Diary of my SLAP tear and how I avoided surgery

I’m Ryan, one of the Personal Trainers at Strength & Soul Whangarei.  I like Brazilian Jiu Jitsu or BJJ for short. But on this one day last year (2017) it didn’t like me.

I was rolling on the mat with another guy and I got caught in an armbar, I managed to escape, but while doing so hurt my left shoulder pretty bad.

After a few physio visits and an MRI scan it was discovered that I had a SLAP tear or lesion.  A SLAP tear or lesion occurs when there is damage to the top of the labrum or where the bicep tendon connects to the labrum.  The labrum is a piece of cartilage attached to the rim of the shoulder socket that helps keep the ball of the joint in place.

SLAP is the acronym for Superior Labral tear from Anterior to Posterior.


When I knew for certain it was a labral tear, I was gutted!  I had a similar injury a few years ago on my right shoulder and that needed surgery.   Therefore I assumed that the only option for me this time, was also surgery.  Over the next few weeks whilst I waited for my surgeons appointment, I was not a very happy person to be around.

On the day of my appointment i went into the surgeons office thinking the worst.  He performed a few tests on me, which all showed positive for SLAP tear, and my confirmed diagnosis was made.  As I sat there in his room I expected him to tell me my only option was surgery. I was surprised and delighted when he actually gave me his reasons to try to avoid surgery and see if we/I could get it to repair itself over time.  Recent studies have shown that labral tears can be rehabbed to 100% without having to go under the knife. This process could take 3 – 6 months and I would need to have patience and perseverance.

As I walked out of his office i vowed then and there that i was determined to rehab my shoulder back to 100%.  First up i needed to do a little research of my own.

 


Discoveries & Research

As part of my initial physio rehab plan prior to the surgeons diagnosis, we discovered that my Left Latissimus dorsi muscle was not working as well as it should be and I was also lacking adequate range of motion with external rotation.

This was my weak point which I needed to focus on.  I needed to be able to activate these muscles and once that happened, I then needed to be able to strengthen these areas.

The rehabilitation exercises that I choose to do were;

  • High elbow face pull with external rotation x 10
  • A move I call ‘No Money’ which is a specific external rotation move x 10
  • A landmine press with no weight x 10

Plus I would foam roll the lat and peanut (2 x hockey balls taped together) the entire shoulder area.

I did this for 3 sets, slowly with my focus always being on proper shoulder movement and muscle activation.  I did these EVERY SINGLE DAY.


What to do and what to avoid

For me ALL overhead movements were off limits.  However I was still able to continue with all my other training.  This is what my training plan looked like;

  • I still kept deadlifting about 150 – 160 kgs for 5 reps
  • Farmers walks with 40kg kettlebells
  • Lots of heavy goblet squats and swings.

All the time my focus was on ensuring my left lat was activating and engaging properly.

The main exercises that I did to strengthen the shoulder were;

  • Bottoms up kettlebell cleans x 3-5 reps with 2 sets
  • Tall kneeling landmine press no weight x 5-8 with 2 sets
  • Kettlebell floor press with double 24kgs x 5-8 with 2 sets

I would do these exercises every second day.  For the first 3 months it was hard if I didn’t have my shoulder in the exact position it needed to be in, then it would bite me. Also I was not able to put much weight on the shoulder.

I also started to hang on the rings and slowly lower myself down.  I would try to hold as much of my body weight as possible and maintain that position until it became uncomfortable.  With this exercise I really didn’t feel like I was making much progress initially, but I persevered.


Progress!

At about the 3-4 month mark I was starting to feel really surprised as it seemed like each week my shoulder was beginning to become more noticeably stronger and stable.  I was able to hang off the rings with my full body weight, then a week later i was able to hang off the rings on my left hand with my full body weight.

The next week I was able to Bottoms Up Clean with a 32kg KB with my left shoulder.  The landmine press now had a 15kg plate and the floor press increased to 32kgs.


Reassessment

I had now reached the 5th month and because I had achieved activation and adequate strength I focused on strengthening and conditioning the shoulder joint.

  • Swiss Ball walkout with a leg lift
  • Push Up Position Plank rolling a med ball from one hand to the other
  • Side-lying Subscap Internal Rotation with a 15lb dumbbell
  • Tennis Ball Wall throws progressing to 3kg medicine ball.

Once I had started this new programme it felt like my progress was happening every day!  Occasionally I would throw in the old rehab exercises as a bit of a check in.


The 6 month Deadline

By the 6 month mark I was feeling 100%.  After a couple of weeks of feeling like this I decided to give an overhead press a go.  With having zero overhead press action for 6 month I was bloody stoked when I managed a single military press at 32kg on my left shoulder.

Then I had my follow-up appointment with the surgeon.  He performed a series of tests on my shoulder, a repeat of the ones I had done on my first visit.

He asked me about my rehab plan and I filled him in on all that I had done over the last 6 months.  With a smile on his face he told me he was pretty certain my shoulder was back to 100% and that I definitely did not need surgery.

That was one of the best things I have ever had someone say to me.  I was so stoked that my patience and perseverance had paid off.

What is ironic is that now my left shoulder feels stronger and a lot better than my right.


My Learnings

The two most important things I can take away from this whole experience is if you do have an injury keep moving!!

Make sure you continue to go through all the range of motion movements that you can without pain.

Secondly once you have selected or been given your exercises to do by your trained healthcare professional DO THEM!! EVERY DAY start light and work your way up from there.  

Consistency was very much the reason for my successful rehabilitation.

 

 

 

 

 

 

Boost your Immune System

Did you know that massage can boost your immune system?  

As the cooler weather approaches and our seasons change, now is the ideal time to start to think about boosting your immune system and beating those winter blues.

 

  • Boost Your Immune System.  

As we all know Winter usually means cold & flu season has arrived too.  However massage can help your body fight off these lurgies by boosting your immune system.  Regular massage increases the lymph flow around the body, our lymph is our immune system which is loaded with lots of white blood cells. These then go and fight infections around the body. **

 

  • Improve Circulation

Are your hands and feet always cold? Do you notice this get worse as the weather gets colder? Do those aches and pains become more noticeable in the colder weather? Massage can help by encouraging our circulatory system to increase blood flow.  This assists in keeping our body warm (yay to no more cold feet in bed!) and also increases the flow of oxygen around the body.

 

  • Bye bye to Dry Skin

The colder, drier air during the colder winter months makes the water in your skin evaporate quicker, and therefore makes your skin drier.  Add to that heat pumps on full blast in the office and being couped up inside all day – eeek talk about dry skin overload! The various oils in the waxes and balms being massaged into the skin as well as improved circulation mentioned above, will keep your skin in tip top winter shape.

 

  • Banish Winter Blues

How often do we get the chance to take time out for ourselves nowadays?  An hour of either relaxing or chatting away whilst getting a massage is the perfect way to get some self-love time in.  Massage encourages positive changes in the endocrine system which is the system that creates our hormones.. Such as decreasing cortisol levels (stress related hormone) & increasing oxytocin levels (happy hormone).  Which then leads to the release of serotonin and endorphins, thus relieving stress and enhancing your mood. Oooooh bye, bye winter blues!

 

** If you actually have a cold or flu, or currently feel under the weather, then massage treatment is NOT appropriate.  The body needs to conserve its energy for fighting off the bugs currently in your system.  Encouraging circulation during this time is just way too much for the body to handle. Plus keep your bugs to yourself at home.  We don’t want to catch whatever it is that you may have!

 

Nutritional basics – Part three of three

Well back to that hand of yours (mentioned in Part One). We will be using it as a portion control guide. If you are a bigger individual you will have bigger hands and so will be requiring bigger portions.

Understand that most food comes as a combination of macros. For example meat usually comes with fat and grains come with some protein. For simplicity we will group our food as protein, starches, fruit, veggies and fat.

Let’s start with protein. Look down at your palm. A normal serving for a man would be two palm sized portions and for females it would be 1. This includes the thickness of the palm as well. For a lot of people it might end up being about the size of a deck of cards.

For starchy Carbs, most males will do well with at least a fist sized portion or two.  Females would do well with one. If you are not an active person or your goal is to go down a clothes size it  makes sense to limit these to one if you are a male and half if you are a female. As for your colourful veggies it would be great to aim for the same bulk as you did with starches. You will have to work very hard to go up or down a clothing size feasting on these so go for gold. If you enjoy fruit then eat up. Fruit is full of  fibre and nutrients just like veggies. Change the fruits and veggies with the season.

Finally fats. Using your thumb as a guide for things like oils, nuts and seeds you can keep your calories in check as these are super easy to eat in excess. Remembering that fat contains more than double the calories than both carbs and protein so it makes sense to be aware of the amounts that you are consuming. A male should aim for about two thumbs while females would do well with one.

A few points to consider are that I do not mean to say that men require double the food than women. This is a simple starting point depending on your size, activity levels and goals, the size of the portions will differ. These hand sizes are approximates and assume that you eat four times per day. That is to say that a male would on average require 8 palms of protein for the day and a female would require 4 thumbs of fat..

For example using a female who prefers to eat 3 meals per day and wants to maintain her same weight and improve her meals. We can say on average she would need;
– 4 palms of protein,
– 4 fists of starches and veggies
– and 4 thumbs of fat.
She can either spread her “four servings” evenly across her meals or save those portions for the meal when she feels the hungriest. If this woman is very active and requires extra energy to support that activity she could add an extra ½ – 1 fist full of starches at her meals and this would make up that requirement.

Another example would be the male who wants to lose some weight. The average male’s daily intake would equal
– 8 palms of protein,
– 4 fist sized portions of starches,
– 8 fist sized portions of veggies and
– 8 thumbs of fat.
Let’s say he wants to eat 5 times per day. Breakfast, lunch and dinner could be standard sized protein, veggies and fat  with 1 fist of starches. That leaves you with 2 smaller sized meals which you have 2 protein, veggies and fat servings and 1 starchy serving left.

If you apply these recommendations you would have taken care of most of what really matters regarding nutrition.

Eating this way takes care of your health, body composition and energy without having to stress about following the latest diet fad.  Your job now is to turn this information into consistent action.

Nutrition Basics – Part two of three

“you are what you repeatedly do”

Making a meal of it

Setting up good food habits is the whole point of this article. Habits become effortless and this is definitely your desired result.

Leaner people have lean eating habits.  Having a firm grasp on what foods to eat, the required portions sizes and being able to apply that knowledge WILL set you up for the rest of your life, not just for the next six weeks.

So what and how much should I eat?

The what part is up to you and how much depends on your desired outcome but let’s give you the options. These are called your Macronutrients or Macros for short.

Protein

First you have protein. Protein is not your stereotypical gym junkie’s best friend, but also an essential part of a healthy diet. Essential means absolutely necessary for good health in humans and must be taken into your body through your diet. Your body requires protein to create the big things you can see like your skin and muscles, and it is also required to create the things you can’t see like cells, hormones and DNA.

It’s also the most satiating of the 3 macronutrients which means it gives you the feeling of fullness more so than the other macros. Which is very handy when you are trying to take in less calories.  Foods which contain the greatest amount of protein come in the form of meat, dairy, eggs and protein powders.

Carbs

Next up are carbs. These are your grains, fruits and vegetables. Funnily enough though also the current villain on the diet scene. Cutting carbs out of your diet is the quick answer that’s handed out for weight loss. The truth is there isn’t anything called an essential carb (sorry potatoes)  but most people perform and function better with at least a moderate intake of carbs.

Fruits and vegetables contain high levels of vitamins and minerals, which will keep you from becoming victim to crazy things like scurvy and rickets. So eat lots of them. A lot of these are “almost free” sources of food. Meaning they have a very small amount of calories and are a great option for snacking on if you are limiting those calories. These as well as grains are a great source of carbs and should make up the bulk of your carb options. The healthy carbs like the ones above will provide you with steady energy throughout the day and contain fibre which… I think we all know what fibre does by now.

Meanwhile the not as healthy carbs such as potato chips, pastries and fruit drinks are the foods that are very easy to overindulge on.* These foods have far more calories with far far less of the fibre and other nutrients that the whole food sources contain. Eating these foods seem to make you  more hungry than when you started. For these reasons the majority of your carb intake should be of the whole food variety. If health, body composition and performance are important to you that is.

* if minding energy intake, beware of liquid calories. Sugary drinks and especially alcohol can throw a good day out of whack and lead to further unnecessary eating.

Fat

Last  up is Fat. Fat used to be enemy number one but the truth is fat is a necessary part of a healthy diet. The omega 3 and omega 6 fats are also essential to good health and must come from your diet. Fat is used in the body for absorbing certain nutrients, producing hormones, as well as a slow energy source. Also as you know, one of fat’s biggest roles to play is to be stored  for future use when calories are reduced.

Having a rough idea about how much you need and what type of fat to eat or avoid will help you make more informed decisions when it comes to your eating. This is important because as well as making food taste delicious they contain twice as many calories as the other 2 macros.

There are 3 types of fat that you should know about;

  • Saturated fat
  • Polyunsaturated and
  • Monounsaturated.

Saturated fat comes mostly from animals and some plants like coconut and palm. Monounsaturated fats come from plant sources such as avocado, olives and nuts. Polyunsaturated fats are usually the ones associated with salmon, tuna and other cold fish but is also found in nuts and seeds. To keep things simple it’s best to aim for an even spread of these fats throughout your day or week.

*Avoiding Trans fat as a rule is a good option.  Any plant based oil made solid or partially (eg margarine) by hydrogenation will contain trans fats.  This causes the chemical structure of the fats to change in a way that the body can’t use.  Basically poisoning the body

 

In the final installment of Nutritional Basics I tell you just how to put all this information together on your plate. . .

Nutrition Basics – Part One of Three

I think it’s a safe bet to say that most people would like to improve their health and then remain that way for as long as possible. After all this could mean a longer healthspan and extra years with your loved ones.

The 3 main behaviours that are used to improve health are
– stress management
– exercise
– diet (duh!)

All of these topics come with extremism and dogma. As if there is only one way to do things and all the other ways are wasted time and effort. No wonder there is so much confusion.

As someone who is very interested in the subject it is frustrating to see it, hear it and read it! Not everybody wants to eliminate a whole food group because it is supposedly how our ancestors ate. Or to not eat anything at all a couple of days a week.  There are many ways to ‘diet’, but if it doesn’t fill your body’s nutritional needs while also being sustainable for the long term, then indeed that would be a waste of your time and effort.

The best results are going to be built on repeating the basics consistently over time. This 3 part article is focussed on just that.

Important Note: *As long as you are not recommended otherwise by your doctor this article will apply to most people.

Calories are king and eat your damn vegetables.
Do that everyday for the rest of your life!

There you go – nutrition basics 101. I should have just started with that.

Seriously though I wish it could be that simple.You eat food and ideally your body will use that energy to keep your heart beating and muscles moving.

Calories are the unit of energy measurement  in our food. If your goal is to lose weight you need to consume less energy than you expend. If you want to gain weight the reverse is true. Continue to do these things and adjust as necessary along the way until you have reached your goal weight.

Having the knowledge and ability to manipulate your body with your calorie intake is a powerful tool. You can use it to offset that crazy weekend you just had, to start finally gaining some weight or to lose weight for your sisters upcoming wedding. But most importantly – be able to keep it off (or on) because that is far more healthy anyway.

Important Note: *Behaviours that match the desired outcome is of huge importance but will not be covered in this article.

 

But there is no need to be getting the calculator out at every meal. Most of you won’t need to be counting up your intake super precisely unless you have far loftier goals and if that’s the case this article isn’t for you. You should be thinking about building habits not following meal plans.The ability to eyeball portion sizes or using your own hand as a guide can be a real eye opening experience. The great thing about using your hand as a guide is that it’s a custom fit for you and you can usually count on having it with you.. . . . .  More on this soon in Part Two.

Health & Seek

“You need to see a Physio”, “You should see my Chiro, he always sorts me out”, “Acupuncture will do it – my next door neighbours aunty swears by it”, “No no no don’t go there, here’s the number for my amazing Massage Therapist”…  ahhhh the minefield that is health!

There are a lot of health & wellbeing modalities out there nowadays, and A LOT of information and opinions.  We live in a day an age where Dr Google can offer you signs, symptoms, diagnosis and cure without having to leave the couch.  Sometimes this is not always bad thing, it can make people curious, it makes people question their own health & wellbeing, and it can weed out the good practitioners from the not so good.  However it can also make you extremely confused!

Health & Wellness is a bit of a journey, it is like a family road trip.  You start off all excited, you know your destination and you have worked out your estimated time of arrival, and you are probably even thinking about how amazing you are going to feel when you finally get there –  oh the adventures you will have and the R&R you will get to enjoy.

Until twenty kilometres into your family road trip you suddenly realize you can’t remember turning off the hair straighteners! U-turn pulled and back home you go, to start off all over again.

Let’s say you have a niggling injury, it’s been about 3 – 4 weeks so you decide to see someone, there is a trusted health clinic down the road, you make an appointment, they give their opinion you start the treatment, everything is going to plan. . . . . .your initial injury seems to be going really well, but now another part of your body is starting to ache too. What’s with that?!  Back home you go.

To be quite frank, sometimes, more often than not, that is just how it goes.  Everybody is unique and different, every one’s health & lifestyle history is different, and how our bodies react, cope & compensate are all different.

The key to the journey is to;

  • Learn to listen to your body, it will tell you what it needs & who it needs.
  • Find & seek your trusted health & wellness professionals.  To be honest this can be a bit of a whole nother journey in itself and a little bit expensive.  But necessary. Trust me in the long run your body will thank you for having taken the time and patience to do this.
  • Ask questions & listen, that is how knowledge is seeked.  This is especially important when it comes to your health professional, ask them questions about your body and health, it is your body after all.  If they can not answer thoroughly and honestly – then find someone who can.
  • Be patient.  If you have lived a certain type of lifestyle for 30 years, it is probably not going to take 30 days to change everything.

Crawling, so what’s that all about?

Apart from looking and feeling funny on the floor what are the benefits of crawling as an adult?

To begin with crawling is a developmental movement pattern that as a baby, you yourself most likely went through on your progression towards walking. As you graduated from crawling onto walking you probably thought, “right I’m done with that part of my life”, but hold your horses. Crawling can be equally as valuable a movement now as it was way back then. I am going to try to convince you that crawling isn’t just a way for our hidden cameras to get funny footage of you, it can also be both strength, conditioning and mobility work.

Reason 1 – It’s good for your brain

To say that crawling plays a major role in a developing brain is an understatement. It helps increase body awareness, nurtures gross and fine motor skills as well as developing the child’s visual abilities. Also not to mention developing the necessary strength and coordination to get up walking. But what about for us adults?

 Some of you who have crawled as an adult may have found it super easy, but I can guarantee that some of you reading this right now, felt as uncoordinated as a giraffe on ice skates, especially while going backwards or sideways. Getting down on hands and knees and moving in a non-ridiculous fashion requires the left and right side to join forces to get things done. Doing this gives you a lot of sensory input from all the parts of the body that are moving and being contacted by the floor. This improves the coordination between the left and right side of your walnut, increases your body awareness and also improves your “reflexive” strength eg. Catching yourself while tripping over before you faceplant.

* It may also add 10 points to your IQ score although I have no data to back that up.

Reason 2- It’s good for your body

If you are over 30 and have been paying attention you may have noticed that your body may not feel as good as it once did. Some will write it off and say “I’m just getting old” but many of the things that cause it to not feel as good as it once did can be minimised or eliminated. It is true that ageing can cause a loss in muscle mass and strength, balance can decline along with your confidence level and your body may start to feel “tighter”. These can start to decline in your late 20s and continue to fall until the inevitable sleep. But what if someone wanted to do something about it?

There are issues that we see at Strength + Soul that are really common in the general population. To see how these can be helped with crawling I will give 2 examples:

A Stiff Upper Back

A mobile upper back or thoracic spine, is an important player in many things but for this we will focus on shoulder health. If this region is tight it can limit the ability of the shoulder blade to move which then restricts how your shoulder moves. As you perform variations of crawling and maintain your eyes on the horizon it can encourage thoracic extension while loading the upper body in a way which improves shoulder stability. Winning!

A Weak “Core”

I cannot think of anyone I have come across where I thought to myself “guess we don’t need to do any core work”. We like to view the “core” as anything from hips all the way to your neck, front back and sides. This is the area which you produce and transmit huge amounts of force through, generate movement from and all the while hopefully protecting your spine and vital organs. Your shoulders and hips must work in a reciprocal fashion to make movement occur and these forces must be transferred through your midsection. A baby crawl can be a gentle way to get these opposite sides working in harmony while setting the blueprint for for more challenging variations such as the leopard crawl or the spiderman crawl. Most crawling variations will challenge many of the jobs of the core such as rotary stability and anti extension. So if you want a strong core start acting like a big baby!

After reading this short snippet i hope you now have a few reasons at least to drop down onto the floor on all fours. Crawling can be so good for the body and brain it’s a wonder why we all don’t do more of it.

2017 Best Emerging Business

Last night we made the cut as FINALISTS for the 2017 Best Emerging Business at the Westpac Northland Business Excellence awards!!!

We are so proud and feeling very chuffed!!

It was a fabulous night to be associated with.

Congratulations to our fellow entrants especially for all the effort that goes into entering. Congratulations to our fellow finalists it was an honour to have our name announced on stage alongside you. And a big Congratulations to the Winners of our Catergory Level.

A massive thank you to everyone of our clients for supporting us every single day.

And yay yay yay thank you Ryan, Kiran and John for making us Strength + Soul.