time to cut back to 190 lbs again.

 

[GoNiners!]

Week 11 Progress Report:

I am starting to slowly increase the weights on my row-centric exercise routine. I continue to go to the gym on Mon, Wed, Fri.

I haven't really felt an increase in range of motion or mobility from the last week. I understand that the incremental progress will be slower at this point as there isn't much left to regain.

External rotations are still challenging. I would say at this point that is the only real range of motion I am still noticeably deficient in.

I did 10 normal pushups on Friday and they were pretty painful and my shoulder swelled up a bit. I will try some again today and see how they feel.

I have never been a runner but I am starting a beginners running routine in the hopes of improving my cardio and also in an effort to challenge myself physically since I still can't do much in the gym yet.

Once I hit the 3 month post surgery benchmark, I will get in touch with my surgeon and ask him if I can start to slowly incorporate more exercises into my workout routine.

 

[GoNiners!]

Week 12 Progress Report:

I was pretty much out with the flu all week last week. I went into the gym one day and that was it. I am still a little congested in my sinuses but will go into the gym today.

I can't really tell much of a difference from the prior week. I find that I will wake up some mornings with my arm hurting a little from sleeping on it funny during the night.

Going to send my surgeon an email this morning inquiring about adding more exercises to my limited gym routine.

**Update**

Got a response from my surgeon and he gave me the green light to resume full activities. The only caution was to take things slowly.

 

[GoNiners!]

Week 13 Progress Report:

I went in last week and did my first chest workout. The best way to describe it is an exercise in pain.

I was literally only doing the 45lbs bar on all of my exercises in sets of 20 and it was downright painful.

Physical therapy session on Friday and my physical therapist worked on the arm more than he had in all of our previous sessions. He felt that the capsule was too tight and that is what is causing my ongoing range of motion limitations. He also recommended I wait another 2 weeks before trying any sort of chest workout again.

Currently I am still having trouble with external rotations, which is why I still haven't tried to do any squats as I can't get my arm back enough to get it to support the bar.

I went on my first hike along the coast since the surgery. I felt fine swinging the arm around while walking the trail. Went a little heavier on my back workout this morning and experienced some spasming in the deltoid area. Haven't had any issues with swelling for a week now. I still feel the occasional stabbing pain when using the arm.

I was prescribed a new set of exercises to do to help open up the capsule. I'll let you guys know how that goes.

 

[GoNiners!]

Week 14 Progress Report:

I continue to do my physical therapy to loosen up my shoulder capsule. These set of exercises are probably the most painful I have done since my arm has been out of the sling.

I have been going progressively heavier on my row-centric back workouts. I will take another stab at a chest workout on Wednesday and see if there is any difference as far as pain goes.

I do feel like I am getting a little more mobility in regards to external rotations are concerned but I am not completely there. I think I am getting pretty close to being fully recovered as far as range of motion goes, which is a milestone that I didn't expect to reach so quickly.

My shoulder is pretty weak though. Any time I engage the smaller stabilization muscles in the shoulder I experience a significant amount of weakness.

 

[the DRIZZLE]

Week 14 Progress Report:

I continue to do my physical therapy to loosen up my shoulder capsule. These set of exercises are probably the most painful I have done since my arm has been out of the sling.

I have been going progressively heavier on my row-centric back workouts. I will take another stab at a chest workout on Wednesday and see if there is any difference as far as pain goes.

I do feel like I am getting a little more mobility in regards to external rotations are concerned but I am not completely there. I think I am getting pretty close to being fully recovered as far as range of motion goes, which is a milestone that I didn't expect to reach so quickly.

My shoulder is pretty weak though. Any time I engage the smaller stabilization muscles in the shoulder I experience a significant amount of weakness.

IMO its a good sign that your PT is adjusting your program, it means he's paying attention. Do you have a bosu ball in your gym? Doing pushups on one is a good exercise for shoulder stability. External rotation was my biggest mobility issue as well. I also found that row type pulling exercises came back much faster than chest pulling exercises, the later requires more shoulder stability.

 

[GoNiners!]

IMO its a good sign that your PT is adjusting your program, it means he's paying attention. Do you have a bosu ball in your gym? Doing pushups on one is a good exercise for shoulder stability. External rotation was my biggest mobility issue as well. I also found that row type pulling exercises came back much faster than chest pulling exercises, the later requires more shoulder stability.

The process has been to go in to see the physical therapist every 2 weeks, measure my progress, and then get prescribed a set of exercises according to where I am at. I would say through this process from the first time I went in, my exercises regimen has changed over about 4 times.

One thing I forgot to note in my update is that the tightness I used to feel in my front deltoid in the incision area has gone away completely.

 

[GoNiners!]

Week 15 Progress Report:

I am still working on external rotations and loosening up the globular capsule.

I have begun going heavier on my row-centric back workouts. More weight, less reps.

This is my second week of doing a chest workout which consists of free weight bench press, free weight incline press, and dumbbell flies. The dumbbell flies are particularly painful but the normal bench and incline press are becoming less painful.

I did a last set of 10x135 lbs on flat bench this morning and I was amazed at how heavy 135lbs felt to me. I have a long way to go to get back to my 355 lbs pre-surgery/pre-injury bench press.

Still can't do squats due to range of motion issues. I am considering adding rack pulls to my back routine to get my traps more involved.

My physical therapy exercises are becoming less painful and easier to do also, so I guess I am making progress.

 

[GoNiners!]

Week 17 Progress Report:

Sorry for missing last week. Was super busy at work and came home pretty exhausted afterwords so I didn't get a chance to update.

Shoulder pretty much feels the same. I am still having the same issues with external rotation. Today after my back workout I went over to a power rack and put the bar on my back. I had a lot of pain and quickly racked the bar. I still don't have enough flexibility to do squats.

My physical therapy exercises have become super easy so maybe it is time to have the physical therapist prescribe me something different.

Next week I will start working in either dead lifts or rack pulls. I haven't worked out my posterior chain since my shoulder surgery so deadlifts will definitely get me going again. I may just dedicate a day strictly for deadlifts twice a week and go from there.

I have my next physical therapy appointment this Friday.

 

[GoNiners!]

Week 22 Progress Report

I took a break from lifting weights and going to the gym. I was experiencing a lot of pain and inflammation in the shoulder so I decided to give it some more time to recover.

For me the hardest part about exercise and lifting weights is walking away and healing. Prior to my surgery I had been following my weekly routine for 4 years.

Initially after my surgery I was just happy to return to having normal use of my arm around the house like reaching for things, shaving, picking stuff up, etc...I may have jumped to the gym a little quick but I kept things pretty light and managed to not hurt myself. It was only when I started to stack on the weights to near pre-injury levels that I found myself in a world of hurt.

I have to admit that the rest was helpful. Some activities and movements that were painful are now normal. I am still having issues with external rotations of my arm.

I will go back to the gym for the first time in about 4 weeks this morning to do a light chest workout. Today is also the first day of my true busy season at work as I begin the process of putting the financial statements together and preparing for my organizations annual audit. So the stress relief valve of gym time will be needed.

I haven't been to the physical therapist in a month since we both decided that the incremental improvements no longer warranted weekly visits. I will be seeing him this week though.

If you guys have any suggestions on exercises I can do to help with improving external rotation, I would certainly appreciate it. To give you an idea of the motion, imagine the position your arm is in when you hold an olympic bar in the squat position. I can't get my arm back far enough to comfortably hold that position.

The break from the gym wasn't a total loss. I have managed to lose 20 lbs in the last 6 weeks. Prior to my injury in June 2010, I had been working on a bulk routine and had gone from 180 lbs to 200 lbs. Then I hurt my shoulder and over the next year managed to pack on another 40 lbs to a max of 240 lbs. I am slowly chipping away at that and have another 50 or so lbs to go to get to 170 lbs. I am hoping to get there by December.

 

[SociallyChallenged]

Honestly, I think the biggest issue is that you keep going back to chest work over and over. Chest work should probably be the last thing you return to and, if nothing else is really bugging you, keep up with the other stuff and REALLY slowly return to the press-work. It's been a long time out and you should be getting close to normal function. Arg, running late, I'll comment more later.

 

[GoNiners!]

Honestly, I think the biggest issue is that you keep going back to chest work over and over. Chest work should probably be the last thing you return to and, if nothing else is really bugging you, keep up with the other stuff and REALLY slowly return to the press-work. It's been a long time out and you should be getting close to normal function. Arg, running late, I'll comment more later.

You are right. It is the pressing that is causing the issues. I have no problems with any type of pulling/rowing motion and am actually back to pre-injury strength with my back workouts.

I will heed your advice and just lay off the chest stuff. If I had the range of motion, I would be satisfied with just doing squats/deadlifts 3x a week with jogging on my off days.

One realization I have come to through all of this, and this is a personality thing for me, is that I have put every ounce of effort and will into lifting weights to the detriment of any other type of fitness. I have always been very intense and an everything or nothing type person, which has been why I have been successful in my endeavors. I refuse to give up and just take the pain and abuse that comes as result. But by doing so, I am taking years off of my life. I feel in many ways, both personal, health-wise, and professional that I am at a crossroads and the decisions I make from here on out there will be no coming back from.

While, I will always consider myself a weightlifter/powerlifter first and foremost, I want to be able to run a 7 minute mile without having a heart attack or get tendonitis in my knee after two weeks of a noobie jogging program.

I need to recover from my injuries and find new ways to challenge myself because I HAVE to challenge myself. That is the only way I feel alive.

 

[Muse]

you really should go in to see a physical therapist... don't do it on your own. you're gonna screw it up.

I had a labrum tear they didn't find until they went in and scoped the shoulder. The shoulder is the most complex joint in the body and they can't always see what's wrong with MRI's, as was my case. I expected to be in a sling 3 days but when I woke up they told me 30 days and it was a lengthy rehab. Key was having a really good PT. This was almost 9 years ago and I still do many of the exercises and stretches she taught me.

 

[Muse]

what leg machine could he use that doesn't require him to hold handles (activating various muscles in his arm, including his shoulder) to brace himself while he does the exercise?

I do leg curls with a machine that uses hand holds, but I stopped holding them when I was having wrist problems and even if my wrists don't hurt, I don't hold on with my hands. That machine requires adding plates, but I imagine there are equivalent machines that only require reinserting a pin.