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.
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.
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.
- It is not worth your time to “max out” with heavy weights simply to see how much weight you can lift.
- Military presses, dips, preacher curls, and hand-stand pushups are not worth your time if you have ever had shoulder surgery.
- 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.
- 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
Hi Dan, you mention some patients have pain for a year. I’m now 17 weeks post labrum repair and my shoulder often hurts especially if I stress it.
While I’m here can I ask your opinion on the safety of shrugging exercise with a shug bar for a repair on the posterior labrum? I’m still unsure which exercises are no nos beyond the obvious dips, overhead presses etc
If you keep the shoulders within range (don’t let the shoulders hang at the bottom-most portion of the range) it should be okay. I would get the okay from the doc and your PT, and start with obscenely light weight.
Hi Dan, I worry I overdid it as despite doing high reps with controlled form my shoulder has been hurting for a few days since doing the shrugs
There was no pop crack or sudden pain but it began to hurt in the back of the shoulder the next day and has been painful to sleep on that side for the last few days
At 17 weeks it should be hard to reinjure without a traumatic event , do you agree this could be muscle and inflammation pain? I had an in office scope done 2 weeks ago where they stuck a 16 gauge needle in through the portal scar in the back (sadly that couldn’t show a good image of the repair)
Thank you again for all your time!
I had labrum slap repair 9 weeks ago and I’m looking to speed up the healing process as much as possible. I feel like PT is holding me back from what I could really do at this point. What are some home exercises and range movements I can do. I’m a quarterback and need to be back by week 12.
Throwing and doing full speed football drills at twelve weeks is a very bad idea. I would double that time expectation. If things are still going very well, I would ask the doc and PT to start gentle throwing at week twelve (that is still early by the way). Stick to the protocol regardless of how frustrated you may feel. Trust me. I have seen what happens when younger people don’t follow the conservative rehab route.
Hi den i sufferd my shoulderproblem approx 8 to 9 month then in 31 march. I get a surgery of shoulder disloaction. Now 2morow i go to the gym then again i have sufferd a lill pain.. but my elbow is also sweeling when i wake up to the bed…
What should i do…please suggest..
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.
Sir i had a bankart lession surgery of my right shoulder can i start gym or workout again plz help me for the best
You need to get permission from the surgeon prior to starting a gym routine. Most surgeons want at least 12-16 weeks prior to starting a gym routine.
But sir i had surgery 1 year ago
And also tell me which exercises i shouldn’t do
But sir i had surgery 1 year ago
And also tell me which exercises i shouldn’t do
Tell me something doc
If it was a year ago you could probably start a gym routine, but I would start it very slowly and with light weight. I would only advance the weight if you can do the routine for a week or so without sharp pain. I would also take at least one day off in between gym workouts.
If you check out the shoulder exercises on our website, that could give you some good ideas as to where to start.
How long dose it take me to get my shoulder full motion back after Laterjet Surgury.
Maybe 3-6 months?
Hii Den sir…..
My shoulder dislocate about 2 month ago…..
Am I reday to start cardio exercises ni gym?
I would get permission from the doctor first. I would start maybe with a stationary bicycle or recumbent bicycle, this is safer that jogging.
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.
This will probably take a good 6 months to get back into the gym. Fractures ache by the way, so expect some pain.
Hi Dan. I am almost 11 wks post op rotator cuff repair, biceps tenodesis, acromioplasty and resection of distal clavicle. I have posted questions here before. I am moving through final phases of active assisted passive rehab. My grip has deteriorated since surgery—-initially I could make a fist or squeeze the rubber ball on the Breg Slingshot 2 without problems and in spite of post op arm and hand swelling. Now most of the swelling has dissipated except mild to moderate in the hand and wrist which I must control by elevation and finger exercises which are difficult due to stiffness/limited ROM. Squeezing the rubber ball has become very difficult and the palm of my hand is sore when I try. I have tingling in the 1-3 fingers along the median nerve distribution. My ortho doc says to just keep using elevation and be more aggressive with my shoulder ROM exercises. Does squeezing the rubber ball aggravate or help since that is painful? I just started Naproxen OTC but don’t know if that is really going to help if this is all just due to edema and accompanying stiffness. Have you seen this before? Should I see someone else for second opinion (he has a partner who is a hand surgeon) or just continue his instructions–what about squeezing the ball when it hurts the palm?
Thank you.
I would get a second opinion. It may also be a good idea to back off the squeezing for a week or so. The median nerve sounds like it may be irritated, the question is where this is happening.
Hi Dan. I got worked into the AM schedule of the hand doctor’s PA whom I already know and he confirmed median nerve irritation but wants to try a night splint first before nerve conduction study though that irritation came on well after surgery and in conjunction with my hand edema.
He injected cortisone into the 4th MC flexor tendon pulley which was inflamed. I see him back in 6 weeks after most of my active rehab is over—he did not feel sense of urgency at this time.
Thank you for your advice which is along the lines of what I thought too.
ABB
One last thing Dan–I was in pillow sling for 6 wks in NEUTRAL position instead of in internal rotation. Now at almost 5 wks out of sling I am doing well in rehab except for extreme limited internal rotation such that in standing relaxed position the operated upper arm remains neutral while the opposite side is slightly internally rotated (normal). So when I try the usual internal rotation exercises with cane or pulley, I cannot internally rotate the operated shoulder enough to get my forearm behind me without over-extention which rolls the humeral head quite anterior against the capsule (rather than simply having the upper arm only slightly extended at my side while bending my forearm at elbow behind me). The sleeper stretch. is also difficult as my shoulder wants to move up and anterior to accomplish that. Suggestions? I am going to point out this problem to PT tomorrow.
Thank you!
Gentle PROM into internal rotation (lying on your back) with the therapist applying a gentle posterior force to the head of the humerus. You can sort of do that yourself by using your other hand to apply pressure to the head of the involved humerus. There is a good photo of the self stretch in Dr .Shirley Sahrmann’s book, I think it is called “Diagnosis and Treatment of Movement System Impairments”.
Is this the supine position with arm abducted 90 degrees and elbow flexed 90 degrees (starting with forearm up) and then rotating downward towards table surface (opposite the classic supine external rotation with cane assist)?
Yep.
Yep.
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.
Hello! I’m about to undergo my 2nd shoulder surgery (Right arm) in as many years. Last one November of 2015 (Same arm). This time around I have a posterior labrum tear, paralabral cyst, biceps tenodesis, and a distal clavicle excision. I have my own woodworking business where I custom make furniture, how long should I wait until I start building again? Also, how long should I wait to resume weightlifting and playing baseball? I’m 29 years old and it’s from an old military injury that was never fixed while active duty. Thanks!
There is a lot going on here, I would guess that it will be at least 3 months until you are comfortable enough to use that arm for moderate force activities such as woodworking. Weight lifting is a minimum of 16-20 weeks, baseball probably a few months after that.
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.
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.
Dan, how soon after rotator cuff repair and biceps tenodesis can one resume sit ups? Thanks again.
Hmmm. I guess it depends on how you place your hands. I would start by keeping the hands folded over your stomach. That type of sit up could feasibly be done 6 weeks after the surgery? (Run it by the doc as well, because it may also depend on how extensive the surgery was.)
If you need a lower abdominal fix in the interim, I would stick to exercises that focus on leg movements.
Well I am at 19 wks postop and have been doing the hands behind the head internal and external rotation without problems—seems this would be the same hand position for sit ups.
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.
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.
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.
Hi Dan,
I am now 6 months post op RTC repair with acromioplasty and biceps tenodesis. I have written you before.
PT recently released me to continue my stretches and strengthening exercises and most are coming along well with exception of two things. First, it has been difficult to progress from abducting to horizontal with a one lb dumbbell to a 2 lb weight. My drop arm test is normal so I assume I am dealing with weakness of the supraspinatus which will take more time to strengthen. Opinion? The other problem is while doing external or lateral rotation with the T-band, I more recently now experience moderate deep lateral upper arm pain (but none without the band) which sometimes radiates down into my forearm (like a toothache). I don’t have pain with dumbbell curls for biceps so don’t believe that to be an issue unless the long head tendon is rotating in the groove to cause this. How about coracobrachialis? Could that be a consideration for this deep ache during and after both dumbbell abduction and lateral rotation with T band? My only limited ROM is internal rotation apparently due to tight lateral rotators or posterior capsule in spite of modified sleeper stretch which I do properly.
Thank you! Avery Brinkley Jr. MD
I do think that the abduction and scaption strength will improve with time. I tell patients with the described exercise to keep the range only to what you can perform without elevating the head of the humerus. Use a mirror for this and compare it to the unaffected side.
The pain down the arm could be referral from one or more muscles that you mentioned, or from the RC slightly grazing the acromion.
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.
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
The supraspinatus helps to depress the head of the humerus as the hand is lifted overhead. The problem with this tendon is that it sits right underneath the shelf of the acromion, so it is in my opinion most susceptible to friction with overhead motions.
Thank you Dan!
John
Thank you Dan!
John
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.
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).
@68 and had totaled shoulder ur post so funny I fell out of the couch.
Hi doctor Dan
I’m currently 6 months postop after a bankart repair on my right shoulder. I have started my motion rehab after 6 weeks of operation (don’t know why but the doctor said I should have the sling on for 6 weeks). Anyways I began my rehab from week 7 doing simple stretching exercises leading to simple rubberband exercises. BUT I was forced to join the military around week 16 (I’m a Korean citizen required to do the mandatory service). Therefore from week 16 I literally had to stop any rehab exercises until recently I was able to have my own time. My questions are following:
is it a fatal setback for a patient to go through stoppage during the rehab course?
Also I keep on feeling muscle stiffness around the shoulder and neck muscles with strong sense of impingement on the top right corner of the labrum, is the pain normal?
For the next year and a half, I am limited to receive professional rehab treatment from a trained physical therapist which means I have to do the exercises base on youtube.. will this make a huge difference for my rehab?
Finally, is it best to avoid usage of my right shoulder even in simple daily activities or should I use it regardless of the muscle pain?
It probably was not ideal to nix the rehab at 16 weeks, but usually by that point there is a sufficient amount of strength and range of motion. My guess is that you probably still need to do some work with the rotator cuff and scapular support strength. There are plenty of resources out there for you to look at.
To answer your third question, it is not a bad idea to use the shoulder for daily tasks. I would probably stay away from overhead type reaching motions, especially if they are painful.
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.
I would have to assess you to tell you it might take to get back to push ups and pull ups, and what your total prognosis is. It is really “case by case”. Another MRI can’t hurt, especially if you are concerned about a re-tear. If a diagnostic test clears you, you would most likely be okay to start back up with rehab. I would ask a PT all of your questions in person.
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.
I had surgery on my labrum 4 weeks ago and still feel a lot of pain. It also feels like it is locking up on me. Is this normal ?
It is still quite early. This is a common occurrence. Let the PT and doc know what is going on as well.
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!
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.
It will be 6months on March 1st from when I had labrum surgery and a post capsular release. I really did not need surgery but wanted to be able to play baseball at a high level again.The injury occured when I was 25 years old doing chest flys and now im going 32. I could lift as much as I want and basically do anything with no pain after the injury. Except when I exerted myself over 85% velocity, I would have a snapping sensation right where the longhead meets the labrum. All the signs of a slap tear. Surgeon went in and found it and fixed and cleaned things up in the shoulder. 1 month after surgery, I was 100% full range motion with physical therapy and strength. The goal was to start throwing March 1st and I waited till middle of January to start training. I have felt no pain what so ever working out but a week ago doing crossoverjacks. I felt the same thing with the bicep tendon like a very minor rolling over something snaping sensation. On a scale from 1-10 the pain was like a .25. Just very disheartening after investing all this money to fix my arm to throw, to feel that at this point in the game. I guess I will really find out in March once I start throwing. My question is, is it normal to feel that once an awhile post labrum surgery. And what should I expect to feel once I start throwing again? I will start light toss and working my way up on a throwing program. Any feedback would be helpful. Thank you
Many people will not be 100% capacity until up to one year after the surgery, especially those who are high-level demanding such as throwers and pitchers. This is a normal occurrence to answer your question. I would invest in a “body blade CXT” by the way, it is a great RC strengthening tool for throwers. When you start throwing, I would expect to feel a bit of ache and soreness. Make sure you allow for adequate rest in between throwing sessions.
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.
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??
Hi Dan,
I found this article and your replies helpful thats why i am asking u my problem, Pain in my right shoulder started many year ago when i used to play cricket & one day i throw ball very rigorously while playing and my shoulder started to pain. i was doing weight training on and off when this happened. my pain limited to some range of motion like while lifting my arm for side raise or front raise but the pain use to disappear within few days without medication. then i left everything and almost 9 yrs have passed and i have started gym again a month back but during all this 9 years i use to have pain on sudden fast sharp movements or lifting weight inappropriately or throwing something and that pain use to go away within one or two days and every time i have pain there was only one or two motion that were restricted especially side raise or front raise. now again i have pain i did dead lift for the first time and i m feeling pain again, and yes one more thing i cannot do push ups (Dips) it starts pain just after 2 to 3 reps. I wanna ask is it rotator cuff damage? do i need surgery? will i be able to weight lift again after surgery.
Ur reply will be much appreciated.
Thanks & Regards,
MZK
I would definitely have this assessed by either a PT or an orthopedist. There may be a rotator cuff issue, or there may be a labrum issue. If you are not having much pain with normal activities I would guess that the course of action would be structured exercises and rehab rather than surgery. I do think that you will have to modify some of the gym exercises that you are doing. I would stay away from “dips” permanently for example.
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.
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.
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.
Hi, about 5 weeks ago I had shoulder surgery. The procedure was a decompression and a partial arcomioplasty. I have been doing the pt exercises on a regular basis. In your opinion when should i start weight liftinging again? Thanks for the time!!
Probably after 12 weeks, with lighter rubber banded type exercises probably okay by 8 weeks. Make sure someone signs off on your progression (MD or PT).
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.
Thanks Dan.. I appreciate your advice and reset my expectations.
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.
Hi Dan, quick question.27 YO, I had a posterior reverse bony bankart repair with a piece of the glenoid coming off done almost 4 weeks ago. I start PT in a few days, but my surgeon wants me in the immobilizer for the full 6 weeks. I play ice hockey goalie, and of course itching to get back on the ice. The arm that was repaired is my catching glove side, and I play in rec league with no physical contact, just the force of catching a puck. Obviously, I am going to be extremely careful here, I do not want to mess this up but my question is when do you think roughly I could start doing some practicing again? Not any games, but just able to get out there and play carefully.
It depends obviously on what the doc says, but I would guess that you might start to be able to practice a bit at or about 16 weeks? I would definitely take your time with this.
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
I would start with wall push ups first around 12-16 weeks, then once those are easy progress to modified push ups. Make sure that the PT is okay with this progression.
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.
Hello Dan. I’m a 26yo male. Nearly one year ago Ive had a Bankart repair. I once particularly hurt my right shoulder by pulling and reaching out too far, and afterwards I *cleverly* continued lifting weights for about a year. I should point out that this shoulder was already weaker even before this (goes back + 2yrs in total). One day, when pain, strenght and mobility were getting worse, I used my limited intelligence and underwent an MRI that revealed a torn labrum. I’ve had it repaired arthroscopically – I believe the labrum was torn 1 to 7hrs o’clock – and surgeon used just two anchors. After 5 sleepless weeks in a sling I had a tough rehab at the PT for over 3-4 months (lots of clicking and popping.) On the 3rd month I started swimming weekly for strenght and continued doing so, along with my daily stretches/rotator cuff work. Today, almost one year later, my ROM is quite exellent for having had surgery, but I still lack a noticeable amount of strenght. Pain now only occurs when crawl swimming (breast stroke is ok) or trying reaching far overhead. Giving a high five to someone or trying to catch something quickly are some of the things that are still somewhat uncomfortable and dont feel all that confident to me. At this point, swimming, along with comprehensive bandwork, usually results in increased stifness the day after for at least 48hours. Ive requested an MRI a couple of months ago to ensure that the surgery did not fail. The surgeon said it looked ok. For almost one year post-surgery, is it your opinion that my shoulder could still improve or get stronger? Should I go back to the PT again? What are you thoughts or is your advice? I thank you. From Belgium – A
You might be able to increase the strength, but it does depend at least partially on if there is demonstrable weakness in any muscle or muscles that support the shoulder blade or shoulder joint. I would have the shoulder evaluated by a fresh set of eyes on the problem, perhaps a new PT? I would ask specifically to have the lengths and strengths of all associated structures and muscles tested. This should give you a good idea if specific training is in order.
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
I’m 9 weeks post op now
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.
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.
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.
Hi Dan
I had a bankart repair of my right shoulder about 10 weeks ago.
Two days back, a few hours after doing my regular PT (external rotations and flexion) I felt a lot of pain in my right shoulder. At present, the pain is nonexistent but when I try to position my arms at certain places it hurts around the sutures.
My surgeon is out of the country for a few weeks and is not responding to the emails so I was thinking if this is something to worry about. What do you think?
At 10 weeks you are probably safe. I would give it another few days to subside. I would also let the PT know so that he /she can adjust accordingly.
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.