Shoulder Rehab Case Study
Вставка
- Опубліковано 9 лют 2016
- Rip demonstrates how he rehabbed his shoulders after a rotator cuff repair and Mumford Procedure while also clarifying shoulder anatomy and the actual function of the rotator cuff.
---------------------------------------------------------------------------------------
SUBSCRIBE: ua-cam.com/users/subscription_c...
SoundCloud: / startingstrength
WEBSITE: startingstrength.com
FORUM: startingstrength.com/resources...
STORE: aasgaardco.com
Follow on Twitter: / ss_strength
Like on Facebook: / 142424022490628
---------------------------------------------------------------------------------------
Find a Coach: startingstrength.org/site/coa...
Starting Strength Gyms: www.startingstrengthgyms.com
Find an affiliate: startingstrength.com/gyms/aff...
Become a Starting Strength Coach: startingstrength.com/careers
Starting Strength Online Coaching: startingstrengthonlinecoachin... - Спорт
I am a practicing chiropractor who happens to believe in rehab more than most. your explanation of the "function" of the external rotators is brilliant. Your " we make things heal, you dont let them heal" and general explanation of normal rehab pain vs. too far , too fast, i too much range of motion is also exactly as it should be taught. Great stuff and thank you
I did exactly what Rip describes here after my Supraspinatus tear was repaired. He’s absolutely right on this issue. Worked like a charm. Many thanks Rip!
How long after surgery did you start with the rings? The video does not seem to provide exact time-lines for the rehab movements
@@sivad1964able Bob, I don't recall exactly, but it was probably something on the order of about 2-3 weeks before the acute pain had settled down enough to permit even the beginning of an unloaded swing of PVC pipe on the rings. It was a gradual process of getting to shoulder level then slowly overhead. Then it was a matter of incrementally loading. In my gym we had those 5' rubberized metal bars ranging from 10 to 40 lbs. that women use for aerobics, so it was pretty easy to gradually increase the weight for the overhead press. You'll get to the point where you can use a standard 45 lb Olympic bar. From there you're back in familiar territory. Good luck!
This video is amazing. I love how a simple explenation of biomechanics can help solve what ive been trying to fix for fucking years... 🙄
PLEASE do a video on knee rehab and lifting post ACL/meniscus surgery. The knee and the shoulder probably account for 80-90% of athlete injuries resulting in surgery. We would like to see your approach to the knee - specifically, getting back to squatting and dead lifting heavy (or at all).
Using this for my recovery from a Mumford procedure, bone spur removals, and bursitis cleanup (no repairs). Just started 1 week out from surgery. Thanks for the great program!
How did it go? I'm 1.5 weeks post Mumford, acromioplasty (spur removal), bursectomy, but the cuff is great. PT just told me that my deadlift might never go over 200. How's yours?
thanks for the video sir Rip
This video could teach me more about my shoulder than 5 doctors could do.
My acromion is pionting out of my left shoulder since years. My doctors are just claiming it will go back in with some flexibility exercises lol
AC joint sprain? The acromion should not just "point out". Ever fall on an out stretched arm?
Hey have you found a solution for this? my bone is sticking up as well and therapists said the same thing
Rippetoe has a such a great no b.s. tone of voice. It's sadly a rare & fading quality among men these days
Dennis Tucker
Poofter??
Oh quit with that yawn-worthy crap. my grandpa was saying that in the 80s. And we'll say that in 2050, and so on. "no bs tone of voice" commonly means someone who says things in a way I personally can understand and won't make the effort to understand substance over style (not saying Rippitoe isn't substance).
True
Excellent Advice
Excellent. Thank you
As a practicing physical therapist assistant for 11 years and an active wt lifter for 25 yrs, the last 8 of which having been primarily kettle bells I can say I agree with your overall attitude and exercise prescription. I feel therapists are, at times,consrevative with exercise prescription and don't know how to progress beyond acute phase below 90 degree protocols. Now that being said weight lifters compared to the average individual office worker who has the AC joint anteriorly displaced from years of computer work are two different animals and should be treated according to fashion and pain tolerance. The former will have an advantage in so far as knowing their bodies and knowing how to elicit different muscles to help stabilize to GH joint. Training athletes is easy compared the the sedentary individual w/an overuse injury superimposed with poor posture. Unfortunately in a rehab setting we see more of the latter vs the former and most therapists, as I mentioned before, aren't forward thinking and only progress certain exercises based on the below 90 degree protocol. With that being said I have encountered many an individual who have had months of rehab following an RC repair and who still have significant pain and ROM limitations. I found your excerpt interesting as you mentioned knowing the difference b/t good and bad pain. The "average" individual has difficulty accepting the fact that rehab is uncomfortable where as athletes know, or are quick to learn the difference. I am curious to know however in your own particular experience if you focused on and learned the value of good posture, the importance of the role of scapular/GH stabilizers i.e.: rhomboid firing etc as these muscle shut down after injury and time under tension or easily put muscular endurance before strength. I must say I learned something valuable and would rather talk to someone who is intelligent and who has personally had the experience of self rehabbing a shoulder surgery vs some DPT who thinks just because they read it in a book it must be set in stone. The point is every one is different and must be qualified before any rehab program is put into place.
TheDirthound .
.
Yawn
Direct simplicity is superior, and it's respectful of someone else's time.
Great informative video. 👍🏾
Never seen a man like him in the whole fitness industry!! ❤🤟
Excellent and informative video, well explained.
"You must participate in your own rescue."
@J M IUTU 🤙
Thanks for sharing Mark. Say could you please link the Q&A video where you mentioned the pre-surgery "hot poker on horses" inspired protocol meant to avoid surgery?
Very interesting. It’s not entirely disimilar from Dr. John Kirsch’s prescriptive ‘dead hanging’ for shoulder rehab in lieu of surgery.
I have a partial rotator cuff tear in my Supraspinatus. I’m using therabands to rehab it. It seems to take forever to see results though. Would you recommend the overhead press for my condition?
If the AC ligament is stretched and slightly pointing upward(clavicle) can this help put it back to its place?
I have a client whose shoulder I have rehab using this technique it works very well I would suggest using after the stick a 4 kilo bar then 7 kilo and then 9-11 kilo i use 4 kilo bar the add 5 pounds each set if poss
Hmmm. This is a great video. But I don't have a problem with deadlifts or shoulder presses. My issue is with being able to bench. Pretty sure my supraspinadus tear from a motorcycle accident is the perpetrator. I really want to increase bench b/c my chest is becoming a weak point for me simply because of a shoulder issue. Can you point me in the right direction for what to do about this?
how extensive was your surgery anchors tendons ect.
Hey rip. Just watched the video and found it timely, Having rotator-cuff surgery in Dec. We're abou the same age and hoping my surgery goes as well as yours. Surgeon warned me of the pain. But I need to get it fixed.
mark, i took your advice and shrugged after lock out, both rotator cuffs were partially torn. i was shocked, is it because my arms were tucked in, i thought by narrowing my grip i would avoid impingement, but perhaps it caused internal rotation. anyways 2 cortisone shots (left shoulder on rc, right shoulder on ac) i learned to only do dumbbell press narrow but half range, gained all my muscle back. did i understood the movement wrong???
amro abdulbade huh, thats an odd case. This may just not be the right exercise for you..
Good presentation. What worries me, since 1.) I'm 60 2.) I tore my rc 20 yrs ago and now tore it again. 3.) It didn't heal or I somehow tore it loose during initial rehab 4.) I now have an allopatch graft reinforcement after revision surgery along w/ stem cell augmentation-- how will I know that the repair is ready to be "pushed" w/ enough load to toughen it up similar to how Rip did it??? And if I were to push using this process, what happens if the repair lets go again?? For me, weighing these risks is very frightening since I want to get back to normal. Thanks.
Oldpuck81 its definitely ready by now..
The problem is a lot ot people have dysfunctional scapulohumeral rhythm so that the acromion isnt out of the way and they press right into it aka impingement. You can get impingement in varius positions because of different dysfunctions or just bad DNA.
I just don't know where I'd be able to use the hook rings with the stick in the middle of it even if I bought those online. Is there a more accessible way to do this exercise
you make things heal.
Sometimes I forget that Rip is hella smart
Says more about you than him
What's the best rep range for rehab?
This is encouraging, I am still in a sling 1 week post op.
Moss how did you go with your rehab ? Did you use this method in the time frame suggested ?
@@jamiegovan that wad over a year ago now. My surgery was far more extensive than I knew when I posted my comment and Rips method doesn't apply to my case. I was in a sling for 2 months and rehab was very difficult and lasted many months. If you get some bone spurs knocked off or just have a minor RC repair fine but my RC was shredded.
@@mossnomad7723 oh ok, I have a 2.5cm tear in my supraspinatus
I broke my clavical, had surgery brace installed 4 days ago.
I am letting pain be my guide, ignoring surgeon who says imobile via sling for 2 wks, then start rehab.
Already can do body weight front riases, side riases and drink cup of coffee.
AM I GOING TOO FAST?
Should I use hyyype draaahvve!!!!! for these?
Three sayuts of fahve rayups
I had a slap tear on my labrum. Can these workouts still apply to me?? Im about 3 months post op
Yep i am using it 6 weeks
Have you being seeing your pt?
do you think there is any benefit (shoulder health related) by doing dips with rings vs a fixed parallel bar? I've heard rings are better because it allows the shoulder to move a bit as you go down into a more natural position.
+Brian Bacc +Brian Bacc Ring dips can be very dangerous, especially if you're not very light yourself. Reason is that very light deviation from the ideal range of motion causes very big change in the moment arm and thus increases the forces on the stabilising muscles very quickly and by a lot. Generally parallel bar dips are much safer.
Brian Bacc hell no, haven't you seen the pec tear and shoulder pop videos..
Can someone fill me in on how he injured his right shoulder? I just got started with weight training and am convinced that doing the overhead press correctly won't injure the shoulders. His rehab method makes sense to me, and I am genuinely wondering what happened to Rip that caused him to injure just one shoulder. It would seem that with barbell exercises, both shoulders would be injured but again, I'm pretty new to all of this.
This video was extremely interesting, btw.
Thanks!
IIRC, he got injured from an accident riding his horse.
He forgot to use hip drahve during his daily curl
Masteroftrancegirl too much hyyype draaahvve!!
So the surgery is unavoidable?
"You 'make' things heal"
Sensei.
excuse my rudeness but why is the overhead press considered a natural human movement but external rotation isn't? They're both made up movements but they're also both movements humans can do, thus they are natural. There's nothing wrong with doing external or internal rotation exercises. There is vast evidence online as well in studies that prove that doing banded rotator cuff work will increase stability performance in these other sought-after movements.
Mark you mention how the shrug at the top avoids impingement but you have to start from the bottom and get there first. So isn't there impingement on the way up before you do the final shrug?
Long story short, it does not. The full explanation is in the book, Starting Strength for Basic Barbell Training.
Its not shrug but superior rotation which happens gradually as you move the shoulder. It also happens "automatically" its not something you have to do actively.
exrx.net/Articulations/Scapula#UpwardRotation
exrx.net/Kinesiology/Glossary#Scapulohumeral
Lol, no, the trap shrugs the moment the bar goes up. In fact you cant not shrug when you press..
Incline bench press,dips, upright rows ,lateral raises are the real culprit.
Ohp is safe.
@Adam Swink incline - less room in the subacromial space dips, internal rotation angle - upright rows - internal + past 90 degree (impingement) lateral raises same as mentioned for upright. OHP is really safe. If you do it eccentrically its EVEN safer. Great for rehab!!!
Mark, If the military press doesn't cause impingement then how did you get hurt?
Did you watch the video?
***** also he was a competitive lifter.
And competing can be hard on your health since it is not actually training but a display of maximum strenght which puts an enormous stress on the body if it is too often
You say ”Chins” do u mean supinated or pronated?
El Chain
Supinated. Source: SS Book
chinups are different from pullups.
As one of the guys who he makes fun of (a physical therapist) I would advise everyone to be very cautious with this approach. In my opinion, this technique is dangerous as could result in re tearing the repair.I don’t think he fully explains the biomechanics of Humeral scapular rhythm or the impingement zone (60-120 deg of shoulder flexion)which you pass through constantly in you approach, This rehab approach overlooks the importance of scapular retraction strengthening through activation of the middle trap and rhomboids while avoiding excessive upper trap contraction. (I know you hate the word activation). People need to know that the most common time to rerupture your repair is 12 weeks after injury. When the pain has subsided but the strength isn’t back.
It’s funny how he bashes physical therapist for not doing enough functional activities with legs but goes right to the non functional (full shoulder flexion) activity for should rehab. Really how many things do we do at end range shoulder flexion??
Maybe if he would have used those bands and small weights to improve External rotation strength he wouldn’t have torn his rotator cuff in the first place? Just some thoughts from one of those dumb overpriced PTs. Remember those weights and bands are a lot cheaper and less painful than a rotator cuff repair surgery. Just my thoughts.
Wow, such a terrible compensation in lumbar spine. It looks like Rip should forget about pressing overhead.
IF YOU HAD SURGERY DON'T DO THIS PEOPLE, WORK WITH YOUR PT.
If you used a sling your internal rotation is fucked up, then you have 90% chance that your scapula WON'T sit how is supposed to and you will fuck your shoulder again.
I had a labrum repair, and I did this ring protocol 6 weeks post op, very slow progression, it helped to recover overhead mobility but my scapula wasn't working right because of the sling, then I fucked up my repair.
Work with a professional, you will recover overhead mobility, but in your time and AFTER the muscles that pull the scapula are working right, before that DON'T DO IT, YOU CAN EASILY FUCK YOUR REPAIR.