Overhead lifts post labral repair

[Chickdiver]

Hi Coach,


Backstory:

In September 2008 I had a posterior labral repair (Reverse Bankart with a Posterior Capsular Shift) and Biceps Tenodesis on the left shoulder. Several months of rehab later the surgeon and PT cut me loose to go back to normal activity with the caveat of "no overhead lifting". This was not my first ortho surgery, and I am fully aware that physician advice is often hyper- conservative. I am (and have been for 10+ years) a regular lifter. In March of this year I started doing Crossfit, and in early June I began having shoulder problems again. The current diagnosis is another labral tear (I have an MRI with contrast scheduled for Wed.)- whether or not surgery is indicated we don't know. I suspect I tore it this time doing cleans. I am hyper-mobile, and pretty sure that the original tear was "atraumatic".

My Question:

In your experience as a coach (I know you aren't a physician, and wouldn't begin to ask for a medical opinion)- do you think it is possible for a 37 year old "Jane Doe" to return to overhead lifts after this type of injury and repair, or am I kidding myself? Thanks in advance for any advice and/or words of wisdom you may have.

Heather

[Mark Rippetoe]

Depends on your rehab. We have had good luck with presses for rehab for these injuries. How did you tear it doing a clean?

[Chickdiver]

I don't know that I did tear it doing the clean, that is just what made it start to hurt (a lot) again- specifically the rotation at the top of the movement.

I had the MRI today, so we'll see what it shows.

Thanks.

[nisora33]

Heather, I know that hindsight is 20/20, and that there's no use dwelling on the past and such, but once you've got this shoulder thing under control, you really need consider returning to lifting with a basic strength training program, especially given that you're shoulders are hypermobile. Because with the hypermobility issue, strengthening the muscles around the shoulder will create an organic sleeve or brace around it, bettering your chances of lifting safely.

Starting Strength, anyone?

Once you've got the groundwork for basic strength laid down, THEN Crossfit might be an option.

My 2 cents.

Stacey

[BradyB]

I would be a little concerned with your overhead technique since you've now torn your shoulder up twice. You should post some videos of your press and see what Coach has to say.

As for lifting overhead post-shoulder rehab, let me tell you my story:

I just finished PT for a moderate-severe posterior labrum tear. I chose to forgo surgery since the posterior labrum is the most technically demanding of all shoulder repairs and my surgeon was very frank with me about the possibility that I wouldn't be able to recover to the 80% I was already operating at. The PT went incredibly well. But then again, I had an incredible PT who had me doing turkish get-ups and dumbbell presses as therapy exercises. Now I am pressing 2-3 times a week with no pain and making good strength gains.

The press is an excellent exercise to both rehab your shoulder and and build functional strength. You're going to want to keep doing presses as often as possible. They will make your shoulder healthier, or at least they have for me. But, you have to make sure that you are using the strictest version of correct form. Make sure you aren't compensating for underperforming muscles by facilitating other groups (middle trap is notorious for being inhibited in shoulder injuries). Have someone watch the movement of your scapulae during the press, if they aren't moving correctly you need to fix it before you start ramping up the weight. And do your shoulder dislocates!

Moral of the story: Do presses. A lot. But with perfect form or you're setting yourself up for another tear.

[JLascek]

We created a pretty good way to rehab a shoulder utilizing the press post-surgery, particularly when the full press is not possible (or in other words, the period of rehab when you are supposed to go to the omniscient physical therapist). Shall we write the article Rip?

[Mark Rippetoe]

What is this WE shit? Does it look to you like I have time to salvage the field of physical therapy? You do it, I'll watch.

[JLascek]

I just figured you'd want to provide some innovative information to your adoring fans. You've gone Hollywood...

[Mark Rippetoe]

No shit?? Hollywood? When does my check get here?

[TomF]

Does it look to you like I have time to salvage the field of physical therapy?

Just drop the "l", and you're good.

I'd be very interested in the article, whoever writes it.