Pec and Labrum Repair Saga: part 3

So more time has passed and rehab is coming along. I thought I would bring up what my training is like along with what are some limitations that I currently still have. The basic goal here is to stay in shape (read: not get too fat), and keep on what muscle I can. Due to issues like keeping my arm out of the way I have had to pick exercises that I can keep my arm in the sling and in a position that it won’t get caught/be bounce off something during the exercise. This has required modifications like not squatting as low initially along with other points I’ll get in to.

Dragging my butt in to shape

Initially my training was essentially just dragging a weighted sled using a belt around my lower waist area and riding and exercise bike. The goal here was to load up the resistance as high as I could safely and just get in some good volume of work. For the sled workout I would just load a plate on the sled and drag it 40-120 yards and then add another plate repeat the walking. This would continue until I couldn’t power walk that distance anymore. I would do this forwards, backwards, and sideways and typically do this three days per week initially. Due to the staples in my shoulder and the sling I wasn’t able to do any real heavy lifting so this helps me mentally.

For the bike work I would either do a moderate resistance on the bike and sprint for 10 seconds and recover for 20-50 seconds before repeating those sprints again. Altogether I would do this for 10 to 20 minutes. The other option would be to put the bike on maximal resistance and pedal at a very slow cadence (20-30) revolutions per minute and do this for 20 minutes. I hated this immensely, but it did make my legs tired and helped me burn off some excess energy.

One armed bandit

Well I still had my one good arm so I was sure as hell going to do something with it. This meant training as hard as I could, but obviously doing every unilaterally which naturally limited how heavy I could go on a variety of movements. Between my pride and lack of time training I only used 25lbs. plates for a few weeks since I only had one arm to put the plates on the bar and 45s were hard to pick up and load with one hand. Also with the brace and bolster on it made sitting super low in the squats not really work well, I would have to hike up my brace on my ribs before each set so I didn’t bounce off my arm and make it move each time in the bottom.

Basic set up

I kept with my general lower/upper six days per week training split, only now I was just doing one arm for the upper body, and most of my lower body work was bodyweight or using a safety squat bar.

Day 1 2 3 4 5 6
Main exercise SSB squat heavy Kb military press SSB squat volume Ground base jammer SSB squat speed Machine bench press
Main exercise two   Single arm pull downs   Chest supported rows   Chest supported rows
Assistance exercise 1 Ssb good morning Dumbbell curls One arm deadlift Hammer curls Glute ham raises Preacher curls
Assistance exercise 2 Crunches Cable triceps Some type of ab exercise Db skull crusher Some type of ab exercise Cable oh triceps
Assistance exercise 3 Sled work Upper back work Sled work Barbell face pulls Sled work Bent over db laterals

 

Rehab

Outside of still working out I was doing therapy for about an hour three days per week. The initial work was all about rolling a ball trying to gain range of motion back along with massage work. Initially I couldn’t even lift my arm above parallel to the floor and had little to no external rotation. Progress was pretty constant, but very slow.

Limitations

The key limitations were load and range of motion. Initially the goal was to do essentially nothing with my arm and then I got to remove the bolster and was only a sling and then that progressed to no sling and try to walk and move like a normal human being. The range of motion slowly improved to where I could do movements that would be parallel to the floor and eventually start working on ranges of motion that were getting to be overhead.

Exercises

The first exercise I was given for my arm was to roll a ball across a table. This was done for high repetitions to just get my arm moving again. Then with time I was doing the same ball rolling only doing so pushing it up a wall. Along with this I was given movements like tracing different angles on the wall with a rolled up towel, some 3lbs. dumbbell rows with dynamic movement, and then other very light high rep kinetic chain movements. Push-ups started with simply leaning on a wall and pressing and then worked their way back to true push-ups on the floor. My least favorite thing to do to get by external rotation in my shoulder was to lay on my back with a hot pad on either side of my shoulder and an ankle weight on my wrist pulling my arm in to external rotation. That was really uncomfortable. This would last for ten minutes and usually get my over ten degrees more in the range of motion for a little bit, but it was quite uncomfortable.

Post op report

Almost three months after surgery I finally got the whole story of what they found and what they did. They were happy with their work on the surgery and I appreciate what they did. So here is the basic break down.

Labrum

Most folks when they tear their labrum have what is called a SLAP tear. This stands for superior labral tear from Anterior to Posterior. What I did was tear not only the superior portion but the entire posterior of it. Overall only about 50% of my labrum was still intact so it was good to hear how my pain and dysfunction was well merited. Luckily there was no arthritis or other issues in the tissue it had simply been torn off the shoulder. They used three anchors to get my labrum back down to the glenoid fossa of my scapula.

Pec tendon

As soon as I could use my arm the pec still felt odd when I contracted it and also it was asymmetrical to the other side and rolled up when I contracted it. I talked with some coworkers and they assured me it was correct, and honestly the strength function was already better than pre surgery. Still it was odd, so when I followed up with surgeons I found out that I completely tore my sternal attachment of my pec of the bone and then tendon was so frayed it had to then be sutured on to my clavicular pec tendon. This is why it is asymmetrical and feels odd when it contracts, but functionally it should be able to get back to striking distance of being 100%.

Boomstick application

When I went to the NSCA national convention I was lucky enough to get the boomstick by Kabuki strength used on my pec and shoulder. How this works is they use a small ball that you lay on and then apply pressure with the boomstick and have you move your arm in different ways to break up scar tissue and restore the normal sliding tissues of your body. This was an invigorating amount of discomfort (read pain) when applied but immediately gave me gains in range of motion in multiple planes. I highly suggest having this type of therapy used. Thanks again to the guys from Kabuki strength for working with me and giving me feedback on my lifting technique.

Summary

Still fighting my way back one day at a time. Thanks again for all of the help I have gotten from my friends, colleagues, and physicians. Hopefully soon enough I will be back to 100% with training. Worst case scenario competitive powerlifting is out for me and it is time to commit to strongman and maybe even weightlifting.

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Pec and Labrum Repair Saga: part 2

After getting my right pec reattached and my right labrum repaired I got to spend some quality time in a shoulder sling with a bolster on. For the first four days I wasn’t allowed to bath or take the brace off at all. This was not a party, but a necessary evil for the healing process.

Following days

Each day I was a bit less sore and slept a bit better. I really didn’t do much at all other than sit around with my arm propped up. I did get to play some old school RPGs which was fun along with working on a few other hobbies of mine. Slowly I started to walk a bit more and more, but the goal was to limit this severely since if I slipped and fell that would really undo all of the work they did. Not to mention any time I just slightly tripped the rapid shifting of my body would send a righteous amount of pain through my shoulder.

Bandages off

On day four I finally got to have my bandages off and take a shower. To say that it took a while and was uncomfortable to have the weight of my arm hanging there is a slight understatement. The hot water beating down on my shoulder felt great though. The stapled parts of my chest and shoulder were a bit gnarly to see, but that was expected. From there I would take a shower about once every other day initially but then things kept getting better and back to my once a day routine which is nice to come back to.

Bowel movements        

Should have put this in the first post of this series, but turns out the pain killers and the drugs they use to knock you out cause you to be constipated. This was not a party, but thankfully after my “movement” on the day after surgery things were back to normal. Be warned though that you do get backed up when on those drugs. Also squatty pottys are a game changer and I could still use mine while in the brace. Other good news is that I could still wipe on my own which was great news for me, my wife, and my graduate assistant.

Supplementation

So in order to make the recovery go as fast as possible I have been using a number of over the counter supplements to expedite healing. This is what I came up with after speaking with friends, colleagues, and researching. Since I’m taking everything at once I can’t really parse what is making the greatest magnitude of effect, I just want this to be over with as soon as possible. So without further ado here is the list along with the amount that I’m taking each day. If you aren’t sure what different things are just let me know and I will explain it more.

Name Dosage Reason
Fish Oil 8 grams or more Anti-inflammation and perhaps speed tendon repair
Magnesium 500mg Helps with muscle relaxation, and I didn’t want any cramping going on after surgery
Zinc 30mg General health, from hormonal production to immune function
Biosil 5-8 drops Helps lay down collagen which is a big part of the tendon repair I’m trying to accomplish
Pantothenic acid 200mg Possible link to tendon strength and recovery
Fenugreek 1g Potentially increasing testosterone to enhance recovery and healing
Protein Powder 50+ grams Building block for tendons and muscle.
Curcumin 1.5 grams Anti-inflammatory

 

Itching

My wounds were closed with staple (and lots of them), after day three they started to itch some. To be fair the staples never really hurt which is nice. Man, that itching though. Turns out that is normal, but I’m not a fan. I was told not to wash it directly or itch it, so it is a bit annoying to say the least.

Staples out

Two weeks and two days after my surgery, we went in for my follow up. They took x-rays of my shoulder and took out all of my staples. Turns out there was a large number of staples in there (over twenty), but the good news is it really didn’t hurt at all to get them out even the ones that had to be dug in to get after and remove. From there I was told it would be time to start the next phase of my recovery. The funny part is my pec tear wound was so puckered up with skin that they actually missed one staple and it wasn’t for a week or two afterwards when the inflammation had come down that you could tell that I still had a staple left that I had to get removed before my skin fully started to grow back over it.

Rehab

Cue the rocky training montage music. Day one was hardcore; checking my range of motion and then having me roll a ball with my hand on top of it. From there some different movement patterns working on getting my scapulas to move correctly. It was obviously very low key, but that was day one. By day there I was doing towel slides in the vein of the karate kid paint the fence. This did allow me to start singing “You’re the best around” while rehabbing which made the folks in the athletic training room either laugh or give me strange looks.

Soreness

Each time after the training I would be sore and my pec tendon would ache. Makes sense since we are making something move that has been essentially immobile for the past few weeks with major incisions being made in my deltoid in order for the scopes to go in there and do the work.

Summary

So things are moving along with rehab and constantly (though slowly) getting better. In the next post I’ll start writing about what I’m doing as far as training goes (still have three other good limbs). Along with anything else that comes up on this rehabilitation journey. I hope this is useful for anyone that might go through something along the same lines as I have and as always thanks for taking the time to read this.