PART 1: The Injury.

The sound of muscle tearing is something no one should ever hear. Unfortunately, I’ve heard it more than once.

It's a sudden loud snap and pop and then a quick ripping sound that shoots through your ears and sends chills down your spine. It's similar to the sound of a car crash where you don't even need to see it to know something bad has happened.

In 2012 I was squatting and attempting a then personal best of 245kg. I had squatted 240kg the week before, 235kg the week before that. 230kg and 225kg in the previous weeks.

Everything felt good in the warm-ups. I felt good controlling the weight down. I was stable. The weight was sitting comfortably on my back. I hit the hole and drove back up only to stop suddenly due to the loud snap and a shooting sensation race across my pubic bone. My body went limp and I dropped the bar.

I got up off the ground and attempted to walk away and as I did, with each step, there was a sloshing feeling in the lower part of my abdomen. Like water moving from side to side in a bowl.

My first thought was that I didn't think I was going to be able to have another attempt at the squat. My second thought was I can't straighten my body.

I hobbled back to my desk and said to a co-worker, “I think I just tore something.” He asked why? I replied, “Because I heard and felt it tear.”

Turns out I did in fact tear something. But even the surgeon didn't know exactly what id done until he had me on the operating table. Upon closer inspection, after cutting me open he found that the adductor tendon in the left leg had pulled a chunk of my pubic bone off. Not the muscle had come off the tendon. The tendon had ripped bone from bone. The Sartorius had been ripped off the bone. The Oblique on the left side had been ripped off the bone and the Rectus Abdominis had also been ripped off. There was also a partial hernia on the right side of the pubic bone.

The surgeon, Prof. Michael Schultz, put me back together and within an exceptionally short amount of time,16 weeks, I was back to essentially the same strength level I was pre-injury. They told me 18 months. Challenge accepted.

This was my introduction to A: tearing muscle and B: recovery and rehabbing from the surgery to repair the torn muscle.

Fast forward 9 years and I've squatted more than 245kg but it was never the same after that injury. My head was never the same. I used to train with reckless abandonment. I used to joke, “What's the worst that can happen?” Living in the naive world of having never experienced a major injury. Unfortunately, I now had an answer to that question and while I still trained to lift as much weight as possible, in the back of my mind that sound of muscle ripping was always there.

I have the utmost respect for any athlete who has a major injury and can get back to where they were pre-injury. The head fucking is brutal.

I hate bench press. I very rarely do it these days. There was a time I was fairly decent at it but now it never makes any progress and doesn't feel comfortable, so I do it maybe once or twice a year for 4-8 weeks and then remember why I hate it and stop.

It was August 2021 and I was doing my annual 4 weeks of bench and had been making surprising progress with it. So at the end of the 4-week program rather than writing a new one, I decided to simply continue on with what I was doing. This was rare for me. I religiously change my program every month. But this was working so I saw no reason to change.

I was doing fixed rep bench press for sets of 3 reps, with the weight increasing each set. I finally had my bench back at 150kg which I hadn't done for a long time.

On the day of the injury, I didn't particularly feel like training. I was tired. Everything felt tight. I should have listened to the advice I give people and taken the day off.

But I started the workout well, doing dumbbell bench 55kgx20,60x7,65x2 which beat the week before and even though I didn't feel great, the numbers showed me the strength was there and I should continue.

So I moved on to barbell bench and did 110x3,120x3,x130x3.

On the last rep of 130, I felt something in my left shoulder. I sat up and rubbed my arm and thought something doesn't feel right. I couldn't put my finger on it, but if you've been training long enough you get used to niggles and pains. It wasn't enough to really worry me but it was in my mind.

I put the weight up to 140kg and started my next set. The first rep felt fine. The second felt fine. Then on the 3rd rep after taking the bar down, I drove back up only to hear the loud pop and bang and feel the tearing sensation shoot from the back of my shoulder down my arm. I dropped the bar instantly and jumped up grabbing my arm. nothing hurt but my hand had pins and needles.

I thought I'd torn the bicep.

The second time I heard that ripping sound had been 4-5 years prior when I was warming up doing a dumbbell preacher curl. My arm was on a funny angle and as I lowered the dumbbell there was that bang/pop sound and a hole formed where the bicep meets the shoulder. After getting it scanned and being told it was a partial tear, I had a dose of PRP and was back to training normally within a month. Although there was still the hole and the bicep had noticeably shifted down my arm.

When I hurt myself on the bench, I figured at best I had torn the bicep a bit more or at worst completely finished the job and ripped it off completely. the hole was bigger now but I didn't know what that meant exactly. For the most part, from what I could see the bicep was still there and I could still contract and flex it. Sort of.

I booked in for an ultrasound a few hours later.

The radiologists weren't able to give me a definitive answer. they used 2 ultrasound machines and 2 radiologists took attempts at getting a clear reading but couldn't say for sure.

the ultrasound findings were:

Conclusion

The long head of the biceps tendon is not well seen within the bicipital groove and could be torn, however, MRI is recommended for further evaluation.

Mild subacromial bursal thickening.

Several days later I had the MRI.

Comment

Complete full-thickness infraspinatus tendon tear.

Partial tear of the inferior glenohumeral ligament at its humeral insertion.

Short nondisplaced tear of the posterior glenoid labrum.

Old AC joint injury.

Probable complete tear of the long head of biceps tendon at the level of the superior end of the bicipital groove.

This result actually confused me due to the language used. I've only ever seen the term “rupture” used to describe a tendon being ripped off the bone. So for it to say a full-thickness tear, somewhere inside me I had delusional hope this might not be as bad as I thought.

Of course, somewhere else inside me the voice of reason was saying, “Sorry mate, you didn't get away with anything. It's torn.”

I had booked an appointment to get PRP at the same time I booked the ultrasound. I went to this appointment in the hope that the doctor would say everything was fine and a single dose of PRP would solve my worries and id be sent on my way.

Unfortunately, he took a look at the MRI and said “It's not your bicep, it's your infraspinatus. That's going to need surgery”

This wasn't what I was expecting. Suddenly I found myself in one of those moments where time stands still and you cant hear what the other person is saying. You can see their lips moving but there is no noise. All that was going through my head was, “That's going to need surgery.” along with, “How am I going to train?”

I was referred to a surgeon, Dr Ezekiel Tan, who, sensing my reluctance for surgery, told me it could wait. It needed to be done but it could wait. It could wait 2 weeks, 2 months, 6 months but if I wanted any chance of being able to train properly again, it needed to be done one way or the other. If I was 60 and just wanted to continue on with a life that didn't involve training then I could skip the surgery. However, seeing as though I'm rather fond of moving heavy weights around, it needed to be done.

I seriously considered not getting the surgery. At that time there was no pain. No swelling. No bruising. I had a full range of motion and other than some weakness everything felt fine. I was still able to train and function. So the idea of getting cut open and potentially not being able to work, or more importantly train for the next 3-6 months terrified me. At the same time though, I knew there was something wrong and I didn't want to hold 100kg above my head, or pick up 300kg off the floor and have my shoulder collapse.

Surgery was booked close to 4 weeks after the injury occurred.

PART 2: Recovery

“Your arm will be in a sling for the first 6 weeks.”

I had zero intentions of keeping my arm in a sling for 6 weeks. I told Dr Tan that I was going to be one of his non-compliant patients. I planed on training my legs as best I could and I was going to train the right side of my body in any way that I could.

“Cross-Education” is something I had read about years prior and had used and seen used by others when injured.

For those that don't know: Cross Education is a neurophysiological phenomenon where an increase in strength is witnessed within an untrained limb following unilateral strength training in the opposite, contralateral limb.

Basically, if you train one side there is a carryover to the other untrained side.

My main objective was to keep the body working. Telling it to keep the muscle and the strength. The idea of building unbalanced muscle was of no concern. After 20 years of training building any muscle is damn near impossible let alone having one side suddenly start changing due to a few weeks of submaximal lifting. At best I was hoping to stop any muscle loss through my continued diet and whatever weight training I could do.

Prior to the surgery, I had been looking up as much info on shoulder reconstruction rehab as I could find. For the most part, what I was reading painted a fairly grim picture.

- first 6 weeks arm in a sling

- at 3 months you can start slowly lifting some weight

- long slow rehab for 6-12 months until back to normal

Every forum I read made me want to curl into a ball and cry. Everyone spoke of how hard rehab was and how their shoulder wasn't the same afterwards. It wasn't until I found one post on bodybuilding.com that I started to feel some hope. This man basically did what I was planning on doing and had great success.

Here is a link to the post. https://www.bodybuilding.com/fun/how-to-retain-muscle-after-surgery.html

On Youtube, I found multiple videos for exercises to do after shoulder surgery. They aren't overly complicated. I'm guessing in part because you can't really do anything with your shoulder or arm. It just won't move. Believe me, I tried.

I took the sling off to shower the first day I got home from surgery. I let my arm hang beside me and after a few minutes of letting the hot water warm the area, I attempted the first rehab exercise. It's simply bending over and letting the arm hang down. You then begin to slowly rotate your arm in a clockwise motion for a few circles and then come back in the other direction. I started out with small circles and then tried to make them bigger. Obviously, this places more stress on the shoulder. Hard as i tried, I simply couldn't make my arm move any more than maybe a 10cm circle. It just wouldn't move. So I did both directions for about 30 seconds each and called it a day.

Rehab had officially started. Long way to go.

For the first week, the extent of my rehab was doing the small rotations in the shower. I did this twice a day and found by the end of the week i was able to make bigger rotations. I always started small and then as I could feel things loosen up, id go a little wider. Then wider again until the shoulder let me know I had reached it limit. I'd get a slight pain and a small amount of resistance at this point.

Because there was no issue with the tricep I was also using resistance bands a few times a day to do simple tricep pushdowns. Very slow and really focusing on the contraction of the tricep at the lockout point. I'm guessing due to the trauma in the area I wasn't able to feel or get a pump in the tricep. I could rep it until it failed but there was no feeling and no pump from doing so. I've experienced this before with injured muscles so it wasn't overly concerning. My main focus was keeping the muscle working and if the arm was extending then I knew the tricep was doing its job.

Training in the gym was 5 days per week and obviously adapted to only being able to use one side. My gym, Recomp:HQ, is made up primarily of free weights and while I could have used my equipment, I knew that using machines would be easier in the short term. There is no balancing involved and the movement is set by the machine. Luckily there is a commercial gym close by that has every machine you could ever need. So my training for the first 2 weeks was done mainly there.

I was able to use the seated chest press, pec dec, rear delt, shoulder press, row, lat pulldown machines for upper body and use only 1 arm. They are actually difficult to use with only 1 side as you cant balance yourself properly.

For legs, I mainly trained in my gym and used the leg press, leg extension, our squat machine as well a safety bar squat which allowed me to hang the bar around my neck and not use my hands.

Training now wasn’t really training. It was keeping the body working while trying to keep a decent level of stress going through the muscle so I didn't waste away. Where movements were usually done with heavy weight and explosively, now the weight was considerably lighter and the reps a lot slower, with more focus on squeezing the muscle and trying to get as much blood as possible into it

By the end of the second week I had stopped wearing the sling 80% of the time. I found it got in the way and actually caused more pain and discomfort for my shoulder. So I wore it to bed out of fear of having my arm do something it shouldn't while I was asleep.

Sleeping with the sling sucked as I had to sleep on my side which I don't normally do. I'm a back sleeper but laying flat on my back caused a lot of pain in the shoulder. So i would prop my arm up with a pillow and lay on my side. I got used to it but once again the sling made doing simple things, like holding my iPad to read next to impossible so the moment I felt comfortable to not sleep with it, I took it off.

At this time I had also progressed to doing a few more things for rehab. Another exercise I had seen online was placing the bad arm on a table and then walking backwards while allowing yourself to lean forward. This mimicked the movement of lifting your arm above your head which at the time couldn't be done. After being in the shower and warming my arm up with the hot water and the rotating exercises I would go to my balcony and hold the railing and then lean back, stretching the shoulder. I would do this about 10 times and hold it for 15-20 seconds.

The first time I did this I could barely take a step back. By the end of the second week I was able to lean right back and bring my arm behind my head. The next step was doing it against a wall which meant I would need to be able to lift my arm up on to the wall. Another exercise I had started doing to help with this was very simply lifting my arm from my side and holding it straight out in front of me for 10 seconds. Then letting it drop and lifting it to the side and holding it for 10 seconds. When I did this it felt like I was holding a 50kg dumbbell. The first time I tried it I could barely lift my arm in either direction any more than 15-20cm. Each day I did it I was able to lift it further and by the end of the second week I was able to lift it and extend it right up above my head. There was still pain and resistance when doing it but the progress was obvious.

In the gym, I took the first steps to using the bad arm again. I was sitting in the seated chest press machine and after doing the first set on the right side, I lifted my left hand, with the help of my right hand and placed it on the handle. It certainly wasn't comfortable. My shoulder didn't like being put in that position and when I tried to push the handle away, nothing happened. I physically couldn't extend my arm. There was no power at all. So using my right hand to push, I extended the left arm and then moved my right hand away and let the left side control the negative back down. There was little to no strength to resist the handle coming back down but I held it the best I could. I did this 10 times and left it there for the day.

2 days later I went back to the machine and tried again. This time I was able to slowly extend my left arm without the help of the right. I kept the right hand very close by in case anything went wrong and I needed to catch it. But with no weight, other than the weight of the machine I was able to extend the left arm fully. it hurt. It felt weak and unstable but this was progress. I then increased the weight by a whopping 1.25kg and did some more reps. adding another 2.5kg I could do a few more before fear kicked in and I left it there.

Something I learnt through the early weeks after surgery was there was no benefit in pushing things beyond a certain point. My body was letting me know what it could do and when it reached the limit, things just stopped working. It didn't matter what I did, the joint and muscle wouldn't allow the movement. That was the sign to leave it be, walk away and try again next time.

Now that I was able to load the left shoulder, as pathetically light as it may have been, it opened up what I was able to do. I also found that once I could start putting force through the shoulder and arm, I was able to stretch more with a greater range. My rotations in the shower were close to a meter in diameter with no pain. I was able to lift my left arm without any help from the right, and place it on the wall and then lean back and fully stretch the shoulder.

I had also moved onto a new exercise which was putting both hands behind my head and pulling my elbows back. the fact I was able to lift the left arm to that position was progress in itself. The first time I tried, the best i could do with the left was kind of put my hand on top of my head with my elbow facing forwards. I couldn't move the elbow back even slightly. Now I could get my hand on the back of my head and pull the elbow right back.

Dr Tan told me one of the movements I needed to be careful of was putting my left arm behind my back. So a movement as simple as reaching behind me and placing the top of my hand on my lower back. A movement you wouldn't even think about until you can't move your shoulder. For the first few weeks the best I could do was slightly bend my elbow, but getting the arm behind me, it just wouldn't go. Slowly though, with the help of the other rehab exercises and loosening the shoulder with hot water I was slowly able to get more movement.

It started with being able to touch the side of my butt. Then a few days later I was able to get my entire hand behind me. I couldn't lift it up to my lower back just yet. Whenever I tried there would be a sharp pain in the front of the shoulder so I stopped. This was obviously putting the joint under stress and I saw no point in pushing it. I tried this every few days and each time I did, it got slightly better. It was the slowest movement to progress out of everything I was doing but it was getting there.

I've always hated the term “mind-muscle connection.” The context so many body builders use it in makes me cringe. But here, now, I understood I had completely lost the connection with certain muscles. Every night before going to bed I would use the resistance bands and do a few sets of tricep pushdowns and some very slow bicep curls. the curls would cause a somewhat painful pulling sensation in the front of the shoulder but i could still curl. but the connection just wasn't there. I could see what I was doing but I couldn't feel it.

I booked my first PRP session just after my 2 week post-op follow up. Some doctors I spoke to recommended waiting 6 weeks until the arm was out of the sling before getting it. This made no sense to me as I wanted the PRP to assist with the initial healing right away.

I found Dr Luke Eggleston and booked in. Ive had PRP before so there were no surprises here. I was actually a little nervous when he started to do the ullrasound. I was terrified it was going to show that I ripped the anchors out of the bone and the muscle had come off. All my apparent progress was all for naught. Thankfully though that wasnt the case and he said everything looked fine.

Between week 3 and 6, everything from the rehab exercises to training continued to improve. I was able to lift my arm right above my head with no pain or resistance. I was able to get my arm behind my back with no pain. I was doing all free-weight movements on both sides and while I wasn't pushing as hard as before I was still able to push to about 75% of what failure would normally be.

I had floor pressed 100kg by this point, dumbbell benched the 40s, trap deadlifted 270kg, seated military pressed 95kg. Obviously the sling was long gone, even at night.

There was no pain in the shoulder. In fact my shoulder now was better than it was before the injury and the surgery.

I had issues with my left shoulder for a long time. I had a very limited range of motion due to hurting it before. This whole experience got me thinking that maybe something was already torn hindering the movement. It didn't matter what I did before: stretching, chiro, massage, it never made a difference. Now though, my shoulder was back to where it should be. I had a full range with no pain. Don't get me wrong, ill never be mistaken for a gymnast, but for me my new found flexibility was a welcomed surprise.

At week 6 I had my final follow up with Dr Tan. I proudly walked into his office without a sling and some training videos to show him. I'm not going to lie, I was proud of myself and my progress. at 6 weeks you're supposed to be taking your arm out of the sling and here I was back to training almost normally and functioning in everyday life as per normal.

Dr Tan said he was impressed. Apprehensive but impressed. He said people don't recover like I did. He said what I've done is amazing. That made me feel good.

I'm not smart. I'm not special. I just saw the recommendations for recovery and thought most of them didn't make sense. It didn't make sense to me to keep my arm in a sling for 6 weeks so all the muscles surrounding the shoulder could atrophy causing a massive loss in strength. It didn't make sense to keep the shoulder in the same position so the elbow and shoulder would lock up. All I could see was the increased potential for a new injury when I did eventually take the sling off. I didn't want to have to try and rebuild all the muscle and gain the strength back. Yes, I understand muscle memory but if I didn't have to do any of that then I wasn't going to.

My other thinking was, there are 4 rotator cuff muscles. I tore 1 of them. So while 1 was repaired and recovering there were still 3 more functioning properly. Not to mention the shoulder muscles, the bicep, the tricep, the traps, the lats. All of these muscles were still functioning and in a sense were there protecting the infraspinatus. If I had torn the bicep off the bone and had it reattached that would be different. So I chose movements that I could do that wouldn't overly stress the repaired muscle. It could be argued that what I was doing caused a great deal of stress but compared to what my body is used to, I was still confident in the strength of the surrounding muscles and their ability to shield the infraspinatus. I also didn't do anything that put the shoulder in precarious positions. If something didn't feel right, I didn't do it.

There were several exercises I tried that simply didn't work. so, I stopped. As I said earlier, I learnt that there was no point in pushing beyond its limits.

As I write this, its just over 10 weeks since the surgery. My training is almost all the way back to where it was. It's not quite there but I'm able to push sets to failure. I'm still doing pressing movements a little slower than I did before and that's resulting in slightly less weight being used, but I've benched 115kg, seated military pressed 120kg, trap deadlifted 310kg, db benched 50kg, lateral raised 20kg, close grip benched 100kg, bb curled 55kg. I've also managed to keep basically the same conditioning I had before the surgery and from the looks of photos I'm basically the same.

Once again, I'm not special. I'm just a firm believer in you need to give the body a reason to heal and the best way to do that is to make it work. Send it a message that it needs to hurry up and heal and it will. Provide it with good nutrition, any supplements that will help, along with plenty of rest and your body will heal.

I got my body moving again as quickly as possible after surgery.

I iced my shoulder every day after I trained. Every night for the first 3 weeks I would ice my shoulder for an hour while watching tv. I used a massage gun every day to try and help keep everything loose.

I eat a controlled diet. At the moment it is a high protein, moderate carb, low fat diet. I eat the same food every day. I didn't drop my food after surgery. I actually increased it. I wanted to give my body everything it needed to recover.

Now am I saying everyone should ignore their doctors and ditch the sling after a couple of weeks? Of course not. I'm very aware of my body after years of training. I know what does what and how different things affect it. If you don't have that awareness then I don't recommend taking things in your own hands. With that said I do think you should seek the help of professionals to help speed things up. It might take some research to find the right people but they are out there. Had I listened to the first PRP doctor I would have waited 6 weeks to get that first injection. But knowing what I know about PRP I was able to find someone who would do it quicker. I'm a huge believer in PRP treatments and think it played a massive role in my quick recovery.

I write this long blog to say that a shoulder reconstruction doesn’t need to set you back for 12 months or more. No injury does. Obviously there will be varying degrees of severity in regards to the injury but your best course of action to start the healing process is to get the body working again as quickly as possible. Whenever I’ve been injured, I’ve let the initial inflammation subside and then I get right back to training the injured area. In a modified way of course, but more often than not ill be back to training at full capacity within a few days or a week, not months like so many others. Before I left the hospital the nurse said I should keep wearing the DVT socks for 2 weeks to reduce the risk of blood clots. I looked at her with a raised eye brow and said, “2 weeks? I’m not going to be sitting on my ass for the next 2 weeks.” Here in lies the problem with how people are being advised to rehab and recover. I understand that things take time to heal, but your body reacts to messages and signals.

If you the body to heal, tell it to heal. Don’t sit around and wait. Send it a message and get back to normal as quickly as possible.

Recovering From Shoulder Reconstruction Surgery