By Sam Pitcairn
You woke up in a sling. The nerve block has worn off. You feel like a truck hit you.
The surgeon came in, gave you a thumbs up, and said the repair went perfectly. They stitched the labrum back to the bone or reattached the rotator cuff tendon. Mechanics: fixed.
But in your head, the doubt is creeping in. You’re wondering if you’ll ever throw a baseball at 90mph again, if you’ll ever snatch heavy again, or if your athletic career just ended in an operating room.
Here is the hard truth: The surgery didn't fix you. It just bought you the opportunity to fix yourself.
If you squander that opportunity in a standard "orthopedic sweatshop" PT clinic, yes, your career is probably over. But if you understand Structural Balance, this is just an intermission.
Standard physical therapy in this country is designed for mediocrity. Its goal is to get you back to "Activities of Daily Living"—brushing your teeth, putting on a jacket, driving a car.
Your insurance company wants you to go to a strip-mall clinic where you will spend 45 minutes doing internal rotations with a yellow elastic band while the therapist manages 12 other patients.
That approach will help you put away groceries without pain. It will not prepare your shoulder to absorb the massive forces of throwing, swinging, or pressing.
At Essential Strength, "functional range of motion" is just the warm-up. We don't aim for normal. We aim for bulletproof.
Shoulders rarely blow up because of one traumatic event. They blow up because of years of accumulated Structural Imbalance.
In 95% of the athletes I assess, the internal rotators (pecs and lats) are massively overpowering the external rotators (infraspinatus and teres minor). The shoulder joint is constantly being pulled forward and out of the socket.
The surgery repaired the damage caused by that imbalance. But if you rehab the surgery without fixing the imbalance, you are just reloading the gun for the next injury.
The surgeon stitched the tissue. Our job is to engineer the support system around it.
The biggest mistake people make is waiting too long to load the surrounding tissues. We need to re-establish the neurological pathway between the brain and the scapula (shoulder blade) immediately.
If your scapula doesn't move correctly, your glenohumeral joint (the ball and socket) is doomed to fail again. We don't guess at this. We use precise Loading Parameters to stimulate strength without shearing the newly repaired tissue.
This is an example of an A-series for a client in late-stage rehab, cleared for loading.
We don't use elastic bands. We use gravity and iron because they provide constant, measurable tension.
A1. Prone Incline Trap 3 Raise
A2. External Rotation (Frontal Plane, Supported on Knee)
Most people use major surgery as an excuse to quit. They accept the doctor's conservative estimate and retire to the couch.
My clients use surgery as an opportunity to rebuild their mechanics from the ground up, stronger than before.
The surgeon did their job. Now it's time to do yours.
If you are in Pittsburgh and refuse to accept that your best athletic days are behind you, book an assessment. Let’s build a shoulder that doesn't just survive your sport, but dominates it.
After you submit this form we will be in contact within 24 hrs to set up an appointment to come into our East Liberty location for a performance assessment.
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