Shoulder Surgery and 1 Armed Workouts

Shoulder surgery does not mean you have to lose everything you have worked so hard for. Some people are rightly concerned about injuring their repaired shoulders after surgery. These people make a surgeon feel better. Some people think the repair is healed right from day one and want to test it; these people frighten me despite my efforts at counseling. I think there is a compromise that can be achieved without losing your all important wind and without hurting yourself. Some patients are concerned about becoming imbalanced and don’t want to work one side of their body. It is my belief that you shouldn’t let it waste away waiting for the other one to heal. I promised I would write about this topic so here it is.

First let me state that these are my opinions about post operative workouts and what can and cannot be done. If you have had surgery as always you need to consult your surgeon and not take this as verbatim. Hopefully you have gone to someone who is familiar with the terms Clean and Jerk and Snatches so your appointment does not take 3 times as long as it should be. Also if you are considering surgery get this stuff outlined ahead of time so you don’t get surprised when your shoulder surgeon says you are not to workout for 19 months and then you can only do big toe raises. I have had people come to me for second opinions just to get things straight about what they can and cannot do after surgery. So here goes:

The first 6 weeks after surgery are critical to the healing of a repair, for argument’s sake let’s say the person has a rotator cuff repair (on left) or a labral repair (on right).

The tendon has to heal to the bone and in order to do this needs a relatively quiet environment almost like a fracture healing needs a cast or splint. So the problem with all this is that if we casted your shoulder joint and immobilized it for 6 weeks, things would heal alright…BUT you would have a lot of trouble moving your joint because the ligament and capsule of the joint would shrink and tighten preventing motion around your joint. So I am a firm believer in passive motion in the first 6 weeks to prevent tightness, gain motion and then when things are ready to be strengthened, you don’t have to worry about flexibility.  This physical therapy dance that we do is predicated on maintaining flexibility without stressing the repair; it is a fine line and one that we would rather err on the cautious side of.  Hell hath no fury like a retear of a shoulder repair. I tell patients I would rather have them healed and tight than loose and retorn! In this initial postop period after the skin has healed in about 7-10 days, stationary bike is fine to maintain cardiovascular activity. Stairclimbers and treadmills are notorious for people losing their balance and falling especially if you are wearing a sling. A cuff or labral repair patient is allowed to move their hand and elbow to prevent hand and elbow stiffness and we encourage this. I do not want the patient reaching or carrying anything in that hand for 6 weeks to prevent bad things from happening. I want people to sleep with the sling on. I have received many a phone call about an alarm that startled the patient, they moved their operative shoulder to shut it off and then proceeded to wake everyone else in the house up with their own scream alarm. 
For the first 2-6 weeks I have allowed patients to 1 arm aerodyne, 1 arm light kettlebell swing, air squat, step up and down boxes, 1 arm dumbbell squat, 1 arm rowing, lunges, 1 arm farmer’s carry, careful situps and back extensions, sled drags. The key to all of this is the THE WEIGHT ON THE OTHER SIDE HAS TO BE SMALL ENOUGH THAT THE REPAIRED SIDE REMAINS QUIET AND UNAFFECTED. THERE SHOULD BE NO MOTION OF THE OPERATIVE SIDE AND NO STRAINING THAT PUTS TORQUE OR STRESS ON THAT SIDE. VERY IMPORTANT POINT HERE.
 
rotator-cuff-repair2
The next 6 weeks are a very dangerous time because you may discontinue the sling but again it is not able to be stressed or risk rupture of the repair. I have seen one armed burpees where a person bends over holding body with good hand planted on floor and chest is off ground like a football lineman. Legs then go back into a 1 arm plank position and then come forward again. Again operative arm is at side and not getting stressed. After 6 weeks things have healed partially and usually enough to begin gentle strengthening of the cuff. By 3 months the repair has a mature scar and can withstand more stress. Dumbbells and bands on the operative side are allowed and can begin to increase strength. I still don’t allow explosive activities until 5 months. I had a patient who went golfing at 4 months because he felt so good. Unfortunately his golf game was not as good as his arm and he hit the ground with the club ripping the repair.
 
Below is a protocol that I use for cuff repairs. again for my patients and check with your surgeon for specifics.
 
1 month
rotator-cuff-repair-labral-repair
2 months nonoperative side
rotator-cuff-repair2
3months
5 months
Skin the Cat…be careful!
You heard me… be very careful!

181 Comments

  1. Forgive me if this has been addressed, but do you have an opinion on tenodesis vs full repair on a SLAP tear? This would be for a hypothetical Crossfit athlete in his mid 40’s.
    Is there a difference in the capabilities of the shoulder with one vs the other?

    • Tenodesis for someone in that age category.

  2. What a terrific post, clear and providing a way to feel human during recovery. Thank you!

    I wanted to ask if uninjured-arm cable exercises, such as pull downs, chest press etc. would make your “OK” list, in the first 2-6 weeks, so long as they are performed mindfully, keeping the repair-side quiet, with no torque? Would there be any uninjured-arm cable exercises you would specifically recommend against in this period?

  3. Hi David, your physical therapist can help you with this.

  4. Hi Dr. Rockett,

    Are these recommendations for open shoulder surgery or arthroscopic? Or does it matter?

    Thank you!

    • I wrote this for my patients who are mostly arthroscopic surgery. You need to check with your doctor about specifics.

  5. How long after arthroscopic surgical repair of full suprasipnatus tear surgery do you usually clear someone to ride stationary bike (e.g. Peloton) in a seated position gripping the handlebars with *both* the non-operative and operative arms?

    • not using the arm at 1-2 weeks, using the arm and holding full bpdy weight depending on the size of the tear can be 3 to 4 months. As always, ask your surgeon.

  6. Hi Doctor,

    My name is Rana and I am from India. A month back i met with a car accident and fractured my humerus severely. The humerus head was broken. I underwent a surgery and my doctor implanted a titanium plate with 6 screws. I have very limited range of motion now. I am very anxious to know how long will it take for around 80% recovery if not full. Moreover will I be ever able to hit the gym and do shoulder workout. The impact of the accident also left my nerve damaged which is why i have constant paim and numbness in my ring and pinky finger. Please advise.
    Thanks

    • All great questions for your surgeon as every fracture and fixation is different. Good luck with it.

      • I guess I would see what the other doctor has to say. Frozen shoulder can cause pain and restricted range of motion. As always happy to see you if you are in the area.

        • I had my pec minor surgically released (left side) underwent a diagnostic arthroscopic shoulder view from the back side and no tears were found so of course no repairs were made. I wore my sling for 2 days like my surgeon suggested. Start therapy tomorrow (5 days post op) I can’t find any info online about the recovery, of course I’ll ask both the surgeon and therapist but I wanted someone else take on it. How long until I can like be active as I’m running, lifting a little bit, working my legs out? I don’t have pain, it’s just sore and tight where my pec minor was cut, don’t have good ROM when trying to lift my arm I can get it to about my forehead then it’s sore. I’m a 24 year old active male.

          • I would definitely check in with your therapist and surgeon on this one.

  7. I am 8 weeks post sugery and trying to get in summer shape with out using my arms…what do you suggest? I would like to lose about 30 lbs.

    • I would ride the stationary bike, check with your doc about things they would allow also

  8. Thank you for the information, I found this site today 7 weeks post-op from repair of full thickness tears of my supraspinaus and infraspinatus, bicep tendon and the removal of a couple very large bone spurs. My shoulder feels great, I had no pain at all post surgery and had a return to full range of motion (passive assisted by PT) within a week ( started PT 2 days after surgery) my question is more long term, as a competitive SHW power lifter my concept of “reasonable weights” is quite different from my doctor and PT going forward. Is there a decent chance that I will be able to return to very heavy lifting after the 6 month mark or are repairs of the shoulder always weaker than your original rotator cuff. Thanks in advance.

    • So in general rotator cuff repair recovery vary depending on size quality of tissue, retraction of tissue, etc. I have had people get back to heavy lifting but you definitely want to talk to your doctor about his or her expecations.

  9. When would you advise running can be resumed after a Bankart Repair?

    I’m roughly 7 weeks post Bankart Repair on my right shoulder.

    • I usually let my patients run but you have to ask your doctor

  10. What is your recommendation for returning to running post partial tear suprapinatous / cuff repair using two anchors. When would you allow gentle road running to resume as well as trail running – with focus being on uphill running more so than the beat ip pounding / potential falling downhill running?

    • It depends on the size of the tear and repair. I usually allow my patients to run after a rotator cuff repair at 3 months

  11. I’m almost 3 months post op from slap repair and torn rotator cuff. Next week I’ll be starting the banded strengthening exercises (only, no dumbbells), and at 6 months I get to start easing back into crossfit. I’m really just curious if my doctor is super conservative? Or is this a normal progression? I’m going to follow my doctors directions, I made sure to pick a good one, but I can’t help but wonder when I see other athletes with similar surgeries doing way more way sooner…

  12. Hi Doctor, I’m Leonardo from Brazil.

    About the GLAD lesion (glenolabral articular disruption)… I’ve no dislocations at all, just the first time. But I still have a arch pain deep on my shoulder, looks like is in the back but its an anterior-inferior tear.
    Could this GLAD lesion give this type of pain or could also be a SLAP tear? arthro MRI just shows GLAD with chondral lesion.

    I have no anterior pain, I can do ring dips and bench press pain free, but when reach across my body or
    do external rotation hurts. Even squats hurts a lot.

    Can’t find much information about this lesion, please help me.

    • This lesion is similar to a bankart lesion as seen in my post on shoulder instability above. The pain can be what you are describing. As always check with your doctor for these answers.

  13. Hi Doc. This page is really useful and encouraging!

    I am 48 and have gotten into OCR and powerlifting the past couple of years. I have a 7 mm full-thickness tear of the supraspinatus and calcification of the bursa. I am getting surgery in 10 days. I was regularly benching around 350 before the tear. Is it a reasonable goal to return to competition in August (I don’t expect to be competitive on bench at that point, but might be able to put up a big squat)? Is it reasonable to try to get back to a 350 bench by the end of the year? I was going to try to reach a 405 this year (before I jut injured), is this still something I can achieve one day?

    • Hi Chris you are asking me for specifics on your condition that I cant answer over the internet without examining you. I have operated on people who have gotten back to their normal exercise routines. Good luck.

      • Thanks Dr. Rockett. Just an update to provide others with some hope. I was able to return to competition 6-1/2 months post-opp. Four months after that and I have regained almost all of my upper body strength — I recently tied my competition bench press PR from last year. I feel great. I am diligent about my mobility and rotator cuff strengthening routine and otherwise careful to protect my shoulders. Best, Chris

        • Great to hear.

  14. Dr. Rockett,
    I apologize in advance if you’ve addressed this question above. I love the information your providing here. Do the same rules apply for full shoulder replacement? Im scheduled for shoulder replacement Jan. 29th, 2018. Im guessing same rules with additional time for healing and increased awareness of keeping a quiet uninvolved post-operative shoulder while doing exercise. I was considering buying a recumbent bike for rehab but not starting use until about week 4 post operative. Thoughts?

    • yes same rules apply, bike is excellent way to keep cardio going, Good luck!

  15. Question re: gymnastics and handstands…

    I’m 10 days out from rotator cuff full tear re-attachment after falling on my arm, outstretched. Prior to surgery (which was 6 days after the accident) I had no symptoms of anything, but the Dr told me during surgery he could see I already had had a partial tear & not known.

    I started basic gymnastics in my 40s, and painstakingly developed a solid handstand & press to handstand. I’m now 47.

    What’s the chances of doing handstands (and body weight stuff) after this surgery, does that kind of stability return?

    • I have been able to return people to all activities and the Games after surgery.

  16. I am 6 weeks post op from a subcromial decompression and 1cm tendon repair, recently discovering I’ve also had the ligament removed between joints of right shoulder. My employer has advised I am not allowed to return to work until I can lift again. Being an Ambulance Care Assistant I am expected to lift in the region of up to 16 stone, plus carry chair weight of 3 stone with assistance of a colleague. Obviously I am concerned that I may damage the repairing tendon, (I had previous surgery to the left shoulder with a 3 cm tear some 5 years ago prior to my current job which has been fine since) and obviously want to avoid doing so. Can you advise how long I should wait before attempting to safely lift this sort of weight?

    • For these guidelines you have to talk to your surgeon as every shoulder is different, sorry I cant answer your specific question about your shoulder. I have athletes return to Games-like lifting at 5 to 8 months after surgery

  17. When would you generally allow easing into 1# Indian Club swinging for the operative shoulder? As a Physical Therapist, I would like to include clubs for rehab of some patients. If you know of any PTs who do this, I would love to connect with them.
    Thanks

    • Indian club swinging would probably be around 3 months

  18. Hello Dr. Rockett,

    I had a Grade V AC joint injury in July and had reconstruction surgery the beginning of August. It was an open surgery using a graft, FiberWire and dogbone buttons. I didn’t really want to have the surgery but thought it would be best for long term because at 65 there is still an interest in being very active.

    The surgery seems to have gone well as I am at weeks post op and doing fairly well.

    I couldn’t find any comments from you on here regarding ACJ reconstruction as to how people should come back. How do you get over the thought of having this repair and ever doing anything physical again? I understand pro athletes, steel workers etc. come back and do well?

    • A lot of the rehab is mentally getting back to feeling normal. As in any rehab going slow and gradually return to light weights and full range of motion is important. Everyone is different when they regain their full strength. It is better to go slower than faster.

  19. Hi,
    I’m a Massage Therapist, Crossfitter, Beginning runner, and bike at least 20 miles two- three days a week. Im having a Scope on my left shoulder to repair the labrum and explore the remaining joint for other issues (because the MRI was unclear).
    How long should i wait before heading back to work as a Massage Therapist? I specialize in stretching and deep tissue work and have more people come to me that are “broken” (their words not mine) and need more therapeutic means vs relaxation. This work puts a ton of stress in my shoulders and i dont want to over do it but i also dont want to let me clients down. Would it be safe to return 4 months post op but only work with one client a day?

    • This is a great question for your surgeon and should be addressed before your surgery. please call your surgeon.

  20. I am ten days post op from supraspinatus complete tear repair.
    My sling has been more uncomfortable (literally more painful) than my arm out and supported. I have admitted been out of the sling more than indicated, though not actively using it, supporting it yes, or it’s hanging as like with my exercises as directed.

    I have done my exercises extra times here and there as it doesn’t hurt, never has to do them, and feels sooooo much relief to do them.

    But…now I’m worried I’m risking my repair. My follow up is this Friday.

    I’m curious though, how would a person know if the repair has been compromised at all? Not talking full tear again but in any way, how would a person know?

    I have also been steady walking on the treadmill and on my recumbent bike (they told me not to be a couch potato….and neither of these cause pain so I’ve assumed it to be fine if I’m in the sling??)

    • We ask people to be cautious with their repair so we don’t even need to worry if they reinjured themselves

  21. Hi.
    I am a left arm amputee, and have to undergo surgery of my right shoulder for torn rotator cuff. Will I be able to move my arm enough to care for myself:(eating,using the bathroom,etc)

    • Hi David, You definitely need to address this with your surgeon WAY BEFORE surgery is done. For people that I operate on I let them move their elbow and wrist but no reaching or lifting.

  22. Hello,

    I’m 2 weeks post op for a complete Pec major tendon tear. My surgeon was able to re-attach what remained of my tendon but also did an allograft repair. In doing passive PT for the next few weeks. Would you say recovery is similar to some of the shoulder repairs you have done?

    • Allografts typically take longer to heal unfortunately

  23. How soon can I start trail running? suparspanatus tear, bicep tendon partial tear.
    Thank you, Ben

    • Ben, can’t comment to you specifically because you are not my patient. If I did a repair on a suprspinatus rotator cuff tear, I would not let someone trail run for 3 months. It’s not the running, but more the tripping possibility.

    • Sean – It has been recommended to me to have a bicep tenodesis operation. I am 62 and very much active in Crossfit as well as Olympic weightlifting. I am curious as to how much overhead, or any for that matter, loss of ROM I should expect.

      • I cannot comment on you specifically. I have had people get back to the Games as Masters after a biceps tenodesis

  24. I am a 27 y/o male 3 weeks out of a bicep tenodesis. You mentioned that you have regional and games level athletes training after this procedure.

    What rehabilitation protocols do you recommend to return to a high level of performance? What kind of time frame am I looking at?

    Are there any risks to other tissues e.g. rotator cuff when returning to overhead pressing and kipping movements?

    Any advice is greatly appreciated. Thank you!

    • Allan, that is an in depth conversation to have. You can email kmee@orthopedicsne.com to set up a consult if you like. I would be happy to talk further.

  25. I had a two anchor posterior labral repair done 6 months ago. 3 months ago I was hit by a car which tore the surgery apart – I had it redone 2 months ago but am much more cautious about recovery this time around.

    My surgeon said “no restrictions” after 3 months including squats (the hand position and shoulder load of these terrify me!) but this seems massively premature to me. I was thinking 4 months minimum then only introducing very low load, range restricted cable and dumbbell work? Your thoughts are appreciated!

    • I would be cautious at 3 months, i still restrict people with their weights and explosive high velocity maneuvers. Once you have shown control then there should be a linear progression with weights then adding high velocity movements. good luck

  26. This was really helpful information. I just had a labrum repair 6 weeks ago and I’m impatiently waiting to start strength training. I definitely don’t want to over do anything. However, my therapist is already having me do some resistance training with the bands. Mainly bicep curls and tricep extensions. Before surgery I was working as fitness model, do you think I’ll ever be able to exercise like before? I mean it was hours of training a day and a lot of different strengthing exercises and sometimes holding positions for extended periods of time.

    • I’m 13 weeks post labrum and supraspenatis repair.
      I’ve done limited strength training up to this point but Will transition slowly back into CrossFit next week.
      Still no overhead strength movements or pull ups but looking forward to gaining my muscle and endurance back!
      Good luck…

    • Hi Elizabeth, I wish you the best and obviously can’t comment on your case specifically. Just so you know, I have had CrossFit Games athletes get back to the Games after labral repair so it is possible. Good luck!

  27. I have a circumferential arthroscopic repair this friday. I will also have an open laterjet on the front of the shoulder. I am 25, boxer, man fighter, wrestler, jiu jitsu practitioner, the works. I also have finals coming up so I need to be in school the following Monday. When can I start the passive movements with my arm hanging on my side, and what is the best indicator of when I am healed enough to do full range of motion movements?

    • Hi Cortland, every surgeon is different and allows different latitudes after surgery so check with your surgeon please.Good luck with it.

  28. Hi, I’m 29 years old and I had sx 11/2016 to tighten the capsule due to my shoulder easily coming out of socket. The surgeon had to tighten the front and back. PT lasted 3 mo. and I was just d/c’d from the surgeon and PT. I can’t believe how much pain I still have in the front and side of my shoulder. I was told the pain is the last to leave, is this true? Still struggling with my ROM in a throwing motion. Thanks!

    • Those can take a while to heal and improve your range of motion. Check inwith your surgeon if not better and keep doing your stretches to make sure you are progressing

  29. 40 year old male Active Army, just had bicep tendonits surgery 5 days ago. I have my first PT appointment tomorrow. I have access to gym and my own areodyne bike at home. After reading many different comments I’m interested in keeping myself in shape while recovering. Any type of program you could recommend I’d appreciate it.

    • check with your surgeon first and then the above post is what I recommend to my patients

  30. My name is Jeff and I have recently been diagnosed with a Type II SLAP tear on my left shoulder. My research has indicated that biceps tenodesis can be the recommended surgical repair in patients older than 35 (I am currently 38). I am afraid that I have a similar issue in my right shoulder, but the pain present in my left shoulder is slightly worse. I have been avid in weightlifting since my early 20′ s. I enjoy performing overhead movements such as pull-ups and variations of a military press. I am curious if these movements would be possible after full rehabilitation has been completed for a biceps tenodesis procedure?

    • I have a lot of people with SLAP tears that I have performed biceps tenodeses who have gotten back to Crossfit, weightlifting and gone to the Games

  31. Great information!
    I am 5 weeks post-op. I had a full thickness tear of the supraspenatus and a labrum tear due to a bone spur.
    My PT is limiting the use (as expected) of my operative arm. I am used to doing CrossFit 5-6 days per week so the down time has been VERY hard to get used to. I’m actually down 12lbs. I have really concentrated on my diet but I’m sure that I have lost muscle.
    My question is… when is it ok to take up running? I’d like to work on my cardiovascular activities since strength building won’t be an option for quite some time.
    My PT and surgeon have said running should wait due to the impact and arm pendulum movements. Would you agree?
    Thank you in advance!

    • It is their call when you return to running and yes I restrict running for rotator cuffs

  32. Dr. Rockett,

    Almost two weeks into recovery of a 3cmx2cm near full thickness tear of supraspinatus and high grade partial of infraspinatus. Surgeons were able to fully repair but was told tissues were under a lot of tension. 8 day post-op visit was uneventful but I have a lingering fear of disturbing the healing process through some reflex reaction, especially as falling asleep, which has happened a few times or getting arm in/out of sling or GameReady shoulder..fundamentally small movements. Is your “scream alarm” indicative of the level of pain a disruption would cause? Ie just a momentary twinge at edge of rom that goes away quickly shouldn’t drive me into panic? 45 yr old former high level athlete…

    Thanks for any wisdom…

    • Being overly cautious is a good thing early on. It can eat at people trying to know if they did something bad or not. Usually keeping the shoulder at the side without any sudden reaches or lifting anything is what I tell my patients to remember.

  33. I am about to have an op for a full thickness supraspinatus tendon tear.

    How long do you estimate it would be until I would be able to do partner dancing e.g. Salsa.

    Also, would I be able to return to planche work, muscle ups, back levers etc. after 6-8 months?

    Working on the planche has given me all sorts of tendon inflammation over the years in the chest, shoulders, forearms.

    thanks,

    Eliot

    • You have to ask your surgeon these questions ahead of time. If my patient were to ask me these questions aggressive salsa can be 4 to 5 months, 6 to 8 months is a good target but it may take longer,

  34. I am 3 weeks post op. What do u think about doing leg extensions and leg curls. Also what about with my good arm doing some curls and tricep extensions?

    • Brent, I would tell a patient of mine that is ok as long as you don’t struggle with the surgical arm and it is completely at rest.

  35. I had decompression and small partial rotator repair 5 months ago. Just last week I tried lat pull down wit Hough weights and I only went half way up. Now I am still sore week after. I hope I didn’t damage anything. What’s your thought.

    • You need to be reexamined to determine that

  36. I had arthroscopic repair for 2 full thickness tears in the supraspinatus and subscapularis as well as a dislocated bicep tendon 29 days ago. Shoulder is feeling ok except for occasional aches and pains, however, my worst, and most painful problem right now, is that about 2 and a half weeks ago I started noticing pain, tingling, swelling, burning, stinging, and numbness in my wrist and part of my inner forearm on the same side as the surgery. It does this while in the sling as well as out and it’s extremely uncomfortable Sometimes when I’m out of the sling and let my arm hang to the side some of my fingers turn purple and are very cold. I have called my surgeon’s office a few times about this, and just get suggestions to move my hand and wrist around, bend and straighten the elbow etc, which I do and it makes no difference. I’m 57 years old. I was given a nerve block just before the surgery and still have a swelling in my neck from the injection. What could be causing this?

    • I cant make that diagnosis over the internet and would ask you to get in touch with your surgeon about this please.

  37. I am 16 days post surgery. I had a left shoulder labrum tear with anchors placed at the 3, 4, and 5 o’clock positions. I also had a ganglion cyst removed that was entrapping my suprascapular nerve. I just started PT on day 15 post-op and my ROM is already well past what my surgeon instructed for the end of the first 6 week PT period. The script calls for me to be at 120degoverhead after 6 weeks of PT, but I am already at 160deg or even a little higher. Could this be a sign that I am recovering faster than average and that I may potentially return to full weightlifting before 6 months?

    • Check with your surgeon, because restrictions in range of motion are put in place for a reason. You want to be careful not to disrupt the repair.

  38. Dr. Rockett,

    Do you offer phone consults regarding this topic? If so, where can you be reached via phone and/or email to discuss cost and specific topic of discussion? Thanks in advanced.

      • Assuming I get my Dr’ approval, when would be an OK time to reintroduce back squatting using a SAFETY BAR? I’m 12 weeks post op and have almost restored full ROM across all planes.

        • I usually tell my patients with a rotator cuff repair that they can use light weights to start at 3 months. You dont want to stress the repair with something sudden or lifting a heavy load.

  39. Hi,
    I have very recently had a shoulder op 5 days ago infact (decompression shoulder subracromal – anthroscopic). I had an MRI scan 3 months before the op and it showed a tear. However the surgeon couldn’t find anything when they were operating.
    I understand that its not as severe as a tear would be but what would the recovery be? I have a sling for comfort and it seems that as there isn’t a tear I could potentially train (obviously NO Pullups, olympic lifts etc) but as for running, swimming, and 1 arm work I should be ok with on a pain basis. Should this be ok or would I be doing too much? Do you have any advice?

    • As always listen to the advice of your surgeon. I usually tell people it is a 2 to 3 month recovery, building up movements over that time. I usually say running when comfortable, swimming takes 2 to 3 months overhead. getting in water and using the water as a form of PT is great to do once incisions have healed in two weeks.

  40. Hello Sean:

    I really appreciate you taking time out of what I know must be a busy schedule to answer reader questions. When time allows, your feedback on mine is appreciated.

    I’m scheduled for arthroscopic repair of grade III ac shoulder joint on my dominate arm at 47 years old. Prior to the injury I enjoyed a number of body weight and weighted exercises. Assuming my surgery is successful, in your experience should I be able to return to these activities post recovery past 6 month period (push-ups *including weighted, pull-ups *including weighted, and handstand pushups)?

    I realize your response is best guess, but curious based on your patient experiences.

    I’m also guessing with no future re-injury the repair should take me to the grave? (button and suture with stem cell injection in disrupted tendons and ligaments being repaired)

    Thanks for your time.

    Regards,

    Chris

    • I usually allow people to get back to that stuff, yes, good luck with it

  41. Dr. Rockett, 2 weeks ago I just had surgery, 1 anchor for labrum and subacromial decompression. I’ve been weight lifting for 17 years and plan to return. I’m 33 years old. Do most people bounce back from what I had and return to tbeir preoperative state? I’m worried I’ll never be the same and have a 11 month old son I can’t even hold. In addition and probably the more important question is, my other shoulder has a moderate partial infraspranatis tear and I’m hoping I can avoid surgery. Have others been fine continuing to work out with a moderate partial tear without any future complications?

    Thank you for your time.
    Chad

    • So yes I have returned people to their normal fitness level, Be patient and follow your surgeon’s and PT’s instructions. It takes a long time for rotator cuffs to heal. Go to my rotator cuff post and you will see there are different dergrees of partial tears, some are minor and people can function well with them.

    • Hey Chad
      I have never had a shoulder surgery but I have had two ACL reconstructions and one meniscus surgery from 19-20 years old. Bother literally both were 9 months apart. I also have a real bad surgery that I need to get taken care of but I can’t afford to take time off work other wise id lose my place of staying. Anyways I thought id never be the same. Well truth is I ain’t them same. I am different now. I learned quite a few things. Pace yourself. Take your time. Work hard but don’t over do it. I may not be able to lift super heavy like I was but I can still leg press 450 pounds for 3 reps. can still squat my body weight (175) and have full range of motion in my legs now. They maybe 80% but I can still run just as fast as I was at 17. My point in this little book I wrote to you man is never give up. Listen to what your doctor says. Don’t get too crazy with activities and be honest with your doctor about anything you are doing. They are there to help out. Especially your Physicians. I owe everything to them. They are so knowledgeable about human anatomy. Ask questions so you keep learning about how to strengthen it and heal it a bit faster. Eat clean and lean protein and tons of veggies. I have faith in you. Surgeries are very scary man. But you will come out a better person at the end of the day. I wish you luck man

  42. Hi Sean,
    Just found this site on Facebook and I really appreciate the great info. I have a question about workouts post-surgery. I am 20 weeks out from a complete tear of the supraspinatous (no shortage of those here, I see). I have been released from PT and my surgeon. I have been modifying workouts at my box so I don’t over-tax my shoulder (eg. I did half-Murph yesterday and did jumping pull ups and kettle bell swings instead of push ups). My question is this: When do I know I can go up on weight with my presses, clean & jerks, and snatches? I haven’t even attempted snatches yet as I have been a bit scared. I did one with a PVC pipe and it hurt a little so I haven’t done any since. The shoulder feels great and no pain except that expected from some stiffness and the workout. How do I know when to increase? Should I forget snatches forever? PT told me to avoid overhead press at all, saying it wasn’t good for my shoulder, but that seems ridiculous since we lift things overhead in everyday life. I’m 48 and have been doing CrossFit for 3 years (not that you could tell my looking at me…LOL). Again, thanks for this website…so helpful!

    • Again speaking theoretically and when I let my people go back to overhead movements. I tell them they can start by 5 months with overhead activity. with a dumbbell to start and then to barbells. They then need to take it slowly and start to increase weights that are easily controllable and not stressful just to dial in the movement patterns. Then they can start to increase weights as they feel more comfortable. Sean

  43. Thanks for your page, Sean. Extemely useful.
    I’ve had rotator cuff surgery 3 weeks ago. Was an supraspinous and infraspinous breaking of 20 mm wide and 18 mm deep. It was repaired with an Arthrex Speedbridge system. My surgeon says that the tissue was in very good condition (I’m 50 years young) and the acromion left enough space with no teering danger for the rotator cuff. I’m sure the tendon breaking was doing flights in the rings and wide kipping in the bar to get a muscle up progression.
    After 3 weeks I have almost no pain during the day. At night I take 1 gr. of paracetamol (I think you call it acetaminophene in the US) but is very hard to me to get some sleep because the shoulder pain. I just can get 2 or 3 hours i total of sleep per night. Is this normal?. This difficult for sleeping will last for a lot of weeks more?.
    When in home, I remove my sling for some hours a day. Of course I don’t elevate the arm. I remove the sling for sleeping too. Shouldn’t I do this?.
    I do some light pendulum exercices and some elbow and wrist ROM 3 or 4 times a day.
    How much do you think I should wait to do olympic lifting and gymnastics again?.
    Thanks a lot.

    • So every repair is different and I can’t give you specific advice because you are not my patient. You should check with your surgeon for specifics. However pain can last a long time after rotator cuff repairs up to several months. I let people come out of their sling and move their elbows as long as shoulder is at the side. sleeping is best done sitting up at about 45 degree angle in a chair or protected by a lot of pillows. I let people progress to dowels at 2 months for simple repairs and by 5 to 8 months barbells and weighted activities increasing overtime

      • Thanks for your fast reply. It will be a hard waiting to put my hands on a barbell again.
        About gymnastics, I assume that the correct way is to start with strict movements slowly progressing to more joint agressive thecniques (kipping, butterfly…) spaced in some months. All the process is about patience (a lot) and common sense.

        • Yes exactly

  44. I had an arthroscopic bankart repair 15 months ago. My surgery went great and I continue to do rehab to keep it functioning well. I recently returned to crossfit (I previously did it for two years before surgery in September 2014) and am wondering if you have any advice for movements to avoid and/or modify. I don’t do any kipping now and am keeping the weights light while easing back into it. I have hypermobile shoulders and had a history of dislocations in the left before getting it fixed due to the pain. My left surgical shoulder now has full “normal” range of motion but cannot hyperextend. Thanks for any advice!

    • Certainly would be cautious with kipping and getting back into things slowly. I like to do strict activities first with great form and low stress and low weights before advancing. Advancing is OK as long as weights are handled well and without loss of form

  45. Dr. Rockett,

    I am having a suprapinatus repair arthroscopically next week. I am an ortho-certified PT as well as cross-fitter. While I am familiar with the standard RTC protocols, I am not as familiar with the progression back to CrossFit and lifting. As long as ROM and strength are good, would a 5-6 month window be typical for return to full activities? Are there activities that I should avoid for the first year? (such as snatches or muscle-ups?)

    thanks!

    • Good luck with the surgery. One of the big issues is the size of the tear. Obviously smaller tears quicker recovery. for small tears I usually quote 4-6 months for everyday heavy lifting and 5 to 8 for explosive heavy lifting. I have gotten people back to normal crossfit activities including snatches and muscle ups. The weight s need to start light and progress with perfect form.

  46. Hi, I am at 16 weeks post-op for a RC/Labrum/Biceps repair. I have been making small gains every week and I have almost my full ROM back and strength is returning in small gains as well. My question is in regard to shoulder tightness in the teres major area which was not involved in the repair. I have been concentrating stretches in this area and it continues to remain very tight. Why am I experiencing this and what will help relieve the tension involved?

    • It could be a sign of a tight shoulder after repair but you definitely want to check with your surgeon about this. Good luck

  47. Hi. Thanks so much for publishing this information. I’m 7 weeks out from the repair of a massive supraspinatus tear and being able to research what I was getting myself into was very helpful before surgery. In general, how long do you recommend patients refrain from loading a barbell on their shoulders for a back squat? I realize it will be months before I will be able to snatch of C&J again (I’m primarily a weightlifter), but I’d like to preserve as much leg strength as possible. And there is only so much load you can add for leg work without placing a barbell on your back. I’m pain free and have 95% assisted ROM back now.

  48. Further to my last question, can I just emphasise that the level of pain I feel in the same spot feels exactly the same as pre op when put under tension.
    Having said this I’ve noticed that when doing light biceps and triceps exercises with a band(this has been cleared by the physio) , I no longer have the same pain in my front delt I had prior to op.
    Again, any advice would be appreciated….. It’s hard work isn’t it being patient with this injury 🙂

  49. Hi. Great site. I am now 9 weeks post op after slap tear repair to my left shoulder following a crash in work. The pain pre op was all in the front of the shoulder whenever it was put under resistance eg the O Brien test. I’ve been following all protocol from surgeon and physio and my range of movement is def improving. I no longer have aching pain all night in bed and can no use the operated side for little things like closing doors, dressing. My question is this…even though I’m being patient with recovery I’m slightly concerned that if I try putting the operated side under any resistance eg The O Brien test I get the same level of pain in the same spot. Is this normal? I would have thought at this stage it would be slightly stronger or am I being Impatient. Any advice would be great thanks. Matt

    • Yes you have to be a patient patient. It can take a long time to feel better and just keep your surgeon advised along the way. Having pain still at 9 weeks is not uncommon. Good luck

  50. Hi Sean, I am a 35 y/o professional athlete (throwing/overhead) and did 8yrs active duty in the ARMY (so plenty of wear and tear on the shoulders), 7 months post-op; I had a 2cm tear of the supraspinatis tendon repaired at the point of insertion, minor tears/ fraying of the infraspinatus and subscapularis (anteriorly) reduced, and a grade 4 SLAP tear repaired with 2 double anchors…and of course the customary bursectomy that comes with surgery on synovial joints.

    The ortho who worked on it is one of the best in the biz BUT I’m still having issues. Further active external rotation when standing, from an apprehension position, is extremely tight and still elicits pain. There is also some popping(but this doesn’t hurt). The strength training is progressing very slowly, as well. This is frustrating. While there is no instability (which is good), I still have concerns that perhaps the surgery was not successful and am thinking of getting it re-images w/ contrast.

    My question is this: In clinic, do you see a lot of patients, several months post-op, that are still ‘popping’ and have issues with loss of ROM and painful tissue rebound(tendon)? Is this pretty normal?

    I’ve asked both him and another surgeon several times and they keep telling me ‘be patient’. This is tough because I am used to being able to do anything. Heavy pulling (like bent over barbell rows with 300-400lb, lat pulls/not bodyweight yet) doesn’t really aggravate it, but flat and overhead pressing is progressing at a snail’s pace.

    Anyway, just curious to see if a lot of your patients present with the same popping/reduced ROM this many months post-op after undergoing similar procedures to that which I had.

    Thanks.

    • I have seen everyting. From retears during PT to popping that is just noisy and did not amount to anyhting even after imaging and rescoping in some cases. When you say they repaired the Type 4 SLAP did they do a SLAP repair or a tenodesis?

  51. Hi, I had surgery 3 months ago nearly, its been 12 weeks coming this Wednesday, I had a terrible incident where my friend pulled my shoulder, by my wrist and I felt my joint in my shoulder pull forward and a tearing or ripping sound was made, did my surgery damage, did I ruin the surgery, is my anchors pulled out, should I be worried??

    • Can’t answer that one on the interweb, you need to talk to your surgeon about it, good luck Sean

  52. I’m 19 weeks post op this week. Been doing some “knee” push ups as of late. feeling a little sore. Good sign or bad?

    • Random soreness is fairly common in the post-op phase especially when you start to return to some strengthening activities. Back down and if the pain goes away, great and if not check in with your MD.

  53. Thank you for your information – Noted on the exercises and plan on working on my core big time.
    I am having rotator cuff surgery on Weds. 05/27 and I am scared as h*ll – Don’t know what to expect as far as pain, recovery, pt & most importantly what exercise can I start doing asap. I am in the midst of a 4 year health/fitness goal/journey (I’ve lost 80 lbs in the last 1-1/2 yr) and not working out until full recovery is, well, unacceptable right now. Any additional input/advice pertaining to exercise is greatly appreciated.

    • Good luck with surgery, I think the article covers the bases but also ask your surgeon what will be ok as surgeries can vary as can surgeon’s opinions.

  54. I am 12 post op – SLAP repair, RC repair and bone spurs removal. I’m still doing PT. I have not gained full ROM and apparently have scapular dyskinesis. Specifically what CrossFit exercises / barbell work can I do? Also, what can you tell me about scapular dyskinesis and how it relates to my injuries?

    • Pat, I was not your surgeon and can’t tell you what you can or cannot do exercise wise. My article above pretty much shows my patients what they can do at certain stages. Scapular dyskinesis is when the scapula is not moving normally in relation to the glenohumeral or shoulder joint. There are a number of causes and it is something you need to discuss with your surgeon and PT

  55. Hi Sean,

    I’m 5 months post op on a SLAP repair as well as cosmetic work done to the rotator cuff. PT was a breeze and I was out in under 2 months with full ROM and the beginnings of dumbbell strength training. So far in my regimen to recover at the gym, I’ve stayed away from any kind of barbell presses and stuck with dumbbells.

    As a former college athlete, I think it’s only my competitive nature in wanting to push my body. I’m still young (25 years old) and thus far have had no complications from surgery (with the exception of pleurisy which was even worse than the SLAP repair). I’ve been cleared by both my doctor and PT to resume normal lifting as my body permits, but am hearing from other forums certain exercises post op should be completely avoided regardless of time frame. These include dips, military presses, and preacher curls, all of which are focal points in my lifting regimen.

    Would you advise that as long as I’m not seeing any complications from returning to the gym to continue along with these exercises and increase weight as my body permits?

    • If you were my patient I would let you return to these activities gradually as strength improves

  56. Hello Dr. Rockett,
    I am 14 weeks post op a SLAP lesion repair and a grade 3 rotator cuff tear. I have good ROM and finished physical therapy and now am still doing the stretch exercises my PT gave me. I am mostly pain free now and am taking meloxicam 15mg til end of this month. I walk on my treadmill for cardio at incline 10 for 30 min. wearing my sling and do ab exercises lying on a wt bench plus body wt simple lunges. My questions are: when may I resume my running and light free wt workouts? I am very fit-minded and afraid I’m losing arm/shoulder/back strength. I am used to running 15 – 20 miles a week on my treadmill. I had a followup MRI with contrast a couple of weeks ago and it appears all is intact, including biceps tendon. (Yay). I don’t want to compromise the repair – yes, HELL WOULD HATH NO FURY if I retore the labrum again! Thank you for your website! Very very insightful.

    • For running and lightweights you need to ask your surgeon. When I operate people are running by 3 months. Good luck

  57. Hey Doc!

    Thanks for all of the info.
    I am 7 weeks post op – torn labrum, complete tear supraspinatus, complete tear intraspinatus, torn bicep.
    I realize that you would have to be my doc to provide detailed medical advice…but the very conservative approach that I am being given is killing me! Atrophy is setting in…and I am losing all muscle in the shoulder/chest/arms.
    I am pain free…have good range of motion…and I just want to do pushups/pullups/etc. I am being told to refrain until my next apt on April 15!!!
    Any thoughts? What can I do to maintain chest and shoulder development?

    • Sorry it would be wrong for me to give advice over the internet that goes against your surgeon’s recommendations.

  58. Hi Sean. I had a labrum repair January of 2014. I had a very difficult time with it. (Extreme pain and NO ROM) The surgeon told me from the get go that he thought there was something more going on then just a labrum tear. Well, I’ve recently been diagnosed with RSD. I used to work out very vigorously but since my initial injury (Oct. 2012. Yeah, it took two years for surgery due to it being a work related injury) At one point in my life I weighed 235lbs and with dedication and hard work I got my weight down to 150lbs and was in GREAT shape. Unfortunately I have gained weight back. Do you have any advice for me to help me lose weight again? Thank you!

    • Hi Constance, weight loss is not my specialty, but I have always believed in burning more calories than you take in if you are looking to lose weight. Checking in with your Primary care would be helpful also.

  59. Hi Sean,

    I have a labral tear as a result of two dislocations. I tore it again in October 2014. As of now I have full ROM and zero pain but still want surgery so I can lift heavy weights again. My ortho recommends a Bankart repair.

    As a bodybuilder, post-surgery and post-recovery, are my days of military press/dumbell shoulder press over? What factors if any would determine if I can do heavy incline chest press/overhead shoulder press in the future without fear of another dislocation i.e. ripping my labrum through the sutures? And how long after a bankart repair surgery can I return to shoulder/overhead weights? 8 months? a year?

    I’m only 25 and since I currently have no pain and full ROM I hope that with a couple of anchors and some healing time I can get back lifting heavy. Thanks Sean!!

    • I tell my patients that they can lift overhead again. There is always a risk of redislocation but at age 25 your chances are better having the surgery as there is a very high dislocation rate without it. Everyone and every surgeon has different recommendations but I have people training with light barbells overhead at 3 months to help with range of motion. Certainly nothing heavy and comfortable full range of motion movements. By 6 months they have increased their weights and are feeling very comfortable with most movements.

  60. Hi Sean,

    I had labrum repair surgery 4 weeks ago and am supposed to start physical therapy on the 16th. You said you don’t have your patients do anything for 6 weeks. Should I wait another two weeks before starting physical therapy? Also, I’ve been somewhat bad about keeping my sling on.. There is very minimal pain in my shoulder. Should I go back to wearing it when I sleep? (It’s just been really uncomfortable the last week with it on.) I am just afraid to reinjure it because I do a lot of weight lifting and play a lot of basketball.

    Thank you.

    • Taken from above:
      For the first 2-6 weeks I have allowed patients to 1 arm aerodyne, 1 arm light kettle bell swing, air squat, step up and down boxes, 1 arm dumbbell squat, 1 arm rowing, lunges, 1 arm farmer’s carry, careful sit-ups and back extensions, sled drags. The key to all of this is the THE WEIGHT ON THE OTHER SIDE HAS TO BE SMALL ENOUGH THAT THE REPAIRED SIDE REMAINS QUIET AND UNAFFECTED. THERE SHOULD BE NO MOTION OF THE OPERATIVE SIDE AND NO STRAINING THAT PUTS TORQUE OR STRESS ON THAT SIDE. VERY IMPORTANT POINT HERE.
      Regarding your sling talk to your surgeon.

  61. Having rotator cuff surgery next week. I have two, one centimeter tears. Not experiencing any real pain. can still do push-ups, pull ups, weighted squats, cleans, and rows. Running poses no problem, nor does the rowing machine. Just wondering if this is a good thing, as far as the severity of my injury.

    • Yes I have seen these tears get bigger and more difficult to fix. I have seen them retract to the point where you cannot reattach them. So I usually recommend surgery for full thickness tears.

  62. I had surgery 8 weeks ago to repair a torn labrum from an old apparent dislocation injury subsequently re-injured during overhead squats at crossfit (I had worked out at cross fit for 1 1/2 years and made good strength and mobility gains). Once inside, it turned out it wasn’t torn. So, the surgeon took out two pieces of bone fragments that he saw in the MRI and cleaned up torn tissue. At post op visit one, he said the bad news was I have “stage 4” arthritis on part of the ball (I’m 54 year old lifelong athlete and active guy). At follow up PT, they said they have many cross fit clients and they don’t recommend overhead presses because of un-natural shoulder movement. My soreness is abating and I want to go back to cross fit. Should I modify my cross fit workouts and/or eliminate overhead presses? If so, what do you recommend? Any other recommendations? Thank you very much!

    • Hi Tom, typically with Grade 4 arthritis I will ahve people modify what they do to still enjoy being fit but not pushing through pain if that makes sense. I recommend people with arthritis try to maintain range of motion as much as possible with stretching. No one can argue with you trying to stay fit and be flexible. good luck.

  63. I was operated on 11/25 with a large supraspinadus tear. Surgeon able to reattach, shave spur and clean out inflammation. I am a crossfit athlete and triathlete. I have an ironman set for Oct. Wondering in addition to the great info you provide in your article what your advice would be in getting back to running, outdoor bike riding and swimming. I just started PT.

    • You have a lot of time and healing to go. So number one is don’t push it, soft tissue can only heal at a certain pace and takes 6 weeks for early scar formation and 3 months for mature scar formation. You may not be 100% for an ironman in october and that is fine because you will always have others in the future if you need extra time for swimming that distance. I personally let people run at 6 weeks without swinging, bike ride at 3 months outdoors in case they fall, and swimming at about 3 months also

  64. Hello Dr Rockett,
    I am 4 days short of 16 weeks post op, on rotator cuff repair that turned into a 2 hour 45 minute surgery with 29 repairs including repairing broken bones and a separated collar bone. I am still in a lot of pain. The surgeons assistant is baffled bt my pain level. However during physical therapy one of the he therapist a girl weighing about 250, pushed her weight down on my shoulder to get past me. I have gained 45 pounds taking it easy and really need to get back in the gym. I am open to any suggestions you may have Sir.
    Thank you so much Gabriel Edelson-Ivory

    • This sounds like advice you need to talk to your surgeon about but stationary biking is certainly a great way to get your heart rate up without having to deal with the pain from a rotator cuff surgery.

  65. Great info! I’m 5 weeks post op for clean out of bursitis, tendonitis, bone spur and a minor tear. Been doing passive ROM exercises, looking forward to removing the sling in a week. Prior to surgery i had pain aroundAC joint radiating down into biceps (told it was impingement). I’m still feeling the same pain post surgery. PT says could be because of swelling that’s still going on. Surgeon said its normal. I don’t feel like I should have the same pain I had before the surgery AFTER the surgery. What are your thoughts? Is this pain typical (feels like a pinching inside…somewhat of a sharp pain) Should I be concerned? Second opinion? Thanks for your help!

    • For your surgery I will typically give someone 2 to 3 months recovery. Biceps pain can be from inflammation as long as there were no tears of the biceps or superior labrum seen at the time of surgery.

    • Val,

      I am at week 13 and I had a good deal of post-op bicep discomfort, fatigue and sometimes outright pain as well. In fact, it was the only outright PAIN I had after surgery (but I am not normal when it comes to pain tolerance, so don’t go by my story). The bicep was more infuriating than trying to feed myself left-handed.

      The best thing I can tell you is that (in my case) Tincture Of Time just made it go away. I think this thing just heals in stages and little by little, things get better. Hang in there.

  66. Hi….love this article! When would you allow a patient to jog after shoulder surgery?

    • I have jogged behind someone i did a labral repair on and saw that they were able to control the shoulder with the slings that we use and not strain it… 2 weeks after with no swinging or straining.

  67. thanks so much for your time in detailing what positive things i can look forward to after surgical repair. im pod12, post RCR/SAD with stalactite osteophytes and bursectomy (4 peek anchors). knowing that the right patient can rehab back to some semblance of “normal”, with limitations, is highly encouraging.

    a CF surgeon is a rare and grand thing (how you find time to do it all impresses me, as i am a retired first assistant). thanks for keeping us one-armed bandits encouraged.

    • Happy to help. It’s what I like.

  68. Typically when I operate a rotator cuff gets to deadlift At 3 months If you mean front and back squat, about 3 also without straining the repair

  69. How long do I have to wait to go back to deadlift and squat after rotator cuff surgery?

  70. Hi sean,have been having shoulder problems for about a year now.. tore my labrum during military press type 2 slap tear had surgery to repair it then it got tight where i lost alot of ROM had 2nd surgery capsular release helped a little. My shoulders are now out of line and hurt alot all the time ive tried physio etc had another mri only showed inflamation and i dont know what to do it wont seem to get stronger.

  71. hello sean……i had an mri of my shoulder…operated for bankart lesion….the labrum is properly attached……the acromio-humeral distance is 8mm but subacromial distance is 6.78 i.e. less than 7mm…..the person who wrote my mri report says that it isn’t significant as it is not too less than the required distance..and asked me if i had pain during abduction which i don’t have………but when i back squat/front squat heavy….i have pain after the workout which extends below the elbow and sometimes upto the wrist and it keeps on moving from point to point….i don’t have any pain in rotations or any other shoulder exercises like presses,bench press,pushups etc…..can it be due to neck issues??or due to weaker trapezius as i haven’t been doing any trapezius strengthning…before injury i used to do lots of clean and snatch pulls….which after the injury haven’t been regular…also the pain goes away when i massage the neck+trapezius regularly and sometimes it goes into my head….please help…thanks in advance

  72. Hi Dr. Rockett,

    Just wondering your thoughts on running. I see a lot of the protocols that hold off for 3-4 months before allowing running. I was told this is due to the jarring on the shoulder and how it might effect the repair? What are your thoughts on running and how does it fit into your protocol?

    Thanks,

    Kevin

  73. Yes you can talk to Denise in my office 617 527 5040

  74. Dr. Rockett do you offer any on-line consulation? i.e. review of existing MRI’s and discusss options? I’m near Washington, DC, am a 52 year old female CrossFitter (2.5 years in). Shoulder issue 18 months. I can give specifics but need another opinion. Recent doctor said “no human being should EVER lift anything heavy overhead”. I’m stuck. Thank you for your time.

  75. Thank you for the information.

    I am an avid road cyclist and runner. I can’t seem to locate much information about the appropriate time to resume running?

    Thanks

  76. Microfracture is an okay procedure for defects. It is the first step if needed. If it is a big defect microfracture not a great procedure.

  77. I am currently in the process of rehabbing my shoulder to avoid surgery. I am about 4 months out doing one arm crossfit workouts and rehab on the injured shoulder. I have been told I have a torn labrum and a glenoid defect. I was cleared to start back with 2 arm workouts last week. I have started back very light with no over head stuff and no hanging stuff, and no kipping. After 2 workouts my shoulder pain is back to where it was when I stopped. So I think I am surgery bound. I feel I wasted 4 months of recover time. I am 41 the dr. is a shoulder and arm specialist and feels confident about the surgery. I can find lots of information about the labrum surgery, but for the glenoid defect he is wanting to do a microfracture surgery. I can find lots of info on microfracture on the knee, but not so much on the shoulder. What are your opinions on the microfracture surgery and what is the recover time on this type of surgery? I am hoping to be able to do crossfit again as I really enjoy it. Even if I can RX every workout that uses heavy weight. I am concerned that my strength is my motor and I don’t want to lose that while in recovery being a triathlete and obstacle course racer cardio is my strength.
    thanks
    DW
    Thanks

  78. Sean,
    I just came in to see you a few days ago regarding both of my shoulders and the potential for a slap tear. I have the MRI scheduled, but I wanted to clarify your thoughts on me working out. as I dont have pain in the majority or my range of motion, is it ok to continue to work out as long as I stay away from things that cause discomfort? I would be happy to just do normal push ups as a scale instead of an overhead press for example. Push ups dont seem to bother me, where as a OHP with load does bother me. strict pull ups don’t seem to bother me, where as Kipping can.

    I will be happy to consult with my coach and scale things appropriately, unless, you think that I should just completely back off on all things arms until we know for sure what is going on. Let me know what you think. ( i really could spend some time working on my double unders anyway)

    thanks again for your help….

    Brian

    • avoiding painful things is good. Check and see if it hurts more 1 or 2 days later and be vigilant.

    • Hey Brian, Avoid painful things and be careful with heavy anything

  79. I can’t tell you how relieved I was to find this site and to read your posting! I am a competitive CrossFitter. I had continued working out with an injured shoulder for almost a year until I ended up with multiple dislocations and chronic instability. My surgeon told me that I required a total shoulder replacement, however I refused to have this done as I wouldn’t be able to continue with CrossFit/weightlifting competitively after. I had a labrum tear, damaged ligaments, extensive cartilage damage with significant cartilage loss, and the tendons that attach the biceps to the bone were completely torn off. I elected to have surgery to repair as much as could be instead (although the surgeon told me that there is only a 50% chance of it working, and if it does I will have at best 2-3 years before I will have to have the shoulder replacement). I had surgery 2 weeks ago for these repairs (obviously not much could be done about the cartilage other than cleaning it up) and also had a decompression (had 6 procedures done in total). My surgeon said that I could get back to CrossFit (but no overhead) in 3 months, and could do overhead 6-12 months. I know that you haven’t examined/assessed me, however given your knowledge/experience with the intensity required to be competitive with CrossFit, and given the issues that I have outlined above, do you think that it is possible that I will have the mobility/flexibility/strength in my shoulder to be competitive again? No matter what my chances may be, I intend on trying, because I have to. This is the only reason that I elected to try to repair my shoulder instead of having it replaced, but I would love to have your educated opinion on this. Regards, Tina.

    • I am sorry to hear about your shoulder. The only real way to answer all these questions that you have is to be patient and rehab appropriately. Hopefully you will feel good and be able to return.. Part of my lecture that i give is that the beauty of CrossFit is that you can modify anything and ramp up the exercises when you are in a better place. Don’t lose your wind and keep exercising within your restrictions. Good Luck

  80. Surgery if your symptoms are that dramatic would be best, good luck and happy to see you

  81. You gave me some really good advice about my hip last year, the replacement surgery went very well and following the Doctors orders i was able to return to Crossfit.

    Now I would like your thoughts on my shoulder. I dislocated my right shoulder in jui-jitsu 4 years ago. I put up with the pain for a couple of years. I eventually saw an Orthopedic Surgeon who felt it was a SLAP tear. I received a cortisone shot and did physical therapy and responded very well. Then my hip failed and my focus was on it. So now my shoulder is hurting again. An MRI shows an intermediate to high-grade partial thickness rim tear present to the distal supraspinatus tendon, distal infraspinatus tendon, and footplate. There is also a near circumferential tear of the glenoid labrum with intact associated scapular periosteum. A 1.5 cm paralabral cyst is present in the 4 o’clock position. the long head biceps tendon is intact.

    I am seeing the same Surgeon, but would like your opinion. I responded well to therapy before, but I really don’t want to keep going through this cycle. I have not dislocated the shoulder since, but I am losing strength. Overhead presses feel sloppy and I am recruiting other muscles to complete the motion, plus there is a lot of pain. Bench press or pushups cause pain and popping/clicking noises as well as catching. There are times when I’m extending my arm in front of me and turning my hand over, like opening a door or shaking someone’s hand, that I lose sensation in my hand and my grip strength weakens. I’ve dropped phones, pens, cups…

    Would you advise surgery over therapy at this point?

    Thanks,

    Paul

  82. It is in the works.

  83. I would be very interested in your rehab protocol after shoulder surgery! When will this be available?

    Thanks!

  84. yes i have gotten people back to weightlifting with regular grip and wide grip activities. Grip width does not matter once it is healed. Dan Pope and I are working on a rehab protocol for people after shoulder surgery and after PT is done to help them get back to CrossFitting

    • thankxxx for responding……nd hopefully i’ll recover!!

  85. I have to say in my practice I have gotten people back to weightlifting and crossfit but you have to talk to your doctor as I did not operate on you.

    • thankx for responding………i can’t travel outside india so had to be operated by the indian doctor….and he said that i can do weightlifting again but starting with a slow pace……i have read a lot of protocols on the net that tell you not to do some exercises like behind the neck presses with wide grip,bench with wide grip,pullies with wide grip????.i just want your opinion as you have operated on and worked with more sportspersons….so you can tell better……..take care…

  86. i dislocated my right shoulder on a 80 kg snatch………..got it reduced and after 40 days got operated for bankart(7 o’clock to 11 o’clock as per mri) and hill sachs(very small) lesion.the doctor has advised me to start weightlifting only after 6 months and i’m ready to wait…no hurry…….but even after 6 months can i do weightlifting again??you know snatches,clean and jerks,clean pulls,snatch pulls……….please advise………….:(

  87. Good, Informative Post, Thanks for this wonderful post and hoping to post more of this, so I’ll put this one on my bookmark list of http://www.manhattansportstherapy.com .

    Have Great Day.

  88. Pain is a sign that you have gone too far. So the goal is to remain pain free with all these movements. I would rather have less done and feel safe than live on the edge and push the repair. SR

  89. Dr. R – thanks again for the surgery last week. This post is exactly what I’ve been looking for.

    Now that I’m 10 days out, I wanted to get back and moving. I biked and did some strength training with my unoperated arm. While my operated arm has no pain during any of these movements, I want to make sure to get your take on using pain as an indicator. Is pain a reliable sign of going too far? What other indicators should I be looking for when I want to keep moving my body (with my operated arm still in a sling and sticking to slow, controlled movements) but want to be careful about reinjuring my operated shoulder?

  90. I have rotator cuff surgery coming up in September and I find the information here very helpful. I don’t like hearing that I can’t do a c/j for 5 months, but I don’t like them anyway. Would that be about the same for a regular clean. When you say light weight, what is light? Do you go by percentage of what we can lift or something you feel is light?

    • Zina, What you will be able to do afterwards will be determined by your surgeon. If you were my patient and I examined you and did the surgery then I could say, but I cannot tell you that over the internet unfortunately.

      • I do have one more question. When do you allow your patients do a sled pull? I see you have that listed as an exercise they can do. My doctor doesn’t know what a sled pull is and looked at me like I was crazy when I told him.

        Thanks for your time.

        • Sled pull for rotator cuff 2-3 months light to start

        • I must have done something wrong, because my comment yesterday did not post.

          I am almost six months postop. I was released from PT and my doctor. A bit disappointed that all I was told was to be careful. No real guidance on how to progress, but I guess that is commonsense. I guess since I have read so much on the percentages of failure for this type of surgery I am a bit uneasy.

          I have been sledding since three weeks after surgery. I just bought a waist harness. The sled has become my best friend. I joined a box where one of the coaches is very knowledgeable in helping people rehab. He wrote me many one-armed wods, so all has not been lost. I have done some group wods and just used the good arm.
          Now just starts the process of building strength in the arm and hoping for the best.

  91. Hey Dr. Rockett, Dan Pope and I interviewed you on our podcast a few months ago (Fitness Pain Free). I actually dislocated my shoulder yesterday doing snatches. I was hoping to get your thoughts on it since I am 12 years post-op for a bony bankart repair on the same shoulder. Hope all is well!

    Thanks!

    • Rob call my office 617 527-5040and give them your number so I can talk to you, Sean

  92. Thanks for posting. Re skin the cat, I just repaired a distal biceps tear in a patient mid 40s excellent health, slap tear in another Mid 40 person. I just think there is a significant amount of stress on the joint. Again young people can and do get away with this exercise, but older folks who have never done it have to be extremely careful with it.

  93. Thanks, that is really comprehensive. I appreciate your perspective and will discuss these guidelines w/ MD. It’s such a bummer about the skin the cat, though! I’ve been doing that since I was a little kid… 🙂

About Me

D Sean Rockett, M.D., is an orthopedic surgeon and senior partner of Orthopedics New England with offices in Natick, Newton and Hopkinton, MA. Dr. Rockett is a CrossFit Level 2 Trainer and co-owner of CrossFit Launchpad. He also enjoys being the head orthopedic surgeon of the CrossFit Games Medical team.

About 321GOMD Blog

This blog pro­vides gen­eral infor­ma­tion and dis­cus­sion about med­i­cine, health and related sub­jects. The words and other con­tent pro­vided in this blog, and in any linked mate­ri­als, are not intended and should not be con­strued as med­ical advice. If the reader or any other per­son has a med­ical con­cern, he or she should con­sult with an appropriately-licensed physi­cian or other health care worker.

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