T Nation

Labrum Tear Recovery Program


#1

Hey all,

I tore my labrum in my shoulder about 3 months ago (Bankart tear, front 180 degrees), had surgery to fix it almost 5 weeks ago, and am currently rehabbing slowly but surely. End of April I'm sleighted to leave for Army training for 4 months in Arizona, so while my focus is on getting back into Army PT shape (namely, pushups), I'd eventually like to get back into lifting again.

Beforehand, I had dabbled in Rippetoe's program with great results, but hadn't been engaged in it since August due to me being in a police academy (call me lazy, but I was just too tired to keep up with it). Anyhow, getting back into lifting I've heard can be a slow process after a labrum tear, so I didn't want to jump into it too fast, which is why I thought Rippetoe's program would be fitting since it's all about starting small and making gradual progress. What are y'all's thoughts on this, any other programs stand out that would be more fitting?


#2

Best of luck to you. I suffered a related injury and got it patched-up this past October. I had two torn tendons reattached and some labrum work. The recovery program? If your insurance provides for it, I recommend you find a GOOD physical therapist, someone who works with your kinds of sport. (I'd share my/his own routine but I'm not sure just how to describe many of the exercises.)

Short of working with an experienced PT or trainer who can closely monitor you, here's some general principles my docs and trainers have told me:

  1. Go slow. As my surgeon told me, it's unlikely I'll tear-up his good work if I do all my exercises very s.l.o.w.l.y. and stop myself at the first sign of a potential re-tear.
  2. Find time for massage / scapular mobility
  3. Check your range of motion. For example, start with more shallow and incline push-ups
  4. Do more closed-chain exercises (where you're body moves) than open-chain ones (where you move the weight). In other words, push-ups over bench presses.
  5. Related to proper range of motion, keep your chin & chest up. I'm not sure how else to describe it but when you're doing your rehab push-ups and pull-ups (or any exercise for that matter), don't slump your shoulders or stare in the direction of the floor. Rather, aim your clavicle towards the ceiling.

Best of luck. Fortunately for you, you're in good shape to begin with. You likely haven't atrophied like a couch potato might.

For me, it's been about 13 weeks since my surgery. Granted, I'm not bench pressing my body weight (nor do I want to just yet; again I do more closed chain). But I can do a zillion pushups and never feel my shoulder get in the way of anything I want to do.


#3

Thanks for the advice and encouragement. I figure it will be a long time before I can get back into actual weight training, so for awhile I'll definitely be doing more bodyweight exercises. I'm not even authorized to try doing a push-up until the start of April for fear of throwing my shoulder out again and ripping out the anchors in my shoulder. For reference, the minute I injured my shoulder I wasn't even able to do a single push-up, my shoulder simply couldn't support my bodyweight, so I haven't done a single upper body exercise since the start of November.

What I was interested in was a more long-term idea of what I could do when I'm ready to progress beyond bodyweight exercises and get back into lifting. I assume I'll have lost a ton of progress, and didn't know if there was another program similar to Rippetoe's where I can get my feet wet and test my shoulder before throwing a barbell over it. Again, I realize this probably won't be for close to six months from now.

On a related note, I do have a pair of Fat Gripz, and I've heard they help with shoulders, anyone have any experience with that?


#4

I had my labrum repaired in August along with a microfracture. I'm still struggling and in pain. My Dr said he's going to give me three more months and if I still have not gotten to full ROM, he's going to have to go back in. THe second surgery will be to cut my biceps tendon and reattach it. Not looking forward to it.

Take things slow and listen to your Dr and PT.

As far as what you will be able to do long term, I've been told by my Dr and PT that bench press and overhead press are not going to be in my future. Other than that, they said I would be able to do everything I was doing pre-injury.

Best of luck!


#5

Keydet,
I tore my labrum after a posterior dislocation and humerus fracture in 2009. After surgery, my PT "graduated" me out 4 weeks ahead of schedule because of my recovery plan. And 12 months later my bench was back to pre-injury numbers (125% BW for reps). Here's what I did:

1) Starting about 3-4 weeks after surgery, as soon as I was completely off prescription pain meds, I started training - the other arm. I read here at T-Nation if you only train one side of the body, the other side will grow. Not as much as the trained side, but still grow. Which is why baseball pitchers don't have giant throwing arms and withered non-throwing arms.

So, I did one arm push ups, seated DB presses, DB hammer curls, one arm cable rows, and rotator stuff. Pretty much everything I could do that wouldn't bump/hurt the other arm. I also did lots of body weight free squats - like 100/day - to maintain as much conditioning as possible.

2) I did nothing for the injured shoulder except the official PT exercises until they cleared me to start using very small hand weights. The minute my PT said "let pain be your guide" I started to work that shoulder. If stuff hurt, I stopped. But then went back a few hours later to try again. I started by putting my hand on the wall and leaning a little.

Once I was comfortable with that, I did a push-up motion leaning my body into the wall. I was doing this 3-4 times per day, as many sets and reps as I was comfortable with. As my arm started to come back, I leaned more and put my hand lower on the wall. Then I put two hands on a chair for pushups, then a stool, then finally the ground. I trained the other arm as much as I could using the exercises above.

3) Once I was able to do pushups without pain, I was doing them every day, building up volume as I could. I was doing a lot of external and internal rotation moves with a band to keep muscle balance. I was also doing as much rowing (horizontal pulling only) as I could handle comfortably. Pain in the repaired joint was the signal for how much to do. I never put that joint at risk for setback. Going slow may add a week or two two your recovery time, but re-injury could set you back months.

4) When the PT graduated me, the next task was vertical pulling. That took about 6 months before I was able to do a pullup again. The biggest challenge for me was getting my rear delt on the injured side to strengthen. I could get plenty of burn from bent laterals, but not stronger. Eventually I discovered that doing "Kroc" rows, one arm DB rows for high reps, was the best medicine.

I did them with ridiculously light weight (35lbs) and did sets of 20, letting my elbow flare out to the side so that the rear delt was fatiguing more. Eventually when I was moving 85lbs in that hand for 20, I felt I was ready to do vertical hangs, slow eccentrics, and other stuff. There are a bunch of great pullup articles on here for people who can't do one. I just followed those.

5) Once you are pretty much back, be a shoulder-nazi. My shoulder will ache after hard training if I have been neglecting my rotator and rear delt work. If I keep the rows and rotator stuff in my weekly program, I can stave off pain, even when doing heavy bench, back squats, front squats and overhead pressing. In fact, the only thing that still hurts my shoulder now is an approaching thunderstorm. I am like an old farmer predicting the weather with this thing.

And Ach34, don't let your doctor tell you what you can and can't do. Docs mostly deal with people who have no desire to really rehab, so they give them that kind a #$%@$ about "never do this...never do that..." If you can lift 2 lbs overhead without pain, then you can lift 200 overhead without pain, if you give your muscles time to heal and get strong. Never let anyone else determine what your limitations are.