Articles
Shoulder Dislocation Rehabilitation for Weightlifting
August 24 2015
August 24 2015
The 2015 National Championships for me seemed doomed from 12 weeks out. First, I sustained a minor tear in my iliacus, meaning I was unable to split and had to switch to power jerks. On top of that, the convergence of several huge work projects and similar issues meant even greater than usual stress and extremely limited and poor sleep for two months, tanking my training. For the 8 weeks leading into nationals, I hadn’t snatched more than 130 in training except for one 135 the last week out, and hadn’t clean & jerked more than a couple hairy 160s. In other words, I was way behind.
The morning of my session (Sunday), I actually felt surprisingly good. I was loose, and nothing hurt aside from some lingering patellar tendonitis in my left knee. I planned to open my snatch at 142—the same plan I’d had from the start of the training cycle. I decided not to alter it despite my bad training for two simple reasons: First, I tend to pull lifts out of my ass in competition, and second, I have certain numbers I want to hit and anything other than those numbers means nothing to me. In other words, I’d rather bomb out attempting the lifts I want than make a meaningless low total; strike out swinging instead of looking.
I warmed up to 139 with no misses and pretty solid snatches all the way up. That’s right—my last warm-up was 4kg more than I’d hit in the gym in two months, which inspired some confidence. I went out for my opener at 142 and grabbed the bar, and immediately started worrying about my grip—the knurling on the competition bar was much lighter than in the warm-up room, and my grip in the snatch has always been a problem for me. I let it get into my head, and as a result, I underpulled the lift dramatically and missed.
I followed myself with a 2-minute clock—enough time to get pissed off and refocused. I followed through on my pull this time, locking the bar out overhead perfectly, except it actually ended up a bit too far back. I immediately felt the strain in my arms and shoulder girdle of the bar trying to fall backward, but being pissed off about my stupid miss, I fought for it anyway. The strain was spread evenly; there was no area in which it felt more severe than any other. I had no indication that any injury was imminent.
It felt like about two seconds of holding the bar when I started hearing the sound a partially-green tree branch makes as you’re attempting to break it—that fibrous tearing noise rather than the abrupt, sharp snap of a dry branch. By that point, I didn’t have time to react and I just listened to and felt my left shoulder finally and suddenly release completely.
It felt like the bar dropped behind me, I fell forward onto the platform, and then immediately stood up, although I had that distinctive feeling you have after having been knocked out. I found out later I was out on the deck for a good 3-count, but I have no idea what did it—I had no head or neck pain, so I have a hard time believing the bar hit my head. In any case, when I got to my feet, I realized my left arm was hanging down oddly, I couldn’t move it, and I had no feeling in it. The shoulder was obviously dislocated (Bob Morris said later that he initially thought I had injured my back, and then saw my arm hanging out once I stood up; most of the audience apparently thought I had blown out my elbow, telling me later it looked like my elbow turned inside out.).
I grabbed my forearm to support it and walked off the platform, jostling the arm a bit until the dislocation reduced, which it thankfully did in a very positive fashion, and the feeling returned to my arm. Med staff did the routine checks for sensation, grip strength, etc., then wrapped me up in a cellophane sling with a bag of ice.
I realized a couple hours later that I had some pretty bad pain in my left lower leg circumferentially that was pretty excruciating if I tried to squat down or put pressure on the leg up on the balls of the foot, although oddly the ankle joint itself felt perfectly fine. My right lower back was also hurting. I assume when I went down, I rolled over on that left foot somehow and twisted my back. Those two things appear to just be muscular strains. In any case, coaching two more sessions that day was fairly uncomfortable.
(Oddly enough, Donny Shankle had done the exact same thing I did a few attempts previously—missed his opener at 135, and then dislocated his shoulder on his second attempt, although I didn’t know it at the time I was lifting.)
Needless to say, this was my worst competition performance: 0 for 2. Also, try going through an airport and on and off a plane with one arm—it’s a lot tougher than you might imagine.
Rehabilitation
I’m hopeful that the damage is nothing that can’t be rehabilitated back to 100% function. I was able to get X-rays on Monday to verify that the shoulder was in fact back in place completely, and that there was no bone damage like chips or lesions. I bullied a shithead doctor into ordering an MRI on Wednesday that he was for some reason I can’t imagine extremely reluctant to order, so I should have an idea of what soft tissue damage occurred in the next few days (by the way, MRI machines are not built for 230-lb people. I had only had the knee tube done before—much more comfortable.).
The first couple days, I had zero active ROM and extremely limited passive ROM. I could abduct my arm under the power of my other arm only 5 degrees or so before it became extremely painful. I can now get maybe 30 degrees of passive abduction without pain and can actively externally rotate the arm about half way as long as it’s held down against my side.
Two different doctors have given me two different slings, but I’m not wearing either. Both are less comfortable than simply bracing my arm against my side and shrugging my shoulder up slightly. I’m also not a big fan of immobilization in general, right or wrong. I had some sample kinesio tape in the hotel room that I used to tape the shoulder, which took some of the pressure off, and I re-taped it when I got home. This way I can still be relatively functional—I can get a T-shirt on and off with some creative positioning, I can hold a coffee cup, and I can lift my hand up onto my desk to type. I just have to be careful not to move my upper arm—although when I accidentally do, or it gets jostled inadvertently, I’m reminded with some intense pain.
The first 4-5 hours, it was extremely painful no matter what I was doing or what position I was in. Ice and high-dose ibuprofen helped a bit, as did being distracted by coaching my last two lifters. By the next day, the pain was pretty minimal throughout the day. At this point, it’s most uncomfortable when I’m trying to sleep, and hurts the most in the mornings when I first get up—I think from a combination of having been in less than perfect positions all night and my last dose of ibuprofen having worn off.
The first couple days, I hit it with 10-minute bouts of ice a couple times each day. On Wednesday (4 days after), I started doing 2 alternations of 10-minutes of heat and then 10 minutes of ice. I’ll continue to do this contrast at least once daily, with a couple bouts of ice only as well.
Training
Obviously my training will be pretty limited initially. Normally the week after nationals would consist of a couple complete rest days, and then a couple of very light, easy days of whatever I felt like doing before starting a formal training cycle again. This week will be an extreme version of that.
I did nothing at all Monday-Wednesday—I physically could have done something, but between doctor visits and work, I decided just to take them off.
Without a functioning shoulder, I’ll still be able to do squats (with a safety squat bar initially), lunges, ab and back work (including good mornings with the safety squat bar), GHRs, and certain grip work. I’ll have to ease into squatting, however, as my left lower leg is still pretty painful.
Following is the training I did this first week.
Thursday 8-20-15 (4 days post-injury)
Decline sit-ups – 3x15
Lunge – 4x10/leg
Gripper – 4x15
Neck
Back extensions – 3x20
Crunches – 4 x max
Ankle stability pad – 2 x 1 min/side
Friday
SSB parallel squats – 40kg x 10 x 4
Squat Jump – 5x5
Back extensions – 3x15
Russian Twist – 3x10
Crunches – 4 x max
Saturday
SSB pause squat – 85kg x 5 x 5
SSB good morning – 45kg x 8 x 3
SSB jerk dip squat – 100kg x 5 x 3
Bulgarian split squat – 3x8/leg
Gripper – 4x15
GHR – 3x5
Decline sit-up – 4 x 15
Reverse crunch - 3 x max
Progress
I’ll continue posting follow-up articles every week or two that contain updates on the healing, and what exactly I’m doing for rehab and training in general. At least one good thing will come of this.
Ted
Greg Everett
I'm in Sacramento and know a great Ortho Surgeon if you need one.
Greg Everett
P.S. I had a similar dislocation of my GHJ during a snatch (not as severe as yours, and the joint self reduced after several "long" seconds). Ursula P. was actually there when it happened and will remind me of the "freak accident", after which I went on to PR my CJ in training, further indicating how that narrow grip allowed more stability/less humeral translation for me. She suggested I use a much more narrow Sn grip once I felt ready to begin overhead movements several weeks later. A couple years later, I have returned to my "normal" one. I also took her suggestion on doing Sn recovery from the rack (she speaks of them in one of her articles on her Weightlifting Wise website) and eventually progressed to tolerating them from the very bottom of the squat. That drill, other than TGUs, made me feel more confident about moderate-heavy weight overhead without the apprehension I had with a full Sn movement. Hope I'm not out of turn sharing my experience, but I really am looking forward to hearing of your transition into that sub-acute phase of healing and beyond.
Greg Everett
Greg Everett