Saturday, January 14, 2012

shoulder rehab

Shoulder Rehab

by Bill Starr
shoulder rehab


I was patiently waiting for the last of my luggage when I spotted Davey amble through the doorway. He stood for a bit, surveying the scene, in hopes of finding me in the crowd around the baggage claim turntable.



I worked my way through the other waiting passengers and got behind him.

“Looking for anyone in particular?” I asked.

“Yes,” he responded with a wide grin, “I’m scouting the area for potential weightlifters, but I don’t see any so far.”

We shook hands and waited together. It seems as if every time an airport upgrades its baggage facilities, it actually takes longer to get your luggage than before.

Presently, a motley-looking suitcase secured with duct tape popped out of the chute. Davey chuckled, “That one has to be yours. No one else would claim that one.”

I went and retrieved the sad excuse for a suitcase which I use to transport my books and paper material.

“But look at it this way. No one would consider ripping it off either.”

“Good point. Have you got everything? I’m illegally parked just in front of the door so we’d better hurry.”

We made our way out of the Dallas-Fort Worth Airport, heading north. The sun was dropping rapidly, framing the skylight of Fort Worth in a charcoal silhouette. As depicts this part of Texas in late spring, it was hot. Dusty, dry Texas hot. The countryside was the color of burnt umber and the road ahead of us shimmered as waves of heat vibrated off the asphalt. The air was thick and heavy to breathe. A thin layer of cinnamon-hued dust filtered into the cab of our pickup and soon everything was coated with a light brown color.

I wondered, as we drove through the miles of flat, dry prairies as to why anyone would select North Texas as a place to live. Unless they were being punished for some crime, or perhaps serving time for some improprieties from a former life.

We decided to stop in Decatur to fuel the truck and satisfy our growling stomachs. The diner was almost empty and we found a cool spot just under the air-conditioner vent.

We were enjoying the rush of cool air over our heads and shoulders when Davey looked up from his menu and said, “If you have some time this trip, I’d like you to help me do something about my shoulder.”

“What’s the problem?”

“I fell on my left shoulder about three months ago. The doctor said I had a slight dislocate. The kind they don’t adjust, as it was jammed, rather than actually separated. I laid off it for a couple of weeks and it got well. Then, just about two weeks ago, I lost a snatch over my head and it’s been bothering me again.”

The waitress took our orders and I asked, “Can you pinpoint the pain?”

“Pretty much.” He pressed his thumb on a spot just where the frontal deltoid meets the top of the biceps.

“It’s right here.”

I reached across the table and pressed at the spot he indicated, then proceeded to trace up the deltoid to the trapezius and down the biceps to the elbow.

“Right, THERE!” He jumped as I hit the sensitive spot.

“Frontal deltoid.”

“That’s what I decided too.”

“What exercises are you able to do?” I asked.

“I can’t bench, incline, standing press – anything where I set the bar on my chest of shoulders. I can still do my pulling and squatting, but I haven’t been able to work my shoulders since I re-injured it.”

“Have you ever tried using dumbbells for your shoulder exercises?”

“No, I’ve never used dumbbells, except for a couple of sets of curls every week. Why? Do you think they’ll work?”

“Sometimes you are able to position the dumbbell in such a way that you are able to avoid the pain. We’ll do some work in the gym tomorrow.”

Just then our food arrived so all conversation came to a halt. We wolfed down our chicken-fried steaks and made our way out into the black heat of the night. Both Davey and I are Hunter S. Thompson fans so much of the remaining drive was taken up in quoting some passage from one of his books. We did a lot of laughing before we arrived at Wichita Falls.

The following afternoon, I met up with Davey at the Wichita Falls Athletic Club, which used to be Anderson’s Gym. Davey sold it to Wichita Falls most celebrated powerlifter, Mark Rippetoe. Now Rip had expanded the facility so that it is one of the finest gyms in North Texas.

Davey was already dressed out and had just finished his stretching routine.

“What’s your program today?” I asked.

“Normally I squat, then do cleans, clean hi-pulls and presses of some sort. I’m only able to pull and squat just now and I wanted to see what you had in mind for me before I started.”

“The first thing that I want you to do, even before you squat, is to do one rehab circuit with light dumbbells. Do one set of: frontal raises, lateral raises, seated dumbbells and curls. Use as light a weight as you need in order to get twenty reps. The idea is to pump blood into the injured area and to insure that it is warmed up thoroughly. Quite often, lifters with shoulder problems will reinjure themselves while squatting since they lock the shoulder girdle in an isometric contraction during the movement.”

“I know what you mean. My shoulder has really been talking to me after I squat. I knew that I was irritating my shoulder but I sure didn’t want to give up my squats.”

He proceeded to go through the prescribed exercises as I did my warm-up sequence.

I walked over to watch Davey finish his set of curls. “So, how’s it going?”

“You know, the pain is gone just now. But what delights me the most is to find that I can do seated presses with the dumbbells. It’s a light weight, I fully realize, but that’s the first thing I’ve been able to do for my shoulders in weeks.”

“That’s a good sign. I believe that you’ll be able to do some work on the injured area. Let’s do our squats and then we’ll do some experimenting.”

“I never like it when you say that. It would help my confidence in you if you wouldn’t infer that you’re using me as a guinea pig,” he laughed.

We finished our squat programs and turned our attention to finding exercises to work Davey’s shoulder.

“One of the things I appreciate about the dumbbells is that they afford the lifter a wide variety of movement. The Olympic bar is less restrictive than the machines and the dumbbells are even less restrictive than the free bar. In many instances, you are able to position the dumbbell so that you can avoid the pain. Let’s try some benches and see what happens. Start with the 25-pounders, just to see if you can find a position that doesn’t hurt your injury.”

He eased the dumbbells to his chest and laid back on the bench. Gingerly, he pressed them to arm’s length. I could see him grimace as the dumbbells touched his chest.

“Does that hurt?” I asked.

“Some, just at the bottom.”

“Try turning your hands so that your thumbs are facing your shoulders.”

“OK. That doesn’t bother me at all. How many reps?”

“Do a dozen, then we’ll work up.”

He did five more sets of 12 reps, working up to the 75-pounders for his final set. He was literally dripping with sweat, but he was smiling.

“That’s the first time I’ve been able to work my chest in a long time. It sure does feel good.”

“Now let’s see what else you’re able to do. We may overtrain you a bit today, but we need to find out your limitations so that we can put together a program around your injury.”

We went to the incline bench and followed the much the same procedure as did on the bench press. Davey started with a pair of light dumbbells, fiddled with his hand positioning until he found one that allowed him to perform the movement without pain.

“On the bench, if I turn my thumbs back towards my shoulders it doesn’t bother me, but on the incline bench, I have to turn my thumbs so that they are facing each other to avoid the hurt. Isn’t that sort of weird?”

“Well, I guess it may be but that’s sort of what I mean when I talk about experimenting. It always takes a bit of trial and error. Now let’s see if you are able to do some standing presses.”

“Am I using the 25-pounders again?”

“You got it. Always start extra light.”

He cleaned them and set them steadily on his deltoids. He pressed them overhead quite easily but I could see that he hit a painful area as his face contorted. He turned his hands slightly on the second rep, but it still brought forth the same look of pain.

“Try turning your hands about halfway in between the two positions you just tried.”

He did and the weight popped to the top and he grinned. “That’s it!”

He did six more sets, moving on up to the 60s, all for 12 reps. We sat on the nearest bench and he jotted some notes in his well-worn workout book.

“So,” I began, “now you know that you can continue to exercise your shoulders, but in all likelihood you’ll probably have to stay with the dumbbell work for a few weeks before going to the Olympic bar.”

“Hey, that’s OK with me. I’m just delighted to be able to work my chest and shoulders at all. Should I try to push the weight up on my dumbbell work or do more sets?”
”I’d stay with fairly high reps, 8-12, for at least a week just to be sure that you’re not irritating your injury. Then, I can see no real reason why you can’t attack. I can assure you that using heavy dumbbells will greatly enhance your overall shoulder strength. I know of a great many strength athletes who use them during certain cycles in their yearly program. If you can get to where you are handling 100-pounders on either your inclines or your standing presses, you’re going to be one strong puppy. Pressing a pair of 100s is the equivalent of doing 250 on an Olympic bar in my book.”

“What about that little warm-up routine I did? Should I keep that in my program?”

“Absolutely. Go through that circuit at the onset of every workout and do it again at the very end of your program. It is most therapeutic.”
”Speaking of therapeutic, what about my taking some aspirin before my workouts. I used a lot after I hurt my shoulder.”

“My advice is not to take any before training while you are injured. While this may seem like a contradiction, it isn’t as I do not think you should camouflage an injury with pain killers of any sort while engaged in training. When anyone does this, he is running the risk of doing greater damage. During the rehab stage, you want to know exactly what exercises hurt you so that you can work around the injury. You may take them after a workout and at night to help you rest. I think this is a good idea as the aspirin helps to break up the pain cycle and this promotes healing.

“Anything else?”

“Ice, after each workout and use it even of the days you don’t train. It is great therapy, it’s very cheap and most available. One little trick that I’ve found to help is to ice all the connecting muscle groups as well as the injured area itself. Ice the sorest part initially, then trace the ice up and down the adjoining muscles. In your case, ice your frontal deltoid for 20 minutes, then run the ice down your biceps, then do the same for your lateral deltoid and even your trap.”

“How about supplements, I know you’re big on them for rehabbing.”

“I would suggest that you increase your vitamin C, B-complex and protein intake during your recovery time.”

“I’m taking three grams of C and a multiple that contains plenty of Bs. Do I need more than that?”
”I believe so. Move your C dose up to 10 grams a day for a few weeks. Your multiple serves as an excellent base, but I would advise that you get some extra Bs, especially B6, just to insure that you are assimilating the extra protein.”

“I can do that easily enough. I’ll start drinking a protein milkshake again. I always like them anyway. Any other words of wisdom?”

“Get plenty of rest. There’s something about injuries that seems to drain energy. I guess we spend lots of mental juice just thinking about them. The Bs will help in the energy department also. And speaking of mental stuff, you can assist your body in repairing your injury by mentally projecting a positive attitude towards healing.”

“You mean I can ‘omm’ myself better,” he chuckled.

“Sort of,” I laughed too. “Believing that you have the power within yourself to heal is a very helpful attitude. That’s what I like about rehabbing with exercise. It’s a positive response on the part of the patient. You, not the doctor or the pharmacist, control your physical destiny. When you believe that you have the knowledge to make yourself better, you’ve come a long way towards being whole again.”

“You haven’t been dipping in the Tao again, have you?”

He was smiling but it was a smile of appreciation and not ridicule.

“I guess it is a bit Eastern, but, whatever works.”

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