Fifth degree AC shoulder seperation

[Edgar729]

Rip,

I injured my shoulder playing football a week ago today. They will be opening me up and giving me the orders for my recovery this Wednesday.

I was wondering what advice you would give me to recover successfully from this injury and get back to the original strength I had prior to the injury. I thought it would be best to reach out to you as early in the process as possible as you will be able to give me then best input on how to recover my shoulders strength.

As a side note, my sister hurt her shoulder as well about a year ago. After going through surgery and doing everything her doctors and physical therapists have told her to do she is still having shoulder problems and has been benched by her College Volleyball coach. This is one of the main reasons I wanted to reach out to you, in fear that my shoulder may have the same problems.

Thanks for any help you can give me Rip,
Alex

[Mark Rippetoe]

You sister's case is typical, because PTs do not know how to rehab a shoulder. Any protocol that relies on isolation of the individual functions of the constituent components of a system which works as an integrated system will be less than optimal. Same for you: presses rehab the shoulder after the healing process has started, and throughout the process, so that normal integrated function is the context in which the injury heals. Partial press from the top at first, VERY LIGHT, with ROM determined by the pain. It heals much faster this way, whereas their way may not make it heal at all, as your sister found out.

[newguy32]

This makes me mad every time I read stuff like this. In the NFL they measure everything. They know how many weeks to come back from a certain injury or from a specific surgery. There's tons of statistics to use to find the best form of rehab for things like this. I cannot comprehend how professionals that are specifically charged with helping people recover from surgery do not use statistics to determine the best plan. Let's see... if we follow the normal approach there's 50% chance that your knee (or whatever) will never be pain free and you'll never play again. Or if we follow this other approach there's an 80% chance for normal recovery, and etc, etc....

Sorry, I don't even have a question. This just makes me angry. I have my own much less severe experience with this, and feel great pity for all the athletes that have chronic pain and injuries due to stupidity.

[Gunnhild Bruno]

This makes me mad every time I read stuff like this. In the NFL they measure everything. They know how many weeks to come back from a certain injury or from a specific surgery. There's tons of statistics to use to find the best form of rehab for things like this. I cannot comprehend how professionals that are specifically charged with helping people recover from surgery do not use statistics to determine the best plan. Let's see... if we follow the normal approach there's 50% chance that your knee (or whatever) will never be pain free and you'll never play again. Or if we follow this other approach there's an 80% chance for normal recovery, and etc, etc....

Sorry, I don't even have a question. This just makes me angry. I have my own much less severe experience with this, and feel great pity for all the athletes that have chronic pain and injuries due to stupidity.

This is because the NFL has the money to hire the best.

In a lot of states, PTs only have to go through an 18 month course.

[Mark Rippetoe]

That's not correct, Spar. Physical Therapy has recently shifted to a DPT terminal degree after many years of Masters Degree guys. I know a guy who is still practicing with a BS. But nowadays they are all in school for many years, making it even more bizarre that they never seem to learn anything. Maybe you mean the PT techs.

[Gunnhild Bruno]

That's not correct, Spar. Physical Therapy has recently shifted to a DPT terminal degree after many years of Masters Degree guys. I know a guy who is still practicing with a BS. But nowadays they are all in school for many years, making it even more bizarre that they never seem to learn anything. Maybe you mean the PT techs.

Yes, I meant the actual people who will be working with most patients in your average PT practice. I would guess that most people who go through those places spend all of 10 minutes with an actual PT. Not that more time would help, in most cases.

[Thomas Jones]

Thursday marks 6 months out from a labrum re-attachment along with a bicep tendon repair.

I wanted to echo Rip's comments. I did the PT work, but, additionally, as soon as I could tolerate things, I was pressing (started with the bar when my pre-surgery 5RM was 140#) and doing pull ups (actually started with body rows). I later added turkish get-ups and walking lunges holding a dumbbell overhead as I find the latter movements tax the stabilizing muscles in the shoulder pretty dramatically, even with light weights. The presses, TGUs, and lunges were all done outside PT/MD supervision, but both the PT and MD are thrilled with my recovery. I'm guessing that they are patting themselves on their backs for their excellent rehab instructions. I have a final appointment with both soon where I will advise them of the extra work I performed.

The MD had told me that, at 6 weeks out, the tissue is 90% healed and the PT had told me that he had only seen one reinjured after the 6 week mark, and that was because of an auto accident. Given these comments, it made more sense to me to adopt a Rip-like approach to rehab.

Best of luck.