Post-surgery training and nutrition - part 2

Training Q&A [Moderated]
1

Hey BBM,

I’m making a follow-up post to this post right here from a few weeks ago: Post-surgery nutrition and training - Training Q/A with Drs. Feigenbaum & Baraki - Barbell Medicine Forum

The procedure I ended up having was a shoulder arthroscopy and a sub-pectoral bicep tenodesis, and the date of the surgery was the 25th of febuary (which means we’re now just about 6 weeks post op). My right arm has been in a sling for the entire duration of this period, and up until this past week i’ve only been allowed to do mainly passive movements of my arm, which has resulted in a significant loss of muscle in my right arm, to the point that it’s about half the size of my left arm, and probably as small as my arm has been when I had just started training over 5 years ago. I’ve still got a few weeks to go before I can start loading my right arm, though I am planning on returning to lower body training that doesn’t envolve the arms (such as the exercises that Jordan has suggested in the previous post).
3 months post-op is probably when I can start squatting and deadlifting as normal (though the weight should probably be within reason initially and I would have to take my time in building my strength back up), and it’s likely when I also start doing relatively light upper body exercises (though I believe that i’ll start training my right arm with some resistance bands and work my way up from there before that point).

I’ll note that although i’ve originally planned on continuing to train the rest of my body as usual, I wasn’t allowed to enter my gym with a sling for insurance reasons, and due to other life circumstances I haven’t been training at home instead, which means I haven’t trained at all since the operation. Even so, I haven’t noticed a significant loss of muscle mass across the rest of my body (apart for my right arm), and according to the scale I haven’t really lost any weight.

Now that i’ve given the background, i’d like to ask a few questions on what my approach should be once i’m nearing the end of rehab:

  1. As I mentioned, I don’t believe i’ve lost a significant amount of muscle all across my body (apart for my right arm), though I have probably gained some body-fat in this period of time, on top of already being around 18%-19% bf before the surgery (My weight was and still is ~82 kg, my height is 180 cm and i’m 22). This is because I was bulking for a couple of years prior to the surgery. I’d like to lose some body fat and hopefully gain some muscle mass back at the same time in the first few months of normal training, when I get to that point (i’m assuming i’d be able to gain some muscle mass while cutting since i’m in a detrained state).

As for my question - since I do want to continue bulking when I can train normally again (probably in about 4-6 months from now), how long should I cut for and what should my bf% / weight goal be? I don’t really care about getting too lean, I just want to lose some fat to put myself in a good position to be able to start a long-term bulk again once i’m back training, without having to stop too early due to getting to a high bf%. Also, as for the cut itself, in how big of a deficiet would you recommend that I start at, and what rate of weight lose should I aim for?

  1. Once i’m back training normally, what should my training look like? I’ve been training for 5+ years, though only for about 2 years with BBM templates, so before the surgery i’ve ran the beginner template, PB I, PB II x 3, PB III x 3 (though I was dealing with the shoulder injury for the last 2 runs of PB III). If I were to start with the beginner template, would you say that I should run it as written, or should I start from block II or III? Also, after that point, should I run through PB I and II before going to PB III (assuming that is the route of programming i’m interested in), or since i’ve already been on those templates several times would you go for different templates and/or jump to a more advanced template (PB II or III) straight after the beginner template?

  2. This is more-so of a question just to squash a worry that i’ve had - do you believe it will take an equally long time to build my right arm back up to where it was (or atleast to be somewhat similar to my left arm in terms of size) as it did to originally build that muscle, meaning atleast a couple of years, or do you believe that it’s more-so a matter of months due to muslce memory (though I don’t know if this term is accurate or just the “gymbro” term for that)?

Thanks in advance for any help and appreciate all the content you guys put out.

2

Ben,

It is unlikely that you’ve lost significant amounts of muscle mass, though muscle CSA can change due to water, energy storage, and similar. This and return of lost size and strength are discussed in detail in our podcast [NODE=“259.”]Bridge and sets across[/NODE] I’d predict months to reclaim lost size and strength, not years. I don’t think you’ve gained significant amounts of body fat either. It’s fine if you want to lose some body fat, but I don’t think doing a cut before a “long-term bulk” is going to make a big difference really. I do not have a personal body fat or weight goal for you, as this is really your preference and not mine. If forced to give you a ball park, it’d be somewhere in the 95-105kg range and <20% body fat.

Regarding training, I think it’s reasonable to start on the Beginner template, yes. I do not see a compelling reason to modify it significantly, save for using exercises you prefer. As a reminder, I do not think it’s a great idea to plan template progression long term, as one should be considering how they’re responding to training, their goals, preferences, and so on. If you want to run a PB-style template after the beginner program, that’d be fine, of course.

-Jordan

3

Hey Jordan,

Thanks for the reply, i’ll make sure to listen to the podcast you’ve linked.

As for the bodyweight - I’m quite far away from being at 95kg+, despite already being around 18%-19% bf. How would the process of bulking up to that weight @ <20% bf go? I assume it should be rather slow and be over the duration of a few years, though how would the body fat be managed in order to not get to an excessive amount of body fat considering i’m already getting close to the upper limit of what i’m comfortable with?

As for the training - sounds good, i’ll run the beginner template when the time comes and see where I go from there rather than plan everything from now.

4

Hey Ben,

There’s no specific roadmap here for weight and body weight management. In general, yes, I would recommend doing this slowly over many years. I also have tried to put forth this idea that waist and BF shouldn’t go > 36 to 37" and 20%, respectively, for most people.

-Jordan