Deadlift with reverse shoulder replacement

Short version: Does a reverse shoulder replacement cause enough risk of injury that a trainee should avoid performing deadlifts?

Long: My father. 71 year old male. 5’8" ~175 Lbs. Overall good health, no heart disease, diabetes, cancer etc. Never exercised, but very active because he can’t sit still and always has projects to do which was “super fun” when I was a kid. Right shoulder replaced early 2016 then he got to have it done again in Aug 2016 after getting an infection from a fishhook.

I convinced him to start training July 2017. Was only able to get him to squat with a SSB and deadlift. (Bench was out because he sometimes gets vertigo after lying back, he says it effects him on an incline too. Press was out due to limited range of motion in right shoulder and pain in left due to rotator cuff.) Form to my very inexperienced eye wasn’t too bad. He is adept at setting his back in both lifts and didn’t try to jerk the weight off the floor. Things were progressing nicely for him on the two lifts twice a week until he was squatting ~135 and DL was 160. Then he saw his surgeon and was promptly “noceboed.” Told him in no uncertain terms he shouldn’t be lifting anything beyond 125 lbs. Had no pain or real difficulty with the deadlift but stopped adding weight to the bar.

Fast forward a few months. After he nearly drowns, I convinced him the strength he gained is why he survived and to take another run at an LP. A month later his squat is now up to about 160, but when I asked about the DL he said he can feel it “tugging” on the replaced shoulder and he’s not comfortable lifting much more because he doesn’t want to “chance it.” Two of my dad’s hobbies are road racing corvettes and flying ultralights so his sudden interest in risk management is bullshit, but I don’t have the technical know how to call his bluff. I found an article referencing a 72 year old powerlifter who had a shoulder replaced then came back to total 1100+ a year later, but he was a lifelong lifter so I’m not sure if its relevant.

Coaching would be a great idea. I’ve suggested it, but the likelihood of getting him to the SSC in Omaha is slim to none. Thanks for the info you guys put out and any help you can provide.

Since I’m not particularly familiar with this surgery, I reached out to a trusted colleague and got this response for you:

This is excellent as I sent the synopsis of the case as a group text to three of my fellowship trained joint surgeon buddies and sat back to watch hilarity ensue. It was definitely a case of environmental influence as the one treating in the villages on a geriatric, overall deconditioned population was the most conservative by far. Here would be my contribution to the discussion:

First, it is spectacular that your father is squatting and deadlifting. The concern with most joint replacements is two-fold, the first being the soft tissue damage incurred during surgery tends to make that tissue more likely to fail in early to mid post operative time frame. This would be mitigated by strength training, within reason, so that is a check in the pro column for continued strength training. Second, increased joint loading on replacements tends to shorten their shelf life and a third replacement would not be an ideal situation for the integrity of the shoulder overall.

Now, to take a more nuanced approach, 125# is an arbitrary weight to choose, but there has to be a risk vs reward discussion on the returns of increasing weight when your father’s primary hobbies are driving and flying. If your father is feeling good pulling 125# to 160# and participating in his recreational activities he is likely in the 99.9999% of strength for his age group. This is not to say that he could not continually make gains, but without knowing the explicit integrity of the cuff (like the surgeon who operated would), or a complete medical history, it would be difficult to advocate for really pushing for continued progression. The article referencing the 72 year old power lifter has to take into account that person’s hobby was powerlifting and it was more imperative for him to return to lifting weights. If your father’s hobbies are driving and flying it is likely most advantageous to develop/maintain a program that optimizes the likelihood of his prolonged participation in those activities.

That is not to say that your father should or could not continually progress in weight. It is likely that if he chooses to do so, the slope of progression should not be as steep as another who’s primary focus is the sport of powerlifting. As referenced earlier, the concern with a shoulder, as opposed to a knee or hip, is the decreased joint contact of the glenohumeral joint and reliance more on the rotator cuff muscles, which have now been reflected twice (subscap being the one of primary concern). He should definitely continue to squat and deadlift, but it may be ideal to include overall dedicated scapular strengthening type exercises as a means of maintaining/maximizing a foundation of strength. By that I do not mean yellow theraband external rotations but likely the same mentality for progressing external rotator strength and scapular retraction strength that you would likely apply to LP.