Rehab

[antgent]

Hey Ripp

Sorry for my prior rather long post, but i could really do with some advice post surgey rehab on my shoulder. The medical term for the injury i have sustained is a posterior labral tear.

I visited my physio this morning to get some rehab exersises to do both before and after the operation, i was advised to to theraband work and push against a wall, which i will do, but the thought of 2-3 months of theraband and puhing against a wall, post the operationg scares me alot, as i would like to resume lifting weights as soon as i can.

Sofar my aim has to be to get as strong as possible before i go under the knife, but today my physio told me i shouldn't be doing deadlifts with more than body weight (im inclined to say sod that and continue training heavy up until my op, as ive been training consistently for about 3 months with no further discomfort/ instability noted, ive excluded press due to the injury)

Any advice on rehab would be greatly appreciated

BTW im a 25 yr old male 5"10 85kg, Sq 100kg Dead 120kg Bench 90Kg (dont do press any more) Clean 50Kg (still learning the technique)

Thanks

[Mark Rippetoe]

My advice is to push as hard as you can. If you go easy like they think you should, it will never get back to function.

[jep6095]

antgent, are you QUITE sure about the diagnosis? The tear actually showed up on an MRI? Surgery is the ONLY option? You have tried low weight/high rep presses and couldn't take it?

The reason I ask you to push a little more for answers is that we have two sports trainers here in small town Minnesota who love to diagnose high school athletes with this 'condition.' They advise an immediate x-ray, stop training altogether and prepare for inevitable surgery. I've had two athletes disregard their advice (one is my HS Goalie daughter) press, bench, deadlift at lower weights and both have felt considerably better. Surgery off the table and useless X-rays averted.

Of course if you feel 100% confident in the diagnosis, good luck to you. The PT won't let you move away from those bands for quite some time.

[Tiburon]

Antgent - Are you sure you need the surgery? I also tore my labrum (stupid intramural softball), and six months ago opted to do rehab instead of the knife.

My shoulder is now better than it ever was -- I just PR'd on press and bench last week. I'm so glad I didn't do the surgery.

Here's what I recommend:

--For one month, do nothing but the Starr rehab for the press, as spelled out by Rip, with light enough weights to do sets of 30. Prepare for the ego burst when you can only do 15 pounds the first day. This is the hardest part - going to the gym every day to do only presses. But this is very important. After a month you can jump back on SS.

--ICE like a maniac. Morning, night, and especially after workouts.

--Determine if you have any shoulder flexibility limitations (your ortho should be able to tell you this), and learn the proper stretches to address them. For example, if you are an overhead athlete, you might have GIRD (glenohumeral internal rotation deficit) and will benefit from the "sleeper stretch."

--Determine which of the rotator cuff muscles are damaged/weak (again, a good ortho will tell you what the problem is - supraspinatus, infraspinatus, teres minor, or subscapularis). Learn the 2 or 3 exercises specific to that area. Some people think that such band work and light-weight isolation exercises are a waste of time, but if done correctly, they can't hurt you. And on days where you aren't at the gym, you can be doing something for the shoulder for 15 minutes while watching TV.

--Determine if there are activities of daily living that aggravate the shoulder, and adapt accordingly. It might be as simple as switching arms when you throw the tennis ball to the dog. For me, I was tweaking the shoulder every time I reached into the backseat while driving.

--Use perfect form on the press. Focus on "active shoulders" at the top. Rip makes a great point in the DVD - "you are never finished with a press."

--Use perfect form on the bench. Most importantly for the labrum, keep your shoulders back/underneath. DO NOT EVER BENCH unless you have someone to give you a proper liftoff.

--Make sure you Press:Bench workout ratio is at least 1:1. Consider going even 2:1 or 3:1.

--If you do opt for surgery, train as long and as hard as you can before going under the knife, because you will be on the mend for a long time afterward and won't be able to lift anything. You're not going to cause any damage that they won't address in the surgery.

--Finally, get a second opinion. Especially for your physio. The advice not to deadlift heavy is just silly and has no justification.