PhysioDC

Physical Therapy

When Can I Start Working Out After Shoulder Surgery?

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At PhysioDC, we hear this question all of the time. It is a vague question, because it depends entirely on what type of procedure/repair you had on your shoulder.

IN GENERAL, here is a basic protocol for many types of rotator cuff repairs, labral repairs, bankart repairs, and acromioplasty. It goes without saying that you should follow your doctor’s protocol exactly and check with your PT to make sure that you are doing the appropriate exercises at the appropriate times.

Dan Baumstark (physical therapist) and Phillip Godfrey (medical exercise trainer) talk in depth about both conservative management of shoulder labral tears and post operative management. Common questions that patients have are addressed in depth with this podcast.

Week 0 to week 4: PASSIVE RANGE OF MOTION ONLY

Passive range of motion means that someone else (the physical therapist) is moving the arm without your help. The first month following most shoulder surgeries is incredibly boring for most patients, because they are not performing active and functional movements with the involved arm. As monotonous as this sounds, stick with the passive ranges and fight the temptation to progress yourself without the doctor’s permission.

One exercise that can be done during the passive phase is called a “pendulum” exercise. Take a look at the video below and marvel at the excitement.

Weeks 4 to 8: ACTIVE-ASSISTED RANGE OF MOTION

Get excited. Now you are allowed to have some participation in your rehab. Active-assisted motion involves the therapist moving your arm with some active assistance on your part. This can be done lying down or in a seated position. The purpose here is to re-introduce rotator cuff and scapular muscle recruitment.

Many therapists will also give the patient a set of pulleys that hook over the top of a door. Active-assisted ranges of motion can be done at home by using the good arm to pull through the pulley to assist the surgical arm into ranges of motion. This phase of rehab is not as boring, but many patients find this stage to be frustrating because re-introducing active participation tends to be painful. Stick with it.

Weeks 8 to 12: ACTIVE RANGE OF MOTION


We routinely use these balls for shoulder exercises and postural exercises. Most people can readily perform exercises leaning over the “55 CM” diameter ball. For those under 5’4″ in height, a “45 CM” ball may fit better. For sitting on the ball to exercise, most people will find the “65 CM” ball sufficient.

Most doctors will clear patients for shoulder motion without any assistance after 8 weeks. Like with any new activity, take it in steps and realize that you will not have full, unrestricted motion immediately. Most patients, when lifting the arm up overhead, will notice that the head of the humerus bone will ride upwards and restrict motion. This is because the rotator cuff muscles lack full control of the shoulder. Practice moving through only the part of the range that looks controlled. You should notice over time that your range will improve.

Weeks 12 to 16: LIGHT RESISTIVE EXERCISE

Now that you are 3 months post-operative, you should be at the point where you can introduce light resisted exercises. A common mistake that patients will make at this point is adding too much weight too soon. Start with very light resistance for the first week and slowly work your way up. Using elastic bands and light hand held weights is common at this stage.

Listen to what your body is telling you as you begin resistance training. Sharp pain is not acceptable: ramp your resistance down and take a few days off to allow your muscles to recover.

Week 16 and beyond: RESISTANCE AND WEIGHT TRAINING AS TOLERATED


We love this product for shoulder stabilization exercise.

After four months of rehab, many of our younger patients will start a light routine in a gym setting. As mentioned before, it is a bad idea to stack heavy weights onto a freshly-rehabilitated shoulder. I will always leave our discharged patients with a few final thoughts.

  1. It is not worth your time to “max out” with heavy weights simply to see how much weight you can lift.
  2. Military presses, dips, preacher curls, and hand-stand pushups are not worth your time if you have ever had shoulder surgery.
  3. Many people will not be pain-free for up to a year following shoulder surgery. Make sure that you keep up with some strength training every week to keep the rotator cuff and scapular rotators strong.
  4. If a certain exercise causes sharp pain, don’t do it.

Read More About Shoulder Issues

• What Does a Shoulder Labral Tear Feel Like?
• How Do I Stabilize an Unstable Shoulder?
• How Do I Deal With A Shoulder Dislocation?
• Is Sleeping On My Side Bad For My Shoulder?
• Why Won’t My Shoulder Rotate?
• Managing Expectations When Recovering from a Labral Repair

Image credits: Minerva Studio / Fotolia

physical therapist recommended products

Discussion

  1. Hi, I’m hoping you can give me some advice. I had a type 1 labrum tear and am approx. 10 weeks post surgery. It’s my understanding no sutures, which is confusing to me considering my MRI showed a tear? Doc told me I had arthritis in the joint too & he scraped out some tissue in hopes of developing some scar tissue on the head of the humerus. I’ve had great range of motion for quite some time, but still have the same pain I had before surgery when I straighten my arm above/behind my head. Why is this? is it possible the repair wasn’t thorough? I didn’t have any arthritic pain prior to my injury that caused the torn labrum by the way. thank you for your advice!

    • Wendy

      I am slightly confused. Did the doctor get in there and decide that it was not enough of a tear to repair? From what you are describing your surgeon did not repair it. It sounds like he just tried to clear some space in the joint for you so that the tendons don’t hit the “shelf” above them with movements. (It is called an acromioplasty.) I would find out the clinical name of the surgery that he did, I can certainly give you my opinion if I know more.

      Dan

  2. Dan –

    Thanks for your column. I have surgery next week to correct a torn rotator cuff, torn labrum, and bone spurs in my right shoulder. Kind of an accumulation of old injuries that I’m finally getting fixed. I’m getting apprehensive about the recovery process and your column helped a bit.

    I do have a question though – you mention

    > Military presses, dips, preacher curls, and hand-stand pushups are not worth your time if you have ever had shoulder surgery.

    Can you go more into this? Is it the risk of re-injury? Restricted range of motion? Or will the affected shoulder just never be as strong as a normal healthy one?

    • Scott

      The exercises that I mentioned are “hard core” and place a lot of stress on the shoulder and rotator cuff. As we age we also lose small amounts of vascularity to the rotator cuff tendons, so they do not recover as well when they are highly stressed. You really do need ideal strength and mechanics to keep the rotator cuff tendons from rubbing against the shelf that lied above it with a headstand push up for example.

      I have seen too many people, some of them young, who screw up their shoudlers 1-2 years after a surgery from doing one of those exercises with heavy weight.

      To answer your last question, depending on your age I would expect you to get back at least 90% of your original strength. Just be prepared for it to take 6 months to a year to get that back.

      Dan

  3. Doctors:
    I had Total Left Shoulder Replacement Surgery over 6 months ago.
    When can I start lifting weights again with my Left Arm? My surgery was because” my cartilage in my Left
    Shoulder was completely worn out.
    How much can weight can I lift in a pulling exercise and in a pressing/pushing exercise?
    I have weight machines and loose Dumbells.

    • Pete

      How old are you?? Shoulder replacements are usually the last option and the range of motion that results is not full. Most of the people that I have seen with this surgery were at least sixty (60) years old, or they had a severe fracture or injury that could not be repaired under normal surgery.

      I would be very careful with weights. It should be okay to do very light weight: something that you can do at least twenty (20) repetitions of per set. You should also stay within the confines of what the shoulder replacement range of motion allows. For example, if you wanted to do a light bench press, I would use a straight bar rather than dumbells, because your shoulder can be brought down too far past your chest with a single dumbell.

      Run a list of light weight exercises by your doctor to make sure that he is okay with it. Remember, it is better to do light weight with more repetition than heavy weight with fewer repetition.

    • Hi Kevin.
      In my experiences I would need to know your approximate age. You’re naming exercises that I never heard of but I am 45-years-old. You must be much younger. I will be shocked if you are older than 25 or 26 at most based on your exercises. I simply never heard of them. I was always just a “heavy as I can lift” for 6-7 reps guy but I also did on average 25-sets for every single muscle. I realize now that I was insane. 25-sets of biceps is crazy and wrong in my experience. 25 sets for forearms crazy. 30 sets for chest insane. 30 sets for shoulders stupid. It took 22-years and 7-GYM related major surgeries to realize that.
      For now that’s all I can think of saying. I would be interested in knowing your age if you choose to give it.
      Your Friend,
      Joe.

  4. Hi Dan-

    I have read all of the posts and found them very insightful!

    I am 49 and have been doing Crossfit for 2 years and have run a few marathons.
    I had a full supraspinatus tear and partial labrum tear. I believe some of it was do to poor posture and of course over use. My surgery was on Oct 15th.
    The recovery physical pain is minimal. The mental pain is ridiculous!
    I am eager to get back to running and my CF family but want to do this wisely.
    Do you have any advice particular to Crossfit on the progression of exercises.
    I understand that from the time I get the green light to go back it needs to go slow. I’m hoping at 6 months. Is that being ridiculous?
    What exercises would you introduce first and which one’s would you save for last? An estimated time line of when to introduce exercises would be BEYOND appreciated!
    Here are a few I had questions about?
    Box jumps, rope climb, rowing, kettlebell exercise to eye level and overhead, burpees, push ups, dubble-unders, wall balls, hang cleans, squats with bar resting on shoulder.
    Do you need to start slow with running or is that pretty safe once permission is given? I’m hoping to start running at 4 months.
    Since a lot of people do some type of cross training, these answers will be helpful to so many of us!
    I really wish there were an info sheet. So many people want to get back to exercising but the Doctors are obviously not specific about each move and I can’t find any information.

    Thank you in advance for your time!

    Joanne

    • In general Joanne the leg exercises should come first. Pass it by your doctor first of course, but I think that starting a slow jog at 16 weeks should be doable. Start on a treadmill so that it is more controlled. If it goes well it should be okay to raise the incline on the treadmill a few degrees. Try to assume a normal arm swing.

      Once a slow jog is pain-free in the shoulder, you could bring in low box jumps and slow running. In terms of the upper extremity, you need to be extremely mindful of how your shoulder is feeling while you do the activities that you mentioned. Double-unders (jump-rope) might be a good place to start as it brings the shoulder into play in a relatively safe position. I do think that 6 months is reasonable to be starting this.

      Keep the weight light. I have also stuck to the opinion that anybody over the age of forty should NEVER be doing one-rep maximums.
      It may also be useful to sit down with your Crossfit coach and work on modifications of some of the more “unfriendly” shoulder exercises. A really well trained Crossfit coach should be able to do that.

      Things that are dangerous in my opinion and may need to be modified out of your routine: Dips, hand-stand push-ups, muscle-ups, overhead snatches. In general if any overhead or pressing activities cause shoulder sharpness, lower the weight or stop it altogether.

  5. Hi Dan,

    My 19 year old daughter plays softball for a D1 college. She had surgery 11/11/2013 to repair a SLAP and a posterior tear in her right shoulder. I have done quite a bit of research and have read this is a lengthy recovery process. What is the realistic possibility that she can DH starting 3/29/2014?

    • Four months is a bit early to be taking full swings after a labral repair. Six months is a bit more appropriate. Given her age, I would say she could probably do it at five months given that she has been rehabbing and not having any complications. This needs to be cleared with the doctor as well.

      She should be taking slow swings as a build up to playing in games.

  6. hi dan
    recently i got an mri scan and i found out i have a labral tear in my shoulder it could be a while before i get the surgery i was just wondering can i weight train until then or would that be a bad idea?
    thanks

    • I would think that you can lift some weights, however listen to your shoulder. No sharp pain is allowed with movements. I would keep all weight light, and I would also avoid any impingement style exercises (overhead presses, dips, preacher curls, etc.). It is always a good idea to ask the MD: I haven’t seen your MRI results so I would ask to be sure.

  7. You Mention preacher curls often as,an impinging movement curious as to why and why you think their bad after labrum surgery? I knew bench and dips but didn’t understand that one. Thanks.

    • Preacher curls are usually done with the elbows protracted forward on a platform. That tends to roll the shoulders forward along with the elbows, which is not a great place for the shoulders to be. It is possible to keep the shoulders in a “less impingey” position, but I have found that most people tend to roll forward, particularly when fatigue sets in.

      Preacher curls also isolate the long head of the biceps, which attaches directly on to the top portion of the labrum. That worries me in terms of placing too much stress on the labrum.

      • If you keep your scapula packed and back, does that then solve the problem? Also would cables maybe not put as much stress on for preacher motions i feel like it’s an important move in my workout

        • If the shoulders blades are controlled, it certainly is less stress. I just think that it is safer to do biceps work with the arms at your side. I don’t think that it would particularly matter if free weights or cables are used with a preacher motion.

  8. Hi Dan,

    I am 35 in the U.S. Coast Guard and 30 weeks out of surgery with a SLAP repair and capsular shift. My surgeon said I was fit for full duty on week 20 without any restrictions and I have been working towards my normal fitness standards to be able to perform my job. About 4 weeks ago I was practicing slap push-ups and at the time it did not bother me. Then maybe 2 days later I had a lot of pain in my shoulder. The pain went away and comes back after a workout. Recently I have trouble doing external rotations with any weight more than 10 lbs. A little history: I suffered with this injury for 9 years before seeing someone about it.

    My question is “should I revisit my surgeon or is this part of the heeling process”?

    • At 30 weeks you are likely healed. You are probably over-loading the shoulder with the amount of intensity / weight with your exercises. Slap pushups require a huge amount of control. Back it off and go light for a month.

      Are you doing the external rotations lying on your side? If so, 10 pounds is a large amount of weight. Lighter weight, more reps if you want but keep it reasonable.

  9. Shourjya one year should probably be enough time for most active people, but please listen to what your body is telling you. If it were me, I would start with “gravitron assisted” pull-ups and dips so that you are not pulling your entire body weight.

  10. Dan,
    I had a SLAP repair and 5 anchors put in my shoulder for stabilization on 12-13-14. Also, my rotator cuff was torn (25%)-not repaired, but “cleaned up”. I do not have my full range of motion yet due to continuing bicep pain. My strength feels pretty good, but there is significant pain on overhead motion and external rotation. Some days are pretty bad, but other days seem to be not as bad depending on my activity. As soon as my activity picks up, so does the pain. Is this bicep pain normal at this stage of the game, and should I have complete full active range of motion now? Tomorrow will mark 17 weeks. THANK YOU!!

    • Post-ops will often encounter what you are describing 6 months and sometimes beyond depending on age, fitness, etc.. The biceps is particularly susceptible to pain by virtue of its attachment to the labrum. Make sure that your rotator cuff and scapular rotators are being addressed in terms of progressive strengthening. If you are not seeing a PT, it might be worth your time to have a check up and see how all of those muscles are firing.

  11. Dan,
    I am 5 months out from labrum/rotator repair. I am 42 and a Strength&conditioning and basketball coach. My pre-op strength and conditioning training routines of choice consisted of kettlebell swings and snatches, Turkish get-ups, KB push presses, plyometrics, and push ups. Prior to surgery I was at a decent level of fitness. My PT suggested including more rowing movements when I returned to a regular workout routine. Should any of my pre-op exercises be removed from the post-op menu? If so, for long or would the weight used be more of a factor?
    Thank you,
    Mike

    • I would stick to a PT constructed exercise schedule for at least the first 6-8 months post-op. The stuff that you are describing is probably doable, I would just fold them very slowly and carefully into your routine over the next three (3) months. It also goes without saying that everything needs to be broght in with a very light amount of weight.

      Dan

  12. I’m a 43 year old male and I had an acromial decompression done at the beginning of December (doc said the rotator cuff didn’t have any tears). Before the surgery on bench press I was doing sets of 3 to 5 with 315. I recovered quickly from the surgery in terms of range of motion and minimal pain. I started lifting weights very light about 8 weeks after surgery. 5 months later I am bench pressing back up to 180 lbs for sets of 5 reps. There is a very small amount of residual pain yet with these movements. Is this normal for this time frame to still have some localized pain? Should I be concerned? The pain is dull not sharp and goes away after a couple of days. One other thing I notice is that I get muscle knots in my Infraspinatus and Teres minor on that side. I usually use a lacrosse ball to calm them down which works to about an 80% degree, meaning they don’t go away completely.

    • I would say that the pain you describe is pretty typical. As we age the amount of space between the acromion and your rotator cuff tendons narrows, so I would at least expect some friction and irritation.

      The amount of weight that you were doing before the surgery is quite a bit. You should consider lowering the weight and maybe go for more repetitions instead.

      • Thanks for the reply. So for my situation if I go back to a much lighter weight for a while, what would be typical for me to expect in terms of localized pain going away completely?

  13. I am 24 years old, in very good shape. I had rotator cuff surgery almost 10 weeks ago. At 6 weeks I had full range of motion. I feel like i am ready to start lifting again being ive had full range of motion for so long and have no pain. My dr. Is beyond impressed with how ive responsed but still only said I can lift weights up to 15 lbs.

    • 10 weeks is too early to start lifting weights! Better to endure the boredom now and strengthen things up very gradually and carefully. Most surgeons will not consider resisted training until at least 12 weeks, sometimes longer. Be careful!

  14. Hi Dan,

    I am 9 weeks after surgery to repair a fractured collar bone and floating shoulder. Apparently no big muscles were cut with split made between the infraspinatus and teres minor. With 2 screws put in to repair a flipped fragment of the posterior and inferior glenoid. Everything I have read speaks to rotator cuff exercises and healing time. Given my situation, does the same exercises and healing time apply?

    • That’s a tricky one given that your injury is quite rare. The collar bone will probably be healed after six weeks, but the glenoid issue might take a few weeks longer.

      I guess that it would be okay to start some rotator cuff exercises by now, but run it by the doctor first. Lifting the arm up overhead gently is also a good idea because it encourages normal rotation of the collar bone.

      One more thing: fractures will often “ache” for many months, so it is normal for you to feel aching for some time.

  15. Dan,

    You say: Military presses, dips, preacher curls, and hand-stand pushups are not worth your time if you have ever had shoulder surgery.

    Can you explain why you put preacher curls in that list? Of all biceps exercises, I would think they would be among the safest since your arm is locked and supported.

    Thanks for your helpful article,
    Kevin

  16. Keith for some reason I did not see this post, sorry about that. It is going to take a while to get back to that kind of heavy lifting. Given your age I would guess that it will take at least 4-5 months under the supervision of a PT and your doc. You are going to have to be very careful about how you lift as well, keeping your hands down close to your sides.

  17. I’m 8 weeks out from a full thickness tear repair my pt says I’m at a 160 degree movement t I have been weight lifting for 22 yes I feel very good little pain if I take it slow can I start lifting again? I know what I just read about not til 16 weeks but I feel pretty good will I damage my shoulder be able to handle it?

    • James I would wait! Better to be safe than sorry. I cannot tell you how many people I have talked to over the years who went back to weight lifting too early and ended up re-injuring!

      You must get the green light from your doc and your PT prior to resuming the weight routine.

  18. I’m 12 weeks out from my shoulder surgery. I’m a elite level boxer and I see the surgeon in a few weeks to see my progress. I’m just wondering if I can start shadow boxing and jumping rope.? I had labrum surgey and had 4 anchors put it. I still haven’t been cleared to do anything with my elbows flared.

      • Okay awesome I will do that thank you! Also I’m also wondering as I’m doing my stretches and shoulder workouts such as shoulder raises and such. My shoukder makes a popping sound on the anterior part and sometimes on the posterior part. It’s all painless but should I be worried?

        • Shoulder raises are usually brought in at about 16 weeks, so if you are going to do that the weight used needs to be super light.

          In terms of the popping noises, if they are not painful I wouldn’t be too worried about them. If there is any pain I would back off.

  19. Having SLAP Tear repair in approximately 3 weeks on my right shoulder, also my dominate shoulder. I know to expect a lengthy rehab, and considering my age, 41, there is already a considerable amount of stiffness. However, as I am a teacher and use my right hand/arm a lot on a daily basis to type, write on chalkboard, etc. I was wondering how long you think I should be looking at booking off of work, considering the amount of PT I will be needing? Thank you

    • Rod it takes a good 4-6 weeks for the anchors to heal in to place. If time is no object, I would take 4 weeks off. The transition back to using the board in particular should be gradual. The typing shouldn’t be that big of a deal. It also depends a bit on the number of anchors and the extent of the work that the surgeon does, so ask him / her about recovery time as well.

      • Thanks Dan. I have booked off 6 weeks. As boardwork is my main teaching technique (math/science) I will definitely consider going back to the board gradually.

  20. Hey Dan, thank you for the help on the post, I received two shoulder surgeries (labrum tares)
    my left arm has fully healed its been 8 months now, my right arm is 1 month away from being 6 months.
    my doctor told me after 6 months i shouldnt have any problems doing any kind of lifting. Im having real anxiety about this, i just dont wanna do too much weight or have an awkward postion that can be really fatal to my shoulder. i just wanted to ask should i really be worried, is 6 months the priar time to when i can start working out? im thinking about starting with really really light weights and working up slowly. thank you again.

    • Weston I totally agree that your return to weight training should be conservative. Start with very light weight for the first week and add only small amounts once you can handle the routine without soreness. It is better to build slowly than to develop a nasty tendonitis from loading up the tendons too quickly.

  21. Hi there, i am a 22 year old. I had a SLAP repair back in April. I was told by the shoulder physio I could start going back to the gym in October. I went for about 4 weeks, not being stupid and I suddenly noticed my shoulder strength has rapidly weakened. I do not have pain, but I have a real discomfort in my shoulder blade area and feels relatively unstable. Any advice? Any advice for types of things to work on going back to the gym?

  22. I have just had my rotator cuff repaired , why is doing things like military presses , hand stand pushups ect a bad idea in your opinion after surgery

    • Those exercises place the rotator cuff tendons very close to the boney shelf (acromion) that lies above it. The result is often “rubbing” of the tendons against the shlef which results in irritation.

  23. Hi Dan, I had a capsular shift to help with instability about 4 and a half months ago and i’ve started lifting light weights as my physio has allowed.
    I had no problems for the first couple of weeks no pain at all which is good, My physio told me to add one exercise a week and see how I pull up, I never knew about military presses being bad for shoulder surgery patients I did them today and i’ve pulled up a bit sore when I lift my arm up and down. Will this subside or have I re injured my shoulder

  24. Dan,
    I am almost 9 weeks post op from having 5 anchors to repair a SLAP tear. I am fine with waiting to lift, but I have been on the stairclimber and stationary bike for 2 months and, frankly, they are driving me crazy. I got the ok from my surgeon to begin jogging at 6 weeks. I decided to wait another week and a half since I am a runner and I run at a crisp pace (about 6 minute miles). My shoulder has been feeling fine after running for the most part, although sometimes there is some soreness afterwards for a couple of hours. Is this ok? should I stop running if it ends up kind of sore? Did I start too early?

    • I love your description of a 6 minute mile (a crisp pace). That is flying Matt, and it involves a lot of arm movement for counterbalancing. The soreness concerns me. Maybe slow it down a bit (8 minute mile) and allow for a few days of rest in between the runs and see if the soreness abates. If that works then SLOWLY work your way back up over the next month.

      If the soreness doesn’t change you are probably starting too early.

  25. Dan – Thanks for the great article. As much white noise as there is out there in internet-land, it refreshing to read something that is right on point.

    I am 12 weeks post a 360 degree labral tear repair, which required 8 anchors. I tore it playing volleyball about 13 years ago, played through it in college (prob tore it worse), and am now almost 32 and wondering why I waited so long for the surgery. I already feel MUCH better 12 weeks out then I did the last 13 years. SO happy I got it done!

    I am very active (a recreational crossfitter, not serious, and have avoided all overhead lifting/handstand pushups/etc because of my injury. I pretty much scale every workout). I am very smart about knowing my limitations and am every surgerons dream…a complete scaredy cat with an intense fear of reinjury. Having said that, I am slowly getting back to some crossfit movements with the advice of my Physical Therapist (Squatting, jump roping, one-armed movements with my good arm) and my questions are as follows:

    1. It is hard for me to find people with similar surgeries as me online, i.e. 8 anchor repairs. Therefore it is hard for me to compare my recovery to others. Will my recovery be longer those with, say, 3 anchors? Or through hard work/dedicatiion, can I recover like everyone else?

    2. Are overhead squats and snatches something that I should NEVER do? Or can I do them at a light weight (eventually, realizing it may be a year from now). And don’t worry, I will never do Handstand pushups or military presses….

    3. My good shoulder is also unstable. My surgeon and I chalk this up to genetics. It’s probably why I injured my right shoudler at such a young age playing volleyball…But there is no pain in my good shoulder. I still fear that I may injure it someday. Am I at increased risk because of my instability? Or with good mid-scap strenghtening and overall strengthing, can I avoid this?

    Sorry for the long post. I thank you in advance for your time and feedback.

    Thanks! Kara

  26. Hi Dan. I’m 7 months out of Frontal Labrum repair. I have been very hesitant of bench pressing or push-ups. When can I start doing these? I have also noticed that my shoulder seems lower on the side of my surgery. Is this common and will it come back?

    • At seven months you can probably (with the doctor’s blessing) start some light bench pressing. Emphasis on the word “light”, just the bar to start. In terms of push-ups, I would start with modified ones with the knees making contact with the ground.

      It is totally normal for the dominant side shoulder blade to be slightly lower than the other side. If it is your non-dominant side that is lower I would say that it is not normal. If you feel that the surgery side is even more lower than it used to be, it might be worth your time to strengthen up your upper trapezium. We have a shoulder shrug exercise in our media tab on the website (password is “patient”). Once again, get cleared by the doc!

  27. Hi, I had a Bankart labrum repair with 3 anchors on December 19, 2014. I am at week 5. I am going to PT 2 X per week and am making good progress. I am/was an avid runner prior to surgery and am dying to lace up my running shoes. My surgeon said I could run after 6 weeks and my PT said longer. What do you suggest? I do own a treadmill and can start there.
    Thank you!

    • Debbie I would go with the PT’s opinion. I would normally say to try some walking on the treadmill first and slowly ramp it up after about week 9? There is a considerable amount of jarring that can go on in the shoulder with the arm swing associated with running.

      I also tell my patients here in physical therapy that you need to start with slow and brief jogs. The first time that you are cleared to jog I would do only one mile at a slow pace. Stop after that, even if you feel great. Once you have done that several times you can SLOWLY start to up your mileage and pace. The soft tissue needs to gradually accommodate to the higher level of activity.

  28. Not exactly Naser.

    It takes a good 6 weeks for the fractured bone to heal, so I wouldn’t be doing too much with the shoulder unless the doc who did the surgery says that it is okay. The screws will make it more stable early on, but I would keep the exercises very basic for the first six weeks.

  29. Thank you for this advise, I just had a bank art repair on my left shoulder on 2/5/15 and I am lucky since I have no pain from the joint, a tad sore but ibuprofen is helping with that. I can not await until tomorrow to start my PT, however I was wondering if it is ok to do moderate lifting with my right arm. I went to the grocery store and bought a 24 pack of water and proceeded to lift it in the cart with my right hand, no pain occurred in my left shoulder but my gf advised that I shouldn’t do any heavy lifting with my healthy hand cause it may cause injury to my left. Additionally, I used a shovel to scrape some ice off the driveway, again with my healthy hand and didn’t lift the snow/ice just move it to the side. Would those actions be OK to do 72 hours after surgery as long as it is with the healthy hand?

    Thank you,
    Paul

    • I don’t think that you are going to hurt your surgical arm simply by using your unaffected arm. If it is a really heavy weight however, you may try to inadvertently brace yourself with the surgical arm to try to stabilize yourself, perhaps if you lost your footing. So I am going to say that you are both partially correct.

      You should be using this opportunity to have your girlfriend to all of the heavy lifting for the next several weeks.

  30. Hello Dan

    i had surgery 25 days ago it was an arthroscopic for Resection of the Distal Clavicle in my shoulder. I was feeling a lot better but yesterday i climbed a wall and it hurt when i pulled and then pushed to climb the wall, i heard that my shoulder pop and it kinda made a sound inside i don’t know how to explain it. Now its the next day and it still hurts again like it did after 2 weeks of the surgery. It hurts when i do certain things like when i try to move my arm across my body, or when i raise my arm, i feel the pain at the top of the movement. I feel like i set myself back a week for pushing myself too soon. What happens when i use my shoulder to soon after surgery? should i be worried? what should i do?is it going to heal with pain killers

    • You definitely tried that too early Carlos. I would touch base with the doctor to make sure that all is okay. Pushing too soon can inflame the structures that the doctor worked on. In most cases it will cause pain for many weeks.

      Moving your arm across your body does press the part of your shoulder in to the distal clavicle, so I would expect that would hurt. You should get a protocol from your doctor or PT outlining what is okay to do and when.

  31. for an average 20 year old I would say 6-8 months, for a 30 year old 8-10 months, for 40+ 10-12 months or sometimes even more. There are so many variables that have to do with age, activity level, health, prior surgery………..it is hard to give you exact numbers.

  32. Hello,

    this may be a dumb question but here it goes. I had SlAP surgery on 2/4/15. I am going to the gym now doing cardio and abs and legs and some one arm hammer strength benching and one arm curls as well. I tried doing tricep push downs with very light weight with both arms with no pain, can I continue to do this exercise or will it do damage. Thank you

    • Mike did the doc give you a timeline for when to return to exercises? I obviously do not know exactly what your doc did, but it is certainly way to early in most cases to perform resisted exercise on that shoulder. Even though the triceps exercise didn’t hurt, I would still clear it with the doc first. People get really bored during the first 12 weeks or so, better to be safe than sorry.

  33. Hi Dan, I had a full thickness tear off the supraspinatus, bone spur removal, debridement of the long head bicep and sub scap and removal of the bursa. I’m 45 and a very active mom and bodybuilding is my hobby. Before surgery, I switched to metal grip work to protect myself from further damage. When I can slowly return to lifting, would it be smart to keep neutral grip work or can I expand into bar bell bench and deads? I’m trying to balance out my symmetry (being smaller on top) and look forward to returning to the gym.
    Thanks!

    • Based on the extent of the work that you had done, you need to find a new hobby. Or at the very least modify it.

      I like the idea of the neutral gripping position, you are less likely to impinge. In your case, I am not a fan of barbell benching. You would be bringing your shoulder into too much of a compromised position when the weights come down to your sides. I would do flat-bar benching instead, at least the bar touching your chest would limit the bad shoulder position.

      A good rule of thumb with weight lifting after RC repairs / labral repairs: You should always be able to see the backs of your hands with your exercises. This will limit some of your ranges, but in the long run it will save you some grief in the form of additional degeneration to your shoulder.

  34. i am curious if i can walk on my treadmill after a humerus rebuilt. I had a donor bone connected to rebuild my humerus and want to start walking on my treadmill. if i have my shoulder taped can i walk at a modest pace?

    • I would ask the doctor Dan. Your type of surgery is rare, and depending on what the doc did there may be a very specific protocol.

      If you want to get your cardio fix, you may want to consider using a stationary recumbent bicycle. You have essentially no risk of falling on a recumbent bicycle.

  35. Hi

    I recently had arthroscopic shoulder surgery to which i had to have 6 anchors put in, labral tear. The operation went well according to the orthopedic surgeon. I asked him when i might be able to return to weight training, hence this was the cause of my injury, he’s reply was ‘Never Again’ I don’t understand why he would say this as the operation went well & with adequate healing time, ie: 12 months plus, i feel i should be able to return lifting light weights. I 38 yrs of age & have been consistant in my training for the past 8 yrs & i find this unacceptable to give up. I would very much appreciate your thoughts in this matter.
    Many thanks!

    • Well I am going to take a middle of the road approach. I tell my patients, “yes, but with modification”. When you are done with rehab you should ask your PT what exercises can be done safely in the gym.

      One rule of thumb that we use here at PhysioDC is “you should always be able to see the backs of your hands when working out with weights”. That applies to most exercises.

  36. As a former college athlete, I felt like I knew what to expect heading into labrum surgery. When I finished my college baseball days I was very active in the gym and performed most exercises without any issues. It wasn’t until the labrum finally tore (more like snapped) that the constant dislocations and acute pain led to surgery (5 months ago). The doctor performed a SLAP tear procedure as well as some cosmetic work to the rotator cuff. I’ve been cleared from PT for about 2 months now, and back in the gym for 6 weeks. I’ve been gradually increasing my workload as my body permits, and thus far have had no issues.

    I’m a bit concerned from the article regarding exercises you recommend to stay away from. The only “pain,” if you can even call it that, I get from lifting seems to be centered around anything to do with triceps movement (have not maxed out and haven’t even considered doing dips). However, you mention to stay away from preacher curls as well as military presses, which are two focal exercises in my regimen.

    I’ve been told by my doctor and PT therapist that as long as there’s no pain, I can continue on business as usual with every exercise. As a 25 year old male, I’ve heard that youth plays out as a benefactor in these types of surgeries. If there is no pain doing said exercises would you suggest it ok to continue on with a light load until I’m completely confident in increasing the workload?

    • Steve I would say that doing the above mentioned exercises with a light load and without pain should be fine. Increase your weight gradually and back off if there is pain.

      I would be be particularly mindful and re-evaluate your routine every year or so based on how your shoulder is feeling. As we age the “clearance” that our rotator cuffs have under the acromion shelf tends to narrow. This makes it easier for problems to develop, and your shoulder is probably a bit more susceptible to this because of the surgery you had.

  37. I’ve just had rotator cuff surgery. Once I get thru therapy and get the green light, I’d like to return to my resistance training routine. I exclusively use a weigh machine (weights with pulleys). I would greatly appreciate your advise on what exercises I can or cannot do (or should avoid). Prior to surgery I worked out regularly doing shoulder width bench presses, triceps push downs, close grip pull downs (palms facing me and in front of my chin) and wide grip pull downs (palms facing out and in front of my chin). I also would like to do bent arm flys (I stopped doing these a few years ago due to the pain from my torn rotator cuff…which I didn’t realize was torn at the time).

    Do you see an issue with me returning to any of these exercises? I’ll take it slow week over week in regards to adding weight – and won’t even consider doing weights until given the green light by my MD (at least 3 months into recovery from what I’ve been told). In the meantime, I’ve been advised that I can run on my treadmill (which I do on alternate days when not lifting).

    Any thoughts or advise would be greatly appreciated.

    Thank you

    • In terms of the bench presses, keep the range so that you can always see the backs of your hands. Same mantra goes for the bent arm flys. The other exercises sound fine, just make sure that you run them by the doc as well.

  38. I had a shoulder surgery in 2012.I have a metal plate in my shoulder. I am doing fine. I can raise my arm almost all the way. I would like to know how much weight I can lift?

    • Prabu that depends on a million different factors (age, gender, weight, health problems, and many more). The simple answer is to start light and see what you can tolerate. Do not lift through pain.

  39. I am due to have surgery on my shoulder on the 23 Jun, the surgery I am having is Arthroscopic Subacromial Decompression.

    I am hoping to run a full marathon on the 11th October, do you reckon it is feasible to start running a month after surgery, this would give me a good 12 weeks of training before the marathon.

    I fully understand that the answer recieved is generic and of course will depend on what the surgeon actually does, i just want some hope before surgery!

    I currently run 40-50 miles per week.

    • Decompression surgery is not as involved as a rotator cuff repair or a labral repair, so the rehab time is generally not as long. It is possible that you could start jogging one month after the surgery, but you would have to be doing well in terms of pain and swelling. You are in that “gray area”. You will need to get the okay from both your PT and your doc.

  40. Hi, I had surgery 3 weeks ago on my shoulder, it’s been 3.5 weeks since, I have been told to take of my slung and do Strenth exercise for the shoulder, as I was doing a exercise, holding a stick with both hands bring it upwards I heard a loud pop/click sound on my shoulder, there is no pain of sort, was that normal, should I be worried.
    Thanks

    • It there was no pain associated with it you are probably fine. Tendons can rub over certain areas of the bone and make loud noises. If you are concerned about it you can always ask the doc as well.

      • Thanks for the answer, it’s been 4 weeks on the shoulder surgery, I still feel popping and cracking, which sometimes causes a slight pain when it does so, if I am experiencing pain after the popping and clicking should I be worried??

  41. I just had a rotator cuff tear repair, bone spurs removed and some arthritis work done today. How soon can I do pt? I know the pendulum is first up, tomorrow!?

    • There are different protocols that doctors will use. Some docs want almost immediate range of motion, while other docs do not want anything done until 1-2 weeks after the surgery, so my answer is ask your doctor.

  42. hi, it’s been 4 weeks and 5 days since my rotary calf surgery, I am worried of what I done today, i have been told not to move my arm unaided, I stupidly made the decision to shave my face today with the operated arm, I did feel hard pulls on the shoulder at times and the whole day since after my shoulder has been hurting really badly. Have I damaged anything??

  43. hi, it’s been 5 weeks of my shoulder surgery, today I accidentally leaned on my operated shoulder for a good 10-30 minutes without reading until I started to get pain, I soon after repositioned my hand, I read many articles on how we should avoid leaning on the operated arm, dis I ruin the surgery by doing so?

    Also, as I was taking of my jacket, I unintentionally swans my whole arm back trying to get the arm out, I then felt a warm tingly sensation with sharp pains following from that, the pain lasted a good hour, again from your understanding is there any thing I should be worried about??

  44. Hi been 5.5 weeks now, my shoulder feels fine now, but one noticeable thing is that my shoulder joint feels more forward and it feels like subluxation, where it feels like the joint in stuck and I feel the need to crack it and pop it to get rid of that stiffness, when I do get the subluxation I can feel slight pain when it feels stuck. Is this normal, as my muscles surrounding is weak is it due to that? I am really worried, got a appointment with the doctor in 2 months. Can you clarify for me, thanks

    • The head of the shoulder tends to ride forward in most people. The weakness that you have from the surgery I am sure is not helping things. I would definitely ask a PT and your doc about it.

      It is a bit tough to tell you exactly what is going on because I am not looking at your shoulder. A PT doing a live assessment may be in order.

  45. I had rotator cuff repair surgery Feb 5th 2015. Three tears – biceps tendon had a lateral tear and was dislocated, sub scap had a tear and the supraspinatus was a full thickness tear. the Biceps tendon was just reloated and anchored and then 3 other anchors at the suprispinatus. I am 4 months post op now and anxious to get back to training with some weights even light weights that I use for PT. I know my competitive lifting days are over, but it’s so hard to see all that hard work to build muscle go to mush. I’ve been told 6 months is when I can start lifting again, but why not sooner with light weights like I use for PT? I was also a group/class instructor at a gym and that has been put on hold too. This indeed has been a very humbling experience.

    • If you are cleared from the doc to do light resistance, I don’t see why you cannot do light resistance at the gym in a responsible manner. Clear all exercise types with your PT, and make sure that the doc okays it to be safe. NO impingement style exercises though (military presses, dips, preacher curls).

  46. Hi Dr.,

    I had surgery for a torn labrum last year. 6 months after the surgery I started trying to lift after being told by my PT that I could after doing a month or two of PT exercises with almost no issues. About two weeks into lifting I started getting pain and stopped. Fast forward another 6 months to today and I started trying to lift again. I went with some light dumbbell flys and curls on a machine. Even with light weight I feel a pinching sensation, minor pain and some faint clicks/pops. The pain is very minor, but I am worried that the surgery didn’t work. Is there a way to be cleared? I could ignore the sensation if I knew it had knitted, or that I wasn’t doing more damage.

    thanks,
    Travis

    • You can ultimately be cleared by the doc who did the surgery.

      Here is an idea, do the biceps work with light hand held weights rather than with a machine that holds your arms in place. Free standing curls are actually less stress on the tendon. In terms of the dumbell flys, shorten your range. You should be able to see the backs of your hands for the whole range of motion of the repetition.

      Both of the exercises that you described are on the riskier side in terms of stressing the shoulder labrum. Modify them and see if it is easier to handle.

  47. Hello! In February 2014 I had three labral tears repaired in my shoulder. I’ve been very happy getting back to a full range of athletic and outdoor activities as well as weight lifting. However, on occasion, even though it’s been more than a year, I do something that leaves me in significant pain for a week or so. How do I know if this “good” pain, like the pain of physical therapy, or “bad” pain, like the kind that signals the potential for re-injury? The activities that provoked pain were, on separate occasions, (1) too many pull-ups, (2) a series of back bends, and (3) a half hour of swimming. However, I usually do pull-ups, weight-lifting, and deal with the forces of wake-boarding and snowboarding without issue. I don’t want to stop these activities and even want to add rock climbing soon, but I want to feel confident I am not damaging my repairs. Can I interpret the pain as simply indicative of a challenge to range and strength that will leave me in better condition? Or could I tear or damage the repair with these activities?

    • Good pain is muscular, in the muscle belly itself. Bad pain is in the joint. It sounds to me like you might be describing the latter.

      If it is the latter I would have the strength of the scapular muscles and rotator cuff checked out to see if you still have a deficit somewhere. If the pain in the shoulder joint is sharp, I would back off the insulting activity. There is potential for tissue damage.

      • Thank you so much! I think it’s possible it’s muscular, but I’m not sure–when I press the muscles (albeit near the joint), I get a temporary sense of relief from the pain. It is not like the normal soreness I get from running or lifting, though, and it does seem to be close to the connections to the bones that the muscles hurt, so it’s hard to tell. I appreciate your time and insight!

  48. On July 13th I had a SLAP tear repaired, some minor repair to the rotator cuff, bone spur removed, and overall tightening of the shoulder capsule.

    I started PT 4 weeks ago, and was cleared by the surgeon two weeks ago to remove the brace and ramp up the intensity of the stretching/torture in PT.

    last week I was out of town at a work event all week and probably over did it. Carrying/holding a 20 lb. brief case while opening doors, luggage, etc. I also messed around an shot a youth model compound bow 3 times(25 lb draw weight, drawing with my right arm, the one operated on, uses mostly back muscles). Nothing I did hurt, in fact drawing the bow felt really good.

    About 24 hours after I returned home I started getting really sore in the front deltoid. Kind of a dull ache, but a sharp pain if I try to raise my arm from my lap too fast. doing my therapy exercises helped out, and the ache/pain comes and goes randomly. Mostly happens after sitting for a while and hurts when I stand up.

    Did I screw something up? Or am I just sore from using muscles that weren’t ready to be used? We’re using 2lb weights for some motions in PT, and she’s really cranking on my arm to get the range of motion back. Again, nothing I did hurt at all during the week, just started getting sore at the end.

    Thanks.

    • Scott that is probably going to take many weeks for that to calm down. You likely just overdid it and caused some inflammation of the rotator cuff tendon(s). If the pain does not slowly subside I would follow up with the doc and have it assessed.

      In the mean time I would ramp back your routine considerably.

  49. Hi Dan,

    I have a small anterior labrum tear. I am 22 and deciding on when to get surgery. When do you think would be safe to return to snowboarding after the surgery? I am not one to do anything crazy and rarely fall.

  50. Hi Dan,

    Thanks for the blog and taking the time to answer questions. I am a 58 year old female and I am very active. I had surgery on both shoulders this summer, the right one on May 21st and the left on July 21st. My left shoulder had a bone spur, some arthritis, micro fracture and the acromiom shaved. My right shoulder had a bone spur, grade 3 osteoarthritis, (only the socket has arthritis) both the labrum and rotator cuff had small tears, (both of these were only cleaned up no anchors were needed) and the acromiom was also shaved. My question is how long before I will be able to get full ROM on my right shoulder? I’ve been going to the PT since May 22nd. The PT can only get it so far even though we have been working on it 3 times a week. Last Thursday I did see the surgeon and was given a steroid injection in the right shoulder to see if that might help, it helped with my arm going up my back but not with overhead or side motion. I am getting frustrated as I want to get back to the gym and Kosama. My left shoulder is doing great no issues! I am using both the bands and 2lb weights for strengthening. Is there anything else I can do to get the ROM back? The PT can feel when the arm stops and I know when he hits the spot when the pain starts. Any feedback would be appreciated. Thanks

    • Grade 3 osteoarthritis is going to keep you from doing certain things, and significant osteoarthritis will keep a joint from obtaining full range of motion. My advice to you is take a good hard look at what you were doing before these surgeries and modify your routine accordingly. A full downward dog position for example would likely need to be modified as would push ups. I definitely think that you should eventually return to the gym. Get a good routine with the blessing of your PT.

      Be patient with pushing the range of motion. You will most likely get most of it back. If the end range feels like it has deep grinding sensation, don’t chase it.

      • Thanks for the Reply Dan! I did forget to ask you about the micro fracture in my left shoulder. All the information on line only pertains to the knee. Since the shoulder in not weight bearing how long do micro fractures last and what type of exercises should I not do. Will I be able to work out with kettle bells or do kick boxing again?

        Kathy

        • Microfracture in the shoulder is rare Kathy. I am not sure what the protocol for that is, but I would assume that since it doe involve perforating the bone I would give it a good six weeks to heal before placing stress on it.

          Start with basic rubber band exercises once you are cleared and build up slowly over months. Punching motions are going to place a lot of direct impact on the shoulder joint. You need to get that cleared wit the doc or PT first before doing that type of exercise again.

  51. Dan, I am 8 weeks out from rotator cuff repair / type 2 slap repair/ decompression surgery. I’m so surprised at the continued pain, which manifests as both shoulder ache and as forearm / wrist ache, the latter making it quite difficult to do my work at a computer keyboard. I’m wondering how common it is for this kind of referred pain to last two months or more. Also, my arm is swelling notably after I do the PROM exercises I’m doing as directed by my PT. That swelling gives me the absolute willies, because I also have breast cancer-related lymphedema of the opposite arm, and I am paranoid that the shoulder surgery is giving me the ‘bonus’ of lymphedema in the arm that was until now unaffected. I had no nodes removed or cancer treatment on the shoulder-surgery side, but I did have bilateral mastectomy, so I lost some nodes with the breast tissue. My questions to you are if full-arm swelling is to be expected after PROM work, and if you have ever seen a patient develop arm lymphedema after extensive shoulder repair. I can manage the swelling using lymphatic drainage techniques, but I would love to think it’s just temporary. My PT is saying not to worry, but I do worry and wonder if you can comment on what you have observed in other patients. Your kindness in answering questions here is a gift.

    • I would bet that the swelling in the arm is an after effect of the mastectomy. Shoulder swelling like that (the entire arm) is not so common after shoulder surgery. It might help to have the arm / shoulder wrapped.

      Bring it to the attention of the doc.

      In terms of your other question, reaching forward to use a mouse or keyboard could easily cause the type of referred pain that you are talking about. I would check to see what your ergonomic set up looks like. Your elbow should ideally be at the plane of your body, not in front of you as you type.

      • Thanks, Dan. Forearm and wrist pain is all the time, not just when typing, and I do appreciate the suggestion to double check elbow placement when at work at the keyboard.

  52. Hi Dan,

    I’m about 7 weeks post-surgery, having had a bankart lesion repair.
    I had my surgery in South Korea and I’m a bit anxious about the level of advice I’m receiving from the Dr, due to language barrier.

    I had my arm in a brace for 4 weeks and I have had a couple of weeks of light exercise.

    I still have discomfort if I raise my arm laterally, and I’m not sure if this is to be expected.

    I wonder how long until I can go back to basic exercises like push ups?

    Also, how much risk is there of re-injury at this point? I’m constantly worrying about hurting it because i don’t really understand the healing process. I’ve been thinking about going back to Bjj, just for light exercise, is this a bad idea? Would one wrong move, after 7 weeks wreck the labrum again?

    Many Thanks.

    • Discomfort at 7 weeks is normal. It may be sore for another few months. I would not do push ups until at least 14-16 weeks after the surgery, and I would start with wall push ups to load the muscles slowly.

      The normal protocol for something like this would be light active-assisted ranges from weeks 6-8, active ranges from weeks 8-12 (meaning gentle lifts with the arm in various directions WITHOUT ANY RESISTANCE), and if cleared to do so, light resistance after week 12.

      It sounds to me like you should see a PT at least once to get the whole timeline thing under control. If you did something too intense at this point, you could re-injure it.

  53. I am now a little over 4 weeks post op from my labrum surgery. I have been wearing my brace and rehabbing as my doctor has instructed. I am at 90 degrees flexion, 90 degrees abduction, and around 45 degrees external rotation. My question is this… I slipped earlier today in the shower and caught myself on the wall with my right arm. I externally rotated my arm more that I have been and had a pretty aching pain initially in the posterior part of my shoulder. It is a little sore now still but nothing bad. I was just wondering if you think I may have done some damage in my shoulder. I didn’t feel a pop or anything, but I am just still a little nervous. The doctor said my tear was a slap tear from 11 o’clock to 2 o’clock.

    • Hmmmmm, I would have the doc check it out to be safe. It is possible that you damaged an anchor because it is a bit early for the anchors to be healed totally in place. If it is only a little bit sore you are probably okay, but run it by the doc.

  54. My daughter had surgery in August of 2015. This was to repair a loose shoulder, 2 anchors were put in anterior and posterior. She started PT in October and range of motion was improving as was strength. In late December during holiday break she went bowling. She is small so she was using a 6-8 pound bowling ball. He shoulder has hurt somewhat since that time. do you think she could have pulled an anchor loose?

    • 4 months post-op her anchors should have been very secure. However, if the pain is still persisting after all of this time I would ask the MD about it. I would say that there is an outside chance that something happened, but the more likely explanation is a strength deficit.

  55. Hi my name is Jenny and I had shoulder surgery a month ago. my shoulder drooped out of place and would not go back in without surgery. When am I able to start playing basketball and soccer again?

    • It is probably going to be a while Jenny. The doctor really has the ultimate say in this, he needs to give you the final “OKAY” to play. If I were to guess, I would say a minimum of 16 weeks from the surgery for some sports.

  56. Hi there I had a shoulder rotator cuff repair and muscle repair.i also had calsivication removed. I have been in pain the entire time after surgery ,I dont have frozen shoulder but my arm is taking its time to streach out straight above my head.I have constan pain in my bisep ( not the muscle he worked on ) I understand that I will have pain as he worked on the bone and the cold plays a role also.
    Is it normal to still have pain?

    • It is possible to have pain post-surgery for many months. In terms of getting the arm over the head, it can take at least six months, sometimes longer. It depends on your age, your fitness level, and the severity of the tear.

      In terms of the biceps pain, I would maybe give the shoulder a week or two of rest. If you are stretching aggressively, you may be causing some irritation.

  57. Hi I am getting shoulder surgery in a few weeks I have nerve damage and a dislocation. It is going to be open shoukder surgery. How long will I be in the hospital for?

  58. I had rotor cuff surgery my second one in a year to the same right shoulder, The first surgery on April 30, 2015 was great and about 2 months in my PT was on vacation and i had a sub she over extended my arm which caused a popping sound and then massive pain. I went back to the DR to have another MRI done to find out that she caused a another rip and a bicep tear and i had to have my collar bone shaved down do to bone spurs. so in all she caused a lot of damage. I had my second surgery April 28th 2016. So now 12 weeks in im back in PT and things are going great. I want to start running on the treadmill and im not sure if i can cause my shoulder to rip again or be in more pain. im on a no weight limit right now and the DR hasnt released me yet. I need to get back to my goal weight as i have lost 270 lbs and feel like im gaining weight even though i stick to my diet. I do have a recumbent bike i do but i dont feel its enough for me. So can I run on the treadmill?

  59. Hello,
    I had arthroscopic shoulder surgey a few days ago. My shoulder is killing me with pain. I’m taking 2 oxycoden every four hours, 2 Advil every 4 hours in between those and nauseous medicine. How long will my pain last?

    • It should gradually improve, but many people will have marked pain for many weeks following a surgery such as that. Make sure that the shoulder is adequately supported with a pillow under the elbow and forearm when you are seated, or at least consult the doc or a PT about positioning.

  60. Hi I had surgery about a week ago. Before my surgery I had an x ray that showed the ball of my shoulder out of place. It stayed out of place until they fixed it in the surgery. When I go in for my follow up appt and the X ray still shows it’s out of place what will happen? Will I need another surgery? Will it be s’more invasive surgery? My previous surgery was arthroscopic. Thanks!

  61. Hello! I am around three weeks post op of a arthroscopic surgery to fix ligaments. Everytime I sneeze or go over a numb my shoulder slides out of place. Should I be worried? Also when I start physical therapy will my therapist make me go back to my doctor if he notices that?

  62. Hey doc, I had surgery March 8th of this year, stayed in the sling for 6 weeks, and began therapy immediately after. Therapy went great for the most part after 3 months of 2 sessions per week and doing the exercises on my own, i finally felt strong enough to do push ups and small resistance training. I feel as though im on the right path, as im almost 5 months post surgery and definitely feel as though im regaining my strength. Although, every once in a while, and im not sure if this is normal or maybe me pushing a little farther then i should be, but ill leave the gym or finish my workout and can feel a small pain in my shoulder that was operated on, which normally subsides quickly after, yet sometimes can come back later on depending on the movement i make. just wondering if you have any thoughts about if this is normal? Or if im putting myself at risk for re-injury or not a full recovery? Any insight would be appreciated,

    thank you

    • Hmmmmmmm. You might be doing one or two exercises at the gym that might be irritating the rotator cuff. I would experiment with taking out certain exercises and seeing if it makes any difference. The usual culprits are incline presses, dips, push-ups, and pull-ups.

  63. Hi!
    I am having my second surgerh on my right shoulder in a week. My first surgery was six weeks ago however, ever since then my shoulder kept dislocating. The first surgery was just stiching up ligaments to make them tighter and repairing the broken ones. I am wondering if after my second surgery will my recovery time be longer? Will I have less range of motion? Will it be more painful?

    • There will probably be a longer recovery the second time due to the inflammation. I would give yourself at least a week or two after the second surgery to totally take it easy and allow things to heal.

  64. Hi, question. I had a SLAP repair about 4 months ago. I had 4 anchors in. I’m young will be turning 20 soon. I currently feel great. I had full range of motion 10 weeks post op. Still breaking up scar tissue. As a time frame at 14 weeks I was doing a few pull ups, some knee push ups, and light swimming, all pain free. Just worked my way up to more pull ups and normal push ups and I’m still pain free. My question is, I was reading that dips and hand stand push ups can never be done after this sort of repair. I find that to be a little unsettling as I got this surgery in hopes that in a year I’d be doing those things again, and seeing how I’m progressing I would think that wouldn’t be a problem if I give the joint enough time. And no, I didn’t get the injury from doing any of these over head movements. I remember the time it subluxated very clearly and it was an unfortunate injury. I lived without surgery for a year before I opted for it simply because the exercises I had done in the past such as hand stand push-ups and some others were a bit painful. I never subluxated or dislocated again after that initial time and I know that my opposite unoperative shoulder joint is very healthy and stable so I would think I could work my way up to the opposite shoulders level of stability and strength eventually. I want to be able to be strong and flexible and do martial arts one day again. Don’t get me wrong, I’m in no rush but I wouldn’t have gotten this surgery had I known that there would be things I could never do again. What are your thoughts?

    • At your age you most likely will be more than physically able to do the exercises that you mentioned. I just think that those exercises are in general not a good idea to do if you have had any work done to your shoulder. In my opinion you would be placing the shoulder at a bit more risk of injury by putting the shoulder in extreme positions. There are plenty of things that you can do besides dips for example. Your call.

      • Thanks for your input on that. One other question I have is though my range has been back to normal for a while now, I still get dull achey sensations with two movements and I’m wondering if I can expect them to go away. I got the surgery hoping to completely eradicate the pain with these movements and a few others. It seemed to get rid of most of the discomfort but a few movements still hurt. One that still hurts is behind the back. The other movement is abduction and external rotation. Like I said I have full range of motion with those movements but they’re still dull and achey, similar to how it felt pre surgery/ post injury though not nearly as bad. Should I keep stretching in these positions? Do you think it’s scar tissue? I usually get immediate relief with those specific positions when I do 3 sets of 20 with bands of external rotation first if that helps.

  65. I have had bankart lension surgery on my right shoulder seven weeks ago. I only start sleeping on my bed this week and since then I experience discomfort and slight pain. Is this normal at this stage? I some time get up with my body leaning on my right shoulder side.
    Secondly I am doin pt 3 weeks now and I have 100 degrees reflection and 60 degrees anduction. However when I am doing my pendulum exercise there is a clicking in the shoulder ( bone touching another) . Is this normal? And for how long? Also pain in the biceps area. This is usually the most painful exercise for me. Thank you.

    • Some people do have pain in the shoulder associated with sleeping for many months following that surgery. I would try to avoid sleeping on that side for the time being. It is typical for the shoulder to make clicking noises with various exercises. It may take a few months for the shoulder to strengthen up enough to decrease the clicking sounds.

  66. Hey dr Bismarck had a shoulder labral tear surgery, 2 o’clock to 5 o’clock position. 2 anchors put in and 2.0 nylon. I’m roughly 8 weeks post op now, doing range of motion stuff. Have 80% motion back. Just a few questions I have to ask. 1 is, is it. Normal to have under arm pit pain and scapula pain still as I get a bit of pain from the bands pulling back from the door with elbow toside of my latts.
    2 when I am cleared for weight lifting again. Is bicep curl work outs ok to do with this type injury. My bi cep tendons were not affected at this point of time and hoping they never do touch wood.
    3 what work outs should I avoid with this injury in future to come?
    Lucky last question relates to scapula again. When I first had this injury my scapula was also affected and it looked like it winged out but I did most of the tests except emg and surgeon said this was due to shoulder instability and hence why I had this labrum repair and paralabral cyst evacuated. Hopefully you can give me an opinion on these if you can I will very much appreciate it. Thanks doc

    • It is pretty common to have the shoulder pain that you are talking about 8 weeks after surgery. The shoulder blade winging thing might add a bit of time to the rehab because the shoulder blade is not in an ideal position for shoulder mechanics.

      Weight lifting and resistance usually do not come into the protocol until 12-16 weeks. Ask your doc when the appropriate time is. In terms of exercises to avoid long term, I have always thought that dips and preacher curls aren’t a great idea. If military presses irritate the shoulder, I would stay away from those too.

      Your scapula position I think is not necessarily related to the labral tear, but it should be addressed by your PT nonetheless. Get a good scapular stabilization program once you are done with PT, and do it weekly.

  68. Hi I recently had scope shoulder surgery. My shoulder feels as if it needs to pop. It has popped a lot before and felt a lot better but now it’s tight and will not pop. Do you have any ideas on how to pop it? Thanks

    • That depends on what needs to “pop”. I would avoid any motion that has been prohibited by the doc’s protocol. Have you tried maybe doing the “pendulum” exercise? That is usually okay to do post-op and it does get the tendons moving a bit.

  69. I had surgery late june for shoulder dislocation. I am 11 weeks out and i can do like 5 push ups, but i get tired pretty fast after that. I’ve been doing training with resistance band, basicly very light exercise. My trainer says i am doing extremely well, so i am happy about that.

    My question is though, when can i return to sports, like Icehockey (i play, thats how my shoulder dislocated)? Havent spoken to my trainer about it yet, because i am dont want to be upset. But when is it appropriate to return? The doctor said 3-4 month, does that sound about right?

    Very helpfull thread!

    • 3-4 months does sound appropriate. I would consider getting a neoprene stability brace for the shoulder as well for when you play sports. You should be able to find a good one online for not too expensive.

      In terms of training, the trainer should be working internal rotation with frequency, unless if your dislocation was not anterior. Find out which way you dislocated and tailor your training to stabilize the unstable direction.

  70. This is probably a question for a physiotherapist but what shoulder exercises can most safely and effectively replace dips, overhead presses and all the other hazardous routines without creating muscular imbalances?

    • Triceps cable work is much safer, as are deltoid raises as long as they are kept at or below shoulder level. I am also a huge fan of doing the exercises “I’s”, “T’s”, and “Y’s” over a physioball. I think that a bench press is a bit safer than an incline press.

      I also tell all of my gym-goer patients to keep the ratio of front exercises (biceps, chest, etc.) to back exercises (rows, lats, middle traps) one-to-one.

  71. I am almost 5 months post op after 2 rotator cuff repairs and a fractured humerous. My goal is to return to work , however I keep getting mixed messages from ortho and pt. A recent mri shows recurrence of partial tear greater than 50%. Ortho says it’s normal and happens to many patients. I have limited range and weakness. I feel like I’m so behind in my recovery and it is extremely frustrating. Any recommendations old be greatly appreciated.

    • That is a tough thing to comment on. I would have to look at the most recent MRI to tell you exactly what I think. In general, people can function just fine with a 50% RC tear as long as everything else is strong and flexible. The humeral fracture does make everything else a bit more messy. I would guess that it will take a good 8 months from the operation date to get a good assessment of how much return you will get.

  72. Hi I had arthroscopic surgery to fix my ligaments in late June and I still have pain lifting my arm and doing everyday movements. Is this normal? How long will I have pain for? I went to the doctor and they saw two things that were not fixed and those were a hagl tear and capsule read. Could the pain be from those? The doctor said he needs to do surgery to fix those DO you know how long the surgery could take

    • These things can take up to a year to get full improvement. If you add another surgery it might be a good idea to let the first one recover first. You may find that won’t need a second. It does still sound like you have a way to go in terms of recovering from the 1st surgery.

  73. Hey Dan,
    I have been doing not stop research for my upcoming rotator cuff procedure, tear, spurs, general cleanup, too. Surgery Nov 10, 2016.
    Little background on me; I am a youthful almost 67 years. Been bodybuilding naturally for over 45 years. Before shoulder started acting up 10 months ago, I had huge guns, chest, back, and legs. Weight and size has decreased considerably this year due to shoulder injury. Workout daily as well as 45min of cardio, and do (did) yoga weekly.
    I know one loses muscles as one ages. What can I expect say 6-12 months out?

    Thank you.

    • You are probably going to have to modify your long-term routine to protect the rotator cuff tendons. Less weight and more reps perhaps, and also perhaps removing a few shoulder-pressing type motions would be a good idea. You will probably be back to doing very light weights by 5-6 months. Take you time with this and stick to the protocols.

  74. Im about 8 months afyer rotaor labrum repair. I started back at crossfit around 6months with crossfit lite its alot of cardio. Started regular crossfit again maybe 2-3 weeks ago. I have excellent range of motion. Somtimes i get sore not where the pain was before surgery but right at the front of arm pit and where pec muscle connects to bicep. Sometimes its real sore there….how would i know if i tore it again.
    Im pretty sure im ok but i just get freaked out im going to tear it again i dont go heavy at gym yet. Thinking my muscles and tendons are weak and they are just getting sore from working out

    • Crossfit is going to be a bit more risky for the shoulder, so I would make sure that the strength of the shoulder is ideal before going back to full capacity. Give yourself extra time to recover as well.

  75. Hi, I fell up a flight of stairs 9 years 10 months ago and injured both shoulders. I had an MRI on both shoulders. The right shoulder had the following – partial thickness tear of the lateral supraspinatus tendon with associated tendinosis and bursitis. Slight fraying of the subscapularis tendon. The left shoulder showed some bursitis and some joint synovitis and osteolysis of the distal clavicle. I had an injection of Celestone and local anaesthetic to see if this would reduce the inflammation and bursitis. In December 2009 I had a left shoulder arthroscopic subacromial decompression which found that I had a Type 1 SLAP tear which was debrided. There was also some synovitis in the rotator interval and there was quite a large subacromial spur with significant impingement of the rotator cuff. I returned to work on reduced hours in January 2010. I waited 6 months before having surgery on my right shoulder on 2 June 2010 – there was a partial undersurface cuff tear with some fraying of the undersurface tear. The subacromial space was then inspected and there was marked bursitis and an extensive bursectomy was performed. There was a very large spur with a tight acromial space and thickened coracoacromial ligament which was released. The anterior acromion was exposed and a wide anterior acromioplasty was performed completely decompressing the subacromial space. I still was having ongoing pain issues 12 months after the surgery but had full range of motion and strength. In February 2012 I had further surgery on my right shoulder due to ongoing pain issues. I had a MR arthrogram before surgery which showed there was a small lateral spur remaining despite the fact that it had been burred away on two occassions and at the timeof the operation the spur seemed fairly small. The rotator cuff however has some damage within the substance of the distal supraspinatus tendon and it was decided that the degeneration damage within the substance of the rotator cuff was causing the pain. In January 2014, I had a revision acromioplasty and cuff repair which incorporated the previous wounds and extended laterally over the shoulder. The subdeltoid bursa was quite thickened and woody. There was a very prominent anterior acromion with a large bump and the subacromial space was very tight. The prominent anterior bump and lateral bump were removed and a large generous anterior acromioplasty was performed widely decompressing the subacromial space. A segment of the rotator cuff was excised and a side to side repair was done to reattach the supraspinatus tendon. I have full 180° of abduction, 90° of glenohumeral abduction and 70°of external rotation. Good strength Grade V internal and external rotation and Grade V supraspinatus. I still have on going pain issues but have accepted that I will just have to live with these instances.
    In May 2016, I had a recurrence of shoulder pain in my left shoulder and had an Ultrasound guided rotator cuff injection and assessment that showed the subscapularis was intact but was hypoechoic and demonstrates a mild bursal surface fraying and the overlying subacromial bursa is thickened. The anterior aspect of the supraspinatus demonstrates a significant concavity along its bursal aspect suggestive of a partial thickness bursal sided tear which extends for about 2.4cm and is about 17.7m wide. The overlying bursa is thickened and echogenic. The remaining fibres of the mid and posterior supraspinatus is hypoechoic and heterogeneous consistent with tendinosis. I have had a further ultrasound and injection in September 2016 which showed that the tendons of the rotator cuff are heterogenous in appearance. There are partial thickness bursal tears involving the anterior and mid supraspinatus tendons. There is no change to the supraspinatus tendon when compared to the previous ultrasound. There is thickening of the subacromial subdeltoid bursa. I am still experiencing pain in my left shoulder.
    I have been continuing my rehabilitation program and have gone back to my exercise physiologist who has stated that there is nothing more they can do to assist me as I am doing everything they would recommend.
    What can I do next as obviously the rehabiliation I have been doing is not helping and after 9 years 10 months don’t know where to go or what to do next.

    • That was quite a read Carole. If those were my shoulders, I would basically avoid any movements at shoulder level or above. It sounds like the acromial space is a recurrent problem with you. Some people are born with a flat contour to the acromion, which makes it difficult for clearance of the RC tendons. I think that having the scapular muscles and rotator cuff muscle bellies worked on by a massage therapist on occasion might help. Light strengthening several times weekly would probably also be a good idea. I think that strengthening too often might actually be inflaming the shoulders. I would also try really hard to avoid sleeping on your sides.

  76. Hi,
    I just had my second shoulder surgery a week ago. The first one was in July. In this second one the Doctor repaired two tares . One tare was a 180 degree tare along the back of the shoulder and he other one was right underneath it. In order to fix them he put in three anchors. What causes an anchor to break or fail? Also before my surgery I was able to push my shoulder out and dislocate it. I can still do that after this surgery. Do you think by doing that I ripped out an anchor? Thanks

  77. Hi whenever I turn my arm over when my arm is in the air I hear this grinding and popping in my shoulder. What could this be? I’m 15

  78. 18 year old college baseball player, currently 25 weeks post op anterior bankart repair with 2 anchors attached to labrum. I have been lifting weights since about 17/18 weeks doing light bicep and tricep work. At about 21 weeks started doing light pulldowns and rows with cables. Have gone heavier with biceps and triceps now curling 20 lbs and haven’t had any pain. Was wondering when i can start doing chest exercises such as push ups and others? Also curious about squatting because i am not fully comfortable yet with the bar on my back and also curious about deadlifting and cleans? Thanks

    • I think that you should be cleared by now to do push-up and light chest exercises, unless if the doc has told you otherwise. I usually transition patients into push ups with a week of wall push ups, followed by a week of modified push ups, followed by regular push ups. In terms of the squatting, start with just the bar and see how the positioning feels. I also am a huge fan of smith machine squats, in my opinion the positioning is much easier to deal with.

      I have always hated dead lifting, especially heavy weight. I think that your time could be better spent, the research out there points to high sheering forces on the lumbar discs when that movement is heavily weighted. Be careful.

      • Thank you very much for the response. Also I am curious about pull ups? should they still be avoided or do you think I can begin them?

        • I would of course get them cleared by the doc, and if you are cleared I would de-weight them (like with a gravitron machine). I do tend to think that pull ups are a bit more on the risky side, if you can get by without doing them you are probably better off.

  79. Just wanted to say you are doing a fantastic job. It’s great to find this page. I’m 46 use to workout 6 times a week.3 days weights 3 days box. I use to Run 15 k every week. Loved working out until I had a slap test procedure in April 16. I have just returned to the gym this month. Feels really good. However have some concerns. I’m getting pain in my shoulder when doing a bench press, when I bring the bad down to touch my chest I feel a stretch in my shoulder. So I’ve avoided using universal bar and use machine supine press instead. I don’t do military press because I feel very vulnerable. I just do seated machine supine press. My concern is should I completely stay away from barbell bench press, barbell military press, skull crushers and preacher curl. Also can I resume regular push ups? Currently I’m working out 4 times a week. 2 box sessions just shadow boxing. No bag work as I’ve been advised that impact or contact will damage the shoulder again. The 2 weights workouts I do I do high reps and 20 reps then 15 reps then enough weight for 12 reps 3 sets. Is it safe to do chin ups using body weight or is it too much I weigh 90 kilos ? Appreciate your feedback .

    • Your ideal work out schedule is really intense for a 46 year old. I think that one of your first considerations should be to back of a bit in terms of the frequency. If it were me, I would back of to two weight sessions and two boxing days per week rather than three of each. Your tissue simply doesn’t have the same capacity to heal like it did fifteen years ago.

      Having said that, I do think that the barbell bench press is more likely to get you into trouble because it brings the shoulder into a more vulnerable end-range. I would skip it. If you have historically been a shoulder impinger, the military presses might not be worth your time either. In terms of the push-ups, start with the modified ones (knees as contact points rather than feet) and see if it is tolerated. Chin ups……meh. Can you de-weight them a bit?

      • Thank you for your speedy reply. I well and truly appreciate your input. Would you also suggest I stay away from hitting a punch bag. Or even pads for that matter. Or is this something I can build up to doing again, or I should stay away from?

        • The punching bags are definitely high-level. I would maybe start with one of those small oscillating bags that are at eye level and see how that goes. Going full force into one of those huge, weighty bags sounds like too much jarring on the shoulder. If tolerated, I would only build up to about 30-50% of your full force. I don’t think it is worth the risk to go heavier than that.

          • Once again thank so much for taking the time to answer my questions. I’m very appreciative of your advice.

  80. Hello,

    About 6 months ago during jiu jitsu my arm was hyper extended. I believe I tore several tendons possibly the subscap and infrapinatus and possibly the biceps tendon all based on how the pain presents. I have done conservative tx on my own for 6 months and about a month ago started a bar hanging protocol based off of research from Dr. Kirsch MD. Surprisingly it has got my arm to about 75% with intermittent pain several times a day. Or when I throw a ball for example. My end goal is to be able to lift moderately heavy weights at the gym while avoiding dips etc. My questions are how long after a tear is surgery still a viable option? Could I go another two years and then have surgery? Or would the tissue be too retracted and damaged for a good repair? I am also looking into stem cell treatment as an alternative but have to save the 6-8k to get it done. So that wouldn’t happen for at least another year. I have also read that rtc surgeries can be pointless. Would it still be possible to lift moderately heavy weights (avoiding pain) if only part of a tendon was attached to the bone? Will it continue to fray overtime or would the physical exercise be healthy as long as I avoid painful motions? Lastly, thanks for taking the time to read this and for your site.

    • I would see if you can do everything that you need to do or want to do without major irritation with conservative management. If you cannot, that might be a good indication that surgery could be an option. If you wait another year and have other conservative management, I don’t think that this will majorly change your overall outcome if you do have surgery. The RC might fray more over time with aggressive exercises or repetitive motions, so you should listen to what your body is telling you. Heavy weights and overhead motions might not be the best idea. Modification will probably help.

  82. Hello Dan,

    I have a type II SLAP lesion, right shoulder. I have an appointment in a few weeks to consult with a surgeon, but your ending comments give me pause.

    The *only* reason I would considering doing this surgery right now is to return to upper body resistance training. Currently I don’t overhead press, bench press (or pushups), dip, pullups, chinups (or any concentric bicep move) – those are the activities I’d like to return to. However, it sounds like even after surgery I may need to abstain from those sorts of activities anyways. Is that the case? Hard to convince myself to go through the financial and rehab burden if I’m just going to “recover” into the same state of activity I’m in. Thanks a ton!

    • You probably could return to many of those exercises after the surgery, but you wold be at more of a risk for a re-tear or other shoulder problems. If you are not having pain with your workouts now, it may not be worth the annoyance of surgery. I would have a good PT evaluate the shoulder to get a better sense of what you are capable of doing now without surgical intervention.

  83. hi I am one week post-op repair of complete L shaped tear pf supraspinatus tendon and biceps tenodesis. I have been walking but wondered if there= are any safe options for working out on a cardio machine (like elliptical) that I can use with no arm activity other than holding on with non operated arm) of couse, I am iwearing my shoulder sling at all times!

  84. i am 8 weeks post surgery, full supra and infra tears, had 5 sutures inserted. I have just begun phase 1 and 2 rehab. I have also started squating with a safety squat bar. is this safe? or too soon?

  85. Sir i had a shoulder dislocation problem but 1 year ago i undergo through a shoulder bankart lession surgery can i do weight training again without harming my shoulder again plz help sir
    And what should i have to do for full range of motion

    • If it was one year ago you should be okay to start with LIGHT weight training. Try to build up the strength gradually and to tolerance. I would also start with the more simple movements. No pull ups, dips, or military presses to start with. Make sure that the doctor is fine with you starting weight training.

  86. I had arthroscopic surgery for a complete tear of right rotator cuff on 10/13/2016. I am 70. I have been going to PTregularly. I would like to return to my little job in a home where there are pregnant women and babies. Job may require me to life a baby or two…at present there are three…one baby is nearly 20 pounds.My boss says I cannot return until there are no more weight restrictions. I recall being told to lift nothing over 2 pounds for the first week or so, them nothing over 5 pounds. there is nothing written about what weight limit is at this time. Can I return to work?

    Also I have been unable to sleep in a prone position since surgery. I have a recliner “zero gravity chair I have been sleeping in since surgery. I try every few says or so to return to my bed but it is painful in an position. I have tried using pillows and a wedge but resort to using the “Electric Chair” as I so fondly refer to it.

    • I would guess that the weight restrictions would be less problematic at about 16 weeks, providing that the rehab has gone well. As long as the babies are kept close to your body, and there is no lifting above shoulder level, you should ultimately be able to return. Part of your rehab should include lifting objects that are close to the size and shape of the babies. I would have your strength and capabilities tested by the PT at about 16 weeks to see where you are.

      I would try slightly different positioning every week or so to see if the sleeping comfort is returning. That too can take some time.

  87. Hello,
    I am having lots of elbow and lower arm pain that radiates down to my wrist. This seems to be happening all throughout the day. I am currently 7 weeks post op surgerh and am 15 years old

    • If you had to wear a sling for a significant amount of time, this could cause the pain that you describe. Sleeping position could also contribute to this, especially if the elbow is flexed. I would also minimize texting for the time being.

      Make sure that the doc knows about this as well!

  88. Hello, i am 4 weeks after a latarjet procedure and a bankart repair. i started doing passive range of motion last week, and it really hurts. I do trust my PT but im wondering if this huge pain during passive range of motion is normal. My shoulder is really stiff. Thank you.

  89. I had rotator cuff surgery 9 weeks ago. Started passive PT at week 2. I have full range of motion with passive motion, using stick and pulley system. However I can’t lift my arm past 90 degrees unassisted and that is painful. I had full range of motion before surgery. I am concerned I will not be able to lift my arm over my head or all the way out to the side. Other people at PT with similar surgery are already at 180 degrees. I had a bad childhood injury and arm was casted for 2 years and my elbow doesn’t straighten. I had 2 anchors and stitches during surgery. Any advice on how to get that range of motion back or how long it takes people? I do my PT exercises several times a day with no improvement.

    • The strength required to lift unassisted overhead is going to take many months to get back. One little step at a time. As long as you are making small improvements from week to week you are on course. This will require basic light strengthening over time, under the supervision of the doc and the PT. Most protocols don’t even really allow for strengthening until at least 12 weeks, so this is not yet a reason for concern.

  90. I am having a laterjet surgery. Haven’t been able to find many reviews on it. Have already had 2 other shoulder surgeries that did not work. I will just be walking and my shoulder will dislocated. So guess I’m asking what the post op is like. Kind of the time frame I’m looking at.

  91. I had a latarjet surgery 7 weeks ago and a bankart repair. My surgeon used buttons instead of screws. I would like to know the difference please, since my surgeon doesnt talk much (but he is a great one tho.) I would also like to know if the latarjet procedure is effective, are the buttons hard to break or not?
    I feel my shoulder stable even tho i lost so much muscle around the shoulder, but sometimes my shoulder cracks,no pain involved nor sound, it just cracks sometimes, should i be concerned?
    Thank you.

    • The shoulder is inclined to crack and pop if there is weakness in the rotator cuff. I wouldn’t be too concerned about that. It should slowly abate as the RC and scapular muscles get stronger. Surgeons are often trained with slightly different techniques, I have heard of both buttons and screws used for that procedure. It is probably a matter of preference of the surgeon.

      • Thank You for the fast reply. It’s very kind of you that you answer people’s questions even tho you dont gain anything from it.

  92. Hello Doc, i had a latarjet surgery on my left shoulder. I dislocated my shoulder 3 times before surgery.
    I read some of your previous answers that crack/pop after surgery is normal, but i am a bit worried about the crack/pop i had today. I am 5 weeks post o, im kinda sick and when i coughed my shoulder had a big crack/pop, no pain involved and i didnt hear anything either, i just felt a bigger pop than usual. I lost a big amount of volume on my shoulder too after surgery (muscle). Is this something serious? have i break the latarjet procedure?
    Thank You doc

    • I have never heard of that happening from a cough or a sneeze. It would be quite painful if something did dislodge. I would stick to the post-operatvie protocol and tell the PT and doc about your concerns.

  93. Hi my question is tomorrow I have surgery 03-05-17 I have a dislocated ac class three I believe.. so the surgeon wants to put a wire through both bones and pull it tight.. I’m okay with that but will the let my AC joint heal? And he also said the wire will stay there forever… But I read some people have had it break and tear other ligaments and veins ext.. what is your option on this matter? Thanks again for hearing me out.

    • That will likely immobilize the AC joint and allow it to heal. You will be left with a tight joint, which might be a small issue because it is supposed to move a bit when you are lifting your arm overhead. I would rather have a tight AC joint than an AC joint that is permanently out of place and too loose. If you are an overhead athlete (throwing, pitching etc.) you might want to consider having the hardware removed at some point.

  94. My friend had a dislocation while snowboarding came out 7-8 tines after during a 2 year period, he just got is surgery 2 months ago will he be able to come back wakeboarding after? Its a sport that requierer fast and quick arms movement is it risky?

  95. I had three surgeries on one shoulder in Dec 2016. Bone spur, partial torn rotator and torn ligament to bicep. Since that surgery I have gained over 20 lbs. I lived in the gym and have really backed off. Its been almost 4 months. Can I start hitting the weights again and if so, what should I avoid. I promised myself NO MORE HEAVY LIFTING. I am 53 and just want to look great

    • It is too early to be doing heavy resistance given your surgery date of December 2016. I would get the final okay from the doc to start weight training. I would avoid anything that you feel is causing pain. The typical culprits are inclined presses, dips, preacher curls, pull ups. I would also opt for a straight bar bench press rather than dumbells.

  96. My shoulder had dislocated several likey abt 7to 8 times and I m worried abt it , is surgery is the only option for it??

    • If it has dislocated that many times, I would say that you should at least get a surgeon’s opinion on the matter. I think that the gold standard of decision making in regards to dislocations is this, “If you are dislocating once a year or more, surgery is a good idea”.

  97. What do you think about the time frame for boxing. I want to resume the recreational class I used to take, but also do not want to hurt my shoulder again. I am one year out from a repair. Thank you.

    • At one year out you should technically be able to try some of those movements. I would start VERY basic, no hard forces, just simulate the movements and slowly work your way up. It does also go without saying that you should be doing a shoulder and scapular exercise routine. If you aren’t, start one under someone who has some knowledge (probably your PT).

  98. I had reverse total shoulder surgery (after 2 other surgeries to repair torn rotator cuff) November 17th 2016. I am doing well with most activities although I still have pain if I try to do to much. My question is can I start using any type of exercise machines to get rid of weight gain and flab I have put on? I worked as a paint line loader so was in great shape but haven’t worked since October 2016 and I am 61, good health except for weight gain. HELP PLEASE

    • Those shoulder replacements take quite a while to recover from, it is still a bit early for you to be doing heavy exercises at the gym. In terms of lower extremity stuff, I think that this would not be a problem. The upper extremity exercises need to be started very light, and with the okay from the doc / PT.

  99. Hi Dan, I had a bankart repair with capsular shift on my left shoulder March 01, 2016 so over a year ago. My physio and surgeon cleared me to start lifting weights at 11 weeks post op. I lifted light and progressed quick but I feel it might have hindered me since I had surgery on the right shoulder this past January. I now have sharp pain in my left from moving across my body and some overhead. My physio and surgeon think it’s impingement and inflammation from over compensation. Any ideas? I haven’t been to the gym since the operation on my right.

      • Saw the surgeon and he said it was impingement with inflammation. He gave me a cortisone shot and I’ve been feeling a lot better. How many weeks in after a bankart with remplissage to lift light weight? I’m 13 weeks out and my phsyio says he wants to be cautious.

  100. Hi Dan
    I recently had surgery to repair my bicep tendon 80 % intra articular bicep tendon tear and a full thickness repair of my supraspinatus, my subscabularis and infraspinatus was normal. I also had a acromioplasty to remove enough acromial bone to make a flat type 1 configuration. This took place on March 13, 2017. So I am approaching week 6 of my recovery. At this point I am instructed to lose the sling and start some active physical therapy. I am 58 year old active white male. At what point can I begin to ride a recumbent bike and start some lower body leg training to include lunges without weight, leg extensions, flexions and leg presses on a machine?

    • As long as the doc gives his or her approval, I don’t see why you couldn’t start any of those at this point. The lunges might be a bit risky just because of possible balance / fall risks, but the other exercises sound safe enough.

      • Thank you for the response. I will check with my doctor if this would be ok. Which weightlifting exercises should I avoid in the future to prevent another rotator cuff and bicep tendon tear?

  101. I had torn rotator, labrum, and bicep tendon arthroscopic surgery on March 31, 2017. The injuries, along with a dislocated shoulder, happened while lifting weights a week earlier.

    So far-I have been in an immobilizer-only taking my arm out every hour or so to help with stiffness.

    I started walking at a slow pace a week after surgery…1.5-2 miles

    I had a post op visit with my ortho at 2 weeks
    Scheduled to begin PT on May 8th.

    I am a 57 year old active female-used to working out with weights, cardio, biking, kayaking, swimming, paddle boarding etc

    I know I am in for the long haul-but already frustrated with my loss of muscle and tone.

    Realistically-when should I be able to resume some light weight lifting and is biking in my future?

    Thank You!

  102. Hii Doc,
    i had a surgery for labrum tear and its been 4 month, I started running and i still feel the pain in my shoulder. The pain is not extreme or unbearable, should I continue running or should i stop and continue running next month.

  103. One month out of bicep tenodesis surgery. About how long after can a person start lifting weights and playing sports again such as baseball? I was told that the tenodesis is a relatively new surgery and that having requires less time in a sling and quicker recovery time.

    • It takes six weeks for the anchors to heal into place, and probably another 6-12 weeks to gradually build back strength. Throwing is an extremely demanding on the shoulder, so I would take it very slowly.

  104. Hi Dan. I am 9 weeks post-op RCR. Everywhere I read has strengthening starting at 12 weeks, however, the PT started doing strengthening at the end of the 7 weeks. Is this too early? This is my second surgery, (1st surgery RCR failed but Bankhart for Labrum was successful). Should I be taking a more conservative approach with my recovery considering this, or just in general? I really want my arm to heal properly and I am not concerned with the speed of recovery. I have had excellent range of motion and minimal pain up until 7 weeks, doctor/PT very impressed. Ever since I started strengthening I have had moderate soreness/pain even at rest. I am already doing standing therband manuvers and sit-down rows on weight machine (40lbs). Should I be waiting until around 12weeks before beginning strengthening?

  105. Hi Dan! I had surgery March 14/17. I am 57 year old female. The procedure performed on my dominant arm was: arthroscopy, bursectony, debridement, decompression, arthroscopic biceps, tenetomy & arthroscopic double rotator cuff repair. My work involves a lot of lifting of boxes up to 50 lbs. how long should it take for me to recuperate & be able to lift this much weight again?

    • That was a lot of work done. I would gather at least 4 months to get some strength back, and even then you would have to start with light weight. You would probably have to rely on the other arm more heavily when you are first back at work.

  106. Hi Dan.

    I haven’t yet had surgery but have seen a surgeon and have one scheduled for June 8th. No MRI was done, but my physio program was a few months and seemed unsuccessful, however, I also don’t think I gave it proper rest while I did physio as I kept playing volleyball.

    My shoulder has subluxated about 20 times in the past year. I believe I injured something playing soccer, and then when I played volleyball a few weeks later, the spiking motion would cause it to subluxate, then I rotate it externally and it just clicks back into socket with minimal pain and no real discomfort or inflammation. It is definitely not full dislocations. Also happens sometimes when I am asleep, I wake up and shoulder is subluxated.

    I also compete in full contact wrestling and jiu-jitsu but I have no issues with the shoulder during those sports besides slightly lessened flexibility,no pain and no subluxations even when fully flexed going 100% lifting bodies or hand-fighting or having it bent behind my body. When I saw the surgeon he recommended an arthroscopic surgery, now I feel like these may be a bit outdated, and am also worried about potential complications or failed surgery making this worse. Perhaps he grinds some bone, or takes out some tissue that makes it worse, when it is not too bad right now and may be able to tighten it up with proper rest and Physio. And from what I have heard there is not a high % chance to come out of surgery with the same or greater mobility, ROM, strength then one had before. Thoughts?

    • If the shoulder dislocates or subluxes with that amount of frequency, it is probably worth your while to have it stabilized if you have any notions of playing volleyball. I would also get a second opinion about the type of surgery that would be used. A capsular tightening might be all that is needed, but it depends on what the shoulder looks like.

      • Hi again Dan,

        forgot to mention Im 25 years old, nad shoulder would sublux when asleep sometimes. PT said may be due to my muscles relaxing during deep sleep and ligaments being stretched so unable to hold it by thenself. Months ago my PT said that my humeral head was loose in the socket and thought Physio for rotator cuff and upper back would strengthen and advised to avoid surgery. I failed to rest initially, but now in the past 2 months have rested and can now play volleyball again (not 100%) and feel like the shoulder has gotten stronger and healed a fair bit. I recall my physio saying that ligaments don’t tighten back up if loosened, is this accurate? Would an MRI show that ligaments perhaps are loosened and need to be tightened or a capsular tightening is required perhaps as you suggested? I can do a private one they are just pricey. I have very minimal pain with everything, just a bit when my arm is chicken winged out or behind my back or coming downwards from overhead.. Unfortunately in Canada second opinions are not really allowed (was told waste of taxpayer $) so I am not really able to see a second surgeon for advice, The surgeon I saw is “upper & lower extremity reconstruction sport & athroscopy” Dr which is perhaps why he recommended the scope, and also advised I could get an MRI but was not necessary. I am young, dedicated to proper diet, physio, etc, is there potential to come back stronger after a surgery with increased ROM, strength, function? Or will it always be worse, subject to arthritis, pains and aches, recurrences, failures etc. Also is a capsular tightening done through a scope, or is that a different surgery type? Is the scope outdated in 2017 or is it fairly successful and still used frequently? I know there are stem cell injections that athletes are using now a days for a variety of joint issues. Are there any other tests or anything I can do at home to know what is my best course of action? I know some of these are general questions and you have limited information, but I appreciate your recommendations and time to answer my questions.

        BTW 0 surgeries or broken bones in my life, but my kneecap used to sublux from a wrestling injury for almost 10 years about once every 2 months, and I have done extensive VMO strengthing of the quad the past couple years which has made that way less frequent.

        • Stretched out ligaments do indeed stay that way. This is why it is necessary as a conservative measure to strengthen all of the muscles that surround the joint.

          When you have a surgery to mechanically stabilize the shoulder, you will probably have a slight permanent loss of external rotation, which is actually a good thing because that tightness would be keeping you from dislocation.

          If the capsular tightening can be done with an arthroscopic, all the better because that is less invasive.

  107. How is the scapular strength doing? I would get over one of those exercise balls and hit the “i’s”, “t’s”, and “y’s” (check out our exercise videos, listing under shoulder). I have found that the stronger those muscles get the less the end range overhead hurts. I would skip the overhead stuff for the time being and only occasionally just do the range with minimal weight only to see how it is doing.

  108. So I have had a labrum repair just over 5 months ago now and everything seems to be on track. My physio has had me doing a gym program for about 1.5-2 months now and have since been discharged by my surgeon and am no longer required to see my physio. My question is how log should I keep this current program and when would it be acceptable to start heavier lifting? All I’m looking for is hypertrophy no 1rms or anything crazy. Since surgery I have lost a heap of muscle tissue being inactive and would like to start regaining. Since I am not seeing my surgeon or physio anymore I have no idea when to increase or what to do.

    Also how long roughly before I would be able to start doing shoulder presses (I would be doing it on a machine not free weighted) even if it starts of extremely light I don’t mind. I just don’t want to train some muscle groups and leave out others because then it would form unevenly.

    Thank you

    • At five months, provided that everything is going quite well, you could probably start adding a little bit of weight to your gym routine. Listen to what your body is telling you though, you may find that you need to take several days off in between sessions. If you are concerned about the routine, run it by the PT.

      The shoulder pressing thing should probably wait until 6-7 months, and as you said, extremely light weight to start and a slow ramp up.

  109. Had slap 2 labreal tear surgery on Feb 7 2017 ..bone spurs removed and tendonitis scraped and rotator cuff debridement. 3 Annchors were put in my shoulder.. i had .severe pain after 3 weeks to 1 month, scheduled mri. 2 of the 3 anchors were tore out and tendonitis was back in full…2nd surgery was done on june 6 2017. My entire upper arm is severely bruised and there was none after 1st surgery…2 of the 3 incisions look infected and are swollen…dr says my next step is pain management bc nothing else can be done??? Is this true

    • Geeze. I am not a doctor, but if there is an infection you should maybe be on anti-biotics? I would not do any real exercise for 4-6 weeks from the surgical date. I would find a really good PT and have it evaluated at about 4-6 weeks post op. You are going to need some hands-on guidance with this.

  110. That recovery will take upwards of a year with a very slow return to weight lifting. Please make sure that you follow the doctor’s protocol. I would guess that you will not be able to do weights with the arm until at least 4 months after the surgery.

  111. hi dan,
    i just underwent bankart repair and SLAP repair one week ago and I am a crossfit athlete and outdoorsman. can i start walking on treadmill with 15 degree inclination at low to moderate speed? will it affect my recovery of my right ahoulder?

    regards,
    nasz

    • Walking on a treadmill should be okay, but a high incline angle and speed require an arm-pumpong motion. That is not a good idea at this point in time. If I needed a cardio fix I would get on a recumbent bicycle and increase the resistance levels.

  112. Hello I had a bankart lesion repair after subluxing my shoulder 4 times to finally dislocating it once through boxing. I was fine weight training or lifting but any time I threw a right hand it would go. Anyway after a couple of years I had the operation as I wanted to carry on boxing. But it’s only been 3 months since my operation and I think I’ve damaged it the repair. Would I know If I’ve damaged it again ??

    • Well, if it is subluxing again that would be a sign. If there is sharp, localized pain in the shoulder it would be worth getting it checked out by the PT or the orthopedist. I would of course stop any intense activity involving the shoulder in the mean time. Three months by the way is not that log after the surgery, a certain amount of pain with increases in activity is to be expected.

  113. Hi!
    Within this past year i have had two shoulder surgeries both on the same arm. they have been to fix instability and the second one (in november) was to fix two tears and put a bone graft in. my shoulder is still extremely unstable, i can move it in and out of socket, and i am still experiencing a lot of pain. do you have any idea what could be causing this? do you think my next step would be a shoulder replacement? i am only 15

    • I would guess that a shoulder replacement is not an option, you are way too young to have something like that done. The annoying thing here is the amount of instability you have will prevent you from using the shoulder to do higher level activities (throwing, pull ups, climbing, etc.). I would keep the arm from going overhead at all times if possible. I would also make sure that you have a gentle muscle stabilization routine that you do weekly. Your PT should be able to get a list for you…..nothing too crazy. Don’t move it in and out of the socket by yourself, that is probably not helping things. I would expect the pain to slowly subside over months, it probably just needs the right environment to do so. You are going to have to be super patient about this.

  114. Doc,

    I am 18 and I just had 2 shoulder surgeries, one on each shoulder. My left shoulder is at 12 weeks from surgery and it was a bankart repair using 5 anchors. My right shoulder is at 17 weeks from the date of surgery and that was a SLAP tear repair using 3 anchors. The left shoulder was injured playing off-season lacrosse and then I injured my right shoulder during hockey season and continued to play with both shoulders injured until I got the surgeries. My question is, when do you think I will be able to do excersises such as planks, bench press, squats, cleans, etc? I have been doing physical therapy for 6 weeks now and have started doing light upper body excersises with weights ranging from 1-8 pounds. Also, do you think my shoulders will make a full recovery and should I be worried if reinjuring them in this upcoming hockey season? I’ve had no pain since getting out of my slings 4 weeks after each respected surgery.

    • Strengthening usually will not come until at least 12 weeks post-op. It sounds like you are already on track in terms of strengthening. The higher level stuff should be phased in slowly after 16-20 weeks, and with very light weight only. I am guessing that your shoulders are naturally very lax. This is going to be a problem for you long-term with sports. If you are only 18 and you have trashed both shoulders already, you are going to have a day of reckoning when you are going to have to decide if these sports are worth it to you. You definitely are more susceptible to further injuries in the shoulders, so at the very minimum you should be keeping up with a stabilization routine.

  115. Hmmm. I would see a doc or a PT about this. It sounds like the strength of certain muscles may not be up to speed yet. A good PT should be able to look at your shoulder and shoulder blade and determine what needs to be strengthened.

  118. Hi dan
    I had a car accident in2011 in which my shoulder got fractured ,it was operated and there are 2 scews in my shoulder..i m running from last 3 months around 5 kms..my weight is 108..and for tightness in body i want to lift weight nd do some dips etc,but i have pain also in my shoulder and sometimes i feel that my shoulder got locked or something like that..so plz tell me what to do to lift weight..

    • Stay away from dips and inclined presses. They tend to place the rotator cuff tendons in a vulnerable place. You are probably better off with the types of exercises that you can do leaning over a ball (check out our shoulder exercises online). I also like lat pulldowns and rows. If you want to work out the chest I would do it with a straight bar rather than dumbbells as the straight bar limits your range a bit.

    • Hello Doctor,
      20 days back i met with a car accident and fractured my left femur and humerus. Underwent 2 surgeries for femur and humerus. Description of humerus fracture : comminuted displaced fracture of greater tuberosity, upper portion of lesser tuberosity and adjacent humerus head. Fractured fragments are displaced posteriorly and medially. Rotator cuff muscles are attached to the fracture fragments. Humerus is displaced superiorly and anteriorly.

      One plate with 6 screws are placed in the shoulder. Just wanted to know the approximate duration for the shoulder to recover and will i ever be able to join a gym and workout. Thanks.

  119. I spent much time reviewing some of Dr. Sahrmann’s book but my remaining question is how does one keep a hand on the humeral head when that hand is necessary to push the operated side towards the table top? My PT told me that without another person assisting, I should retract my scapula (rhomboids) at the same time to counter the anterior glide of the humeral head. Plz comment.

    • The shoulder that is being rotated moves into an “active” internal rotation while the other hand is securing the head of the humerus in an anterior to posterior direction. I will typically insturct patients to try to gently reach the hand towards the table while maintaining 90° of elbow flexion. It is preferable of course if you have someone else to apply the pressure and a passive stretch.

      You could also try the prone internal rotation exercise in Dr. Sahrmann;s book. The table and a towel roll is used as a passive block to anterior humeral head translation.

  120. Hello,
    I was a competitive powerlifter and had a complete rupture of my supraspinatus.

    Had it repaired and also had a bicep tenodesis performed.

    I have decided to change my focus for a while and get into shape with boxing/kickboxing.

    How many months after surgery before I even consider boxing (as a rough guideline)

    Thanks

    • That would not be my first choice of a new activity given your repair and the jarring nature of punching.

      At least 4-6 months. You would have to start very, very gently with light shadow boxing (no impacts) and listen to what your body is telling you. I would also have your PT check the strength of the serratus anterior, middle traps, low traps, and rotator cuff prior to starting. Everything needs to be in order.

  121. Hi Dan,
    I have corresponded with you previously after my arthroscopic rotator cuff repair and biceps tenodesis which occurred June 14 (19 weeks ago)–(age 65, retired MD, good health). My orthopedist started my passive rehab at week 4, and PT moved me to active assisted about week 8 and to some active gradually about week 12-13 with T band and other resistive exercises about week 15-16. I have seen steady improvement EXCEPT for notable weakness in my and anterior and lateral deltoid which is a source of distress as I cannot resist any force placed downward on my arm from 90 degree horizontal plane (after elevating or abducting to that point). I also pointed out to my PT that the only obstacle to an easy active elevation or abduction of my arm to vertical position above my head seems to be deltoid weakness, as we determined that I have decent biceps, triceps, internal and external rotator, and extensor strength (with only ROM limitation being incomplete internal rotation despite modified sleeper stretch with intermittent counter resistance to reach capsular end point. I have just begun some VERY light dumbbell exercises in supine or slight elevated position to stimulate the anterior deltoid but am at a loss as to how to start similar program for the lateral deltoid weakness without standing and abducting which causes my shoulder to hike up. Forgive this long presentation, but do you have any suggestions? Thanks!

    • Hmmmm. I don’t think that the deltoid is your only problem. If the head of the humerus is hiking upwards when you are abducting, the first culprit is usually lack of strength in the supraspinatus. The supraspinatus is supposed to depress the head of the humerus and allow appropriate gliding with elevation type motions that you describe.

      I see tons of surgical repairs that have this problem. I will have them practice abduction / scaption while facing a mirror, going only through as much range as can be done without humeral head elevation. I also find it useful to have the patients practice humeral head depression while having the patient seated with the elbow and forearm resting on a table. I will often place my hand in the armpit and ask the patient to gently “press the humeral head down into my hand”.

      • The shoulder does not hike up until just below horizontal plan during elevation or abduction and when it does, it appears to be the entire shoulder—scapula/acromion accompanied by compensatory contraction of trapezius. When I get to horizontal, as long as I have momentum I can get to vertical BUT if I stop at 90 degrees and try to continue, I don’t have the strength to move on up to vertical (180 degrees) which I presume depends on trap and deltoid. Since this occurs in flexion (elevation) and abduction, I assumed it was mostly deltoid. The least pressure on my arm while held straight out in front or to the side causes my arm to give way. I did have an acromioplasty and distal clavicle resection as well.

  122. Hi dear sir.
    3 years back I have done my shoulder operation(which was dislocation problem) know am getting little pain their which am afraid to do gym, suggest me should I start gym or any exercise for that .

    • I would start with very simple exercises that do not involve bringing the arms overhead. There are exercises that involve using resistance rubber bands for the rotator cuff, I would guess that those would be useful as well (internal rotation for example). You can find some good ideas by googling “rotator cuff stabilization”. As always, make sure that the doctor is fine with you starting these exercises.

  123. Sir, 2 months ago I was diagnosed with brachial plexopathy and I couldn’t move my arms for over 1 month. Now I have totally recovered from it but now I have realised I can’t do and pull ups and it’s been over a month since my neurologist gave me a 5/5 power rating. Can you please help me out with this

    • Motor recovery will in many cases take much longer than 2 months with a brachial plexopathy. My guess is that you will be able to return to the pull ups, but it may take another several months to build sufficient strength. I would work on exercises in the mean time that address the lats, biceps, etc. to build the muscles gradually. Allow for at least one day of rest in between sessions to allow recovery.

  124. I had rotator cuff surgery in june still cant pick up 3 pounds up to shoulder height 40 times in workharding program when will i be able to do jt and why wont my shoulder let me lift 3 pounds

    • It does depend on a bunch of factors. It could have been a really big tear, which takes a lot of time to rehab. Sometimes it also depends on your age and previous activity level. Surgical outcomes are not as great for the over-forty crowd. Another factor could be if the rotator cuff had been completely torn for a long period of time prior to surgery. This also adds to time. All in all, this can take up to a year to get a good amount of function back.

  125. Hi Dan!

    I am 23 . I have a supraspinatus partial tear in my left shoulder . my shoulder pops when i lift it over the head sometimes with pain. i counsulted a doc and i was told to get a shoulder arthroscopy with acromioplasty. i am scheduled for rotator cuff surgery in coming weeks.

    i am worried if i can get back to my regular weight lifting after the surgery , given that i had an excellent rehab..so my concern is will i be able to lift weights that i used to lift before i had this injury?

    Thanks
    Gautam

    • If your supraspinatus was torn, it might have come from repetitive overhead motion. I would adjust your weight lifting routine (once you are totally recovered) to not include the overhead exercises. You can still do tons of things at the gym. It is a good idea to collaborate with your PT about this once the time comes.

  126. Hi Dan,

    Firstly, fantastic web site and thank you so much for the information you provide!

    I had RC surgery 2 weeks ago, full tear of supraspinatus (non dominant side) re-attached and subacromial decompression. I’m late 40s, male, very active in sports prior to surgery. I’ve been told to start PT at 4 weeks, after using the sling during sleep and when out and about for 4 weeks.

    After the procedure, I learnt that one of the small ligaments is removed during this surgery and I’m wondering how this contributes to long term shoulder stability/instability?

    My main question.. I enjoy a lot of body weight training like push-ups, handstands (painstakingly developed with years of work), muscle-ups and wondering if I’ll still be able to do these things in say 6-12 months, when fully healed? Is the repaired tendon able to support body weight?

    thank you for any information, John

    • Forgot to add, the tear was due to an accident.. I fell and landed very hard on my arm, reached out behind me, shoving my shoulder forward. It was re-attached 6 days after the accident.

    • If a ligament was removed, there might be slightly less stability in the shoulder?

      In terms of the exercises that you mention, in my humble opinion it is time for you to re-evaluate what you are doing. I would never tell you to stop going to the gym……..but handstands and muscle ups are really no longer a good idea for your shoulder. I would find a PT who is willing to go over your routine with detail and come to a sensible alternative list of exercises. I do think that if you try to imitate exactly what you were doing before there is an increased risk of re-injury.

      • Thank you Dan for the reply!

        I guess I felt this would be the answer. I’ve had fun doing those exercises over the years but going forward don’t want to do anything that can increase the risk of injuring/re-inuring myself or place any undue stress on my shoulder.. I don’t want to go through this again.

        Regarding supraspinatus, I’m struggling a bit to understand just what it does, and what would positions would stress it in the future. Is it’s role just to lift the arm forward/sideways? Would body-weight exercises for core, where the arm is held straight, like the ‘L-Sit’, still place high stress on it? Also regular push-ups, even though the body is horizontal the arm is still lifted forward?

        thank you again for the reply and for your website!

        John

  127. I am about 12 weeks out from labrum surgery. I helped my 60 lb dog into the tub and have been having sharp pain since then. The pain sometimes goes from the shoulder through the tricep and into the fingers. How likely is it that I re-tore my shoudler?

    • At twelve weeks, unlikely. It sounds like a muscular strain with some stretch to radial nerve maybe? I would take it easy for the next several days and let the doc know what happened. Don’t freak out, these things happen often.

  128. Great Website. I am 6 months out on having Total shoulder replacement. I have joined a cross fit gym and have modified many of the workouts. I’ve been working out 4-5 times a week for the last 7 weeks. Can I safely bench press and what about doing overhead dumb bell presses? I closely monitor the amount of weight and have never felt any pain only tightness in the biceps. My surgeon has said be careful of the weight. My fear is that I will loosen the hardware. Is this a real fear and how much do you worry and then become incapacitated.
    I should add I am 68 and determined to remain quite active.

    • Wow. I am both impressed and concerned at the same time. Cross Fit as you know is pretty “hard core” in that the exercises can be quite intense. In my clinical practice I have found that shoulder replacements are a last-ditch effort to eliminate shoulder pain, and restore some range of motion. It is my understanding that the prosthesis used will not allow for full ranges of motion. I think that you should be very careful about what ranges of motion you are putting that shoulder in. If it were me, I would skip anything that is overhead and I would keep everything light. Do not let any coach try to convince you otherwise.

      I applaud your determination to stay active!

      • Thank you for your advise, I will take it very seriously. I do have many of the exercises modified to my limitations. This has been very informative and will certainly change the way I approach attempting to rebuild muscle in my arm and shoulder. The take away for me is – less weight more reps (all within reason).

  129. Thank you so much for the quick detailed reply sir, you are truly a kind hearted doctor.

    Just have few more questions after I read the reply:

    1. How long (roughly) will it take for me to be able to do steady pushups and pullup exercises if i say I will start diligent rehab day by day from now?

    2. Do you recommend me to take another MRI scan for my shoulder before I restart my rehab? (I still have muscle and aching pain even after daily office activities which makes me worry about whether the bankart repair got displaced)

    3. Is there lower chance for patients who nixed the rehab like i did to regain full shoulder condition compared to those who kept on their rehab since day 1?

    Thank you again sir.

  130. Dan–I underwent Arthroscopic RC repair, with Biceps tenodesis. !5 years ago, I had an MRI that showed a full thickness tear of the RC. The day after Thanksgiving 2017, I was putting suitcases into my truck, one slipped and I tried to “muscle” it back in. Needless to say, my wife heard the string of 4 letter words as tried to shake it off. I went to my Orthopod, we started conservative, but the lack of strength and ability to lift my arm was limiting. I am a CRNA–anesthetist,one that puts people to sleep for surgery–and have started passive Rehab the first of Feb. 2018. They are already calling me to come back to work, on “light duty”. The research I have done, and talking with MD and PT, says 3-6 months after resistance workouts have begun. the risk of re-injury is greatest at 3-5 months. My work requires the ability to lift at least 50#,turn awkwardly in my limited work space at the head of the bed, and lift and retrieve objects over my head. I am 63 years old, and have no desire to re-injure my dominate arm. My Md is on my side, to a point–they are working on him to let me do “lite duty”. Your thoughts on my being able to return to my full duties as a nurse, protect my patients and myself, will be appreciated. I have the majority of your responses to others, and find them insightful and spot on. Thanks Ron

    • Well, I think that the answer to this question really hinges upon what is exactly going on in the shoulder. If you have no strength in your arm and you cannot lift your shoulder, there is a real possibility that there is a full tear of the supraspinatus tendon again. I would usually expect to see significant elevation of the humeral head with attempted overhead motions in these cases. It’s usually pretty obvious to an observer.

      I would do the conservative route for a couple of months and see where you are. Partial tears can be built up in many cases to acceptable functional levels. If it were me I would also get the diagnostic test done to get a more clear picture. In terms of job requirements, that is a tough one to give advice on. It does sound like it is not that plausible for you at this time to lift 50 pounds. I would push for light duty for at least one month and see how the rehab goes. Good luck with this!

  131. Hi dan. I had an Latterjet procedure done almost 2 years ago. As a result, ive lost a lot of muscle as many people keep reminding me. I want to go to the gym and start getting my muscle back but, i have really no idea whats okay and what is not, for example, are pull ups okay? Can i hit a punching bag? Bench press? I have a million quesiirns about which exercises are okay and which ones i should stay away from. I guess just a general rule of thumb to give me a better understanding of what i can do as i do not want to harm my shoulder. Id love and really appreciate your professional opinion.

    • I would start very easy. Scapular work over an exercise ball, light lat pulldowns, cable work for internal and external rotation are all decent ideas. I would wait on the more “hard core” stuff like pull ups and punching bags until you have done a month or so of strengthening.

  132. Hi Dan
    My shoulder was dislocated twice playing sport. I damged it enough to have open stabilazation surgery and laberal repair.
    I think its called anterior and posterior repair. So i have a 2-3 inch scar on the front of shoulder and also at the back.
    Surgeon also said he had to fill the bone where i kept fracturing parts in the trauma.
    Its been just over 6 months i have a had a winged scapula throughout recovery.. which is improving with constant rehab and Pilates and range of movement and pain is improving. Im 30 and been back at gym for 7 weeks. Im starting to feel comfortable lifting heavy bench press and only recently been able to do light weight for shoulder press. All other exercises seem to be fine and strength ia starting to feel good. Is there any advice you can give me as im keen to keep lifting heavier and getting stronger .. hopefully returning playing Australian rules football again
    Thanks

    • I am going to assume here that you dislocated the shoulder in the forward direction??? You need to ask your PT about this because the exercise choices would be shaped by how you dislocated. In general, I would not place undo stress on the shoulder joint with heavy weights. Two such examples would be dips and bench pressing with dumb bells. The dumb bells in particular will place your shoulder in a stressed position when you are at the bottom most position or when you are trying to throw the weights off to the side when you are done.

  133. I am a 28 year old athlete and ER nurse that bikes, climbs and lifts for those sports. Last June I fell off my mountain bike and had extreme pain, 7 months later after PT and cortisone it was found on MRI I had a 2.5 cm full supraspinatus tear with 2cm of retraction. My shoulder pain is almost gone now prior to surgery and I have almost full ROM, but it will be bothered if I lift wrong or fall on it skiing. My questions are:

    1. If I have full ROM and decreased pain but still plan on mountain biking and climbing do I need surgery?
    2. Surgery is scheduled in 3 weeks, when will I likely be able to get back to mountain biking and at least bearing weight on that arm for workouts like planks and elevated push ups? Also when could I possibly get back to work without “light duty” in an ER setting (ie. CPR compressions, moving patients, and catching patients falling)?

    Thank you!

    • The climbing thing might not work out long term with a large supraspinatus tear, and the physicality of your job might also be a problem. I think that having the surgery is probably a good idea.

      Post-op, mountain biking and bearing weight will probably not be cleared for at least 4 months. The light duty restriction will probably be in effect until 4-6 months??

  134. Hello,

    Should I be ok snowboarding (no big hills). I’m 5 months post op for bone spur removal and posterior caposuloraphy

    • I think that you probably could handle that, but get the doctor’s permission first. I would also consider getting one of those neoprene sport braces that provides a bit of support for the shoulder.

  135. Hey I have a question regarding my torn Labrum. Do you think it is at all possible for me to be sprinting in track 9 weeks after my surgery?? Also what about playing basketball 3 months after my surgery. Thanks!

    • Probably not the best idea. Those timeframes are a bit aggressive. I would say normally for my pateints here at the clinic, sprinting at 16-20 weeks and basketball 16-20 weeks, each with a gradual ramp up of course. Better to be safe than sorry.

  136. Hi there sir, my situation is a little weird so I wanted your opinion. I am a baseball pitcher in college and I started to feel pain in my shoulder and bicep, I go to the doctor and he tells me I have bicep tendinitis, so I start going to therapy for that for about a month and a half, it was getting better but my shoulder wasn’t. So I go get an MRI and the doctor tells me I have a small slight tear in my rotator cuff ( the one in the front of the shoulder) the doctor decides to give me a steroid shot to basically fix the problem. After that I go back to therapy for a month and my therapist thinks that I’m all healed up and ready to go and I personally feel ready to go as well. I am on a throwing program that should last about a month until I get back to my old self. I really want to get back and start working out with weights but I’m not sure when I should start tho, do you have any opinion on when you think it will be smart for me to start lifting again?

    • If the PT has discharged you, my guess is that you could start with light weights again. I would avoid anything that puts the shoulder in a compromised position. I would stay away from dips and preacher curls for starters. I would get a routine from your treating PT.

  137. Hi Dan. I am a golfer. It’s been 6 weeks since my surgery–subacromial decompression, subacromial synovectomy , mumford procedure and debridement of labral tear. I am seeing a PT working on ROM and starting last week strengthening. My doctor told me there was no risk that I could do harm since the RC was not operated on. Therefore I started limited pitching and chipping. There was no pain during the activity but an increase in pain the next day. I’ve backed off on golf activity. What is a realistic time frame to expect full recovery?

    • The RC is likely weak right now and cannot control the head of your humerus with golf swings. I would typically think that you could start light / low ranges swing at about 12 weeks, provided that the strength is coming along well. Full recovery is probably more along the lines of 4-6 months.

  138. Hi Dan,

    I had a labral tear operated on last November following 3 anterior dislocations sustained over the course of a few years. A small number of anchors/sutures were used and I have been having PT every couple of weeks since. Whilst strength is slowly returning I am having real problems with my ROM since surgery – I have difficulty crossing my arms, and can no longer hold a squat bar across my back without considerable pain in my right shoulder. As I am now almost 6 months post-op I’m wondering if this is normal and if there is anything I can do to return to my full ROM. My PT is stumped as the stretching exercises seem to be having little to no effect.

    Any advice is most appreciated.

    • I would guess that the range will probably iron out over the next six months. It is not uncommon for range to take up to a year to normalize. I would keep up with strengthening every 2-3 days and light ranges of motion per the guidance of the PT.

  139. Hello,
    it’s been 8 weeks post op for an anterior Labrum repair and I’m wondering when it will be safe to start running again. Also when roughly do you think I’ll be able to do simple exercises such as bicep curls? Next pt session is in 2 weeks where I will begin hydrotherapy.
    Thanks

    • I would guess that you could start a slow jog at about week 12, and simple biceps curls with very light weight sometimes around 12-16 weeks. Some docs have different protocols, so I would ask the PT this question as well.

      • Thank you for the response, how about an estimate of time for when I’ll be able to do push-ups again? Thanks

  140. My right shoulder surgery was done in 2012 and doctor and removed half of the shoulder bone. What kind of exercises I can do now for weight loss. I am thinking for weight lifting over cardio but not sure if my shoulder will be hurt. Please pour suggestions.

    • Depending on the type of replacement / surgery that the doc did, you might be able to get back to weight training once you are recovered, but I would probably stay away from overhead pressing type exercises Most other weight training exercises long term should probably be okay. Bicycle, treadmill, elliptical machines would probably all be okay to start with for cardio. MAKE SURE THAT YOU ARE SAFE DOING THESE as the last thing that you need to happen is a fall. Run these ideas by your PT and doc.

  141. How about with body weight exercises such as burpees? (I’m 200 lbs). My end goal is to get back into boxing and I’m aware through reading general recovery is about 6 months… do you honk it’s best for me to keep on PT through to 2019 and start then? Thanks

      • Burpees are really a full body weight push up, so my guess is that needs to start as a wall push up, progress to a modified push up, and then to a standard push up before burpees are done. The wall push ups could be started at about 12-16 weeks depending on how things are going and what your PT thinks.

  142. Hello Dan and thanks again for some of the best shoulder surgery information out there! My 16 y.o. son, who is a serious baseball player is 6 months post SLAP surgery and doing VERY well. He was cleared to hit a few weeks ago and is 5 weeks into his throwing progression and that is also going better than we could have hoped. Our 6 month follow-up with Ortho Doc is in two days and we are optimistic he will be cleared to play some first base. My question is actually in regards to a workout program that my son is starting and is fairly aggressive for strength building. Includes flat bench, shoulder presses, deadlift, squats, power cleans, farmer’s carry and tire flips. Our ortho doc has cleared him to lift, advising us to use pain as our guide, but no limitations as long as the lift does not cause pain or discomfort which none have… YET…. but I am nervous. I am monitoring his lifting, making sure he is not yanking any lifts up and constantly making sure there is no pain. Any advice you can give on lifts to exclude completely and ones to be cautious with would be appreciated. At six months IS his shoulder for the most part fully healed? I have this somewhat paranoid fear that he’s gonna do one movement wrong and BLAM! Shoulder is retorn! I guess if his Ortho Doc is OK with him lifting, I should be too… but…

    • A few thoughts here………. sixteen year-olds can take a veritable beating. His tendons and soft tissue structures probably heal quite quickly. By six months he is probably reasonably strong.

      But……..those exercises are hard core. I would recommend a gradual ramp up of those activities. I would also make sure that on a separate day he is doing a scapular stabilization program. He would also need a solid two to three (2-3) days per week of relative rest. In terms of which of the mentioned exercises are most problematic, I would have him monitor for pain with the overhead throwing motions, military presses, pull ups, thrusters, etc.. Tell him to start with light weight for all of these to get the forms correct.

  143. Hi Dan

    I previously had around 10 shoulder dislocations before having a Laterjet operation to stabilise it. After the operation I have felt strong apart from anything overhead and a slight feeling of instability if throwing a ball overhead. I recently I lifted a heavy weight building a wall and felt a dull ache but nothing severe a few minutes after. It was not a sudden pain but it is now 2 weeks and the pain is not subsiding and feels fairly noticable at a 4/10 on the pain scale, at night especially in certain positions. It does not feel unstable although in certain positions I get a sharp pain when
    moving my arm. It is not easy for me to see a Specialist at moment but I would like to know your thoughts. I am worried I may have caused some damage to the repair or am I being slightly paranoid. Do these things usually subside after a longer period of time?

    • I would try to avoid sleeping on that side for the time being. I do think that if the pain does not go away that you should see an ortho or a PT about it. It does sound to me like that this might be more along the lines of an “impingement” rather than a traumatic tear.

  144. Hello Dan and thank you so much for your generosity. Truly a great resource.

    I am 13 weeks post-op from a posterior and anterior labrum repair (2 anchors each). I was in a sling for 4 weeks full time and then another 2 for sleep and any activity. During that time I thought on a few occasions reinjury had occurred but bounced back. At week 11, slept on my arm awkwardly and again, severe pain in the joint in the location of the repairs (almost like a burning sensation right along the joint line). After a couple visits to the PT and to the surgeon, they say not to worry about it. Two weeks later and feeling good (last weekend), used the arm more than normal while boating and general activities with friends, but no specific “incident” that I recall (there was drinking involved). Again, I have had constant pain in the joint for almost a week since. Today, almost a week after I noticed discomfort, I had very severe pain. I am worried that I reinjured the shoulder, but am not certain what it would feel like if I did. My PT says that I would test with weakness in one particular direction if the labrum were torn again… which he says is not the case. But I still have severe pain with certain motion (reaching across my body or behind and up my back). At times I feel he is being aggressive with the manipulations to my shoulder where I am feeling pain in the joint during PT (before and after this most recent pain event). Is that normal? Or should I tell him to back off? Is there a way to be confident that reinjury has not occurred without scoping my arm again?

    Every time I have freaked out about this so far I have been fine a week or so later. But it has been a week since I’ve had the most recent pain and it has gotten worse if anything. Again, I’m at week 13 and I understand that it would take a lot to re-tear… but what would that feel like? My ROM is fine but I have constant light pain and occasional shooting pain. My PT track I feel is fairly aggressive with moderate resistance exercises and wall pushups.

    Thanks in advance.

    • I really don’t think that you re-tore the labrum. My guess is that the PT may be a bit too aggressive right now. I would back off PT for 1-2 weeks and do some light things yourself every couple of days. If the range is good I would just give it time to heal up.

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