Post-Surgery Shoulder Rehabilitation

by Nick Delgadillo, SSC | October 05, 2017

Bre joined WFAC at the beginning of the summer wanting to get strong after a long time doing CrossFit. She showed up with the chronic shoulder pain – the hallmark of those who do ring dips and kipping pull-ups for time. Her shoulders were hurting badly from day one and after a couple of months of pressing, there was little improvement. She decided to go to an orthopedic surgeon who scheduled her for surgery shortly thereafter to repair a supraspinatus tear and to remove bone spurs from the right shoulder. Bre trained normally up to the surgery and was told by her doctor that after surgery, she should immobilize the shoulder for a few weeks other than during physical therapy, that she shouldn’t load it for 8-12 weeks, and that it could take up to two years for her to “get back to where she is now” in terms of her strength training. He never inquired about what she actually does in the gym or current training loads.

Bre is a worrier, and I spent lots of time assuring her that she’d be just fine post-surgery, but that we’d have to take things very slowly. Her main concern was with how long it would take to be able to productively train again. I shared our Shoulder Rehab video with her as well as some stories of people who’ve used the method Rip demonstrates in the video to restore range of motion and strength after surgery.

She went in for surgery on August 3rd and I told her that she should take a couple of weeks off from the gym to let things heal a little. She was adamant about doing things, so she started doing “Arm Pendulums,” walking, and taking her sling off throughout the day. She showed up back at the gym on August 10^th, one week after surgery, and started using a wooden stick suspended by rings to work on getting her arms overhead. She asked if she could do anything else, so I told her to rack pull using the stick.

Bre came in 3 days a week and worked on getting the stick higher every session. By the end of the second week back in the gym - 20 days after surgery - she was pressing a 15 pound bar for 3 sets of 5 from the top after using the rings to get the bar to the lockout position. She had progressed her rack pulls to 70 pounds for 3 sets of 5. It’s important to note that we intentionally held her back a little since she seemed eager to push things. Rippetoe kicked her out of the gym one day after he found out that she’d only waited 7 days before starting to do the ring work.

On week 3, she moved to a rack and started pressing from the top down by setting the bar at lockout height, stepping back in the lockout, and pressing from the lockout back to the lockout. Later that week, she found she was able to get under the bar and started squatting a 35 lb bar. Over the next few weeks, she progressively loaded the press and lowered the starting position to a standard start position.

Here’s a more detailed look at her progression:

• 8/3: Surgery
• 8/4–8/9: Arm pendulums and moving around
• 8/10–8/15: Ring press progressing ROM to lockout position 3x10. Rack Pulls 3x10
• 8/16–8/22: Ring press to lockout then progressively lowering the bar to standard bottom position 3x10. Rack Pulls 3x5.
• 8/22–8/25: Ring press to lockout then full press 3x5 with 15 lb bar.
• 8/28–9/18: Press from the rack starting at lockout 3x5. Added high bar squats.
• 9/20–present: Resumed training the full press, low bar squat, deadlift and chinups.

Eight weeks post-op, Bre has resumed training and is a few weeks away from passing her previous training loads on her Novice Linear Progression. She experienced no pain during any of the rehab and has been cleared for “strengthening” by her orthopedic surgeon. By carefully applying the principle of stress, recovery, and adaptaion using normal human movement under a load, Bre experienced a quick recovery from the trauma of the surgery. The repaired tissue was able to do it’s job in precisely the right amount, under the protection of the larger muscles responsible for moving the load. In contrast, at week 5 the physical therapy “modalities” used during her weekly PT visits included a series of rotator cuff isolation exercises with bands and came along with the recommendation that she not lift anything over her head.

Bre’s successful rehab matches the experience of physical therapists using our method, the experience of SSCs who are physical therepists, and the experience of lifters training in their garages and gyms all over the country who’ve recovered from shoulder surgery using this method. To no one’s surprise, Bre’s doctor remains unaware of what she’s done for the last 2 months. He never asked.