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Narcissus
05-31-2007, 12:33 PM
Background
I had a arthroscopic distal clavicle resection on March 20th, during which they shaved ~10mm off the edge of my left clavicle and shaved down my left acromion to flatten it. I had injured myself ~2 months prior to the surgery, and tried alternative treatments (NSAIDs and corticosteroid injections) before choosing surgery. During that time I was wholly incapable of any chest or shoulder weight training, and had to cease most of my back exercises. Since the surgery, I have been going to physical therapy 3x/week and had my last PT appointment yesterday. I still have AC joint pain when resistance is applied in 2 arm positions, but my PT said that should dissipate in the next 4 weeks as I strengthen the muscles surrounding my AC joint and the bone continues to heal. I have been cleared to begin weight-training at the gym again, with a few stipulations. For the next 4 weeks, I am not allowed to do any squatting (holding the bar across my traps closes the AC joint, and during front squats I rest the bar on the joint), nor any overhead pressing. I am allowed to begin dumbbell benchpresses (30 lbs) for this and next week, and begin barbell benching at week 3 (though I am told never to touch the bar to my chest again). Also, I am allowed to deadlift no more than 135lbs for the first 2 weeks. Aside from physical therapy, I have not done any training during the last 11 weeks, and because of the injury, have not trained chest and shoulders for over 4 months. My diet has been decent since surgery, but I have allowed myself many, many meals that I probably should have not eaten.
Stats
Height - 6'0"
Weight - 224 (the day before surgery I was 241)
Diet
See the attached picture for the FitDay breakdown. The food will be spread over 8 meals (I can write these out if anyone is curious). I will have the same meals Monday through Saturday, and on Sunday will have healthy "cheat" meals to curb cravings and prevent psychosis.
Schedule
Monday - Chest, Calves (+ PT stuff)
Tuesday - Back, Abs
Wednesday - Legs, Calves
Thursday - Shoulders, Abs (+ PT stuff)
Friday - Biceps/Triceps, Calves
Saturday - Legs, Abs (+ PT stuff)

Chubrock
05-31-2007, 12:40 PM
Haven't seen you around here in quite awhile. How'd you hurt it, if you don't mind me asking?

Hatred
05-31-2007, 12:54 PM
Hey, Matt! I lost your damned number! I was hoping like hell you'd pop up.

Organichu
05-31-2007, 12:55 PM
Best of luck working your way back into stuff. Are you still suffering from pain in everyday activities?

Glad to see you back.

Narcissus
05-31-2007, 12:57 PM
Haven't seen you around here in quite awhile. How'd you hurt it, if you don't mind me asking?

According to the literature, there is no conclusive agreed upon cause of the condition (distal clavicle osteolysis), but there is a heavy correlation between it and heavy trauma and/or a series of microtrauma. My surgeon and physical therapist both believe that it was the result of my history of gymnastics (hard, brutal falls from the high-bar and during tumbling), and the way I bench pressed. I always used a wide grip, and had my elbows out - unfortunately, this forces all the resistance through your AC joint.

Narcissus
05-31-2007, 01:07 PM
Best of luck working your way back into stuff. Are you still suffering from pain in everyday activities?

Glad to see you back.

I appreciate it bro, I just have to summon some patience especially during these first 4-6 weeks. I really have no pain whatsoever during daily activities. The only time I feel any discomfort in the joint is if I press down with both hands when getting out of bed or up from the couch (the dip-like motion), and even still it is negligible.

Organichu
05-31-2007, 01:08 PM
Good to know you can function day to day without horrible pain.

Like I said- glad to see you back in it. I'm sure you'll achieve any goals you have in relatively short order.

Isaac Wilkins
05-31-2007, 01:10 PM
Hey big fella, good to see you back.

Now stop being so damn skinny!

RBB
05-31-2007, 01:26 PM
nice to see you're recovering well, matt. i remember you saying something about surgery not too long ago. best of luck with the recovery, bro. the worst part about it is having to ease back into everything when you're ready to go all out. i'm sure you'll be back up to speed in no time, though.

Built
05-31-2007, 02:56 PM
Oh wow - I WONDERED where you had been. That sounds unpleasant, but hey, if it works, it'll be wonderful once you've healed.

Nice to see you posting again.

Diet looks brutal. I eat more fat than you do and I only eat 1800 calories.

<pats PB jar lovingly>

Chubrock
05-31-2007, 06:33 PM
Any certain plans, other than getting healthy?

Sidior
05-31-2007, 08:17 PM
Awesome the surgery went well. Get jacked again!

TwiloMike
05-31-2007, 08:27 PM
Welcome back! :clap:

Congrats on the successful surgery, and welcome back to the lifting world! I'll be watching your journal.

Narcissus
05-31-2007, 10:55 PM
Isaac, Russ, Sidior, Mike - Thanks very much for the well-wishes! The biggest challenge, I believe, will be lifting cautiously and VERY conservatively until I am completely healed.

Built - Do you have any critiques for the foods (and amounts) I have chosen? Would you add anything additional in? More fat perhaps?

Chub - Aside from getting healthy, I, of course, still hope to look like a competitive bodybuilder (without ever competing). It has been roughly 18 months now since I finished my last (which was my second) cycle, and am anxious to begin another. I planned to about a year ago, but then scrapped it to improve naturally for a while; then planned to start again, but then began partying too much; then got the bug again, but then had surgery ... and here I am. I don't anticipate beginning anything until close to the new year, and at that point it will have been 2 years since my previous course.

Narcissus
05-31-2007, 11:04 PM
Back
Physical Therapy Stuff
Deadlifts - 135x12 (4 sets)
Stiff-arm Lat Pushdowns, Unilateral - 40x15, 45x15, 50x12, 50x12
High Cable Row, Bilateral - Stackx15 (3 sets)
Mid Cable Row, Bilateral - Stackx15 (3 sets)
Hammerstrength Row, Unilateral - 90x12 (3 sets)
Lat Pulldown - 80x12 (3 sets)
Abs stuff

Comments
The volume is high, but I believe that because of the relatively low weights I am using, any negative effect is negligible. During the lat pulldowns, I am experiencing AC joint discomfort/slight instability for the first couple reps.

heathj
05-31-2007, 11:36 PM
welcome back and good luck!

why so much protein and not so much fat in the diet?

TwiloMike
06-01-2007, 04:57 AM
The biggest challenge, I believe, will be lifting cautiously and VERY conservatively until I am completely healed.
I agree. You'll have to check your ego at the door of the gym for a while and that's difficult to do sometimes. I trust you'll figure out a way to do it, though.

Back workout looks good- definitely high volume. Did you experiment with varying grips on the lat pulldown? (overhand versus neutral)?

Built
06-02-2007, 12:03 AM
Okay, while you're off-cycle, bring the fats up. On, it's a different story, and I defer to the knowledgeable folks in the anabolic forum, but off, you need support for your endocrine system - saturated fat can come up some.
I'm delighted to see the fish oil - that one's good for EVERYTHING - and can help with reducing systemic inflammation - I'm sure you already know all this or you wouldn't be cranking it. Double the avocado, bring the butter up to a tablespoon or two, get some olive oil and or natty pb in there (salted natty pb on chunks of Fuji apple is so good I should be arrested for telling you about it). Diet looks otherwise tight, of course, you clearly know what you're doing (d'uh!)so these are just small suggestions.

Usual guidelines for fat are half a gram per pound LBM as a minimum; about a third each from poly, mono and saturates. If you go higher than half a gram per pound LBM, lean more heavily on the monos.

So good to see you on the mend and in good spirits.

Beast
06-02-2007, 03:06 PM
I always used a wide grip, and had my elbows out - unfortunately, this forces all the resistance through your AC joint.
Good to know. I've been doing the tucked-in form for a while now.

Welcome back.

JustinASU
06-04-2007, 11:36 AM
Matt - good to have you back and good luck on the recovery. I've dealt with heavy surgery and several injuries myself over the last 2 years, so I feel your pain, both literally and figuratively speaking.

My advice on the lat pulldowns is to try a neutral grip. I have similar shoulder issues and I have not opted to go with surgery, but neutral grip doesn't hurt nearly as much and allows me to ease back into the motion after a long layoff due to injury. Eventually overhand will feel better and that's when you can re-introduce the motion back into your training.

Shark
06-04-2007, 11:38 AM
Welcome back bro! I'll follow your progress in here and make fun of you for lifting small weights =).

Built
06-04-2007, 11:44 AM
I second the neutral grip recommendation - close parallel works great and won't irritate your RC. You can try one arm at a time if you have hammerstrength stuff - like you're climbing up a wall. I call 'em Spidermans.

Unholy
07-06-2007, 09:19 PM
Hows recovery going man?

Narcissus
09-25-2007, 06:58 PM
I should update this more regularly, and figure now is as good a time as any for a new update.

Weight:
The last two Mondays I have weighed 242ish, and the last two Fridays I was 236ish.

Diet:
Same as the FitDay .jpg above, but per Built's suggestion, I have increased the fats and have slightly more butter and 1 whole large avocado each day. This is Monday - Saturday afternoon. Saturday night and Sunday I indulge on whatever I have been craving throughout the week. Calories on Sunday are roughly 6-7k.

Training:
I'll just go muscle group my muscle group and mention the notable, and in a few cases lackluster, accomplishments since the surgery...
Chest:
I have been, and will continue, to do only 3 different chest exercises (the only 3 I've found to cause no discomfort to my left A/C joint): flat dumbbell press, seated Icarian machine flat press, and Hammer Strength plate-loaded incline press. Yesterday on flat dumbbell I pressed the 85s for 5 unassisted reps - I am quite happy with this considering I was using the 30s a few months ago.
Back:
I am able to do all back exercises except lat pulldowns with the bar. My typical back workout consists of conventional deadlifts, unilateral straight-arm pressdowns, seated dual pulley pulldowns with neutral grip, and seated Hammer Strength plate-loaded rows. Today (just 6 months since surgery), I deadlifted 495 for 1 very clean rep - again, quite happy with this.
Legs:
My leg strength seems to be returning painstakingly slowly. I suspect that it can partially be attributed to my lack of confidence while holding the bar across my traps while squatting. The movement forces me to stress my A/C joint in a very precarious position as I move holding the bar. Last week I was able to squat 315 for just a single rep - I am looking for significant improvement in the coming months.
Shoulders:
My shoulder work-out consists of 4 exercises: anterior dumbbell raises with thumbs up (hammer curl type grip), Smith machine military press to the chin, medial dumbbell raises with palms down, and seated rear delt flies either on pec-deck or lying face-down on bench. I am now doing the anterior dumbbell raises with the 30s for 10 reps, which is a significant improvement from using the 7.5s just 4 months ago. On the military press I am finishing with 4 quarters on each side for 5 reps.
Arms:
Nothing much to comment on - strength increase seems to be what I expected.

Other:
I have added 2 new cats to my menagerie since the surgery, and had to fly to New Jersey to pick them up from the breeder. See attachments - Katya is the odd-eyed solid white, and Natassja is the green-eyed black smoke.

Unholy
09-25-2007, 08:53 PM
Good to hear from you Matt.

TwiloMike
09-25-2007, 09:00 PM
Hi Matt!

Great to see you posting again.

Regarding the squats, how much are you squatting? Are lumberjack squats an option for you?

Narcissus
09-25-2007, 10:17 PM
Regarding the squats, how much are you squatting? Are lumberjack squats an option for you?

I squat just once a week - I do 3 working sets, normally at 225, then 1 set at 275, and 1 set at 315. I'm not familiar with lumberjack squats, what are they exactly?

SW
09-26-2007, 09:28 AM
Hi Matt. I remember you posting a while ago, and you seem pretty cool and knowledgeable. Don't remember talking to you much though. I think I'll follow this journal and see how your progress goes. I wish you luck!

DoUgL@S
09-26-2007, 10:25 AM
Good luck on the recovery front. Hope that you are pain free sooner rather than later.

TwiloMike
09-26-2007, 08:02 PM
I squat just once a week - I do 3 working sets, normally at 225, then 1 set at 275, and 1 set at 315. I'm not familiar with lumberjack squats, what are they exactly?

OK. Lumberjack squats are described here: http://www.t-nation.com/readArticle.do?id=1713043

You don't have to double load one end of the bar to get the same effect you get from having both ends loaded. That's according to my testing of this movement.

Narcissus
10-01-2007, 01:47 PM
OK. Lumberjack squats are described here: http://www.t-nation.com/readArticle.do?id=1713043

You don't have to double load one end of the bar to get the same effect you get from having both ends loaded. That's according to my testing of this movement.

Thanks Mike - I definitely do not think that my shoulder could bear that style of squats though. Having the load in front of my body and supporting it in such a way would certainly cause pain at the joint.

Bohizzle
10-01-2007, 01:52 PM
How about proper olympic style front squats? Are u flexible enough to hang onto the bar in the clean grip, while supporting the weight in your rack?

Andrew

Narcissus
10-01-2007, 02:01 PM
Nick and Douglas: Thanks for the well wishes.

Last week's workouts went pretty well for the most part. During the biceps portion on Friday, I did have some shoulder discomfort and lingering (slight) pain during and following Hammer Strength plate-loaded preacher curls - it's not the first time, so I think for the next few weeks I'll remove that exercise from the rotation. My weight on Friday was 238, which is the heaviest Friday weight since prior to surgery. I'll update later following today's chest workout ... I am hoping to continue improving each week, so in order for that to be the case I'll need to bench the 85 dumbbells more than 5x today. I do have a few short-term goals to reach by an arbitrary date of Dec 1st:
-100s x 5 on DB bench
-495 x 5 on deadlifts
-315 x 5 on squats
-4 25s/side x 12 on Smith machine military
-consistent Friday weight of low 240s

I had meant to take a picture of each meal today, but only did so for breakfast. That said, I've attached a picture of the omelet I have each morning. It's made with 12 egg whites, the filling is 1 smashed, large avocado, and the topping is a homemade salsa roja. Breakfast is my favorite meal of the day.

Narcissus
10-01-2007, 02:04 PM
How about proper olympic style front squats? Are u flexible enough to hang onto the bar in the clean grip, while supporting the weight in your rack?

Andrew

Thanks for the suggestion Andrew. I've tried them prior to and since surgery, but my grip is simply not flexible to hold the bar properly. Prior to surgery, front squats (with the arms-crossed, self-chokehold type grip) were one of my favorites, so it especially sucks not to be able to do them.