Rotator Cuff Surgery - handstands

[John Christiansen]

I’ve just had re-attachment surgery for a full rotator cuff tendon tear on my right (non dominant side) shoulder a week after an accident - and know it’s a slow recovery. I’ve not yet started PT. Also I’m late 40s.

Im not sure which tendon it was (will ask on my follow up) but pre surgery I was unable to lift my arm forward or out to the side

Im wondering what is possible long term - how strong the tendon will be in, say, a year. And what training positions could irritate it?

prior to the accident I had a solid handstand (arms to ears), solid press to handstand, straddle hold/lever to handstand, front and back lever on rings. I have good flexibility, front and side splits and bridge kick over on floor.

even without the surgery pressing down type movements didn’t hurt much - support position on rings/pommel, l-sit/half lever, straddle lever/hold - do these activate different tendons than lifting the arm to the front/side?

I’d like to get back to where I was in time, is really only for fitness&interest 

thanks for any help and tips!

[Alessandro Mainente]

Hi John, you can fully recover from a rotator cuff tear especially there is no involvement of the labrum tear.

My suggestion with your PT it is:

-full recovery of the external and internal rotation first then shoulder flexion and extension;

-strengthen of the scapulae synergistic muscles like middle / lower traps, rhomboids and serratus anterior;

-release the scar tissue.

- I would avoid completely rings work until a full recovery it is achieved.

[John Christiansen]

Thank you Alessandro.

I had my follow up with the surgeon yesterday, he seems to think I will be able to return to all I was doing before, that the issue is more with time.. 9 - 12 months for full complete healing.. I'm ok with that, I am patient!   My repaired tendon was supraspinatus, no labrum issues.

 

[John Christiansen]

Another question, longer term, would skills like L-Sit, V-Sit, scissors on pommel, i.e where the arm isn't overhead,  aggravate supraspinatus?

 

[Alessandro Mainente]

What aggravates supraspinatus is : all the overhead movements with a bad shoulder mobility.

[Petra Dvorak]

I am now 9 months after complex rotator cuff surgery (supraspinatus, infraspinatus, subscapularis and tenotomy of long biceps).

Only now i start to feel i might recover fully, i tried my first pull up and first wall handstand a few days ago, until now i avoided all full-overhead movements. I have good hope :-)

I wish you a good recovery!

[Ari Moilanen]

Hello John. I'll explain here in brief some more what the supraspinatus is for and when it activates.

One of it's funtions is to keep the head of humerus in its place, depressed and not let it hit the acromion above leaving the supraspinatus tendon and subacromial bursae suffering in between the bones. This, i believe, would be your biggest caveat and reason to rehabilitate the tendon and the muscle well before doing any strength work with the shoulder reagardless of direction of force applied. Since, I see, you have had a strong shoulder prior to the injury, you will be fine as long as you dont tear it again and make sure to build the ROM and good function of all muscles of shoulder, especially the damaged supra.

 

Also after a surgery, in addition to scarring, there's allways issues with the joint capsule and tendons sticking together due to blood and fluid drying between them during the healing phase. This makes the ROM work a bit harder but all the more necessary. If you PT is decent you will work this out with him/her.

[Coach Sommer]

On 1/7/2018 at 1:54 AM, Petra Dvorak said:

I am now 9 months after complex rotator cuff surgery (supraspinatus, infraspinatus, subscapularis and tenotomy of long biceps).

Only now i start to feel i might recover fully, i tried my first pull up and first wall handstand a few days ago, until now i avoided all full-overhead movements. I have good hope :-)

I wish you a good recovery!

Hi Petra,

How did you injure your shoulder so severely?

Yours in Fitness,

Coach Sommer

[Bas Albinus]

On 12/31/2017 at 8:02 AM, Alessandro Mainente said:

My suggestion with your PT it is:

-full recovery of the external and internal rotation first then shoulder flexion and extension;

-strengthen of the scapulae synergistic muscles like middle / lower traps, rhomboids and serratus anterior;

-release the scar tissue.

I had a labrum tear fixed about 13months ago. After about 4-5months of daily physio  which looked a lot like what Alex described above (not to underestimate a lot of careful stretching and fascia release)  I could slowly get back to Foundation 1 basics like wall push ups and rows. Now after 1 year strength has finally caught up and generally speaking ROM is better than before thanks to GB. 
The joint and biceps tendon is still not 100% though. I need to make sure to put in enough rest after exercising or pain and inflammation will flare up. A week rest between upper body elements usually does it and despite what feels like a long rest I'm making progress.
Interestingly, I had a breakthrough just last week! After adding long swimming sessions to my exercises - and stupidly going back to the heavy bag for a few rounds, my shoulder got pretty bad. I refrained from any pushing/pulling exercises for several weeks. Once I carefully picked it up again it took just a couple of workouts to get back to where I had left off AND the following week I could easily double the effort. The inflammation and subsequent layoff had actually helped me to get stronger.

I've read Coach's comment somewhere, that recovery from surgery can take  a shoulder up to a year to be good, and 2 years to be great!  So I'll be patient and carefully keep working towards bullet proofing my shoulders.
 

[Petra Dvorak]

Hi Coach

In the end it was one hard shoulder-move in the bouldering gym

But my shoulder(s) was used from >20 years of climbing/bouldering, manual work as physiotherapist, and most probably some partial tears from multiple "shit-happens"-microtraumata like slipping feet on a climb, falling on ice, falling from a bike etc.....
I can remember episodes of inflamation/pain in the last decades, which i always overcame through stabilizing exercises and progressive training.
That was also the reason to join Gymnasticbodies in 2016, because i believe in the concept of correct movements and adaptation of connective tissue

I love your program and hope to be able to persuite it for a long time! Thank you for your work.

Yours in fitness
Petra

[Andrew Gatewood]

I'm interested to hear about others who have worked through shoulder issues.

Having had two surgeries (same shoulder, first was slap tear with rotator cuff reattachment, second was bankart tear repair), i'm interested in any experience, guidance, suggestions etc. that coaches or other members may have on working around similar injury histories. 

My reasons for joining gb in the first place was to continue to learn about and master my body, which obviously has some unique imbalances. I'm currently progressing through fundamentals 1 and am finding that, not surprisingly, thoracic bridge is my biggest weakness hands down.

[Nick Murray]

@Andrew Gatewood look up some of my previous posts, I've had a few shoulder issues which GB has helped to resolve.

[Andrew Gatewood]

Thanks @Nick Murray , I'll check those out.

[John Christiansen]

I started this thread back in late December and just wanted to follow up as I'm now 5 months post surgery and thought it might be helpful for others in the same situation, or contemplating the same surgery.

The first month post surgery was tough. I wore a sling everywhere I would go, outdoors, and often indoors. My arm felt tender and vulnerable. The surgeon allowed me to release the sling and let my arm dangle or be propped up if I was at home, e.g. on the laptop. But outside the sling was on. Sleeping was hard the first three or four weeks as I'd have to sleep at a 45 degree angle, propped up with pillows. They told me to not be a hero and to take all the pain meds for the first week. The night after the nerve block wore off I knew what they were talking about.. it hurt. Showering, getting dressed and putting my phone in my pocket were all hard as I had to use just the non operated arm. Lacing up shoes just didn’t happen. Same with t-shirts.. no way.

I started physio at 6 weeks and the range came back quickly. My arm felt very weak and I couldn't lift it all the way up for the first few weeks of physio. I had to use the other arm to lift it (this was the first physio exercises I was given). By 3 months though my arm felt very normal and I was allowed to do pushups from the knee and various range increasing exercises. Putting heavy pressure onto the shoulder , e.g a kind of partial/assisted l-sit (I wasn't supposed to do this but couldn't resist trying a little bit, out of curiosity), was still uncomfortable, but not like I imagined it would be. It would feel more like I was straining it, not an outright “yelp” kind of pain. 

Now at 5 months I can comfortably hold a handstand, arms fully extended to ears. I can't detect any difference in balance or stability from pre-surgery. I can comfortably hold an L-sit and straddle lever on the floor, there is no pain or instability. Today I tried an L-sit walk. I’ve lost strength but I could do a bit of a shuffle. Earlier this week I tried to gently do a bridge but it was uncomfortable. My shoulder flexibility is ok though and I don't really care if I never do a bridge again. Squats feel fine with a loaded bar, weighted stiff leg deadlifhts feel fine, bicep curl feels fine, rowing feels fine both weights and cardio. I don’t really do bench or overhead so can’t comment if they would be the same. Physio told me I was not to attempt heavy bench/overhead, or handstand pushup, but I told them I don’t do it anyway. I’ve not yet been on rings but next week might try just holding a support position and an l-sit to see how they feel on the low rings. I’m not sure I ever want to do swings etc again as I think mentally I will just picture the tendon straining even though the physio said theoretically I’d be fine.

I'm going to continue to take it slow, but at this point I'm very happy with the outcome so far, and wanted to share a positive story. I felt terrible when I had my accident and thought my days of gymnastics were over, and that my shoulder “would never be the same”, but it’s not been the case, although I know every case is different.  Regardless, I’m still going to take it easy from this point on, and just keep it basic. I started gymnastics to keep fit and improve strength and flexibility and I’m just happy that I’ll still be able to do this, post surgery.