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Episode #62: Powerlifting Shoulder Rehab | Modifying the lifts through injury or post-op
The shoulder is one of the most commonly injured areas of the body in the sport of powerlifting and strength training. But injuring your shoulder does not mean you should stop training. Barbell lift modifications can be made so you can continue to powerlift while you rehabilitate your shoulder injury.
In this episode of the PRS Podcast the Clinical Coaches discuss our algorithm for technique modification to allow you, your clients, or patients to continue to train each powerlift while rehabilitating a shoulder injury. Additionally, we discuss how you can continue to train your whole body early on after having shoulder surgery and what early return-to-sport for powerlifting looks like.
We break down technique modifications and return-to-powerlifting after surgery via a discussion on each lift so there is no reason why your athleticism should decrease when you are recovering from a shoulder surgery or injury.
Resources mentioned in this episode:
Pain & Injuries Part 1
Pain & Injuries Part 2
Pain & Injuries Part 3
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Email: podcast@progressiverehabandstrength.com
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Dr. Rori Alter, PT, PRSCC: [00:00:00] A point I just want to highlight there is that if you have symptoms in your shoulder or any injury and you've got a baseline before you start lifting and you lift and it doesn't worsen, you're okay.
Dr. Alyssa Haveson, PT, PRSCC: [00:00:15] I get that question a lot, and here's the way that I like to describe it. We don't want to leave the gym thinking I shouldn't have done that. Right?
Dr. Rori Alter, PT, PRSCC: [00:00:25] I like that. Welcome to the Progressive Rehab & Strength podcast.
Dr. Alyssa Haveson, PT, PRSCC: [00:00:27] We're your hosts, physical therapist, strength coaches and clinical coaches, Dr. Alyssa Haveson and Dr. Rori Alter.
Dr. Rori Alter, PT, PRSCC: [00:00:35] Join us on our journey of barbell strength training and rehabilitation. All right, guys, welcome back to the Progressive Rehab & Strength podcast. I'm your host, Dr. Rori Alter, head clinical coach here at Progressive Rehab & Strength, with my lovely co-host, as usual, Dr. Alyssa Haveson, here in our shoulder month. We obviously, if you've been listening to the podcast for a while, are all about continuing to train no matter what. Really, there is no excuse for not training unless you're in the hospital or in jail, but you probably have access to some type of training equipment in jail, so that's not even an excuse. All right. So before we dive into today's podcast, if you like this podcast or you get any good value out of it, please leave us a rating or review. Your comments, your insight, your excitement about the podcast, and your questions all help us stay motivated and continue to record podcasts and then deliver them to you guys for listening, so that would be really helpful. What we're going to talk about today is modifying the lifts so that you can continue to train. We're not going to really talk about programing considerations. We're really going to talk about how you can modify movement specifically for shoulder injuries and surgery. Surgical considerations, we're going to talk about at the end. We're first going to talk about pain and injury. Specifically with barbell lifts, we kind of have an algorithm that we outline in our pain and injury series. I'll link those three episodes in the show description. I feel sometimes like we're on repeat or deja vu every time we do an episode talking about hip injuries and how to train with them, shoulder injuries and how to train with them, knee injuries, because it's really the same approach. We're going to modify your stance or your grip. So with shoulder injuries, obviously stance doesn't usually have anything to do with your shoulder, although it might. We're going to look at modifying your grip with adjusting your wrist position because sometimes just adjusting your wrist position can help pain and injury in the shoulder. We might look at a different bar type or placing the bar slightly differently on your shoulders, and then we're going to if none of those modifications work, we're going to look at range of motion and load modification. Or we might do those in combination with the grip and bar placement. The interesting thing is that with shoulder injuries, grip and bar placement are actually range of motion modification. So even though we do, those are separate for other areas of the body. Their grip, bar plate, and bar placement are a range of motion modification.
Dr. Rori Alter, PT, PRSCC: [00:03:37] So then we'll modify the load, see if lowering the load changes the sensation that you have in your shoulder, and then we'll look at frequency and volume modifications to improve the recovery of your shoulder, because sometimes you just need a little bit more rest between sets, between exercises, or between training days or across a whole training block when we look at everything from the outside in. Those are kind of how we do it for just all injuries in general, but what we're going to talk about specifically first is pain and injuries in each lift, and then we'll also look at how we modify those lifts if we've got a surgery to the shoulder. Actually, first, why don't we talk about surgical considerations? So Alyssa, can you talk to us a little bit about if someone has surgery on their shoulder, what does that process look like from immediately post-op to a transitioning back to your normal bar position and your normal training frequency and intensity?
Dr. Alyssa Haveson, PT, PRSCC: [00:04:43] Yeah. So usually within the first at least couple of weeks after surgery, we may not be able to perform some barbell movements depending on the surgery and depending on the lift. But that doesn't mean that we can't do anything or that we should avoid training altogether because there are other areas of your body that you can train if usually it's just one shoulder we've had surgery on. We can do things with the other arm, with the other side. That's all really important. But early on in the rehab process after surgery, we might be looking more towards isolation exercises, lighter weights, and higher volume to still train the musculature around surrounding movements or joints without actually moving the surgical shoulder in a way that we can't initially.