ASK A PHYSIO..November

Hi SquareOne Team, Loving the newsletter. Here’s a question you may wish to answer to settle an argument. My mate Lucas recently damaged his shoulder (A/C Joint…again) and is off to the surgeon to have it repaired. Lucas is a very active triathlete and just doesn’t enjoy sitting around. I think he has returned too early. My question is this: I understand healing takes time but how do you manage the conflict of rest/recovery vs. remaining active? Thanks, John (29).

Hi John,

Thanks for your question. It sounds like Lucas has been pretty unlucky. He needs to make sure he is:

1. Allowing sufficient time for the injury to heal and

2. Minimising as much fitness loss or deconditioning during this down time without compromising his healing.

It is often a fine balance and one we see patients get wrong all the time leading to further problems down the track. Doing too little can sometimes be just as bad as doing too much.

Initially he will need a few days to get over his surgery…

Hi SquareOne Team, Loving the newsletter. Here’s a question you may wish to answer to settle an argument. My mate Lucas recently damaged his shoulder (A/C Joint…again) and is off to the surgeon to have it repaired. Lucas is a very active triathlete and just doesn’t enjoy sitting around. I think he has returned too early. My question is this: I understand healing takes time but how do you manage the conflict of rest/recovery vs. remaining active? Thanks, John (29).

Hi John,

Thanks for your question. It sounds like Lucas has been pretty unlucky. He needs to make sure he is:

1. Allowing sufficient time for the injury to heal and

2. Minimising as much fitness loss or deconditioning during this down time without compromising his healing.

It is often a fine balance and one we see patients get wrong all the time leading to further problems down the track. Doing too little can sometimes be just as bad as doing too much.

Initially he will need a few days to get over his surgery and anaesthetic but after this he can start training in a modified manner. In the event of a fractured collarbone or disrupted AC joint which are two very common cycling injuries he would be looking at approximately 4 weeks before he can run again and 6 weeks before he can swim and ride on the road. However in this time he would want to be doing as much to minimise his fitness loss and the deloading effects on his musculoskeletal system, especially if he has events coming up that he is planning on competing in. Examples would include starting a small circuit comprising of variations on lunges, squats, calf raises and hill walking to keep condition in the muscles he uses for running. He will be able to get on an indoor bike trainer 7-10 days post injury and get quite reasonable workouts without endangering his shoulder. Swimming is more of an issue but once he has clearance from his Surgeon to begin rehab he will have a program to follow to regain his strength and expedite his return to swimming.

Following a program like this will allow Lucas to return to normal training in a much better state of fitness than if he had done nothing during his down time. It will also and probably more importantly, reduce his overall risk of injury when he returns to training as it minimises the deloading effect on his musculoskeletal system. Earlier this year we had a patient in a similar situation who had major shoulder surgery after a mountain bike accident and after following a program that addressed the above issues at twelve weeks post injury they posted a personal best at Ironman Australia. As long as Lucas’ shoulder isn’t being exposed to any movements or forces that will compromise healing then he needs to remain active in a manner that best resembles the activities he is planning on returning to.

Hope this helps

Campbell.