T Nation

Shoulder Microfracture


#1

hi guys,

not sure which forum to post this in.

Microfracture is common and well documented surgery in the knee, but less so in the shoulder.

I have recently had microfracture surgery to fix a hole in the hyaline cartilidge in my shoulder around 11mm in diameter. This damage appeared after surgery to fix a torn labrum, which is now OK (the repair is intact).

has anyone had this surgery (Microfracture) and succesfully returned to lifting?

So far both surgeon and physio has been non-commital over what I will/won't be able to do in the future.

there's very little information on google about it, I found 1 medical study and that's all!

Thanks,
Jim


#2

bumping this as no feedback at all.

really struggling to find any information about the effects of microfracture on weightlifting ability.


#3

I don’t know about the microfracture procedure, but I would say go slow and ABSOLUTELY do the physical therapy.

I’ve had a shit-ton of shoulder work done. Lifting wise my bench now sucks, but deadlifts and back training was largely unaffected.


#4

hi,

i will be going very very slow with recovery.

i’ve had a lot of work done on my knee in the past (ACL, menisectomy etc) so understand what it means to not rush recovery.

i have a feeling though that physiotherapy will only take me so far. my physio won’t say whether i could/should lift again, neither will my surgeon.

i’m trying to find out if microfracture means no more weights. if it does, i guess that’s OK (it’ll have to be), but i hate not knowing…


#5

try searching glenohumoral and chondral abrasion


#6

(glenohumeral chondral abrasion athlete) This is what I searched on google and there are plenty of journals. Go to a local uni and see if you can access them.


#7

tveddy - thanks, found some information there.

one thing which is a little worrying is a couple of articles advocate pendulum exercises with hundreds of repetitions a day to mimic continuous passive motion (like the machines you get after an ACL op). i was told to do 3 times a day of 10-15 repetitions. i may raise this with my surgeon as a concern as my shoulder is nearly completely immobilised at the moment.

there’s still not a great deal of information about long term activity. i know i had 2 small lesions, one 11mm in diameter, one about 5mm, straight through the hyaline cartilidge to the bone. there was also some scar tissue, and the pin in place from my labrum repair had moved a bit.

the surgeon took out the pin, removed the scar tissue and performed microfracture on the two holes in the cartilage, so hopefully they should now have fibrocartilidge in place once i have healed.

i know fibrocartilidge isn’t as strong as regular cartilage so want it to last as long as possible, so i am guessing certain movements are definitely out (barbell bench, dips etc) but i would have thought keeping my shoulders strong would be my best insurance against trashing the cartilage again. having said that, i cant see how any kind of heavy lifting is going to do it any favours; i would guess that even deadlifting nore than a couple of hundred pounds, or doing some chin-ups, really stresses out the shoulder, and if it’s delicate already… the last thing i want is to have to go through all of this again.

i know that rehab for the first few months is going to be limited to rotator cuff and shoulder stability exercises with therabands, but i’m thinking about the longer term.

i’ll try to talk to my surgeon about this again when i see him in 3 weeks.


#8

I actually had microfracture on my knee, and I just squat lighter with more reps. It feels great now. Don’t know if you’ve read these articles yet, check them out.


#9

hiya,

yeah, i’ve seen those articles before, they are great. i actually followed a lot of the advice in them prior to labrum surgery but it became obvious no amount of strengthening was going to cover for the pain the torn labrum was causing.

that’s great news about your knee feeling good. are you worried about the (new) cartilage being damaged easier than the old? that’s my main worry with the shoulder - i don’t want to undo the effects of the surgery…


#10

It was a lateral femoral condyle defect so it won’t be as bad as if it were my medial condyle which bears the brunt of the forces. So I’m not that worried about it. I’m kinda hoping that they have partial knee replacements down pat in 30 years. I wish I knew more about shoulders to be of more help.


#11

no problem… it’s encouraging to hear any positive noise about microfracture to be honest!

i can’t wait to get started on rehab. being in a sling is driving me crazy.


#12

How long have you been in a sling? After my procedure I was in a sling for over 6 weeks.


#13

3.5 weeks, 3 to go


#14

Tough to compare microfractures of the knee with those of the shoulder. The knee is weight-bearing and stable, whereas the shoulder isn’t weight-bearing, but needs a lot of mobility.

I am working right now with a high-level pitcher who had it back in October. He’s doing very well and is just starting to throw now with an anticipated return to play this fall. I have trained him since two days after his surgery - lots of work for the lower-body and non-injured arm!

If you don’t mind me asking, who did your surgery? Not many guys who are qualified to do it.

www.EricCressey.com


#15

hi eric,

that’s encouraging to hear.

the surgery was performed by Marcus Green:

http://www.bhamknee-shoulder.co.uk/index.asp?article=1198&link=24&menuOpen=5&mHighlight=6

(I’m in the UK)


#16

[quote]Eric Cressey wrote:
Tough to compare microfractures of the knee with those of the shoulder. The knee is weight-bearing and stable, whereas the shoulder isn’t weight-bearing, but needs a lot of mobility.

I am working right now with a high-level pitcher who had it back in October. He’s doing very well and is just starting to throw now with an anticipated return to play this fall. I have trained him since two days after his surgery - lots of work for the lower-body and non-injured arm!

If you don’t mind me asking, who did your surgery? Not many guys who are qualified to do it.

www.EricCressey.com[/quote]

what would mobility vs WB have to do with how the cartilage heals and functions?


#17

eric,

assuming a succesful rehabilitation period, and that i am still able to train at all (will need surgeon to confirm), what kind of exercises do you imagine would be off limits for the upper body?

i am guessing that overhead squats, any kind of olympic lifts, dumbell flyes, benching with the bar and dips are definate no-go…

also eddy, out of interest what’s your squat performance following the microfracture? i know you said you are lifting lighter, but are you still able to push yourself or are you always worried about re-tearing?

thanks guys,
jim
1.5 weeks left in sling…


#18

I had microfracture surgery on my shoulder March 31st on my left shoulder. I’d had four previous surgeries on my right shoulder, the worse being a capsular shift and rotator cuff. However, this microfracture repair is more frustrating. The pain is worse and the length of the recovery seems much longer. Have you heard percentages concerning success of microfracture surgery repair of the shoulder?


#19

[quote]jim2406 wrote:
eric,

assuming a succesful rehabilitation period, and that i am still able to train at all (will need surgeon to confirm), what kind of exercises do you imagine would be off limits for the upper body?

i am guessing that overhead squats, any kind of olympic lifts, dumbell flyes, benching with the bar and dips are definate no-go…

also eddy, out of interest what’s your squat performance following the microfracture? i know you said you are lifting lighter, but are you still able to push yourself or are you always worried about re-tearing?

thanks guys,
jim
1.5 weeks left in sling…
[/quote]

before I was squatting 620 for 1rm. Now I stay under 500 for reps, and I haven’t maxed out since last year when I got 575. The reason I’m weaker is that I don’t train as hard as I used to, not because my knee hurts. The only time I notice anything is after playing raquetball or anything high impact like that, its a little swollen. Hope that helps.


#20

i am now out of the sling and have my first physio session next week.

spoke to surgeon about recovery, he said he’d be “very happy” if in the long term i was able to do ‘swimming and very light weights’.

to put this in perspective i had 2 full thickness tears of the hyaline cartilidge. The first was 1cm in diameter in the front of the shoulder (ie it was a circle). the second was 15mm by 2mm at the rear of the shoulder, (a thin strip).

prior to surgery i’d been getting pain at the front of the shoulder.

i am having trouble dealing with the fact i won’t be able to lift again. granted i’ll never be a powerlifter, but weightlifting was an important part of my life and i can’t imagine not being able to do it in the long term.

not feeling too great at the mo!

jim