Surgical Question

[Clobber]

On November 2, 2018 I had arthroscopic surgery and manipulation under anesthesia on my right shoulder to release remnants of adhesive capsulitis from about 15 years ago. The surgery went very well. My post op pain was very low. I did not use any of the opioid pain meds prescribed. I ditched the sling two days post op. I’ve been doing the prescribed post op physical therapy very regularly. The surgeon has said no weight bearing (of any significant amount) until at least six weeks post op. Being out of the gym is driving me nuts.

What are the risks of beginning typically prescribed strengthening now versus late December (six weeks post op)? My pain is at a zero level. I’d like to get things moving such that when the six week mark comes up, I can very carefully transition into barbell lifts. I was thinking of a linear progression beginning with an empty bar at six weeks and listening to my body for intensity increases.

I don’t want to rush. I don’t want to mess anything in my shoulder up. But, this feels like an overly conservative approach that is typically used on untrained folks. What do you think?

[Michael_Ray]

@Clobber

On November 2, 2018 I had arthroscopic surgery and manipulation under anesthesia on my right shoulder to release remnants of adhesive capsulitis from about 15 years ago. The surgery went very well. My post op pain was very low. I did not use any of the opioid pain meds prescribed. I ditched the sling two days post op. I’ve been doing the prescribed post op physical therapy very regularly. The surgeon has said no weight bearing (of any significant amount) until at least six weeks post op. Being out of the gym is driving me nuts.

What are the risks of beginning typically prescribed strengthening now versus late December (six weeks post op)? My pain is at a zero level. I’d like to get things moving such that when the six week mark comes up, I can very carefully transition into barbell lifts. I was thinking of a linear progression beginning with an empty bar at six weeks and listening to my body for intensity increases.

I don’t want to rush. I don’t want to mess anything in my shoulder up. But, this feels like an overly conservative approach that is typically used on untrained folks. What do you think?

Hey Clobber,

Sorry to hear about this issue.

I think it would be short-sighted if we didn’t address the adhesive capsulitis narrative. I want to preface this with - what’s done is done and there’s nothing we can do about it BUT this narrative needs to be addressed before moving forward. I did a podcast previously on this topic: http://www.clinicalathlete.com/clinical-athlete-podcast/2018/8/7/8ou5de7xnkw25o7c86kak793cs60ad.

I’d be happy to consult with you on returning to activity since the MUA. What exercises are you currently completing? What exercises do you want to get back to?

[Michael_Ray]

@Clobber

Prior to surgery I’d been power lifting. My frozen shoulder from 15 plus years ago never fully “thawed” making even high bar squats difficult and very uncomfortable. I tried many methods to regain range of motion both on my own and through physical therapy. I tried the non surgical approach for more than a year. (This is the short version of the longer story.) I finally elected to have this dealt with surgically. Surgery was arthroscopic “cleaning” of the joint followed by manipulation under anesthesia to make sure range of desired range of motion was achieved.

The surgeon has told me not to weight bear for at least six weeks post op. Given my lack of post op pain, lack of swelling, not using the sling within 48 hours, not using any of the prescription opioid pain meds, and being a lifter (versus other general population folks who do no training), my questions are:

What risks do I assume if I start strengthening before six weeks (say at four weeks)? If I did accept these risks, what are the warning signs and/or indicators of a problem?

Being a bit impatient and thinking the typical protocol is for the general population and is too conservative for trained folks, I’ve begun some strengthening on my own. It looks a lot like this video https://youtu.be/IzTFCZv0--E with the exceptions of I’m using skinny therabands instead of the wimpy stuff she’s using. And, at the 4:45 mark, I’m using dumbbells instead of stretchy stuff. And by “dumbbells”, I mean “soup cans, etc.” I started with a one pound for 1 x 5, then one pound for 3 x 5, and now I’m upping by the weight by one pound daily for 3 x 5. Doing these exercises I feel zero pain. I do get sore, but no pain. The soreness goes away before the next day’s exercises.

Are there any medical reasons I should not continue this type of strengthening?

I have my six week post op appointment on December 17th. I expect to hear I can begin to strengthen at that time (though I’ve already started). It is my intent to get back in the gym after my six week appointment. It is my intent to start very light (empty bar) and do a linear progression until that stalls out. Then, I’d go back to more advanced programs. My question - are there any medical reasons that would prevent me from following this type of action? I will ask these exact questions with my surgeon. However, he’s a skinny dude, non-lifter. I’ll see what he says, but my guess he’ll say I can go back to the gym but keep things “light.” I’m looking for practical, sound advice from doctors that are lifters (or lifters that are doctors) as they are much more apt to have useful advice given that combination.

I’m looking for guidance as I get back to lifting. I had the aforementioned surgery on November 2nd and I want to know how soon can I strengthen, what that should look like initially, and how soon I can get under a barbell.

Thanks!

These are great questions and we can address them with a consultation. Given we have not consulted on your case and aren’t aware of surgeon instructions, the best response we have is follow your surgeon’s advice.

With that said, I’m not currently aware of any reason to not load the area based on the information you have provided.