2

votes

Lifting, HIIT, and Massive Shoulder Injuries

Answered on September 12, 2014
Created July 11, 2011 at 7:00 PM

Hey PaleoHacks! You guys have given me great diet advice in the past (I'm all paleo all the time), so I want to take some time and ask some of the lifting/workout questions I'm wondering about, with specific regard to my personal situation.

The Vitals:

  • 23 years old, 6'1, 160 lbs. Yes, I'm skinny. But I have real good definition. Hard six pack, very defined big chest. The trick is, my arms are both very skinny. Here's why:

  • about 15 months ago, I absolutely destroyed my right labrum playing basketball. Tore the shoulder out of the socket, and then it jammed back in when I hit the ground, basically shredding my labrum (bankart lesion). My surgeon was the team doctor for an NHL team at the time, and he told me it was one of the worst shoulder injuries he'd ever seen. The arthroscope picture of the inside of my shoulder post-surgery is gnarly, there's so much string, it looks like a laced up shoe. Before my injury, I was closer to 180 lbs, and pretty much all of the weight I lost came from my shoulders, back, and upper arms, as I basically didn't lift for a year. And now I've been through a full year of rehab/PT, which is now finished, and at this point my shoulder is "recovered", so I'm cleared to lift weights as I see fit. But as many of you who have had serious joint injuries know, my shoulder is still screwed for life. It's about as good as it's gonna get, but I've had to seriously alter my workouts because of this. Without further ado, this bring me to my questions.

The Questions:

  • How can I even realistically be adding size at this point? I'm more or less just "maintaining" right now. I'm back to benching, and a liiiittle bit of overhead lifting, and I can do biceps curls til the cows come home. The issue is that I'm still not comfortable throwing "big" weight (a relative term, for me) on the bench or overhead, not because of lack of muscle strength, but because of my reduced joint stability. In the same way, I do not feel comfortable dead lifting or doing exercises that isolate my shoulder joints like that via having really heavy weight hanging straight down. I think barbell rows might be ok now. Right now I'm doing dumbbell shoulder exercises (low weight), biceps/triceps dumbbell exercises, cable chest flies, dumbbell benching and hitting the assisted barbell bench, and i feel the burn, so to speak, but I know it's not the same as when I was able to pack on size before. Any suggestions regarding exercises for me to focus on that will allow me to add some size back onto my shoulders, upper arms, and back without making me afraid my shoulder is going to explode?

  • That being said, I've never wanted to be a huge dude with pounds of muscle. I just don't think my frame is meant for it. Even before my injury, I was pretty cut, but I wasn't large, you know? I'm definitely going for much more of a lean, cut, toned look, but also trying to eliminate the inherent "skinniness" from my shoulders/upper arms. With that in mind, I've only recently started combining weight training with HIIT. I really love HIIT, as it has allowed to continue to keep fat off without losing (more) muscle. Right now, I do all my HIIT via sprinting on a treadmill (yeah, yeah I know, outside is better. it rains a lot in DC though...). But I know that the HIIT world is a lot bigger than just straight cardio via running. Can anyone give me a quick rundown of other HIIT exercises that maybe don't involve running? Burpee stuff, burpee pushups, stuff involving lunges, or anything else?

Any other suggestions/thoughts of course welcome. Hell, if you have a list of exercises you think I should do, even if they're all different from what I'm doing now, I'll try it! I'm sort of lost at this point, feeling a little depressed about the limitations my body is placing on me currently. Thanks everyone!

E3d9d9309af8338c807257a915eaa44a

(10)

on September 01, 2011
at 09:55 PM

Treadmills usually have a pressure plate to absorb the shock, way better than concrete. They should tech this stuff in Phys Ed. The taller you are the sooner you will lose your knees, ask any middle aged guys still shooting hoops.

E3d9d9309af8338c807257a915eaa44a

(10)

on September 01, 2011
at 09:25 PM

Sweet! More fun with the Iron. Any military connection with this one ?

7cc85cf98e4d0cac622f755294ac7ee1

(355)

on August 31, 2011
at 08:49 PM

Crossfit WILL help... I love how people with no experience jump all over it. See my above post, I DO crossfit and have had multiple shoulder surgeries.

F6c1df7d5699661bd1f0d6d0a6c17fc6

on August 31, 2011
at 10:40 AM

I'm not sure a program that focuses mainly on getting the shoulders as big as possible, as fast as possible is the best for this guy

F6c1df7d5699661bd1f0d6d0a6c17fc6

on August 31, 2011
at 10:38 AM

I can't see how a CrossFit gym would help someone with these specific needs.

0a2dd50f2d3951bf3fb83fc4638c9512

(1960)

on July 14, 2011
at 04:01 PM

Appreciate your caveats, bens -- I know they are well-intended. My reply was pretty superficial, after all. I should have included more information on the scalability of CF programming. And also a lot of it will come down to the trainers of any given box, and their level of experience, commitment and knowledge about exercise, injuries and recovery. At my box (SPC CrossFit in Kent, Ohio), we're lucky to have a number of trainers who have professional backgrounds in PT, for example. They push us, but the last thing they want is for anyone to get hurt. That's so important.

Aafdecd018b18faa16faac5e7289efa6

(25)

on July 12, 2011
at 08:39 PM

yeah i kind of agree there, crossfit doesn't seem like it would be a good fit to me, based on how involved the shoulders are

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 12, 2011
at 12:15 AM

Yeah man, those were crazy times. I used to own a Westside powerlifting sled. Every weekend I would drag it around the sidewalk with 45 pound plates stacked onto it! One time I was close-grip benching and dropped a stupid amount of weight onto my chest! I was an RA in college and spent all my activity money organizing a strongman contest. I wish current me could go back in time and tell young me to stop being an idiot.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 11, 2011
at 11:40 PM

Can you rotate the shoulder just enough to backsquat? I know there may be mobility issues with that but at least the weight/pressure won't be directly on the shoulder itself. Some hardcore places may even have a cambered bar that allows a kind of neutral/pistol grip while the bar is still on the traps.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 11, 2011
at 11:38 PM

Hey K, nice, I didn't know you were serious into the lifting. Sucks about your injury.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 11, 2011
at 11:36 PM

Whoa, I beg to differ. While Crossfit incorporates essentially anything on their kitchen sink repertoire, a LOT of what they do most of the time is going to heavily use/abuse the shoulder.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 11, 2011
at 07:53 PM

I weighed between 165-185 pre-injury (bulking and cutting) at 5' 9". I now weigh 170, 2.5 years later, but the muscle is gone and has been replaced by fat. Because of a series of unfortunate coincidences involving a pain disorder, I can't really exercise in non-weight training ways much either. So now I spend a lot of time on paleohacks :) But I'm currently trying to hit the dumbbells hard (the pink 5 pounders, that is) and be patient until I figure things out. I used to know a lot about shoulders though, so please do update this after you figure out your new plan.

Aafdecd018b18faa16faac5e7289efa6

(25)

on July 11, 2011
at 07:29 PM

"Use low body fat to create the illusion of size." Good. Call. It really sucks to have your whole life's fitness plan altered in an instant eh? Do you mind if I ask how much you weighed pre-injury, how much you weighed a year after, and how much you weigh now? And also, how long ago your injury was? And for that matter, how you stay in shape now if you can't lift weights at all?

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10 Answers

4
7cc85cf98e4d0cac622f755294ac7ee1

(355)

on August 31, 2011
at 08:47 PM

Three shoulder surgeries here, including an open bankart repair and six months of physical therapy.

TURKISH GET UP... Google it, learn it well, start light, do it several times a week. Once you can do it with 50+ pounds let me know if you have any shoulder problems still(you wont).

I am back to playing rugby and crossfit... My doctor said I wouldn't even be able to do "overhead lifts" again. I call BULLSHIT =)

PS: All of my surgeries were by 20.

E3d9d9309af8338c807257a915eaa44a

(10)

on September 01, 2011
at 09:25 PM

Sweet! More fun with the Iron. Any military connection with this one ?

2
21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 11, 2011
at 07:23 PM

Hi Ben, welcome to Paleohacks!

Take my example and be very very careful. I used to be quite jacked, then had a huge reverse Bankhart lesion (350 degree tear, with the labrum just barely hanging on). Several surgeries later, I can't lift weights at all.

My hunch is that you should focus on things that will not internally or externally rotate your arms to a significant degree. Use a neutral grip instead of a pronated grip. Focus on high reps. If you want size, use low body fat to create the illusion of size. But no matter what, do not do heavy deadlifts, olympic lifts, heavy shoulder presses, or anything of that nature. That being said, the whole orthopaedic episode turned me into a big wuss, so this might be a tad bit conservative.

Good luck!

Aafdecd018b18faa16faac5e7289efa6

(25)

on July 11, 2011
at 07:29 PM

"Use low body fat to create the illusion of size." Good. Call. It really sucks to have your whole life's fitness plan altered in an instant eh? Do you mind if I ask how much you weighed pre-injury, how much you weighed a year after, and how much you weigh now? And also, how long ago your injury was? And for that matter, how you stay in shape now if you can't lift weights at all?

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 12, 2011
at 12:15 AM

Yeah man, those were crazy times. I used to own a Westside powerlifting sled. Every weekend I would drag it around the sidewalk with 45 pound plates stacked onto it! One time I was close-grip benching and dropped a stupid amount of weight onto my chest! I was an RA in college and spent all my activity money organizing a strongman contest. I wish current me could go back in time and tell young me to stop being an idiot.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 11, 2011
at 07:53 PM

I weighed between 165-185 pre-injury (bulking and cutting) at 5' 9". I now weigh 170, 2.5 years later, but the muscle is gone and has been replaced by fat. Because of a series of unfortunate coincidences involving a pain disorder, I can't really exercise in non-weight training ways much either. So now I spend a lot of time on paleohacks :) But I'm currently trying to hit the dumbbells hard (the pink 5 pounders, that is) and be patient until I figure things out. I used to know a lot about shoulders though, so please do update this after you figure out your new plan.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 11, 2011
at 11:38 PM

Hey K, nice, I didn't know you were serious into the lifting. Sucks about your injury.

1
E3d9d9309af8338c807257a915eaa44a

on August 31, 2011
at 05:24 AM

"my shoulder is still screwed for life"

Your young and a lot of science will improve over the next 10 years. The people on this site will try to help you forever as far as I can tell. A positive attitude is known to help people get better, even in a clinical setting if my memory serves me well. For all any of us know someone may read this post in a few months that may just happen to know an Orthopedist who has made major advances in shoulder repair and be able to bring yours back to better than new.

I'm reading a book called "Change Your Brain Change Your Body" by Dr. Daniel Amen M.D., 2010 and having a good mental outlook can do some amazing things. So far there is not much about your specific issue but there does seem to be a growing awareness in many diverse groups (body building, paleo, medical research, molecular biology, etc.) that mind power is often our biggest challenge (I know it is for me).

With all the Genetic, Metabolic, Proteomic, Meta-Genomic (,etc) disciplines making advances that are rapidly becoming accepted science it is easy to miss another called Epigenetics. As it turns out what we think and how we feel apparently has a direct effect on which of our genes are expressed or inhibited (we adapt to our environment without changing the DNA Sequences).

The implications are that if you are willing to commit whatever it takes for as long as it takes and have a positive outlook biological repair processes driven by your genetic code will much more likely kick in stronger and faster than if you have gotten depressed or given up hope.

When you get older, your body starts going to hell and the first to go in men is the knees. Well, my right knee hurts, bad, whenever I forget to baby it. But I'm going to keep trying to get it back into shape as long as I'm drawing breath. God willing that thing is going to get better, and if it does not it won't be for any lack of me trying.

Iv'e heard plenty of negative crap from people who should know better and I kick it to the curb and keep on going because positive medical outcomes can and do happen often without Doctors really believing they will, much less knowing why. Paleo-Omnivore? my Doctor would say, until my last checkup. After running some tests and getting numbers back (a lipid panel) he was surprised enough that he had to call me and say he had never seen anything clinically like it in his 35 years of practice.

There is a lot of information out there about what was (and is) effective for any given individual and one of those sources is this site.

What I'm doing for my knee is trying all the supplements and nutrition that support knee joints including dropping as much fat as I can to get the pressure off. I'm up on the Teta's, Dukin and a lot of the research (as many here are) and I'm amazed at what I come across every week. I've got the free weights and resistance band. I've done the HIT thing but I really cringe at the thought of you doing it unless you are ultra careful and conservative.

So, If your REALLY CAREFUL, I'd like you to try a do a few light "Flys" horizontal, down and a few up with the resistance band (I know, that overhead fly contraption at the gym does not do up if I remember right). Fly's let you work into the classic body builder pose and hopefully there is a mirror nearby where you can see yourself getting "Pumped-up".

Man, that is a great image to get and keep in your head, you and the iron, she never lies. Please take your time, low resistance (or weight) low slow reps, patiently and with conviction incrementally increase a little each month.

Trainers make me nervous when it comes to injuries because they tend to push hard, usually a good thing but for me and you, could be catastrophic if we are not ready for that kind of intensity.

Give your shoulder WHATEVER time it needs for recovery before exercising again. I'm assuming you also take all the supplements and nutrition needed for joint repair plus Protien and BCAA shakes before and after. OH-BABY that hot shower/bath/sauna feels sooo good after and seems to help recovery.

My best workout for the knee is the pool. I've worked up to an hour in there, swimming laps, big loops, figure eights, clockwise and counter clock wise, stretching before and after in the water using every stroke known to man plus the dog paddle and just treading water. To make it interesting I try to work on my pirate accent.

Eventually It might make sense to do aerobics that have a lot of arm movement (people do it to music but I forget what its called). I'd also try some wrist weights if movement is no problem in enough directions. My Resistance band is 12ft so I can stand on the ends, grab it with my hand and raise it (with tension) above my head. I've also learned to push it above my head, then directly over the shoulder and then to away form the shoulder about six inches.

Don't forget you can do the "Flys" with the resistance band, hopefully in front of a good mirror and watch your progress as time goes by and get a real good visualization of what you and your shoulder will look like in the future.

$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

PALEO BALLERINA ??? Strange but maybe true in an Evolved Hybrid kind of way.

"Callanetics is an orthopedic exercise program developed by Callan Pinkney, author of 'Callanetics Countdown.' The exercises modify traditional ballet conditioning to create a gentle, yet effective program that can be performed at any age"[CAL]

I checked out a few utube clips and it appears to be the real deal w.r.t. an "Orthopedic Exercise Program" targeting specific body parts, low impact, lots and lots of reps, difficult static positions for long intervals, etc.

[CAL] Ref: livestrong.com/article/346133-free-callanetics-instructions

In Competition with "Callanetics" is Yoga which has a lot more resources and been around much longer. I was able to put together about 12 exercises that will (hopefully) help my knee out. I also like how the discipline focuses on listening and discerning what body pain means (is it being challenged or is an injury about to occur). Breathing is also useful but I lean toward a navy seal's military fitness site for his 2:1 method for oxidative metabolism. To much material and to many URLs to post here.

ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo

This kind of sucks but its what I do. There is no margin of error here. I have a prescription pain killer for the knee, grind up a couple of tabs in a mortar with pestle, mix in a little water based moisturizer and apply it on the joint and let soak in for 10-15 minutes. It makes a long walk tolerable but stay focused and baby the joint. Uptake is not all that good (compared to an injection) but it takes the edge off.
ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo

PALEO MRI

According to Dr. Walt Lowe at drloweshoulder.com/en/cms/?251

"A Bankart Lesion is one of the more common forms of instability in the shoulder.
This injury is damage to the anterior labrum of the shoulder. This is due to the stresses placed on the front of the shoulder due to overhead activities. The lesions can also be in the back or posterior part of the shoulder."

There is a picture of a baseball pitcher with his arm cocked all the way back (I never could figure how a human could do that) ready to accerlerate forward toward the plate.

"Injuries to the posterior labrum are known as either posterior labral or Reverse Bankart lesions. The picture to the left is a depiction of a Bankart Lesion. If you thought of the labrum as a clock face, these injuries would occur from about 2 o???clock to 5 o???clock."

There is a detailed MRI and patient injected with contrast to highlight the soft tissue.

"The injury shown on the picture to the left is at around 4 o???clock on a right shoulder." Apparently the patient feels like the shoulder wants to come "Out of the Socket".

The URL below (10 of 10) apparently came from a * Professional Baseball Trainer. *

This is a cross post from questions/24493/paleo-hit-exercise-with-a-shoulder-injury

"Give this a try": surfbodyfitness.com/category/injury-prevention

WARNING: "use very light (1-2 lbs) weights to start" !

10 out of 10 rating by me. Recommended therapy for Shoulders and Elbows. Can be executed without weights or in a pool. More weight can be added for body building and strength training. ............................................................................

1
Medium avatar

(19479)

on July 12, 2011
at 01:08 AM

There is likely a ton of things that you can do and many exercises that you THINK you cannot do that simply need to be modified in order to accommodate your shoulder. However, it wouldn't be responsible to tell you to do X, Y, or Z without having an opportunity to see you move, conduct an assessment, and to coach proper execution.

My recommendation would be to seek out a trainer who has experience working with athletes with shoulder injuries. Although I personally love Crossfit workouts (I do at least 1 every week), the group atmosphere promotes competition and inevitably dilutes the trainers attention (I don't care what anyone says, it is IMPOSSIBLE to give EVERYONE full attention in a group class). You need someone who can work with you one on one.

That being said, I encourage you to investigate exercises that will help stabilize your shoulder joint. Some examples are Turkish Get-ups, Farmer's walks, and planks.

0
25b139cc1954456d9ea469e40f984cd3

on September 02, 2011
at 07:23 AM

I have similar injuries with other bodyparts. In no order, I suggest you

1) Avoid flat benching 2) Strengthen rotator cuffs (decent book: http://www.amazon.com/7-Minute-Rotator-Cuff-Solution/dp/0944831257 ) 3) Avoid Crossfit and ballistic exercises like the plague 4) Train almost exclusively with machines when it comes to pressing exercises 5) Use a slower rep range

I highly recommend you consult an expert--Drew Baye comes to mind--and pick his brain regarding the specifics of your future programs.

0
39ccdc07ecb843b6399e0df9c1a6aa1a

on August 31, 2011
at 09:00 PM

I like the Turkish Get Up advice. Great exercise that works your shoulders but doesn't require you throwing weights around.

I would recommend other whole body workouts as well if you can do them. I would try squats (will grow your whole upper body as well as lower body). I have a friend who injured his shoulder and can't do squats because the way you have to position your shoulders. He is however able to do front squats which essentially works your whole body the same way without as much strain on your shoulders.

Good Luck.

0
Fbd2f71e901c267794d07c4b8cf2b5b0

on July 11, 2011
at 11:22 PM

Nah bro. You should probably focus most of your HIIT stuff on things that don't involve your shoulder. Plyo box jumping, sprints, etc. are your best bet. On the other hand, at your size, without a caloric excess you can simply forget about putting on any extra mass. There are a ton of bodyweight related things that you can do to build strength that don't involve throwing heavy weights around, but if you're staying super lean, it's almost impossible for a hardgainer to put on significant muscle.

0
1ec4e7ca085b7f8d5821529653e1e35a

(5506)

on July 11, 2011
at 07:48 PM

If you are concerned about shoulder mobility and still want to have defined arms I would go back to classic bodybuilding isolation-style exercises. Find movements designed to place emphasis on specific parts and use those. Be careful and start slow for sure.

-1
0a2dd50f2d3951bf3fb83fc4638c9512

(1960)

on July 11, 2011
at 07:41 PM

Have you looked into joining a CrossFit gym? I think it would give you what you're looking for.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 11, 2011
at 11:36 PM

Whoa, I beg to differ. While Crossfit incorporates essentially anything on their kitchen sink repertoire, a LOT of what they do most of the time is going to heavily use/abuse the shoulder.

Aafdecd018b18faa16faac5e7289efa6

(25)

on July 12, 2011
at 08:39 PM

yeah i kind of agree there, crossfit doesn't seem like it would be a good fit to me, based on how involved the shoulders are

0a2dd50f2d3951bf3fb83fc4638c9512

(1960)

on July 14, 2011
at 04:01 PM

Appreciate your caveats, bens -- I know they are well-intended. My reply was pretty superficial, after all. I should have included more information on the scalability of CF programming. And also a lot of it will come down to the trainers of any given box, and their level of experience, commitment and knowledge about exercise, injuries and recovery. At my box (SPC CrossFit in Kent, Ohio), we're lucky to have a number of trainers who have professional backgrounds in PT, for example. They push us, but the last thing they want is for anyone to get hurt. That's so important.

F6c1df7d5699661bd1f0d6d0a6c17fc6

on August 31, 2011
at 10:38 AM

I can't see how a CrossFit gym would help someone with these specific needs.

7cc85cf98e4d0cac622f755294ac7ee1

(355)

on August 31, 2011
at 08:49 PM

Crossfit WILL help... I love how people with no experience jump all over it. See my above post, I DO crossfit and have had multiple shoulder surgeries.

-1
88517c58c4c7752304e1f335303cd4e8

on July 11, 2011
at 07:38 PM

If your main goal is just to increase size you could do something like The Hollywood Physique program which will add mass but not strength.

F6c1df7d5699661bd1f0d6d0a6c17fc6

on August 31, 2011
at 10:40 AM

I'm not sure a program that focuses mainly on getting the shoulders as big as possible, as fast as possible is the best for this guy

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