T Nation

Shoulder Surgery Experiences

Hi Everyone,

Long time reader first time poster. Sorry in advance for the long post.

I am mid-20’s, 5’11", weight is currently an unimpressive mid 180’s. Training history is 14 years of wrestling training, started wrestling at the age of 10 and wrestled through college(only D III, but nevertheless the wear and tear on shoulders was notable). My first introduction to lifting was through my own messing around and what little I picked up through muscle and fiction in my early teens, lifted heavily in the “off-season” each year using the typical bodybuilding splits until I was introduced to westside as part of team training spring of my sophomore year of college. Fell in love with it, and continued to push a westside split following purchasing my own set of bands until the next season.

Spring/Summer of Junior year tried 5/3/1, and also had some great gains(relative to my lanky/skinny standards, my lifetime gym lift PR’s are a measly 275 bench, 385 squat, and 450 DL).

I first injured my left shoulder, SLAP tear, fall of my senior year. Decided to wrestle on it, finished the season, though by the end my left arm was quite useless, and had it repaired April 2010. Had rotator cuff and labral repair requiring 7 anchors. Surgeon was highly skilled, does work for the olympic swim team, and repair held up very well. Following completion of undergrad, I was fortunate to have the opportunity to continue studying for two years in a foreign country, affording me the schedule/flexibility that really only exists for a student.

As soon as I got the go-ahead I returned to the gym hard. While it took time to really get back after things, I felt confident in the repair the surgeon did, and started pursuing strength training again with serious intensity. This manifested itself in 4 months or so of 5/3/1 following the 6 months of rehab, a transition back to westside for about a year, and then a foray into sheiko(after being thoroughly inspired by ben rice and others), running #29 and then #37 for ~6 months.

Sheiko was, quite simply the most fun I have ever had in training. I returned to the states 4 months through my Sheiko experience, and continued pushing it hard for another two months. As things progressed, I began experiencing notable looseness/pain in my right shoulder(which I believe I actually injured back in my senior year wrestling with a bum left arm). Being young/stupid, I ignored it back when I first felt any looseness and felt I could train around it.

Continuing on to fall of 2012, I had to transition away from the beloved Sheiko to a more conservative 5/3/1 with what I felt to be a conservative exercise selection. My shoulder continued to hurt/bother me following training until Dec. where it most often than not it bothered me. In a last ditch attempt to avoid surgery, I embarked on a seated cable row extravaganza, performing 100 at 100-140 lbs. every day. After about a month of this rowing happiness, along with pull aparts and rotator cuff exercises, I had regained sufficient stability to bench, dip, and shoulder press pain free. Then one day, towards the end of a great workout, I decided to throw in some seated DB power cleans to continue to strengthen my right rotator cuff, wind up reinjuring my left shoulder, being unable to use it for almost 2 months afterwards.

I can now use it for some movements but most things still bother it. This was late Jan. 2013. Fast forward 3 months and I have seen a number of docs, had an MRI arthrogram on my left(confirmed labral tear, bottom of the labrum), and am scheduled for an MRI arthrogram on the right and surgery on one of them this Thursday.

Sorry for the long run-up, but here are my questions.

What are your experiences with shoulder surgeries(esp. if you have had more than one)?

For the older guys who have had shoulder surgery, what has been your experience in continuing lifting and living life? Barring any miracles, I am anticipating having had 3 shoulder surgeries by the age of 26, which is certainly not a great track record.

For those of you that have had both done, possibly multiple times, how did you go about programming training following your repairs? I am at the point right now where my arms are useless for anything more than moving a chair or foldable table, and has been a bit of a shock psychologically to say the least.

The mental conflicts that I have been unable to answer for myself so far are weighing the importance of lifting in my life with the importance of having functioning arms later in life. Lifting has been incredibly important to me as a means of grounding myself, relieving stress, as well as being a source of self confidence. While somewhat cliche, I believe most on this site can relate to the notion of having lifting be a part of your identity rather than just an activity you use to fill your free time. It certainly is a part of my identity, and I am wondering whether or not I will have to change that to a large degree moving forward.

While it is just about blasphemy to write the above sentence on this site, I am weighing continuing lifting by T-Nation standards with the importance of family in my life. Family has always been incredibly important to me, and I look forward greatly to having a family of my own one day, and the notion of being in constant pain and living a life restricted by my body(like I do now), bothers me greatly, and is something I wish to avoid if it all possible. While potentially grandfatherly/presumptuous of me, the ability to play a pain free round of golf with my brother, son/daughter, and grandchild one day far in the future is a goal I have for myself.

So, for those of you with experience, thoughts, or advice on my current situation, please post away. Thanks.

Sparknotes:

-Mid-20’s, 15 years of wrestling/lifting wear and tear on shoulders

-Had labral/rotator cuff repair in 2010, re-tore left and believe have a tear in right as well.

-Currently unable to use either arm for much more than lifting a chair or backpack.

-Lifting is very important to me, but so is being able to function later in life.

-Looking for thoughts on programming, preventing arthritis in the future, ensuring full rehab, and generally having two arms that work and are injury free for the rest of my life.

Surgery tomorrow 9 AM on the left shoulder. Spoke to the physician’s assistant this afternoon, full recovery should take 3 months. Great news in the face of the 6-8 months it took for the first try.

Also had an arthrogram (dye injection MRI) on my right shoulder this morning. We will see what that yields. There will be some times where I am less than pleased, but its a start.

I had a torn labrum in the right shoulder with 4 Anchors. I did a lot more PT than most apparently and am back to 100% but it took 6 months to get there. If your experience is anything like mine at 3 months you’ll be back to normal daily stuff but not lifting in the gym yet. On the bright side my shoulder is now better than it had been in years since I had injured it previously and they fixed both issues at the same time.

I would be comfortable doing almost any movement with the caveat that you will likely have to transition into it. The only movement I would/have had issues with is military press due to how much tighter my shoulder is now. I realize you’re probably on the way home by now but I wish you a speedy recovery!

Thanks for the response PeterD! Congrats on the progress you’ve made brother, that is very impressive. Out of curiosity, when on your path to jackedness did you get your shoulder fixed?

I’m just shy of a week out, have the follow-up appointment on Friday and have begun pendulums, not much more.

The surgeon performed a Bankart Repair with two additional anchors(6 total in my left shoulder now). From what I could understand through my drugged-up stupor, he said that me previous surgery tightened the posterior capsule a lot, and over the past 3 years that has placed excess strain on the anterior capsule leading to the tear. Will know more Friday as to whether this is a chronic accumulation or an acute injury. I dream of landmine presses and pullups at night right now.

Plan is to start PT in two weeks, first steps on the road back

although I am older than you 38 and on my first shoulder surgery … I sit here 1 week and 1 day post op… My situation is similar in that I have been training for 20 years and it is a big part of my life. I have won overalls in state bodybuilding competitions and my wife just did so several weeks ago… So this is important for both of us… I have arthritis in my Glenohumeral joint and have had for at least 10 years… i have continued to train regardless. It hasnt caused me much pain but I just tore completely off my supra and infraspinatus…

This happened in sept and i was misdiagnosed because i didnt fail any test due to my shoulder strength compensating for my rotator cuff muscles. Well it got better and I continued to train pain free but many lifts didnt feel stable… so eventually i went back in and got an MRI and it showed both complete tears and mild atrophy in the retracted muscles. I went to the best surgeon on the state … he is the team shoulder surgeon for the MN twins baseball team. His mid level is a freind…

Even they looked at the MRI and said they werent sure they could fix it and without it fixed because the humerous was sloppy my arthritis was going to get worse and quickly… So I was fucked… I went under the knife last tuesday and surprisingly they got out and said they completely put it back together where it belonged. Big relief this means that as long as it heals without retearing I can train again to some degree and I will just have to deal with the arthritis later… Of course the surgeons never want me to train again … but it is part of who I am…

BTW i am already having very very little pain and im off all meds … no OTC meds either. just mild discomfort but I will be in a sling for 9 more weeks. So it will be just legs and right side of my body at the gym… also they wasn to check my other shoulder next year just to catch it before it too is wrecked this bad. KEEP YOUR HEAD UP … there is always hope and nothing saying you cant stay fit… of coures no dips, flat bench etc anymore but I havent flat benched in 5 or more years and im bigger than I have ever been… keep me posted on your recovery.

[quote]Swolle wrote:
of coures no dips, flat bench etc anymore but I havent flat benched in 5 or more years [/quote]
Curious why you say this. I know a number of powerlifters who have had shoulder surgery and returned to flat bench. Did your surgeon expressly forbid it?

There are many degrees of shoulder surgery… there are simple surgeries IE spur removal,acromial decompression. They can have partial tears (tears that dont go through the full depth of the tendon) or full tears (tears that go through the full depth but not the full width) these both can be fixed and many times will give you a good secure post op strength because not all the tendon was removed from the humerous.

Also labral tears can be fixed and more often than not all of the above can return to a normal routine. If you read my post I had what is termed a massive rotator cuff tear involving 2 tendons… In that both the infra and supra tore completly from the humeral head and retracted back away from the humerous and atrophied. I also have arthritis in my GH joint…

IF I were to retear and they could not fix it when the time comes and not if but when the time comes for me to get a replacement shoulder… because the arthritis will eventually cause the shoulder to be bone on bone… The options without a fully functional rotator cuff are limited to one… A reverse shoulder which most surgeons in the US wont do until you are in your 60s.

With a fully functional rotator cuff i have multiple decent options and even some that could be done much earlier. The surgeons told me 9 years ago to stop lifting and they said now I have no choice. I will not stop but I most certainly will avoid the biggest offensive lifts for destroying rotator cuffs… 3 lifts are by far the worst flat barbell bench, dips, and overhead pressing… All three can destroy an already weakend tendon.

Now if you are blessed with great shoulders and have no other issues and simply a mechanical impingement and have a simple surgery to fix this as stated above you can for reasonably resume your previous lifting habits… Not saying that you wont in time wind up wrecked again but its your life. Ask any orthopedic surgeon what their thoughts are on the bench press. Then ask them to run you through the physics of why… and why some people can get away with it and some can not. Genetics come into play arm length, shoulder width, acromium process type I,II, or III, balance in workouts to keep your shoulder stability strong, utilizing a powerlifting form for benching (elbows nearer sides and not flared, bar path that ends nearer lower chest and a decent arch to shorten the distance between the chest and lockout so your elbows dont come to far behind the shoulders when your the bar touches your chest).

All of these things come into play but are not guaranteed to keep your from injuring your shoulders. All of this comes into play when I make my decisions as to avoid these movements.

I had a similar injury to yours, Swolle. That’s why I was asking. I have to agree that OHPing and dips are killer on a repaired shoulder, and I don’t do them anymore. But I do flat bench pain-free.

I will say that the recovery process was slow. So don’t dispair, Williams74. I found that I was still noticing tiny improvements up to two years after my repair.

Overhead has never bothered me… But flat presses and dips have always been a problem … Always

Very interesting. It’s one thing to read in an article on the site that different bodies indeed react very differently to certain exercises.

Swolle, good luck with coming back. Very impressed with your achievements so far. Got some wheels on you dude. I’d never even heard of a reverse shoulder replacement. While very interesting conceptually, I hope that’s not a road you have to take.

kpsnap, curious, how did you get into PLing? And how does your programming now compare to your programming prior to surgery?

On a positive note, back to typing with two hands, making responding much easier. I’ve been able to get out of my sling pretty comfortably for a couple days now, which is a small but notable step in increasing comfort. Swolle, not sure about you brother, but they gave me a monster sling with a metal “brace” on it, not sure what else to call it. Ditched that as soon as I got the OK from the doc on it.

Not to take this thread on a bit of a hike, but regarding mechanics and muscle involvement, do either of you know the finer points of the differences between pushups and bench re smaller/stabilizer muscles used and joint mechanics?

W74

Yes push ups are significantly better for your shoulders … when you bench press you lay on your back and because of this your scapula are pressed into a specific place… When you do a push-up your scapula are much more free to move around and with the correct type of push up… What some call a push up plus… You are able to pull apart your scapula on the peak of your press and utilize your rhomboids, lower trapezius, and serratus and sort of pull your scapula out of the way and down when you transition from top to bottom… If you don’t understand this… Look up push up plus… Great way to build health shoulder movement… Even doing weighted push-ups when you get stonger is a good stabilizing movement.

I am in a bump sling for 8 weeks total and then a regular for 2 weeks

i’ll try and be brief.
i’m 54, had AC-joint surgery 9 years ago (they sawed-off 3/4 of an inch, still have it in a jar).
i don’t think that AC-joint work is as complicated as your surgery, but i am no doc.
However my doc said leave it alone for 6 months, then ease back into things. Which is what i did.
As of today i continue to increase my PR’s in both the snatch and clean n jerk (my passion)
Correct me if i’m wrong but here is what i read in your posts.

FIRST and most important.
You just keep right on training when you know your injured.

Unless your getting paid(ALOT)to train, continuing to train when you know your injured is referred to by us old guys as being stupid. But your young so i understand that.
Unless you are a professional, you don’t have access to the same recovery “supplements” or have the free time for proper recovery so you need to learn how to train for a “normal” person who has other responsibilities.

SECOND You go into all kind of detail about your lifting and routines blah blah blah and i don’t read a damn thing about your flexibility training. And how much time you devote to that. My guess, not a whole lot. I spend a minimum of 30 minutes a day. And i honestly believe it is the one thing that allows me to continue to olympic lift at my age.

Get a great surgeon

Get even greater PT folks for recovery.
Those guys are precious if you get good ones. Now a days thats a 5-year degree that ain’t no walk through the daisy’s. They know there shit.

Get into a serious flexibility program BEFORE things start to hurt again.
Everybody waits till they’re hurt before they start stretching, then they say hey this ain’t helping. No shit. Its suppose to prevent the injury, not treat it. Do it when you don’t hurt. Yeah, i know…thats boring. So is recovering for 6-months from surgery.
Check out mobilitywod.com and Kelly’s youtube videos. Good stuff.

good luck. didn’t intent to write this much.

LB

Some great points LB. Thanks man. Kelly’s stuff is awesome.

Fortunately I can put a check in the great surgeon box. Have a great guy lined up for PT too.

My apologies for leaving the warmup stuff out. I typically devote(d) about 25 minutes to warmup, 10 or so just cranking on a bike to get a sweat, then rolling, lacrosse balling quads, IT band, lats, pecs, anything else that felt junky. Also a very good point about training like someone with other responsibilities. Up until this past year I was fortunate enough to have a good deal of time to devote to prepping for and recovering from the weight room. It very likely is not a coincidence that I hurt myself following a transition from that to commuting 5-6 hours a day five days a week. It has been quite a learning experience.

LB,
I’ll be brief… an AC resection is what is considered an easy surgery… for several reasons and I’ll run it down for you. Fist the acromial clavicular joint is a useless joint and serves no purpose… actually the clavicle itself really serves very little purpose… Many lifters experience pain in this joint and the body actually will break down the joint itself if given proper amount of time… It is called distal clavical osteolysis…

What happens is that from lifting you bang your clavicle into your acromium process over and over and it gets inflammed and causes pain and starts to wear away this joint… Your surgeon just sped it up considerably. Many lifters just lift through this pain and eventaully it goes away. This doesn’t make the actual shoulder joint any less stable and when they do it they dont touch the rotator cuff muscles/ tendons. They may however do a subarcormial decompression and remove the bursa at the same time… This and the healing process are really the only reasons for the 6 month recovery… None of which affect the shoulder long term.

Most who get this surgery are back to full strength with zero long term issues. Very very different than labral tears, rotator cuff tears or gleno humeral athritis. Your damage was unpreventable… All the warming up and stretching in the world wont stop acromial clavicle issues. The acromium is part of the scapula and thus it moves along with the scapula… the underside of this hooked boney process is what can cause impingement issues with the suprapinatus and the infraspinatus and the end of it butts up to the clavicle which causes the issues in the AC joint.

This movement cannot be stopped but with good strengthening during presses and overhead movement one can train the scapula to remain back and down to give enough space for the supra and infra to move freely without impingement during pressing movements. Which is why everyone says do more back work etc… what they mean is strengthen the rhomboids, lower trapezius, serratus muscles so that you can squeeze and depress the scapula during pressing movements… also stretching the chest can help to lengthen this over tight muscle to facilitate easier squeezing of the shoulders back and scapular squeezing. Sorry this was long.

[quote]Williams74 wrote:
kpsnap, curious, how did you get into PLing? And how does your programming now compare to your programming prior to surgery?
[/quote]
Used to race (5Ks, 10Ks, sprint triathlons). Started seriously lifting at age 40 to get faster. Fell in love with lifting and left racing behind. Spent about two years frequenting PLing meets. Was just fascinated with the sport. Started competing at 43 and have done ten meets, I think, in the last four+ years.

My programming has changed in that I cannot handle as much flat bench volume as I could prior to surgery. Also, I cannot do any OHPing or dips. Also, I used to dabble with the Oly lifts but cannot anymore. Interesting how everybody’s experiences are different because unlike Swolle, I can flat bench pain-free but cannot really do pushups except at very low volume. I’ve tried all different hand positions, but my shoulder does not like them.

I had a totally detached supra with a full-thickness U-shaped tear and retraction. Five anchors now .

Kp it all comes down to basic physics and everyone’s angles are slightly different as well as their flexibility. Biggest culprit in my tear was a ligament had calcified and was sawing through the tendons at certain angles…

Swolle, was that in any way related to the gleno-humeral arthritis you mentioned?

No… Basically the tendon had been inflammed so many times due to impingement an once it was inflammed and swollen it rubbed on the ligament enough to cause the ligament to defend itself for lack of a better word… And calcify…