INJURY LOG: SLAP repair, prehab / surgery / rehabilitation training log

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    Definitely, you'll like it. It's a pretty interesting show and nicely twisted.

    I took my first dose of TB-500 this morning. I read that high doses can cause flu-like feelings at first, so I only used half my 5MG vial this morning. Felt fine after. Going to dose the rest tomorrow or the next day. Plan is to use 5MG weekly for 4-6 weeks, then 2mg monthly after this for maintenance.

    Today is my first day that I didn't wear my sling, but I took a car to work. I'll keep the sling for busy areas and subway only now.
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    So I took the remainder of the 5MG of TB-500 last night, so ended up taking the total 5MG in one day. Nothing bad to report back, and I didn't heal overnight either lol. I still have fairly constant pain deep in the shoulder (likely from the anchor) or it could be my lateral delt, which is by far way overworked at the moment. Hopefully the TB-500 has a fairly quick effect on this, but I will start daily massage to the area as well. I also have an area on my bicep, just below the lateral delt, that has a hard ball in the muscle. That part doesn't hurt, but I'm trying to massage it out daily as well. Feels like a golf ball in there.
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    4 Weeks Post-op - Friday April 26


    My sling is now officially off and Friday was my first day back in the gym. It's a powerlifting specific gym and it's all familiar faces in there, so I spent some time catching up with people I haven't seen in a while before getting into my first workout in over 2 months.

    4-5 sets of 8-10 bulgarian split squats, going deep and holding at bottom, keeping shin straight/vertical

    I was just grabbing a 20 pound weight in my right hand. Surprised myself at my balance, usually I hate these but balance felt fine and I was able to get in most of my reps. I may have done more than 5 sets, can't remember since I was taking my time and chatting a lot. Didn't want to have an intense workout since it was my first day back.

    4 set of 8-10 GHR's (Glute Ham Raises)

    Just did bodyweight. Getting into position was awkward with one arm, but I did it.

    Glutes n Hams are hurting today! Split squats always nail the glutes for me and so do GHR's. Next workout I will be getting out the safety bar and squatting. Goal is to squat, do GHR's and split squats twice a week, and heavy, eventually. Going to build up some big legs at least if I can't work upper body.

    ROM is getting better daily. I can lift my arm directly overhead now and internal rotation is getting better now. Using the arm for day to day things. I had to take my dog to the emergency clinic for surgery on Saturday, for a blockage in his intestine. He's an american bulldog and chews threw anything. Really sucks, I can't give him any toys now. Hopefully will have him back tomorrow! But wow that was a test for my arm. I had to lift him in and out of the SUV on the way there, using both arms. It hurt a bit after but I iced it and today it feels fine.
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    Good updates man. Glad to hear everything is going well. I had my first PT appt Friday and went and worked out legs afterwards as well. It was my first time being back in the gym too and boy did it feel good. Just being in the environment etc was cool to me. PT went well, but it's just PROM for the next 4 weeks. After that we begin strengthening etc. My PT made a comment that my doctor was going a little slower than normal as far as treatment goes, but she said it's up to him and how he thinks PT applies to my situation etc. I'm confident in him and the PT center as well so I'm sure it will all work out fine. Shoulder is feeling better everyday. Keep those updates coming bro b/c it is very beneficial to me reading about someone else going through this and we both had surgery at pretty much the same time. Be careful with that dog too lol. Hope he comes out of there better than ever.
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    Thanks man, I'll be picking him up this afternoon, he's doing well
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    What was your best lifts, in the big 3 prior to the injury?
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    My 1RM's:

    Standing overhead strict BB Press: about 190
    Deadlift: 475 (hip mobility is bad, not firing up hams during standard deadlift at all)
    Squat: pretty ****ty around 300, hip mobility needs a LOT of work, not firing up the hams when I squat, something to focus on now
    Bench: ~ 250

    Since making the switch to more of a powerlifting program and gym last summer, I've noticed some pretty serious issues with my form and mobility. Mainly hip flexors that are cranked ultra tight, not allowing me to fire up my hams very much at all during the squat and deadlift. I have really bad hyper-lordosis. It's all quads, glutes and back for me when I do squats and deads, so I've been focusing on GHR's, posterior chain work and intense mobility work since January, but had to stop the mobility stuff after the injury.
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    Not bad!

    Tight hips is an issue I have as well(MANY people have it).

    I started training full time with a friend who is a PL as well, and am thinking of doing a meet maybe in the fall. I would like to come out east and do an APA meet and attempt to take the 198lb strict over head press record(pending it doesn't get smashed before then..lol)
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    Not bad lifts though Gutterpump! Not at all considering what you have been through!
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    198lb is the current APA record for strict press? My coach is doing 225 for reps, but he's a freggin beast 260lbs @ about 5'8 or so. I'm not actually sure when/where he competes though, he's fairly new to our gym and I've been out for a while.

    The last I tested my 1RM for strict press was last summer, and I got 181lbs, that's how I'm assuming my 1RM was about 190 in January, but I may be off a bit on that.
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    Quote Originally Posted by Axillist View Post
    Not bad lifts though Gutterpump! Not at all considering what you have been through!
    Oh these were all numbers prior to surgery when I was healthy hehe. I can't wait to take care of all my mobility issues and blast through to the 500's in my deadlift though. Has to be my favorite lift. I love ME lifts, and pulling off the floor feels better than squatting to me.
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    Quote Originally Posted by Gutterpump View Post
    198lb is the current APA record for strict press? My coach is doing 225 for reps, but he's a freggin beast 260lbs @ about 5'8 or so. I'm not actually sure when/where he competes though, he's fairly new to our gym and I've been out for a while.

    The last I tested my 1RM for strict press was last summer, and I got 181lbs, that's how I'm assuming my 1RM was about 190 in January, but I may be off a bit on that.
    No 198lb weight class. I have done 225 x 2(230 x 1 immedietly after that) already and am probably closer to 240 right now when fresh on a true max. I hope to be around 275 by winter.
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    Ahh I gotcha. Yeah you're waaay ahead of me lol. How long have you been powerlifting for now? That's a really respectable number man.

    I started last summer, but last fall my training was really inconsistent too, so that's why I didn't' really focus on mobility till the new year as well. I was so busy last fall and also had a couple recurring injuries around that left shoulder.

    Tbh though, I am starting to re-think my goals and training now. I don't want to go through another injury like this again. From what I've heard though, it's pretty commonplace in the PW'ing world and doesn't mean I'll have to stop. I just may scale back a bit and go for more volume.
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    Thanks!.

    Umm roughly 3months ago. Did an 8 week conditioning phase, and am on week 4(deload) of our strength phase. So really not that long.

    Best lifts so far are 505lb DL(this was like 4 months ago), I pulled 480 last week for an easy triple, and will pull 500 next week for a triple IIRC I did 405 x 12 reps in my conditioning phase. Goal is 600lb by fall.

    345lb bench. My worst lift..lol I need to get my form down a bit here. Would like to hit 405 at some point.

    230 SOHP Shooting for 250 in the not too distant future.

    425 squat, but we train squats after DL. I would like a 500lb raw squat.
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    Damn, your lifts were already great before focusing on strength! Wish I had numbers like that!

    I was pretty happy last summer when I pulled that 1RM for my deadlift though. I hadn't been deadlifting consistently at all, ever( due to lordosis / pain / tight hips), so that was an essentially untrained deadlift that maxed out way above my other numbers.

    I mainly switched my style to powerlifting so that I could be more athletic (functional strength), focusing on full body movements and proper form/mobility.
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    Quote Originally Posted by Gutterpump View Post
    Ahh I gotcha. Yeah you're waaay ahead of me lol. How long have you been powerlifting for now? That's a really respectable number man.

    I started last summer, but last fall my training was really inconsistent too, so that's why I didn't' really focus on mobility till the new year as well. I was so busy last fall and also had a couple recurring injuries around that left shoulder.

    Tbh though, I am starting to re-think my goals and training now. I don't want to go through another injury like this again. From what I've heard though, it's pretty commonplace in the PW'ing world and doesn't mean I'll have to stop. I just may scale back a bit and go for more volume.
    Haha. Damn I misunderstood! I was really feeling terrible about myself thinking you were lifting that much this soon after surgery!
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    Haha noooo, I won't try those lifts for a while. =D Band work / strength training won't start in my left arm/shoulder for another 3-4 weeks. Only isometrics for now!

    I'm doing split squats and GHR's with bodyweight. I'm so far behind right now in my lifts but hey, it's only temporary!
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    ~ 6 Weeks Post-op - Monday May 14

    Physical therapy is still the same, doing regular ROM and adding a bit of AROM into the routine. Doing some isometrics and yoga as well in and out of therapy.

    Major problem right now: Muscle adhesions and knots in surrounding / supportive areas. I am not sure what is causing this so much, other than the muscles are getting used to the shoulder's new position. It's possible I am using the arm too much as well. Anyone have any input here?

    I've been constantly trying to roll out all the knots that I have using my yoga tuneup ball and lacrosse ball against the wall and floor. There's a major one in my bicep, my outer delt, and tricep. There's also a big knot in my trap, around where the 1st rib is attaching at the top. My infraspinatus is SUPER sore and tight most days, supraspinatus is also tight but not as bad.

    Last night I rubbed in a lot of magnesium oil into the areas and am feeling much better today.

    Gym workouts are twice a week, Mondays and Fridays:

    I'm now able to use the safety squat bar. It feels fine on my back/shoulders, the handles are in the perfect spot as well. I thought I'd have to keep my left arm down or away from holding the handle, but I was fine with holding both. I made sure that my arms didn't kick in at all, the weight was fully balanced on my back and kept low.

    After squatting 5x5 with the safety squat bar, I moved onto:
    5x8 Bulgarian Split Squats, holding just a 30 pound db
    5x5 GHR's with bodyweight

    I may start to step it up soon, and add sled pulls into the routine. Once things are going well, I will add a third day (on Wednesday) into the leg routine. This day would just be very light weight and high reps, just to aid healing and recovery.

    Hopefully once I'm fully back in action, I'll be a 500 pound squatter! That's the goal with all this leg work I'm doing..it's basically the only goal I can have right now. I have no idea how things will be when I start lifting with upper body again, but most people tell me I should heal fine from this, according to what I had done.

    Peptides:

    This is my 3rd week of pinning 5mg of TB-500.
    Haven't started up CJCw/dac + GHRP's yet.

    Btw: Atrophy has been fairly bad on the affected side, but not as bad as I had thought, and not as bad as photos I've seen. It may have something to do with the supplement and diet protocol, as well as having been out of the sling early. The Dr had me out of the sling on day 3, only for short periods during the day while walking around my apartment, while working at my desk or while doing assisted passive ROM. I am almost certain he had me doing this since I had a lot of strength going into surgery. As a side note, if you're not athletic but following my log, I wouldn't follow what I am doing unless your Dr says so.
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    Don't give up buddy!
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    ART. Find a local practitioner and get in there asap. I get knotted up on my lower trap(ie. behind my shoulder blade/upper back) something fierce. It literally is like a golf ball. I get an ART session, and after that they have the massage lady work on it a bit, and I feel like a million bucks. If I keep up with it, like monthly appointments I never have issues. I actually just went last week and it has been a year.
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    Thanks, I'd thought of that but wasn't sure if it'd be ok so soon post op. It would be my first option as well if the Dr clears it. I'll ask him, I should be seeing him sometime this week.
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    Quote Originally Posted by Gutterpump View Post
    Thanks, I'd thought of that but wasn't sure if it'd be ok so soon post op. It would be my first option as well if the Dr clears it. I'll ask him, I should be seeing him sometime this week.
    Def clear it with him and make the Chiro aware of the surgery.
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    Yeah, my atrophy was horrible after my repair. Took around 4 months to catch up with the other side. ART def would help with the adhesions but a good PT should be able to work them out. Keep doing what you're doing dude, sounds like you are ahead of the game right now.
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    Oh, my PT has been working on them every session. He's even been using ultrasound on the knots that won't go away. I have to say I've never had knots like these before, they're huge and ultra persistent! I'm also massaging them daily and using the lacrosse ball a lot.

    The last couple days I've tried to really limit how much day to day stuff I'm doing with the arm, and it's been helping..also the magnesium oil is a lifesaver. Really helps to calm the areas when rubbing plenty on.
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    Well I missed my PT appointment yesterday due to work, and can't get in to see him till next week since he's booked solid. Really sucks. Things were supposed to change this week too. I guess a week's delay won't be significant though.

    I've been a bit slack lately with the supplements except with the TB-500, Elastamine, SAMe, Androhard and Androdrive. Going to create a new protocol tonight and start the other peptides. I just need to get new slin pins. I'm also very tempted to run EQ for 16-20 weeks to aid the healing / recovery process (I'm on TRT, length isn't an issue as long as I give blood to lower hematocrit and drop RBC back down after). I have to keep reminding myself though that this is not a race. The DHT derivatives are supposedly great for collagen synthesis though.
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    7.5 Weeks Post-op - Tuesday May 22


    First day of adding strength training into my PT program! My ROM is almost back to normal, I'd say 80-90%. We started PT with heat, then abduction with the cane while laying down, then ROM (pullies). We then started exercises with the cable machine. Very light RC exercises. We started with 5 pounds external rotation, keeping elbow locked in and arm bent at 90%. Was a bit much so we lowered to 2.5pnds. I didn't want to push too much when starting strength training for the first time post op. I did 3 sets of 10 external rotation, 3 sets of 10 internal rotation. Then we 2 sets of 10 starting with arm internally rotated by opposite hip, then ending movement in abduction, arm up like I'm holding a sword. The movement is similar to unsheathing a sword and then holding up in the air (think reverse cable flies). We then moved onto cable rows 2 sets of 10 at only 10 pounds (using both hands, squeezing shoulders back). Our last movement was holding the cables high in front of me, one in each hand, then pushing down and behind me, squeezing shoulders back again (targeting the muscle between the shoulder blades). I'll get the proper name for each exercise and post later.

    We then did some Yoga, a couple poses and one sun movement. Not sure the names. After that I had a lot of body work done by the head PT. Told him about all the knots, and he fixed me up. He found an area that was causing problems, that I wasn't aware about. There's a spot where my lat attached to the ribs on the side, mid-back, which was CRAZY sore when he massaged. He focused on that for a while and did a lot of manipulation of my arm as well as massaged around the shoulder blade, triceps, bicep and delts as well. Feeling great today. I expected some pain from strength training, but everything is feeling great.

    Supplements:

    TB-500 - 5mg per week
    SAMe - 600mg day (200 / 200 / 200)
    Twinlab Joint Fuel
    Androhard (4 caps)
    Androdrive (4 caps)

    Nothing too crazy supp wise at the moment, nothing compared to the first month - 5 weeks. Slacking on starting my CJC + ghrp's... they're really inconvenient due to multiple shots per day and timing away from carbs, plus I'm low on pins. Ordering more and will start next week. EQ/var is in my sights - maybe in the next month or two, since we've started strength training now. I think it would've been a waste before and the TB-500 should be doing it's thing right now anyhow.. if the progress is good as is, I may not go there though. I've tried deca once, but 19nor's don't interest me at all after that. Never again. Var/EQ is much better at it's intended purpose anyhow (connective tissue repair), and GH even better than those 2.
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    Hey man I'm glad you updated today as I just came on to AM to ask how you were doing. I had my 8wk follow up with my surgeon yesterday and he gave me clearance to move my arm in any position and as much as I want. I am to use no resistance besides gravity when not in a PT session. Lifting my arm and moving it around again is an awesome feeling. I was almost scared to move it yesterday b/c I didn't know how it would feel, but it is great and pretty motivating. I have pretty good ROM which should only get better with time. I'm really anxious to hit the 12 and 16wk marks b/c then I'll really be able to do more. I'm glad things seem to be going well for you and hopefully those knots don't give you any more trouble.
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    thanks for posting, definitely keep letting me know how things go. I'm at my surgeons office right now waiting for his checkup. I just saw my GP and my BP is way up! 136/105! I'm thinking it's due to the TB500, since I am already on cozaar for blood pressure. He gave me a light water pill to start taking with it.

    Its def a great feeling to be able to move the arm around again. I'm lucky to have almost full use of it again for day to day things. It feels fairly normal except for the occasional tweak if I move quickly with it or grab something quickly if I forget that it's injured. I can carry my laptop fine with that arm, pull on my shoes etc..

    I am really kicking myself for stopping cardio though. I've gained about 15 pounds in the last 2 months.. Can't believe I'm 250 pounds now. I've NEVER weighed that much. I can't really see a huge difference either. Def carrying a bit extra around the waist now though, but not a WHOLE lot more. I must carry the weight well? Either way, I'm getting on a low carb diet soon to shed water (lower blood pressure) and shed some fat.
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    Just saw the surgeon. He's really impressed with how quick I've recovered. ROM is great, strength is normal (when doing resistance tests) and at 2 months post op! He called me the poster boy of recovery for this. I guess I made the right decisions on supps to take

    He told me to continue the strength traing in PT but not to hit heavy weights in the gym for a couple more months. I told him I'd be doing high rep stuff only when I start training upper body again, and he said 'sounds great'. I'll see him again in another month to see where I'm at. I can likely start high-rep upper body training then...not because I won't be able to lift heavy, but just to be protective. That's the name of the game.

    Heavy lower body training will continue though..

    BTW (adding onto the log for anyone following): the TB-500 calls to be injected sub-Q, but I've been shooting it directly into the affected shoulder (outer delt) IM, with a .5" pin. Just a technical note.
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    Today marks 2 months post op!

    Since I've been recovering so well, therapy now has no limitations (as per Dr's comments). We are doing strength training via various methods now. Cables, bands (I'm using the strongest band they have), flexible body bar (quick side to side movements while holding it straight out, while the bar wobbles side to side rhythmically - this one is REAL tough and really burns) - we used various positions with the bar. We are still doing some yoga as well. The nots are slowly dissipating..I still need to ask if A.R.T is ok to do, but at this point I'd think it is. I'm really not in any pain though at all anymore though. Some tender spots, but still rolling them out against the wall with my lacrosse ball.

    I attribute the quick healing to the use of my cold compression ice machine in the weeks immediately after surgery ( I was EXTREMELY diligent with it, using it for hours daily) - and the good range of supps I've been taking, as well as the TB-500. One area I need to keep an eye on is the incision area on my bicep. I need to continuously massage it to prevent any adhesions with the tissues beneath it.
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    9 Weeks Post Op


    I am just over the 2 month mark, we've been strength training since week 7. Last week - my 2nd strength session, we dropped the cables, etc, and went straight to dumbells. I used 3,5, and 7 pound dumbells for various rotator cuff exercises, tricep extensions and bicep curls. He then did PNF for a while. The PNF felt like it will help a lot. But I've been very sore the days after, nothing severe, just nagging soreness. I have been icing/heating and rubbing magnesium oil on it, and take many supplements as well.



    I am also still working out on the regular. I work my core and lower body. I squat with the safety squat bar (w/ handles) and do GHR's, ham curls, etc. I am able to do pec deck now, but not the full range of motion, only 3/4 and no stretch... very important to keep it that way for now, and only low weight high reps... In 2 months I will be back to training fullbody, but I will not powerlift yet - instead I will focus on bodybuilding techniques which are easier on the body - volume training - high reps lower weight. Once I am ok'd to power lift again, I will start training with the conjugate method (Westside). I will use the current time to rebalance my frame/muscle balance, and improve conditioning.


    I am giving up supersetting and the like - this is too hard on the body and CNS/recovery. Check Defranco's site for info on someone who went through TONS of surgeries, and completely changed his training protocols to prevent future injuries:


    defrancostraining.com/ask-joe-test/41-st...raining-regimen.html


    Training which address's hypertrophy, strength, mobility and function.

    ISSUES WITH RECOVERY:



    The largest hurdle I forsee, will be the scapular area, infraspinatus, teres major, and side of neck. Strange I know, but these are supporting muscles. They are causing me the most issues right now. I spoke with others who are further down the road of reovery, and they said this is very intuitive, so for anyone reading, pay CLOSE attention to these areas!!

    UPDATES:

    I forgot to mention that I've changed my diet completely now to a Paleo diet, somewhat following the lean gains protocol. I am trying to lose the weight I gained during the first month of recovery when I wasn't moving.
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    ~10 Weeks Post Op


    I had a Physical therapy session last Tuesday. We used the body bar on a bosu ball, doing the range of motion with it from opposite hip to up in the air (think sword in scabbard, to drawn sword) all while shaking it / wobbling it nonstop for 30 seconds, short break then repeating 3 times. This was challenging at first but once I found the rhythm with it, I was fine.

    We used 3,5,7 pound dumbbells again. 7 pound dumbbells for bicep curls, 3 sets of 20 each arm (easy). 7 pound dumbbells for overhead triceps extensions (easy). 5 pound for rotator cuff external rotation (bilateral). 3 pound dumbbells for front raises (easy).

    I threw in an extra set just because I felt I could.

    After all this we did PNF again, and then I had bodywork done (working out knots and such) and had some kinesio tape placed carefully on the traps and neck - the main area that's bothering me.

    This was 2 days ago. Today I feel great so I'm going for another session. I'm going to stick to 2 sessions per week, and if I feel fine after today's session, I will do these exercises on my own from home as well, with one day of recovery in-between.

    I never would have thought recovery would be moving this quickly after reading other logs. The atrophy is almost reversed now too, it's not bad at all.

    The only pain that I get now, once in a while, is around the incision on my bicep. I have to keep remembering to massage that area. The pain is likely due to adhesions.

    Just saw Prometheus at IMAX last night and it was f&*kng amazing. Can't wait for part II to answer some questions!!

    BTW, I'll see if I can take a photo of my PT chart and post on here to share.
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    I'm 11wks post-op today and feeling pretty good. I'm only going to PT once a week b/c I started summer classes after work, but I do my normal routine at home 1 or 2 days in addition to the PT appt. Glad to hear everything is still going well for you. Keep up the good work man.
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    Thanks. What do they have you doing now? Mainly AAROM and PROM? Watch that scapular area when you start strength training.
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    This is what I do when I go in there:

    1. Lie on my back on a table and do stretches using a weighted stick (idk the real name, but last week I moved from 1lb to 3lb). stomach to behind the head (best way I can describe the motion lol), pushup motion, circles, side to side, etc. (all while holding the stick with both hands)
    2. Using a 1lb dumbell so far I do punches from that same position on my back and then sit up and do curls.
    3. Move onto the yellow band for rows, internal, and external rotation.
    4. front raises with thumbs up, front raises with thumbs down, all without weights or bands and all at a 45degree angle.
    5. 6 min on hand bike. 3min going forward and 3 min going backwards.
    6. Ice pack for 5-10min
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    Oh that's great, I didn't know how far along you were. Watch the hand bike - I got them to up the tension on it because it felt easy, and I was paying for it after! Right now I use it for a 5min warmup before the dumbbells. I totally forgot to mention it above!
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    Fantastic log bro and really great detail, sure it will help a lot of people. Glad to see you are recovering well
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    When do you expect to be able to do things like pushups and pullups? I'm going in for my 12wk visit on Tuesday and my PT is feels as though I'm ready to be without restrictions, but she said of course it's up to my doc. She told me she wishes all of her patients went through PT as well as me b/c it would make them and her a lot happier. I can't imagine how depressed I would be if it was nearing wk 12 and I was still having a lot of problems with things like ROM etc. I'm very happy everything has went well for me so far and I'm sure you feel the same way.
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    My doc said no restrictions in PT, but definitely restrictions in the gym right now. He told me not to attempt lifting heavy until after week 16 or so, depending. He said you'll still want to protect the repair, but that volume training is fine. Today I did chest press with a light weight and felt fine. I also did rotator cuff exercises on my own in the gym and front raises. I'm also leg pressing 400+ pounds for reps now, which is nice. I want to really aim on the areas that will improve my squat when I get back to normal training, so I'm also hitting the core real heavy and doing back extensions as well. I really need to up my hip mobility still though and ham flexibility.

    You will not want to do dips anymore, or flies beyond parallel to floor. Not for a long time if at all anymore, definitely no more dips or upright rows at all, ever, if you want to stay injury free and protect the repaired area.

    Are you doing wall pushups? It really helps strengthen the scapular area. If you're not doing them, ask your PT about them and how to perform them properly to focus on the scapular area.
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    There are things my PT would have me doing, but my doc still has me on a conservative schedule. I think it will really kick up after this week since it's week 12. Probably start doing wall pushups and ball tosses. Wow that sucks about dips!! I really loved doing dips. Never really did much upright rows or deep flies so those won't be missed. I wish I could just fast forward a few months and be back in the gym on a normal routine lol.
  

  
 

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