Training After a First Rib Resection

[asmuts]

I'm writing to see if anyone here has experience with training after a first rib resection.

Some Background: I'm schedule to have surgery in May. They are going to removed my right first rib and trim back the anterior and middle scalene muscles. I was diagnosed with Thoracic Outlet Syndrome back in September. At the end of June I threw a clot down my right subclavian vein. It extended down the axilliary vein and into the basilic.

The subclavian vein is damaged. The extent is unclear. It's getting smashed between my first rib and my clavicle when I raise my arms. A MRV made that clear. My surgeon worries that the damage makes me prone to clots. The goal is to relieve the compression by removing the rib, then do a venography to assess the damage, and then do angioplasty if it looks bad. . . .

I have no nerve pain. But my arm is somewhat discolored and my hand turns dark if I get a lot of blood pumping in the arm, say after doing intervals on the rower. I've been on warfarin since the clot.

After self diagnosing, I resumed training in August, omitting all overhead movements. (No pullups, chinups, or presses. As substitutes, I now do inverted rows, dumbbell rows and, God help me, lateral raises and reverse flyes. I'm not sure what else to do. I'm open to suggestions. . .) My surgeon said that I should simply avoid overhead movements for now.


My Question: I don't have a great idea of what to expect after surgery. My surgeon says that everyone is different and that it will be at least 3 months before I can lift anything heavy. I can't find anything in the literature that addresses recovery and strength training. Hence, my post here.

I know that a strange number of the pitchers on the Texas Rangers have had this done as well as some other athletes. But it's unclear what to make of that.


A Note of Thanks: I want to thank you for running this forum. I would have had no idea what to make of my situation if I hadn't found the thread "Training while on rat poison."

The doctors in the ER here didn't know what to make of my clot. (As such, they didn't perform thrombolysis and I likely have far worse damage now that I would have. . . .) I saw several doctors here that just didn't have a clue. Dr. Prewitt's post on this forum gave me something to work with. I read a huge chunk of the literature on DVTs and finally found some specialists in Boston. As a result, it took me several months to get a diagnosis. In any case, as you said in the rat poison thread this forum does indeed have important information that you just can't seem to get elsewhere. So, thanks.

[Mark Rippetoe]

No experience with it, no ideas. At least not right now.

[Carlos Daniel]

I'd have to do some studying to give a more useful response but all I can say is the obvious: what you have is serious shit. It's not like going against thr doctor's order after shoulder surgery, where the worst thing that can happen is you fucking up your shoulder (again). This is the kind if shit that can get you killed. So really, really listen to your doctor.

[vanslix]

This is the kind if shit that can get you killed. So really, really listen to your doctor.

Indeed. Do not think you can just "power on through" this. Follow your doc's orders, be religious with your Coumadin monitoring, get the surgery, see how much vessel damage there is, and go from there. This is serious shit.

[asmuts]

Sounds like good advice. Thanks. But rest assured, I'm appropriately scared.

The only doctor's orders I've received are to avoid overhead movements. I don't think I've raised my arms above my head more than a few times since July. . . . My INR is very stable, so stable they have me on a 4 week blood testing schedule now. I used to go every week. . . .

My question was likely premature. I was mainly interested in whether anyone had any experience with post-surgery training. I'm not looking to start training before my wounds heal. I wasn't so concerned with when I could start training as if I'd ever be able to get back to normal. I have two sources of concern:

(1) How might losing the anterior and middle scalenes affect training? From what little I know, I don't think the anterior and middle scalene muscles do much for neck stability. But I'm not sure what kind of role they might play when things get heavy. For now I mainly worry about loosing their role in forced respiration. This shouldn't be a big deal. I was less clear about how this might play out when lifting weights.

(2) Will the loss of the first rib compromise my ability to lift heavy? I can't see precisely how it would. But I don't fully understand the function of the first rib.

Again, both questions are kind of premature and somewhat poorly formed. Besides, there doesn't seem to be much I can do about it anyway. The surgery is necessary. . . .

I don't mean to waste anyone's time here. It's just that having a surgery like this sitting in front of me is making me a little anxious. I thought I check here to see if anyone could help me understand the long term implications. This board has seen so many kinds of different problems, I figured it was worth a try given the rat poison thread.

Hopefully, I'll be able to post back here in a year and say that I'm back under the bar.

[Mark Rippetoe]

You'll be fine.