T Nation

Diet While Laid Up Post-Surgery


#1

Hi guys, I have a major shoulder repair coming up involving two separate labrum repairs, removing some calcification, relocating the biceps origin, etc. My surgeon says I’m going to be in a non-movable sling for the first 4-6 weeks, start physical therapy around month 3 and then resume semi-strenuous exercise after 6 months.

I’m worried about getting fat(ter). I lift weights, push a prowler, hike, bike, etc. on and off throughout the year. My most recent squat, bench, and deadlift are 405, 310, and 495 respectively. I’m a little overweight as it is, and I can only imagine how much fatter I would be if it weren’t for the little bit of physical activity I do get in. I work a desk job, and I’m a grad student in my free time, so I spend 14-18hrs a day sitting in front of a computer.

My surgery is tomorrow. Now that I’m going to be almost completely out of commission for the next 6 months, I’m terrified of turning into Jabba the Hutt in the first couple months when I’ll be doing next to nothing. The only reason I look even halfway decent in street clothes to begin with is that I have a decent amount of muscle mass and my bodyfat is well-distributed, so I carry a lot more fat than people think. The Army tape test puts me at 20%, but in actuality I think I’m closer to 26-28%. It’s something I’ve worked on with limited short term success many times in the past.

I want to get serious this time, avoid getting fatter, and avoid anything that might hinder my recovery. I’ve purged my house of alcohol and tobacco, and most junk food. I’m pretty sure it will require lowering my carb intake, and maybe even increasing my protein intake. What I need though is an easy diet strategy (preferably one I can execute with one hand) that lends itself to consistency. Consistency has always been my problem. Any mental or diet strategies you can offer to help one be consistent would be greatly appreciated. Any diet advice specific to lowering caloric intake in a sustainable manner while not exercising would also be greatly appreciated.


#2

My $0.02 - your goal after surgery is to recover from surgery. Surgery is a major trauma to your body, and you don’t want to introduce another stressor (low calories). The repair process on its own actually requires nutrients. I would eat good whole foods and stay hydrated. Just cut out junk foods. You can walk in a sling, I believe, so that could be an activity that will complement your goal of getting leaner. Could be a blessing in disguise! So, in summary:

  1. Recover from surgery and get ready for PT - this is really your only priority.
  • Eat good whole foods
  • Drink water
  • Walk, with your surgeon’s permission

#3

High intens8ty intervals on a stationary bike. With doctors approval, of course.


#4

All good points. I definitely don’t plan to go into a serious caloric deficit, just want to curb my eating and appetite to match my activity level. I’ll try to start walking regularly as soon as I am able. I’ll be in a neutral type immobilizer sling, so it might be clunky until I can get rid of that.


#5

I currently live too far away from a decent gym, so I cancelled my membership. I have a pretty well equipped garage gym though, but no stationary bike.

I was thinking about getting a safety squat bar so I can still squat, but even that probably won’t happen until month 3 or 4, and that’s dependent on whether or not I can tolerate having weight on my traps. I do have a treadmill, and a big hill i can walk up and down. I will probably also attach my prowler to my weight belt and walk around with that, just to change things up.


#6

Mag-10… Lots of it.

And turmeric.


#7

Well it’s been 5 days since my surgery, and all is well so far. I have very little shoulder mobility, but at this point I’m not supposed to be doing anything other than grip exercises anyway. Diet has been easier than I thought it would be. I eat when I’m hungry, and make a point to get plenty of protein at each meal. I’ve been snacking on fresh veggies with ranch in between meals, and taking my supplements - multivitamin, assorted minerals, circumin, garlic, fish oil, green tea extract. Overall my carb intake is a lot lower than normal, but I don’t feel restricted.

I’m currently 6lbs lower than my pre-surgery weight, and I just started exercising (walking) yesterday. Today is my first day off of the painkillers, so we will see how it goes. Hoping to ramp up my walking to an hour per day. I’m still a ways out from beginning physical therapy, and I’ve got 3 more weeks in the sling.


#8

Recovery has gone well so far. I’ve eaten plenty of meats and green veggies, as well as a fair amount of healthy fats, moderately low carb. I’ve also been walking for 30-45min 2-3 times per week, and I even pulled my prowler around once with it tied to my weight belt. Alcohol and tobacco use are both zero. I’ve lost 7lbs so far.

This is the point where I always plateau in my weight loss endeavors and quickly rebound, but I still have another 20lbs to lose. So I decided to calculate a starting point for my macros and get more precise with my diet. Based on a BMR of 2,044 and a TDEE of 2,810 kcal, I’m going to aim for 500 kcal short of that, so 2,210 kcal per day. Using a 40/40/20 protein/carb/fat macro ratio that puts me at:

220g protein
220g carbs
50g fat

I’ll start there and adjust as necessary That amount of protein is really high compared to what I’m used to, but I’m going to suck it up and choke it down, sticking with bodybuilder friendly foods throughout. I’m also consuming 3L of water every day.

As far as exercise I still can’t do much at all for upper body weight training or anything that involves holding weight with my hands i.e. deadlifts, and won’t be able to do so for several more months. But I have a GHD for back extensions and situps, and I can do bodyweight squats and calf raises, in addition to walking and pulling the prowler. I just ordered a safety squat bar, so as soon as I get the sling off I can probably start using that carefully.

Any advice or suggestions are greatly appreciated.


#9

I’ve had both my labrums done, and my focus would be more on not losing LBM than putting on a bit of fat. Now I’m certainly not saying to intentionally get fat, merely that covering a few bases nutritionally can possibly help stave off unnecessary atrophy until you can resume more normal gym related activities.

After my 1st surgery, I spent a week just in PT, but after that, I was in the gym 4x a week doing legs (two quad focused sessions and two hams and calves sessions). This isn’t for everyone, and obviously each situation is different.

Mentally, just realize that this is a temporary set back. Eventually, it will all be in your rearview mirror and you’ll be back on track with renewed focus.

S


#10

Thanks Stu. I’m upping my protein intake to 220g per day which I’ve never even approached before, and I also have micellar casein on deck for a nighttime shake, another thing I’ve never done before. Is there anything else you’d recommend that might preserve lean mass? I occasionally do fasted cardio, but take BCAAs before-hand so it’s not completely fasted.

I just had two labrum repairs on the same shoulder, one Bankart and one SLAP. He also relocated my biceps origin and used a portion of the tendon to reconstruct a missing ligament. And my shoulder capsule was ruptured leaking fluid into my chest cavity which caused a cyst. And to believe I was still lifting weights! It was several injuries I had accumulated over the years, and was tired of living in agony. Glad i got it done, but life is still a bit miserable this early into my recovery.

I dont’ have access to a gym right now, but I have a pretty good home gym. I plan to do leg workouts several days per week like yourself, but will require a little more creativity I think.


#11

glutamine apparently helps recovery after surgery. I’d get some of that


#12

I’ve read that as well. I already get about 10g per day from my protein powder, so I’m hoping that is enough.

What I think will really help my recovery is getting TRT soon. Just got labs back and my total T is at 304. Free T is at 9.5. My doc said he’s going to put me up at the very high end of normal so that’s a lot more than I have now. Can’t wait!