Shoulder Health
17 post(s),
5 voice(s)
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I recently went through shoulder surgery (subacromial decompression) to relieve some impengement issues I was having and and starting to make my way back into the gym after this. My AC joint is where most of the pain was, lots of grinding and popping accompanied by a constant aching pain. My SC joint recently started acting up too, gringing and cracking when I would shrug my shoulders. My sergeon explained to me that I shouldnt get my SC joint going because it is very ricky to fix. Keeping my shoulder still has helped with this and it seems to be getting better with time. I was wondering now that im slowly getting back into the weights what are some things I can do to ensure shulder health. I know the standards like focus on dumbells over barbells and emphasize healthy form but what are some other things I can do/avoid to ensure the health of my joints?
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Keeping the subacromial space opened up is as easy as making sure your shoulder blades are pulled down and in at the beginning of any chest or shoulder exercise and making sure they stay there. The shoulder blade is where your arm/shoulder get all their stability and without anchoring them down, the head of the humerus can translate forward sloppily and grind your supraspinatus tendon to powder - as you know. But, you also have to keep the anterior shoulder capsule, rotator cuff, and pecs stretched and flexible so you can retract the shoulder. And lastly, you need to treat the shoulder pain like a strain. That tendon still takes a beating in chest/shoulder work and even with the decompression, you're likely going to feel it barking at you once in awhile.
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Flat bench is going to be harder on the shoulder then incline. So yes, keep to dumbells and focus on incline dumb bells. Gelatin, as simple as it sounds, is efficacious for joint health over the long term. Knox unflavored. Put it in your whey shakes. (Just a suggestion of the many possible approaches.)
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Actually it depends on where an insult to the tendon is. Some anterior rotator cuff issues will make incline much worse. Totally depends on the injury. But, barbell is definitely always harder on the shoulder than DB.
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Im becoming more and more in tune with stabalization of the shoulder after the surgery. Im currently doing internal/external rotations with a thera band and some scapula stabalizing movements along with stretching to get my normal ROM back. Even though I think I had decent enough exercise form before the surgery Im researching this more and am finding exactly what you said about keeping the blades down and in and holding them in place. At this point Im also concerned about the same thing happening in the other shoulder and am hesitant about doing over head movements. I think as I get back into this thing its going to be a touch and go process as far as adjusting my training style to maintain healthy joints for the long run while growing as much as possible. Mary - thanks for the gelatin suggestion, I hadnt even thought of that. Im currently using a glucosamine, chondroitin, msm supplement but am unsure of its effectiveness. I will definitely pick up some of the gelatin and give that a try as well, Ill try anything I can at this point. |
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Joe - in your opinion as a physical therapist when would be a safe time for me to start getting into some decent weight training after my decompression? It will be seven weeks post op. this friday. So far Im doing the standard therapy and have recently started doing light free weight work. I mean light as in twenty pound chest presses for 15 reps. My surgeon seems to think Im pretty much good to go since there isnt really risk of any soft tissue damage but my therapist seems to want to take things more slowly. What is your opinion as far as a timeline for getting back at the weights after something like this?
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You'd want to look at four things: 1) pre-surgical injury. If you've still got some tendonitis/strain stuff going on than you still may need to take it slow even after the decompression. 2) post-surgical inflammation. If you're not having pain, you've been using some ice, and you're going to keep icing after upper body work, then you're one for one. 3) neuromuscular reintegration. You need to have done enough scapular stabilization work (isometrics and short-range stuff) just to make sure the stabilizing muscles are firing and ready to hold the glenohumeral joint during arm movement. 4) moving up slowly. Make sure you take all workouts/progression slowly. Don't wait to see if a workout was too aggressive - make sure it's not and move up one step at a time. Avoid things you know are too aggressive like chin ups, barbell chest work, dips, overall shoulder presses, etc. Sounds like you can definitely start moving forward; just make sure it's not one step forward and three back. |
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Ok I think my shoulder is definitely more stable than it was before surgery. As far as scapular stabalization Ive been doing mainly scapula presses or ceiling punches (dont know what else to call it) is there anything else I could do to further stabalize the scapula/rotator cuff in general? Tendonitis is something I have thought about too. Pain is doing really well, almost non existent. Tightness is really the main problem, Im doing a couple of stretches for this but it seems to be going slowly. Any other suggestions as to how I could loosen this up? I really appreciate your input with this, its great to get a second opinion from someone qualafied (especially someone who is also involved with bodybuilding). |
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A little update on my shoulder situation- Over the past few weeks I have been slowly working back into a 3 day training split. Taking it very slow to let my body and especially my new shoulder adjust to being under the weight again. All done with PT except for what I do on my own at home. I have to say that my body really loves weight training though and it feels great to put some work through my muscles again. Its crazy to take some time off and then see how your body reacts when you do some squatting/dead lifting again. Ive been using ice pretty consistently to stay ahead of any irritation that might occur to my shoulder but I still have ran into a few problems. Even doing workouts that feel "ok" and very light while doing them in the gym have the potential to cause some serious soreness in my shoulder a few days later. Im kind of in the process of gaging the pace at which my body will be able to return to lifting. but after its all said and done the key word is progress and it feels great to be working toward a goal again! |
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It is a fine line of progressing and making sure to not over do it and end up with long-term inflammation on top of the surgical healing. The scap stabilization stuff has a lot to do with individual muscle reintegration neurally and also strength. When you've had an injury or a surgery, the nervous system just shuts down some muscles - you would think, "I don't need to do that little sissy tubing exercise or that prone arm extension with a one-lb dumbbell - I can do rows with a 250-lb stack!!" But, the muscles not compromised and neurologically inhibited stay dormant and the others overcompensate causing new problems and not solving the current ones. Really focus on individual muscles, contractions, and work on the upper scapular muscles in a rehab-fashion while continuing to ice, etc. The tightness is really best worked on by a good manual therapist. There are joint directions, joint mobilization things you just can't do with a stretch on your own. Hope it continues to go well!
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I currently have taken about 2 weeks off from heavy lifting... I'm just kinda playing it by ear now... I think I will stay away from heavy lifting for a while... I'm trying to allow my body to heal after 2-years of intense training and competitions.. It's one of those things where, I know my body and can tell it needed a break... I felt symptoms of shoulder weakness and my knees do this weird cracking thing... when im in a seated position, I flex and extend in the air and my knee catches more and more then finally cracks... I don't know if this is the plica or wear and tear of the meniscus... NO PAIN when i do this... I read that a plica will pseudo-lock sometimes... I went to 2 doctors and both said I was fine... What are some good preventative and healing knee exercises? My shoulder ROM was reduced so I went about "primary prevention." I've been doing nothing but functional training.. And even if my muscles atrophy somewhat, that won't bother me.. they will get big again and at the same time, my internal foundation (intrinsic muscles) will be stronger and more conditioned.. I love training my rotator cuff b/c it feels like it's getting better week after week... Currently, Im training for a 10k race... Ever since I stopped heavy squats and leg presses, my knee has felt more recuperated... It still does that popping thing, which I know it's not significant if it's painless, but it still bothers me... As for my knee, I've been doing the following:
1) Bosu ball balance exercises 2) Quarter single leg squats and leg presses with lighter weight 3) Seated straight-leg hip flexions 4) ACL terminal knee extensions (There is a pad behind my leg and I extend the knee so that the pad moves back and my knee straightens)... I've seen this done in PT for ACL rehab... I'm using it for prehab... |
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That is a whole lot of information without much specific to go on - as much as you laid out, it would almost take a physical exam just to sort it out. I'd find a good physical therapist to evaluate instead of just a doctor.
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I read it's $1,000 for contest prep for 12-months... I am only interested in perhaps 12-16 weeks of contest prep.. I'm an open class middleweight, I finished 2nd in my last show a few points from getting the pro card... I'd like to hire you for 12-16 weeks... My main goal is to get as shredded as possible and ultimately, to have split hams and striated quads I've never had these 2 before...
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I don't work with competitors for less than a year; you can have your first show in 16 weeks, but I go for the year so we can do more shows together. One and done won't help you get what I can give. It's not formulaic or cookie-cutter. Email me.
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What is your email address? I've emailed info@dietdoc but no answer... I looked on your profile, no email address...
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