Final Stages of Shoulder Rehab - Is this normal?

Hi,

I’m a 18 year old male who was diagnosed with a strained rotator cuff at college in December 2019. I went to a PT who was very unhelpful, only prescribing rest and telling me that shoulders take a “long” time to heal. After months of doing bs band internal/external rotations in my dorm room we were sent home from college due to COVID. It was at home that I began reading SSBBT. It was in it that I learned more about rehab than I had from months of going to physical therapy.

The section on the press clarified to me that the rotator cuff muscles are worked during a press and I figured I could rehab myself using dumbbells that I have at home. With a little more digging into the strength training world I came across the following article and videos which completely changed my outlook on pain. It’s safe to say that learning about the bio-psycho-social model of pain was a literal game changer. Dr. Baraki’s lecture linked below gave me hope that I could get become to being pain-free and eventually, stronger.

https://www.barbellmedicine.com/blog…ining-what-do/

In quarantine I started my rehab with light 7.5 lb dumbbells for 3 sets of 20. Progressively, I loaded my shoulder to the point where I am now able to do 3 x 10 with 25lbs dumbbells. My shoulder used to ache all day, and it is now to the point where I experience no pain. I am happy with the progress that I have made and I am excited to continue strengthening my press when gyms open up and barbells and heavier weights become available to me. My only issue is that I typically feel a sensation in my rotator cuff which feels like tightness. I’m assuming its just weak and needs to be strengthened.

After using the content I linked above, I strongly feel that I am simply in the final stages of my rehab, and that I need to be patient and keep making incremental progress. I just figured that I might as well ask so i stopped worrying and catastrophizing:

1)Is this common with an injury?
2)Is it likely that this sensation will simply fade with time as my perception and fear of the injury diminishes?
3)When returning to the gym is it advisable to simply press until my shoulder feels strong, or should I start lightly with my squat, bench, deadlift, and press, and load appropriately?

Thank you very much

I’m not part of the BBM team and will be interested to see what a BBM coach says, however, here’s my take:

  1. All sorts of little sensations and nagging feelings are common, an injury probably makes these experiences even more likely and more likely that you’ll take note of them. Personally if I feel threatened by a particular movement and use of a particular body part that sometimes maifests as a sensation of stiffness/tightness (seperate from any pain I may be experiencing) that limits my engagement of that bodypart/movement (or at least I have to conciously tell myself it is ok to engage a bodypart/movement).
  2. I expect so, especially if you continue to expose yourself to shoulder use and increase your tolerance.
  3. Getting a strong press is awesome, but I don’t think you should stop there. You could probably figure out a way to exercise all your major muscle groups starting now. This may help for now: https://www.barbellmedicine.com/blog…rcise-at-home/ (perhaps your shoulder/pressing could differ from the template and you could just do the lower body and trunk resistance training). When going to the gym is advisable you could use this https://www.barbellmedicine.com/blog…-prescription/. Squat, bench and deadlift aren’t required, but can certainly be dominant parts of a great way to train all your major muscle groups.

It’s really awesome that you’ve been reading up on and implementing resistance training, hopefully you’ll never stop :slight_smile:

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I will try and go through your questions and I am happy to hear you have found success with out content.

  1. This is very common with a broad spectrum of injuries. We tend to think of comebacks as and athlete being “good to go” or not while there are many grades along the way. It is often not are you ready so much as are you ready to do what you are wanting to do. This is part of why once you start rehabbing, normal everyday tasks tend to feel better rather quickly. These tend to be lower level tasks that do not demand much. It is also why we can often have a ceiling as we return to lifting specific movements such as pressing where you can perform the movement, but feel symptoms at a certain weight. All of us would like to squat/deadlift/bench/press more, but it is taking the incremental, slow steps that allow us to do so. 2) It will fade over time, but it is not uncommon to feel something when you are getting close to the ceiling again. This just makes the case for building more capacity. Odds are, if you enjoy training you will always want to do more, so the process of training is slowly preparing you for the task. Picking up more weight and decreasing symptoms are the same in this regard.

  2. I don’t know that I would recommend pressing until you shoulder feels strong so much as pressing, and performing a variety of tasks, until your shoulder feels better. Odds are the band work the PT was giving you was way too easy to elicit any real change and often it is just flat out boring. That does not mean there are not other shoulder exercises that you can do that will be both challenging and helping to increase capacity for other movements.

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