By Frank Alexander
Baseball Health Network

When someone is injured and needs surgery, the hard part is not undergoing the surgery itself. The hard part is being patient and maintaining the drive to get through each physical therapy session. For our patients with active lifestyles, the desire to get back to the activities they love may feel far away. But there is light at the end of the tunnel. Many patients want to get back to playing their sport or even just get back into the weight room or gym. In some cases, getting on a stationary or recumbent bike is possible within days of surgery. However, that may not be enough. The type of surgery a patient has determines the length of time away from the gym and sports.

Once being cleared to return to working out, there are a number of exercises we would like our patients to steer clear from. Whether you are recovering from surgery or not, we strongly advise our overhead athletes to avoid these exercises.

Exercises to avoid include: dips, chest flyes, lat pull-downs behind the neck, heavy-weight overhead shoulder presses and wide-grip bench presses. Patients should also avoid allowing the shoulders to be stretched to the extreme end range of motions. While these exercises are discouraged, there are variations and other exercises that can be substituted. Variations include: lat pull-downs with the hands in front of the body, using a medium grip for chest press and lat pull-downs, and using dumbbells for bench pressing. Substitutions include: the Thrower’s Ten exercises (internal/external rotation with TheraBands) and lying light dumbbell exercises such as Y’s, T’s, and A’s.

Upon being cleared to return to the gym or weight room, it is best for a gradual return to activities. For example: when returning to cardio, avoid using the moving arms on the elliptical for a number sessions or stick with the bike a little longer. As for weight training, it is suggested to start with light weights and gradually progress to heavier weights. If you are not sure if you should progress, feel free to ask in the office or check in with your physical therapist. Your physical therapist is a great resource for guidance when returning to unsupervised exercising.

While some exercises should be avoided, many should be done regularly. The Throwers Ten Exercises are a staple of all throwing athletes’ shoulder programs and should be done throughout the off-season and regular season to help keep the shoulders healthy. Core and leg exercises are integral for any throwing athlete. When performing lower body exercises with a load, be sure to listen to your body. If soreness is present, modify the lift or avoid it if possible.

If you are ready to return to weightlifting, our office has a handout with guidelines that you should follow as well as the Thrower’s Ten. Following these guidelines and the advice of our team and your physical therapist will help ensure the ability to safely return to the gym and sports!

Frank J. Alexander, Jr., M.S., ATC, is a Physician Extender to Dr. Christopher Ahmad, Department of Orthopaedic Surgery at Columbia University Medical Center.