Good program for limited gym availbility and shoulder issues?

[rascal14]

A year ago I had a Labral repair surgery and I have been out of PT for a few months now. I started lifting lightly about 3 months post surgery.

At my peak when I was running cycles I got to about 230lbs at 6' and probably 15% bodyfat. I haven't cycled in a year and a half, and now I'm about 185 pounds and 15% again if I had to guess. And no plans to run future cycles. I am 21 years old.

I have just been doing machines basically since then, I've been holding off on trying bench press and other things until I have someone I can lift with to help me get back into it with form help.

My shoulder still bothers me some days, and I also have issues with my other shoulder as well. The shoulder I had surgery on has some mobility issues, I can't get it to move independently from my shoulder blade, if that makes sense? I'll be going back to PT when I move back home to address this.

I have only been getting to the gym 3-4 days a week now due to work, and I have been cutting but recently just started eating maintenance and working out trying to hit everything once a week with no real structure. I am running out of motivation so I figured if I could get a decent program set up it may help bring some motivation back to actually want to be in the gym.

Does anyone have any suggestions based on my current situation? I would definitely get bored with one of the main/beginner strength programs, I like to mix in high reps to get a good pump throughout as well.
booneman77 The Solution muscleupcrohn VO2Maxima

 

[VO2Maxima]

I would address the shoulder thing ASAP because limited motion at glenohumeral joint is going to effect not only bench and other pushing movements, but pulling movements as well. And it'll also probably effect squat (if you squat low-bar or use a narrow grip), since limited shoulder mobility is going to mean you'll be compensating somewhere else (possibly t-spine, but more likely elbow and wrist). With limited mobility coming off of a surgery, I'd look into Active Release Technique (ART), and hopefully your PT is well-versed on rehab work for getting athletes back to where they want to be (as opposed to only being familiar with geriatrics or something like that). Until you get in to see them, look up rotator cuff work with therabands and pendulum exercises...those are easy things that are appropriate in most cases and can be done as part of a warm-up or mobility work before doing upper body day.

With 3-4 days per week, you could probably run some type of U/L. Since it sounds like you're well past the beginner stage, I'd split it up a bit more to be something like:
Day 1: Upper push
Day 2: Lower anterior chain
Day 3: Upper pull
Day 4: Lower posterior chain
Or something along those lines, to break it up a bit more. If it were me, I'd probably start with a heavy movement (as compound as possible, I realize you're limited right now), and then move on to higher rep bodybuilding-style work (think the way Conjugate, PHAT, etc do it...both those programs use speed work, but even if you like speed, I would hold off on it until your shoulder is healthy). By now, I'd assume you know what kind of assistance work is best for you and what will target your weaknesses. However, at least for now, you'll want to work around your shoulder. If your shoulder mobility is limited, you'll probably be stuck with doing machine work for pressing movements (you can try dumbbell, though start lighter than you'd expect). You may be able to get away with doing regular upper body pull work...play that by ear. For any squatting movements, I'd highly suggest using a safety squat bar or Buffalo bar, at least for now, as they require far less mobility than a straight bar. Buffalo bar is preferable for keeping the motion as similar to a squat as possible (it does put you at a slight mechanical advantage lever-wise, so you can use a little more weight than on a straight bar), and a safety squat bar is very quad dominant (think like super-high-bar).

 

[rascal14]

I would address the shoulder thing ASAP because limited motion at glenohumeral joint is going to effect not only bench and other pushing movements, but pulling movements as well. And it'll also probably effect squat (if you squat low-bar or use a narrow grip), since limited shoulder mobility is going to mean you'll be compensating somewhere else (possibly t-spine, but more likely elbow and wrist). With limited mobility coming off of a surgery, I'd look into Active Release Technique (ART), and hopefully your PT is well-versed on rehab work for getting athletes back to where they want to be (as opposed to only being familiar with geriatrics or something like that). Until you get in to see them, look up rotator cuff work with therabands and pendulum exercises...those are easy things that are appropriate in most cases and can be done as part of a warm-up or mobility work before doing upper body day.

With 3-4 days per week, you could probably run some type of U/L. Since it sounds like you're well past the beginner stage, I'd split it up a bit more to be something like:
Day 1: Upper push
Day 2: Lower anterior chain
Day 3: Upper pull
Day 4: Lower posterior chain
Or something along those lines, to break it up a bit more. If it were me, I'd probably start with a heavy movement (as compound as possible, I realize you're limited right now), and then move on to higher rep bodybuilding-style work (think the way Conjugate, PHAT, etc do it...both those programs use speed work, but even if you like speed, I would hold off on it until your shoulder is healthy). By now, I'd assume you know what kind of assistance work is best for you and what will target your weaknesses. However, at least for now, you'll want to work around your shoulder. If your shoulder mobility is limited, you'll probably be stuck with doing machine work for pressing movements (you can try dumbbell, though start lighter than you'd expect). You may be able to get away with doing regular upper body pull work...play that by ear. For any squatting movements, I'd highly suggest using a safety squat bar or Buffalo bar, at least for now, as they require far less mobility than a straight bar. Buffalo bar is preferable for keeping the motion as similar to a squat as possible (it does put you at a slight mechanical advantage lever-wise, so you can use a little more weight than on a straight bar), and a safety squat bar is very quad dominant (think like super-high-bar).

I really appreciate the response. I will look into ART, I have never heard of that before.

I am able to do dumbbell press and have done some light weight dumbbell chest flies and incline press, but that was only once or twice. I have good mobility in the shoulder, it just comes along with some extra movement in my back that doesn't happen with the other shoulder.

I will be back in town the end of next month so I will be able to get back into therapy then, but I will start with some of the exercises on my own.

I do enjoy PHAT, which I was planning on basing whatever I choose off of it like you said, start with a heavier somewhat compound movement followed by lighter weight accessory type work.

 

[Rodja]

Left or right shoulder?

 

[VO2Maxima]

I really appreciate the response. I will look into ART, I have never heard of that before.

I am able to do dumbbell press and have done some light weight dumbbell chest flies and incline press, but that was only once or twice. I have good mobility in the shoulder, it just comes along with some extra movement in my back that doesn't happen with the other shoulder.

I will be back in town the end of next month so I will be able to get back into therapy then, but I will start with some of the exercises on my own.

I do enjoy PHAT, which I was planning on basing whatever I choose off of it like you said, start with a heavier somewhat compound movement followed by lighter weight accessory type work.

Concerning extra movement in your back...the biggest reason that's worthy of concern is because with certain compound movements, you generally keep your back so tight that scapula movement is minimal (and not keeping your back tight and scaps retracted and depressed puts your shoulders in a riskier position). If you can avoid those movements and find alternatives though, I would think you'd be fine. May be able to sub in an overhead movement for bench...while obviously you need to keep your back tight on overhead movements, your scapulae are more free to move.

 

[Rodja]

Concerning extra movement in your back...the biggest reason that's worthy of concern is because with certain compound movements, you generally keep your back so tight that scapula movement is minimal (and not keeping your back tight and scaps retracted and depressed puts your shoulders in a riskier position). If you can avoid those movements and find alternatives though, I would think you'd be fine. May be able to sub in an overhead movement for bench...while obviously you need to keep your back tight on overhead movements, your scapulae are more free to move.

If he can't move his scapula along his ribcage, he'll have difficulty externally rotating the humerus and elevating the traps to complete the movement.

 

[rascal14]

Left or right shoulder?

I had surgery on my right shoulder. My luck as well, that happens to be the side of my underdeveloped pec I've had issues with for quite some time. I'm thinking I may need it eventually on the left as well.

 

[celc5]

V02, are u a PT? You sound educated beyond the gen pop.

Also, this sounds like a frozen shoulder to me. It can sometimes happen after a labral repair bc it's sometimes a tough balancing act with post op restrictions vs coaxing the motion along. OP, did u say u were already DC'd from PT?

 

[Rodja]

I had surgery on my right shoulder. My luck as well, that happens to be the side of my underdeveloped pec I've had issues with for quite some time. I'm thinking I may need it eventually on the left as well.

Reason I ask is that most people have the seatbelt pattern and a left shoulder injury often stems from a jacked up right ankle. You may want to have your ankle evaluated first to see if anything is messed up there.

 

[rascal14]

Do either of you wanna make your way out to Oklahoma to help me out? Lol

My physical therapist is good, her husband is also a top level NCAA women's gymnastics head coach so they are both smart people. I'm not sure how well versed she is when it comes to lifting weights though.

 

[rascal14]

V02, are u a PT? You sound educated beyond the gen pop.

Also, this sounds like a frozen shoulder to me. It can sometimes happen after a labral repair bc it's sometimes a tough balancing act with post op restrictions vs coaxing the motion along. OP, did u say u were already DC'd from PT?

Yes I was I was a few months ago, but they told me to come back anytime I wanted to if I was having issues.

 

[rascal14]

Reason I ask is that most people have the seatbelt pattern and a left shoulder injury often stems from a jacked up right ankle. You may want to have your ankle evaluated first to see if anything is messed up there.

I had never even heard of that, interesting.

 

[Rodja]

I had never even heard of that, interesting.

Ive been calling it commuter syndrome. With the right marketing, you can make a living off of people with this. Weak right ankle, tight right hip (psoas, piriformis, glute med are the most common affected), weak left iliacus, and then a tight left lat.

IASTM (gua sha, Graston) would help to loosen the tissue. Focusing on the insertion behind the humerus along with the serratus/ribs should help to loosen it up.

 

[VO2Maxima]

If he can't move his scapula along his ribcage, he'll have difficulty externally rotating the humerus and elevating the traps to complete the movement.

I read it as limited glenohumeral movement, and overcompensating with too much scapulothoracic movement. But I could have interpreted the post wrong, and that's definitely a tough thing to determine without evaluating in person.

V02, are u a PT? You sound educated beyond the gen pop.

Also, this sounds like a frozen shoulder to me. It can sometimes happen after a labral repair bc it's sometimes a tough balancing act with post op restrictions vs coaxing the motion along. OP, did u say u were already DC'd from PT?

Chiropractor.
Frozen shoulder is probably a good guess, would be fairly high on a differential diagnosis list, especially given that it's after a surgery. I hate trying to play the guessing game online, since you're basically just working off a history, so I'd still definitely suggest OP see his PT to be evaluated in person. Generally some type of soft tissue work (whether you go with something movement-based like ART or something IASTM like Graston is up to you, they basically do the same thing but some parts of the body are easier to work on with one method or another and some practitioners prefer one over the other) along with joint mobilization and appropriate rehab work is the way to go for treating this type of issue.

Do either of you wanna make your way out to Oklahoma to help me out? Lol

My physical therapist is good, her husband is also a top level NCAA women's gymnastics head coach so they are both smart people. I'm not sure how well versed she is when it comes to lifting weights though.

It sounds like you're in good hands. Even if she's not well-versed in lifting weights, she understand the sports med part. So even if she doesn't get the nuances of certain lifting movements, she'll have a better idea of the way different structures in your body act with athletic movements, and she'll also treat you like an athlete. Good luck!

 

[rascal14]

I definitely appreciate all the help, and to be honest a lot of the physiology goes over my head so I have some researching to do. I would like to go back into PT with a good amount of ideas myself so I can give my input.

My regular physician, surgeon, and physical therapist are all very understanding and don't mind me having my own ideas so I am very lucky. I let my PT know I was using peptides to help with recovery and she just told me to make sure it was a reputable place. Lol

 

[celc5]

I agree with VO2. Ur PT sounds like she's given u appropriate care thus far and will be able to help.

Hang in there OP. This sounds like it can be resolved!