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

[Gutterpump]

Hi everyone, I hope some people will find this thread useful. I'm mainly creating this to keep myself motivated throughout my recovery from surgery.

After a lot of research and talking to other athletes that have been through the surgery, I'm now ready to get mine done fairly soon and will begin to log everything leading up to and including the rehabilitation process.

Here are the details:

SLAP tear on my left shoulder occurred in January during a MAX bench press attempt after being out of the gym for a month due to pneumonia.

I caught a lift off on the bench with my arms locked out, and the weight bounced. Did my 1RM fine. Felt OK. 2 days later I did a killer shoulder workout, and felt severe pain after heavy upright rows (taking these completely out of the routine now). Took 3 weeks off, returned feeling OK but again severe pain after the workout. Got an MRI w/contrast done, and I've got a SLAP tear, with the superior portion of my labrum torn away from the bone.

Surgery will be in around 2 weeks. Getting a traditional SLAP repair done.

Here is the current plan, which will obviously change as time goes on:

Keep going to the gym doing lower body work, but start training the opposite side of the injury (upper body) since this utilizes the opposite side for stability without causing further injury. Reason being - delay atrophy in injured area and aid the rehab/recovery process.

Here will be the routine for the time being, pre and post surgery:

MWF - fullbody, volume training only

(I used to train 5/3/1 w/'Periodization Bible' assistance work, combination of strength and hypertrophy focused training, pretty much a power building routine)

Monday

Squat w/safety bar (good morning bar that has the handles in front) - 2 sets of 10
GHR - 3 sets of 5-8
Split Squats - 2 sets of 8 (with dumbbells) - this will change while I'm in the sling, for obvious reasons (balance, lack of 2 free hands)

flat DB bench - 3 sets of 10 on the uninjured side
DB rows - 3 sets of 10 on uninjured side
standing DB press - 3 sets of 10 on uninjured side

GHR situps - unsure of reps/sets yet

Wednesday

Squat w/safety bar (good morning bar) - 2 sets of 10
GHR - 3 sets of 5-8
Split Squats - 2 sets of 8 (with dumbbells) - this will change while I'm in the sling, for obvious reasons (balance, lack of 2 free hands)

One arm kettle bell work - TBD

GHR situps - unsure of reps/sets yet

FRIDAY

Squat w/safety bar (good morning bar) - 2 sets of 10
GHR - 3 sets of 5-8
Split Squats - 2 sets of 8 (with dumbbells) - this will change while I'm in the sling, for obvious reasons (balance, lack of 2 free hands)

flat DB bench - 3 sets of 10 on the uninjured side
DB rows - 3 sets of 10 on uninjured side
standing DB press - 3 sets of 10 on uninjured side

GHR situps - unsure of reps/sets yet

SUNDAY

mobility work only (I will be doing some mobility work daily, but Sunday is a 1.5 hour dedicated time for mobility)

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The above training will be done before surgery is done, and also post surgery while in a sling. I'll likely begin training one week post surgery again. The sling comes off 4 weeks post surgery, and I will be adding in REHAB work for the repaired shoulder, while keeping the above routine active.

If anyone wants to add their 2 cents, has questions, or wants to join in, feel free! If not, feel free to read along and follow my progress. Mods, I thought the Exercise Science forum was a good place for a Rehab/Recovery log, but feel free to move this to the Training Logs forum if you think it'd be better there.

[saderboy80]

I have had a slap and bankart repair surgery, and the second time a revision for both. Before both surgeries the tears were larger then 180deg. And as for my surgeon, physical therapist and regular doctor they all stated that besides rehab and walking the first 4wks post-op, you are not allowed any other exercise. I was not even able to do the stationary bike for quite some time. I would ask your surgeon for a specific timeline for lifting/exercise in general, as all surgeons have there preference to things.

My advice is dont take things to fast with the exercise....you'll regret it. And work your ass off in those therapy sessions and sometimes they will cut short the nnumber of sessions you need.

[Gutterpump]

Here is my reasoning for my plan, quoted from the person I've been consulting with:

i was not impressed by the referral so took it upon myself to find my preferred specialist, specifically a sports orthopedic surgeon, i settled for Dr Zvijac who happens to be head orthopedic surgeon for Tampa Bay Buccaneers (NFL). When i met with him it was like he was talking a different language to original doc. He told me i would be back playing golf in 12 weeks in addition to many other positive outcomes. After meeting with him i decided to have the surgery, i had to wait approx 4 weeks, during this time i completely shut it down (no golf/no gym).

Had surgery Nov 16th 2011, surgical notes say classic type 2 SLAP 11 to 1 o'clock in addition to small tearing of supraspinatus and debridement of frayed posterior labral tear. Post surgery i was scheduled to meet Dr. Zvijac 21st November, just 5 days after surgery. Stitches were removed and surprisingly he advised only to wear sling for comfort and when in busy public places, needless to say sling came off when i got home and never wore it again. He also advised that gym was good, work the good side and stationary bike is best for cardio. I was also given a PT prescription and advised to start immediately. My first PT session was 9 days after surgery, i remember the physiotherapist commenting "this prescription is aggressive", i was doing active assist immediately i.e. pulley, spider crawl and some isometrics. I had PT 3 times a week and on off days just followed what i was doing in PT at home or in gym. I never did more or less, just what i was cleared to do however i followed my PT schedule religiously and never took a day off.

My plan may change, depending on what my surgeon says, but overall it should remain the same. I am unsure if I will start my training again in the couple weeks prior to surgery though.

[Gutterpump]

The surgery is tomorrow morning, so the log will begin tomorrow.

So far I have my oxycotin/tylenol blend RX for the first couple days post op, as well as a medical professional coming over to my place this evening to setup a cold compression device for use at home. I wasn't aware that I'd be receiving this as part of rehab, and it's fully covered by my insurance.

[saderboy80]

The surgery is tomorrow morning, so the log will begin tomorrow.

So far I have my oxycotin/tylenol blend RX for the first couple days post op, as well as a medical professional coming over to my place this evening to setup a cold compression device for use at home. I wasn't aware that I'd be receiving this as part of rehab, and it's fully covered by my insurance.

Make sure you have someone changing the ice for yoou every 3hrs on those things. Makes a big difference in recovery time

[houstontexas]

Just had my slap tear and impingement taken care of yesterday afternoon so I'm in my sling for 4wks now as well. Been eating like crap this whole week. Definitely need to get it together. Hope your surgery goes/went well.

[Gutterpump]

Make sure you have someone changing the ice for yoou every 3hrs on those things. Makes a big difference in recovery time

The machine I have does all the cooling itself and keeps it at a constant temp while also adding compression with air (it's all automated). It's all covered by insurance too!

[Gutterpump]

Just had my slap tear and impingement taken care of yesterday afternoon so I'm in my sling for 4wks now as well. Been eating like crap this whole week. Definitely need to get it together. Hope your surgery goes/went well.

Yeah I've been eating poorly the past few days after surgery as well. I just had the surgery on Friday. I'm sitting here at my desk now with the sling off and typing, and I'm also starting rehab. I thought it was quick to start so early in my first week but I guess my Dr doesn't think so.

Now that I'm not on pain meds, my diet, etc will come back to normal. I'll post a full report in a minute on how the surgery, etc went.

[Gutterpump]

So, surgery was a success on Friday. I went to the hospital in the morning and we started everything around 10am. By 10:30 I was getting my nerve block and being put under. That's the last thing I remember. I then woke up, asked what time it was and was told it was 4:45. Right then I knew the surgery was a bit longer than I'd expected, so I knew they must've done some extra work in there.

I went in thinking I had a bad SLAP tear and that my biceps tendon was healthy (according to the MRI done w/contrast). This was false.

My SLAP tear was not bad, and only required 1 anchor.

My biceps tendon WAS bad, and half of it was torn and retracted. They had to do a bicep tenodesis. My Dr showed me the photos of the procedure, and showed me how they drilled a hole through my arm bone and used a T anchor for my bicep tendon relocation, instead of just a hole and a screw. He said this is extremely strong. My bicep is very sensitive right now though..

They also saw fraying of my rotator cuff and so they did a debridement of it and cleaned it up.

Overall, the damage wasn't as bad as expected, even though we thought that biceps was healthy. My Dr thought it strange that the MRI didn't pickup the torn biceps tendon at all though.

-----------------------------

Day of surgery: Went home a couple hours after waking up. Had to keep taking full dose of percs every 4 hours for pain. Used the cold compression machine that my Dr hooked me up with. Couldn't sleep till 3am for some reason.

Day after surgery: Still very sore. Pain meds in use all day, but only 1/2 dose. Slept very well at night, kept myself slightly elevated using a ton of pillows and wore sling to bed.

2 days after surgery: No more pain meds, trying to get some movement in my arm after speaking with Dr. Passively moving elbow joint and shoulder joint to prevent / fight stiffness.

MONDAY the 2nd - my 3rd day post op: Had an appointment with Dr, he removed all the dressings and put bandaids over stitches. He did some flexibility movements with me overhead (I was shocked), while supporting the bicep. Bent elbow (while laying down), as he rotated my arm overhead. Also movement of my arm with external rotation while laying down. He then wrote a prescription for PT - 2 days a week of flexibility work with a therapist, while also prescribing work for home.

[napalm]

Congrats on getting it fixed. My advice (drawn from 5 shoulder surgeries) is:

1. Work it early (meaning immediately after surgery)
2. Work it hard - within reason, the first few weeks of PT will just be ROM.
2. Work it often

Good luck, I'll be following along!

[Gutterpump]

thanks! today was my first day of PT since the surgery last friday. I'm a bit behind with it and my log because I made the stupid decision to not book any time off the week after surgery, besides the monday. I'm working from home off my laptop but by the time 5-6 rolls around, all I want to do is veg with my automated cryocuff and just blaze (I stopped the percs after 2.5 days).

PT was good today though. We just worked on ROM like you said.

- 10min or so of heat
- slight check/massage of supporting musculature around the injuries

- 90-100 degrees upwards with the pully's. Did about 16 of them holding at top for 5-8 seconds. Anterior delt was hurting/locking up a bit

- standing against wall, pull / pinch shoulders back so they're both touching the wall with my shoulder blades. this was fine

- massage of areas

- got some kinesio tape placed on my bicep to help it stop spasming during the day (from the tenodesis)

- ice for a while then left their office

I'm likely missing a few things we did as well, but he was mainly testing things for a while.

I think I'm doing well since I rarely use the sling around home now and always keep the arm moving a bit, squeezing my lacrosse ball or foam, and externally rotating my arm at the elbow about 30 degrees, and moving the elbow a lot. I don't have hand or elbow stiffness anymore and it looks like my injured shoulder isn't dropped down/sagging much anymore either. It was bad post surgery. I try to keep good posture / shoulders back and high enough while at my desk and it seems to have added the strength back there quickly

[Gutterpump]

Oh, a big shipment just came in today from Nutraplanet as well. I'll post up my new supplement protocol later or tomorrow. I haven't been one to supplement much for a whiiile now, but I've gotta say I went with a solid $200+ order for just a month's or so supply, so it's kind of excessive but I think it will all aid in recovery.

[houstontexas]

My ortho has me in the sling most of the day mandatory and for 5wks total. No PT until the 5wks are up so everything latches on and heals nicely before PT. Funny how different surgeons follow diff routines. My friend at work said his had him doing PT 18hrs post op!!

[Gutterpump]

Your PT is going to take much longer if you wait that long. You arm must feel really stiff! Damn!!

Well I also only had 1 anchor used for the SLAP, and an extra strong T anchor used for the bicep tenodesis. I thought they only used a screw but this thing goes right through the full bone and out the other side! Looks hardcore on the pics he showed me that he took with the scope!

Good luck with recovery dude. It sucks but it's only temporary!

In 5 weeks I (hopefully) plan to be squatting again using this bar:

http://elite-kinetics.com/tag/safety-sqaut/

[houstontexas]

I looked at a bunch of diff sites and it seems to really depend on the exact injury and how it was fixed etc. More to it than just thinking all slap tears would be treated the same. I also had impingement with some bone spurring as well. Idk what role that plays. My arm was stiff, but I he did give me permission to loosen my sling and move my lower arm a little to use the mouse at work. I can also remove the sling for showers of course and he said I could do some small circles as my arm hangs to my side.

[Gutterpump]

ahh that's good, so you are getting some movement in. If not, it can get rea; stiff real fast. You should also try ball/grip squeezes too, it helps the hand/forearm from locking up as well.

[napalm]

Bumpage

[Gutterpump]

Some good updates coming today! Been real busy.

[Gutterpump]

Update - 2 weeks post surgery

Things are feeling good, not really feeling much pain and ROM is growing by the day. I find I need to stop myself from doing things with the operated arm. Opening doors, doing my hair, sex (me on top, weight bearing on both arms) etc, all unassisted and active movements - mostly feels fine while doing them but I'm told not to do this kind of stuff for a few weeks post op with the bad arm. The day after sex, I did feel more pain though, but I iced it away and it's fine. It seems a little strange though that I'm not experiencing much pain? I have not been using any pain meds since 3 days post op.

I'm taking about $300 a month worth of sups now geared towards inflammation and healing. Pics and details to come today, below this post. I think it's been helping a lot so far, but I wouldn't really know because I've never been through this before.

Diet is changing this weekend to Paleo/low carb. I've been gaining fat from being inactive, but also worried about not getting enough protein. This diet will not only fix those issues, but it's great for reducing inflammation in the body.

PT is going well, just doing passive ROM movements, pulley, doweling, etc. I can't really get my hand/arm behind my back at all, but overhead motion is doing REALLY well, I'm over 100 degrees already. Same with the outwards and up movement. Surprising the therapist. I need to work on behind the back and up (reaching towards shoulder blades) with the pulley though. I am going to start doing all my stretches twice per day after today. I think strength training starts in a week or two, but not sure yet. I will see my surgeon on Tuesday again to talk about it.

[napalm]

Great to hear gutter. At this stage, I'd recommend not even trying to get your arm behind your back - it's still way too soon. That kind of internal rotation takes about a month to even two months. I had a full thickness supra and infra tears so the surgeon wouldn't let the pt do any of that for 16 weeks.

Sounds like your doing pretty well so far, just listen to what the pt says and don't push it.

And let the wife get in top fer christs sake