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Grip training to support shoulder surgery rehab

Dave H

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I am about to go through rotator-cuff surgery on my dominant (R) shoulder. Thinking of adding grip training to support my rehabilitation. Does anyone have any positive or negative experience with this? Any recommended protocol(s), resistance/set/rep combos, device type and resistance level? (I will - obviously - run this by my surgeon and PT prior to incorporating, but looking here for novel approaches to support traditional rehab.) Thank you!
 
I had an UNDIAGNOSED shoulder problem where I overstretched it, so take this for what it is worth. I did the Ido Portal 5 minute hang challenge when hanging was comfortable for my arm a month after my injury. I did a daily 5 minutes spread with comfortable sets of a seconds across the day for a month, never doing more seconds than felt comfortable.

Having been familiar with steady state cycles (SSC) I found where I could move weight off my uninjured arm slightly (Convict Conditioning 2 hang progressions) to do a 20s sort of max. I said "At 15 seconds it's feeling a bit weird so I'll call it a max hold with a few more seconds but won't risk finding out and just presume the max is 20s" on the injured arm, and did a SSC using half the max for most sets for 12 weeks. Then I did a full one arm hang as an SSC for 12 weeks. I think that one started with 14 seconds to my "At 11 seconds it's probably good enough to say that 14 would be a max" point. I felt pretty good for anything after that. The steady state cycle is gold for rehab. Of course it was an undiagnosed problem with no surgery but when you read about the SSC concept you know why it is useful.

With an SSC you don't train at your max, just let the volume build strength, then soft tissue, then the firmer tissue. Whatever your rehab goal the SSC concept is at least worth sharing with your PT. The "underloading" information is the key for why you want it in therapy, especially if you're not trying to overload it much:
For the "overload" part of your first SSC, it could be the "whatever hang time felt comfortable" part, and perhaps cut THAT in half. Doing a lot of "half of whatever felt comfortable" should be safe enough to use for volume if authorized by a PT.

Of course I can't possibly know if hanging for time is appropriate. I presume a one armed hang is for after your therapy and not during your therapy. But that is how it worked for me.
 
@GreenSoup, recommending hanging for someone whose shoulder need surgery seems dicey to me.

The SSC concept you mention, having just read the link you provided, is what we call a step cycle - you stay with one thing until it becomes easier. It's certainly a sound way to train.

-S-
 
Thank you for your thoughtful and relevant reply. I do plan to (continue to) do whatever I can - including hangs, swings, etc. - with my "good" arm.
 
I've had surgery on both rotator cuffs, due to injuries suffered playing basketball.

Not necessarily advice, but my experience:

I started training with bands, then clubbells and kettlebell DLs, on my uninjured side just as soon as I could without negatively involving the surgical side.

Then, once I was out of the sling, but still recovering and unable to do ballistics or presses with the surgical side, I did a few months of pretty intensive training, mainly A+A snatches, on only the good side. I basically did the same volume I would normally do, but with only one arm instead of split between arms. I made a few adjustments to rest periods and sometimes overall volume to account for increased grip fatigue, but didn't dial back the volume much overall.

My injured shoulder was my non-dominant side, so I was doing all the training on the side that was already stronger.

There were absolutely no negative consequences of doing this. During my recovery, the surgical side had a lot of atrophy, but once I was cleared to train normally it quickly regained size and strength and caught up to my dominant side (within my normal range of difference between dominant and non-dominant). I strongly believe that the unilateral training actually helped the recovery of the injured side.

In consultation with my doctor and physical therapists, I took the attitude that anything that didn't involve my injured side in a way that might interfere with recovery was fair game.

BTW, a few post-surgery essentials:
--A comfortable upholstered chair to sleep in. I needed to sleep in a chair for many weeks before I could sleep lying down.

--A good sling. If you have to live in an arm sling for weeks and months on end, even small differences in comfort add up to big differences in tolerability over time. Having your arm immobilized is just a very uncomfortable feeling on it's own, and there is pressure on the neck/opposite shoulder from the strap/harness.

In my experience, essential features of a tolerable sling are an abduction pillow and an offloading harness with a second underarm strap to pull the main strap away from your neck, direct the load more vertically onto the uninjured shoulder, and distribute some of the load under the arm of the uninjured side. It does take some experimentation to get the lengths of the different straps right for a comfortable fit, but it's definitely worth the trouble.

Some slings with this design are the Donjoy Ultrasling Pro, Ossur Formfit, and Breg Slingshot 3. Your doctor will probably send you home with a random sling that may lack an abduction pillow and/or offloading harness. It is well worth it to get the best sling you can, and get it ahead of time. For my second surgery, I got several different models to try because I knew how important it was, and ended up rotating a few different ones, since they each had different aspects that made them more or less comfortable, and even mixing and matching straps and other parts to get the best combinations.

--A good ice system. I'm not convinced that ice helps healing, but it definitely helps a lot with pain. A good basic cold pack that works well for the shoulder is the T-shaped Cryomax Pro. It gets very cold, stays cold a long time, and the T-shaped model fits well over the shoulder. It's by far the best basic cold pack I've used. Get at least two so you can rotate them. Then there are ice buckets that pump cold water through a cuff that straps around the shoulder, such as the Aircast Cryocuff. And then there are units that refrigerate the cold water themselves, so you don't have to put ice in them, which are the most expensive. My doctor set me up with one of the fancy refrigeration units, that my insurance paid to lease while I needed it, but I found out that they were charging my insurance thousands and thousands of dollars for it, whereas an Aircast or similar system is a couple of hundred dollars and multiple cold packs are less than a hundred. So even though I wasn't paying out of pocket for the refrigeration unit, I felt bad about using it.
 
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Fantastic information. Thank you. I plan to emulate your "everything else unless" plan. Also, great advice on the "essentials". I appreciate it.
 
Ask your doctor about suitcase carries and finger extension work with rubber bands, because no matter what grip work you do, you'll have to do extensor work. I have the $14 Ironmind bands but the bands that come with broccoli or possibly other produce items should also work fine.

If the doctor says suitcase carry is fine but light weight only, take that as a win - it's better than nothing.
 
Physio here!
This depends so much on the surgery and the WHY in need of a surgery. If it's an injury or only pain, are they going off your symptoms or image diagnostic, before or after surgery and so on.
Impossible to answer from a forum post.
 
Welcome to the forum. Had a full shoulder replacement and they had to go through the rotator cuff. Squeezing a rubber ball 4 weeks post surgery will be the extent of your grip training. The Rehab isn't bad until you have to get flexibility back. 5 months to get back to normal.
 
I am about to go through rotator-cuff surgery on my dominant (R) shoulder. ,,, but looking here for novel approaches to support traditional rehab.)

How the Crossover Effect Works to Preserve Strength & Size During Injury Recovery


The crossover effect refers to the phenomenon where strength or muscle gains occur not only in the trained limb but also in the contralateral (opposite) limb. This concept has been explored in the context of rehabilitation, particularly when one limb is injured or immobilized.

The crossover effect of heavy training opposite an injured limb has been observed in various studies, showcasing the potential for preserving strength and muscle mass during rehabilitation. Integrating unilateral resistance training into rehabilitation protocols may offer a practical and effective approach for optimizing outcomes in individuals recovering from limb injuries or surgeries.


Contralateral effects of unilateral training: sparing of muscle strength and size after immobilization


The contralateral effects of unilateral strength training, known as cross-education of strength, date back well over a century. In the last decade, a limited number of studies have emerged demonstrating the preservation or "sparing" effects of cross-education during immobilization.
 
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@GreenSoup, recommending hanging for someone whose shoulder need surgery seems dicey to me.

The SSC concept you mention, having just read the link you provided, is what we call a step cycle - you stay with one thing until it becomes easier. It's certainly a sound way to train.

-S-
Depending on the injury any exercise is dicey, hence the disclaimers and suggestion to share the idea with the PT. My injury allowed hangs but pressing was out for months.

I'm surprised the SSC is regarded as a step cycle. PttP's step cycles have trainees staying at the same weight for a few workouts and then increase the weight and sticking with that new weight for a few workouts, repeating the pattern as "steps" to ever increasing strength. It was like a linear cycle with repeated workouts.

Coach Sommer's steady state cycle has no changes whatsover until the cycle has concluded. You test to determine what your program looks like and the first day's workout is the same as the last day's workout before the test at the end of the cycle. The focus is to get some strength at the beginning but ensure connective tissues fully adapt to it. There is no "step" in that cycle since it is designed to be a plateau from start to finish. That seems very different from any step cycle I've seen from StrongFirst.
 
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