Wednesday, February 25, 2015

Ream and run: rehabilitation tips from the super stars #9

We've invited some of the folks who have done a great job of their rehabilitation after a ream and run to share their tips.

Here's #9:

I have been a life-long exerciser and have used my body heavily in my job as a Physical Education Instructor and Coach of multiple sports for 35 years. This took its toll in terms of joint wear. My shoulders were totally warn out and exercising them was painful prior to the surgery and my recreational activity was becoming increasingly compromised. Sleeping and daily activities were affected as well. I led an active life-style even at the age of 64 when the left shoulder was replaced. I was exercising right up to the time of surgery so the muscle holding the joint together was a plus. I followed the doctor’s instruction and faithfully did the pulley exercises to retain the range of motion for the first 3 months while the surgery healed. I also walked and did sit-ups and other exercises that did not require the use of my left shoulder. After three months post-op I began a full regimen of calisthenics and weights with walking miles and or running stair on alternate days. I also continued to do flexibility stretching of my shoulders morning and night and off and on throughout the day as it came to mind. The way I went about the exercises was to increase the amount of weight I lifted each day or the number of repetitions as long as it felt good, didn’t hurt and there was no undue soreness or stiffness. If there was, I backed off a bit. Fortunately the progression was smooth, but I did not do any full-blown pull-ups or any violent jerking exercises for fear of damaging the joint. I did however work it hard and was able to pull down 150 lbs. on a Lat-Pull exercise 25 times, doing 4 sets during the course of a 12 exercise total body work-out which took an hour. At the end of 6 months post-op and 3 months into full exercises, my shoulder felt really good and I was able to do 20 forward or reverse grip pull-ups easily. I still do not bounce excessively on the drop motion of the pull-ups like I used to when I coached Gymnastics. I am more guarded and probably treat my replaced shoulders better like I should have my original ones, but you live and learn.

I religiously following the stretching exercises and exercising regularly to build the shoulder back up is critical. Then it is a matter of continuing the regimen the rest of your life. I am on a three day rotation exercise wise. On day one I lift weights mixed with body exercises like push-ups and sit-ups doing 4 sets of 12 exercises which takes 60 minutes. On day two I run a set of 17 stairs up and down for 30 minutes during which I usually make 110 round trips. I also do one set of forward grip pull-ups for a maximum number of continuous repetitions just before lunch. Normally I can do 30-32. Then before dinner I do as many push-ups as I can continuously, usually calling it good at 100 push-ups. On day three I walk for an hour and cover 4 to 5 miles. I do reverse grip pull-ups often called chin-ups for a maximum performance which normally is around 30. I consider day 3 really as my day off since it is not strenuous and start with day one all over again. It has been a way of life for me and I am motivated to keep my shoulders and the rest of my body in good condition for endurance, strength and flexibility. Living in Alaska, there are many adventures to go on which requires year-round conditioning to be safe. I admit I have an advantage in that I have all the exercise equipment for these exercises in my home which makes it convenient. Two things that really are key to successful exercising is good nutrition and rest. Also setting a designated time aside and being committed is important. I have an exercise chart that I fill out daily which includes my weight. Making things happen by charting them visually keeps focus rather than just letting them happen and not being consistent. Habits are important and new ones can be formed if we believe in them and force ourselves to do what we know we should. Pretty soon it becomes automatic. The body feels better, we sleep better and everything functions better. It boils down to making healthy choices; prioritizing our day. With the right amount of exercise, nutrition and rest, we have more energy and can accomplish more in a given day. So we really can’t afford not to make these things a priority in our lives!

Our bodies respond to the stress level we put on it and it should be a gradual progression. If done too quickly, ligaments and tendons do not adjust as quickly as muscles and injuries, pulls or inflammation (tendonitis) can occur. This may require reduction, some time off, or change in exercises. I experienced this with the patellar tendon and had to reduce the amount of weights being used on my leg exercises and worked through it, but it took a couple months. Luckily this did not happen with my shoulders, but it could have. I probably work myself harder than most people will because of the level of performance I want out of my shoulders and other joints as well. You can definitely do too much, but not enough is not good either. I just listen to my body and increase as it allows. I think most injuries in exercise programs arise early on, and have found that sticking with a gradual build up program is key and big strides are made after the initial first 6 weeks and after 6 mos. of regular exercise, great muscle tone and sound attachments to the bones by tendons has occurred. This may take longer in someone not used to work hard. One last thing; speaking of working hard, I think it is important to not lift too heavy of weights to begin with and do more repetitions with lighter weights working on endurance. In fact, at my age I do not lift really heavy weights on a maximum lift or only where I can do a few repetitions. I try to do sets of from 25-50 repetitions. This still builds good muscle mass and strength as well as working the heart, getting a good sweat going and burning lots of calories. A good way to think of it is: “Train and don’t strain”. Over time you will find that you will be able to lift more or do more repetitions with greater ease and in a shorter amount of time; which would actually have been a strain in the beginning. Keeping a chart of exercise progression reminds you of how far you have come, the improvement and is a motivational tool to get to what ever level you desire. You take charge and own what is happening to you. I have seen this with my students in my physical education classes and teams I coached. It is empowering and teaches self-discipline. We only realize what we are capable of when we really try and don’t give up!

I thank God for modern medicine and specialized skillful doctors that are able to give us a second chance. When that happens, we must make the most of the opportunity by doing Our Part and thanking doctors and God for their part! I am reminded of this daily because of the pain free movement that I now have and to be able to perform not only basic tasks that were compromised prior to surgery, but to function at high levels is amazing. How can I not be grateful!


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