Hey BBM,
I’m making a third (and hopefully final) follow-up post about training post shoulder surgery: Post-surgery training and nutrition - part 2 - Training Q/A with Drs. Feigenbaum & Baraki - Barbell Medicine Forum
I’m now around 4.5 months post shoulder surgery, and due to the surgery itself and other life factors, I haven’t really been training at the gym at all since the surgery. I’ve been going regularly to physiotherapy and doing the required exercises to work on regaining a full range of motion of the shoulder, and I’m getting close to that goal. Currently, I can fully lift my arms above my head and to my sides, though I still struggle with my arm behind my back and getting into position for squatting (even high bar).
My surgeon has also cleared me to train without restrictions (as long as I don’t feel too much pain) and said I don’t need to come back for follow-up checks, and that the overall progress in terms of ROM is very good.
I’ve started training my upper body in the gym in the last couple of weeks, mainly using machines and very low weights as a starting point.
My questions are: 1. Should I jump straight into the beginner template even though I haven’t been working with free weights yet? I haven’t tried benching at all and don’t know if I can achieve a full ROM or not. Or should I continue working with machines and in ROMs that are pain-free until I feel I’m able to SBD without ROM limits?
2. Where should I start in terms of weight and how quickly should I progress? For example, I’ve been doing the chest press machine with 5 kg each side to start and have slowly worked up to 10 kg (adding 2.5 kg each side every week since I got back into training). I was doing 40+ kg each side before the surgery, so I don’t really feel any struggle at all, though it did feel weird at first after not training since the surgery. As a second example, when I move over to regular barbell benching, should I start from just the bar and slowly work my way up even though I assume I can do much more without struggling? Should I take big jumps if that’s the case until it starts getting somewhat challenging, or should I start with a higher weight that’s somewhat challenging but is > RPE 5 straight away?
Thanks for the help!
Hi Ben,
Glad to hear you’re progressing well. To your questions:
I would not jump right into the template given that you have not yet achieved a normalized range of motion on the target movements. Given that this sort of “goal-directed rehabilitation” is the entire point of physical therapy, I would encourage you to discuss your goals with your physiotherapist so that they can guide your rehab progression towards those ends. This would similarly be a way to address your second question, as they will presumably know you better than we can here via the forum (or, if you want more individualized guidance towards barbell training-focused goals, a consult with our rehab team could go a long way here).
Given that you are in a post-operative situation, not on a specific competitive timeline, and there is no rush, when it is time to reintroduce bench pressing I see no reason to jump to heavier loads or to make big jumps right away. I would be starting with a very low load (empty bar or perhaps a small load) and assessing how it’s feeling and adapting as loads are increased. I would also continue the remaining “routine” upper body/shoulder training while doing this.
Hey Austin, thanks for the reply.
I’ll go ahead and discuss with my physio as you suggested.
As for the timing of when I should start running the beginner template, which is probably a question less suited for my physio since he has less experience with barbell training, how far down the line should it be before I move to that instead of the general routine I’ll be running with his help? Should it be once I get to slightly more challenging weights that are approaching RPE 5 and above, which would presumably take a couple of months from the moment I start SBD movements again, or should it only be once I’m back to training at RPE 7-9 without issue?
I’ll also definitely consider working with the rehab team down the line if I feel I need more personalized help, as you suggested.
Should it be once I get to slightly more challenging weights that are approaching RPE 5 and above, which would presumably take a couple of months from the moment I start SBD movements again, or should it only be once I’m back to training at RPE 7-9 without issue?
It does’t need to be one or the other. For example, once you get to handling weights that are, say, RPE 5-6, you could reasonably transition over to a beginner template-type setup, and simply adjust the RPE targets down to make it a more gradual progression upwards in effort & load.