I have a question regarding the Shoulder Rehab template—which I have finally started on Monday! Context: This coming after 22 weeks of intense therapy on my shoulder (3x/wk) and 4 weeks of therapy on my elbow plus some major setbacks—I had biceps tenodesis surgery after a work accident which damaged my shoulder and elbow. My question is how many times per week do I perform the GPP arm exercises (biceps/triceps) as well as the lay pull down work? The template has the shoulder rehab exercises programmed on Day 1 (ext rotation), Day 2 (raises), and Day 3 (access), but not GPP. *The app does have biceps/triceps programmed on Day 1 and lat pull downs on Day 3, but I am also trying to rehab my elbow tendinopathy as well and I’m not sure that the once per week volume is sufficient? **So, should I program more volume through the week for 3-0-0 tempo lat pull downs and biceps/triceps work? If so, would 3X/wk be the right dose? For context, I am using extremely light weight in order not to exceed a certain level of pain as indicated in the template (3-5 pound DB’s for lying tricep extensions and 5-10 pound DB’s for bicep curls). For example, I was thinking of alternating triceps exercises: Day 1 - lying tricep ext, Day 2 - cable push downs, Day 3 - single arm cable ext. I really appreciate your feedback! Also, I appreciate opinions from those who have done the Shoulder Rehab template previously! Thanks!
Hey Paul,
I think in the context of this program and your report here, keeping the template as it is written is probably the move. I just don’t think more movement at very light loads is likely to do much of anything considering you’re doing a lot of upper body exercise on the template already. I WOULD NOT do 3x/wk lat pull downs or biceps/triceps work for you.
Thank you for the reply! I appreciate your feed back!
I am really intrigued that you would NOT do biceps/triceps work more than 1X per week as written in the template. I assumed that 3X per week maybe a little too much volume, but I asked because in the tail end of my therapy the PT had me do biceps/triceps work 3X per week. Each day consisted of alternate DB bicep curls (up the 15lbs per arm), a variation of tricep push downs and lat pull downs or TRX rows as well as DB chest press/push-up plus, external rotation, etc.
Due to the pain, I have retrained a little and I’m now using less weight than I did at the end of therapy. Based on your recommendation, I am postulating that it may be possible that they had me on too high of volume???
At this point (moving forward), I appreciate you helping me to wrap my mind around what is the appropriate amount of volume for biceps/triceps work for my rehab situation (shoulder coupled wiith my elbows). I am certainly not trying to undermine your recommendation, just trying to better understand why 1X per week would be better than 2-3 times per week volume, especially since the weight I can now do (due to pain) is less than when I ended therapy.
Again, I appreciate your help! Have a blessed day!
I can’t really comment on what their thinking was, especially in isolation. I stand by my recommendation in the context of shoulder and other upper limb pain requiring program alterations. I think frequency is a good tool to manipulate volume, but more frequency is not necessarily better if the volume is the same. Why would we assume 2 or 3x/wk is better than 1 or vice versa? There’s more to that comparison than just frequency, e.g. total volume and volume load, proximity to failure, and so on.
I think the programmed work in the template is probably pretty close to what you need based on what you’ve said so far. I can’t see a reason to repeat what you just did either, you know?
Thank you for the further feedback and clarification! You pose a good question, as to why I should repeat the same rehab I just did. I guess I figured that since I regressed a little in weight due to pain, it was a logical choice to continue with the 3X/week frequency I had been doing. Although, I can see now that I have not considered the cumulative volume of the other pressing exercises in the Shoulder Rehab template and how these other pressing exercises would also add volume to the triceps. Thus, I can see why you are recommending no additional tricep volume other than what is stated in the program.
Regrading the biceps, I can see how some additional volume would be beneficial (please tell me what you think of my rationale) given that my right biceps is still quite smaller than the other. In late February, I had biceps tenodesis surgery where the cut and reattached the long head of the biceps just above the bicipital groove on the humerus. My right bicep and shoulder musculature lost a lot of size during the first six week post op. My biceps and shoulder have gained back some size and strength, but they still lag behind the left in terms of size and strength. Thus, given this situation, would you still recommend the 1X/week frequency for biceps or would it be acceptable to add another biceps day on say Thursday or Friday? Again, I appreciate your feedback! I want to make sure I am thinking correctly or not! Thanks and have a blessed day!
I do not think your R biceps is likely to respond well to more volume, as it is relatively detrained. If you do more before it’s tolerated, it’s likely you’ll get less growth.
To be very clear, I would recommend running the rehab template as it is. Afterwards, I would consider increasing volume depending on response.
Thank you Doc for helping me think rightly about what volume is appropriate for me currently, but also not to exceed what I can tolerate. From our dialogue, I am understanding the importance of adjusting volume/intensity intensity based on what my body is able to handle. I appreciate you taking the time to interact with me!
Sounds good. Let me know how it goes!