An Athlete’s Detailed Account of Open Bankart Repair Recovery
Kincade Pavich // March 26, 2020
In December of 2016 I underwent an Open Bankart Repair on my right shoulder to combat recurring dislocations. I remember it being a slow and demanding recovery during a really deep Montana winter, but as humans we tend to forget about our recoveries once we’ve regained health. After a successful couple years with no further dislocations and an unmeasurable amount of fun, I dislocated my left shoulder in October of 2019 during a dirtbike crash at the St. Anthony Sand Dunes. I opted for surgery after MRI results showed a very high probability of recurrence.
I felt motivated to write this article for PUSH as I know dislocated shoulders are a hugely common injury in action sports and everyone wants to know the same thing: when can I get back after it? I remember I rode my mountain bike for the first time at the 4.5 month mark after surgery on my right shoulder. I was very thorough and consistent with my PT for this surgery and went to the gym every day I could once I was cleared to do so. I’d say that shoulder took about 3 months to feel great for day to day things (like grabbing a mug from the top shelf or getting a gallon of milk), 5 months to feel strong and somewhat confident in sports, and probably close to a year for me to stop thinking and worrying about it so much.
Move onto my current situation, where I’m at 1.5 weeks post-op. I remember the overall timeline and exercises from my right shoulder, but have forgotten all of the specific details of how progress and recovery feels. So, for the next 5+ months I’ll be documenting my recovery for your reading and learning pleasure… I feel for anyone who has to go through this, but you can do it. One day at a time.
Also, a little background on me. I’m a healthy 23 year old guy, 5’10”, 155 pounds. I’m not sure if I send it too hard or just suck, or if it’s a combination of both, but I’ve now had 2 collarbone surgeries (both left) and both left and right labrums. My injuries that have resulted in surgery happened snowboarding, mountain biking, and dirtbiking. I also wakeboard and skate. Obviously we’re all built differently and have varying interests, but I figure a bit about me will help to let you know how your recovery might be different based on your build, health, and interests.
Alright, let’s get into it…
The day of surgery was cake – the nerve block did its job well and I felt no pain until around 3am. I was sure to stay on my painkiller schedule, and that is super important. They take a while to kick in, so if the pain kicks in before a painkiller has it’s going to be a miserable half hour. The first 3 days were manageable and never unbearable pain. I struggled to stay asleep some nights. I found it best to sleep in a recliner.
I was off heavy painkillers within 48 hours after surgery and had the bowels moving pretty normally within about 4 days. My first day of PT was 4 days post-surgery, and my shoulder wasn’t feeling ready to move yet. My PT got a good feel of how I was doing so he knew where our goals for the next session were.
I started to feel a bit more like a functioning human again week 2. I left the house a couple times for groceries and such and also started working from home. I’m a web developer so I need to type. It’s difficult and I need to situate my arm carefully, but it works. This phase of recovery is only passive motion, so I’ve been doing pendulums, shoulder rolls, shoulder shrugs, and seeing my PT 3 times per week. PT is super motivating as you get to see your arm move more and more every week.
I’m allowed to have my arm out of the sling at home (in safe, controlled environments), but I still tend to wear it unless I’m playing Xbox or doing my exercises. The arm is still quite sore if it’s out of the sling for very long since it’s so weak. I can also lay in a bed now. I use 3 pillows under my head and one under my left arm and it works pretty well. I still find myself sleeping in the recliner a lot, but I imagine I’ll be sleeping in bed full-time again next week.
I got my stitches out and saw my doctor just after the 2 week mark. He was happy with my progress. Taking a proper shower felt so damn good.
Unlike week 2, my arm no longer prefers to be in the sling for comfort. Almost all of the small movements I made in weeks 1-2 that caused me to wince are gone. I spend almost all of my time at home out of the sling, aside from sleeping. I almost never feel any pain anymore, aside from the stretching at PT, but that’s a good pain. I’m becoming a lot more comfortable using my hand/forearm for easy things. I couldn’t touch my face for the first 2 weeks, as it requires just the smallest bit of motion in your shoulder. I’m now able to do that with confidence.
Little things are getting easier – like pulling up my pants with 2 hands or putting a sock on. Essentially anything that’s incredibly light that I can do with moving my forearm/hand but not my shoulder, I’ve started doing. I’m still very limited, but slowly beginning to feel closer to normal. My external rotation is improving greatly and I can now type with no discomfort at all.
I road tripped to Minnesota from Montana to attend a wedding with my girlfriend. I figured this would be a decent test. I spent around 12 hours behind the wheel (left arm in a sling), and driving is no issue at all. I’ve been driving since the end of week 1, but no longer feel sore and things like backing up are getting much easier. The wedding was awesome, and you better believe I danced my ass off with my wing in a sling. My shoulder was mildly sore at the end of the night, but overall no issues and felt good. Progress at PT is better every day, and every day truly feels better.
I sleep in a bed every night now, and am down to 2 pillows under my head. I can sleep without the pillow under my arm, but still prefer having it. I’m a side sleeper when I’m healthy, and I’ve started to lay on my right side just a little, but my arm still feels like it wants more support than that. It’s also kind of awkward with the sling on. I also prefer sleeping on my left side, and have not yet tried that. I probably won’t for a couple more weeks.
My day to day functions are improving noticeably. I use my left hand quite a bit now, always taking very careful caution not to use it to bear weight beyond a coffee cup. By the end of week 4, my ROM (range of motion) is as follows. All of this has been achieved passively (my PT moving and stretching my shoulder with none of my own strength):
- External: ~10 degrees past neutral
- Overhead: ~100 degrees (0 being at my side, 180 being my arm above my head)
All of my exercises are getting easier, which include pendulums, shoulder rolls, shoulder shrugs, and mild external rotation in a swivel chair with my arm on a table.
This week was good for the most part, though with additional exercises at PT my bicep tendon has been experiencing some quick, sharp bursts of pain. Relaxing my arm helps mitigate this, and it generally acts up during and after PT, but rarely other times. My therapist says this can be normal and is purely a symptom of tightness and weakness. He’s added a few exercises to my list of things to work on at home, now including very small wall slides using my own strength (or what’s left of it). I’m also using a ski pole to work on my external and forward rotation.
I can also lay on my left side! I’m still not quite comfortable enough to fall asleep that way, though that is partially due to the sling.
My bicep tendon has really been acting up a lot, but my PT helped me figure out how to solve that problem today. It seems that with the tightness in my shoulder, after exercises it’s almost as if my bicep tendon needs to “reset”. Previously, I would do pendulums to sort of loosen back up after each exercise. Lately, if I go straight into pendulums after a stretch the sharp pain attacks my bicep tendon. My PT had the recommendation to go into pendulum position (a little hunched over, arm dangling down) but to squeeze my scapula back a few times before doing pendulums.
This has helped reduce the occurrence of the pain immensely. It seems like the bicep tendon just gets a little misplaced and can’t move back properly with how tight my shoulder is, and that tends to “reset” it. Very happy we’ve figured that out, but also motivated for this pain to subside all together. This never occurred with when I had this surgery on my right shoulder. Still feeling happy with progress, but very excited to see my shoulder start moving better in the forwards/upwards direction. It’s still stiff that way and compared to my right I can see that my entire shoulder is moving to compensate, as opposed to just the ball in the socket. Doctor’s orders are full ROM by 10-12 weeks, so it seems we’re on track for that.
I’m starting to feel like I’ve turned a bit of a corner. The “active” range of motion phase has began, and it’s nice to begin working the muscles in my arm and shoulder. My bicep tendon is feeling better and bugging me less (though it does still act up) and ROM is continually improving. I’m completely out of the sling now, and that’s been very nice for sleeping as well as driving. I am not using my left hand on the steering wheel yet, but I can help my right hand put my seatbelt on and it’s just a bit more comfortable without the sling overall.
I’m dropping down to 2 days per week of physical therapy since I’m able to begin doing so many more exercises in my free time. I had another followup with my doctor and he was happy with my progress. I’m still not allowed to lift more than a coffee cup, but I’m allowed to use my arm for pretty much whatever I feel comfortable with at this point that doesn’t involve weight bearing. The list of things I’m comfortable with isn’t very long, though day to day functions are getting better and better. I’ve started eating and brushing my teeth with my left hand again. I squeegeed my shower glass with my left hand, which was awesome.
General day to day functions are easy at this point. My doctor said weight bearing should still be very minimal, though I feel like I could pour a gallon of milk now. I still haven’t. PT is going well, and almost all traces of sharp bicep pain are gone. My doctor wants me at full ROM by 10-12 weeks, and I do feel I’m getting quite close to that timeline and my vertical ROM is still pretty poor.
I can see my shoulder moving as it should up to 90 degrees, and then it gets stiff and movement happens more so in my shoulder blade than my actual arm in the socket. My PT seems confident that it’ll come back just fine, but I am putting a more intense focus on my overhead stretches to work on this. I’ve done really, really well with this recovery so far, and this has been my first week or so of somewhat negative thoughts.
For one, I start to think “am I ever going to be normal again? What if it doesn’t come back?” Of course I will get through this eventually, but month after month of never seeing your arm go above your head can become taxing on the mind. I’m working on handling the mental side of this recovery. I’m also just bored. I’ve done a great job staying occupied and finding projects to do, but as an action sports guy no matter how busy I stay I will always miss getting outside and riding, whether that be on 2 wheels or a snowboard. 1 day at a time, still plucking away!
I’ve put a lot of time and effort into my overhead stretches, with continued focus in other areas as well. For the last 2 weeks I’ve had friends (or my mother when I was home for Christmas) help me stretch overhead while lying down. Improvement has been steady, and as I approach the 12 week mark I’m feeling more confident that I will be at or very close to full ROM. I’m feeling functional for most purposes; I’ve been rebuilding a dirtbike and have been fully capable of taking it apart, moving parts, breaking bolts, etc.
My PT has given me exercises to help begin strengthening (which actually help with ROM quite a bit) as well as work on areas that are still awkward or not perfect. We are starting to bridge the gap between stretching and strengthening. I plan to focus heavily for the next week or so on perfecting my ROM so I can then focus fully on getting strong again. My overhead stretches are at about 170 degrees now, so I’m almost to full overhead.
Day to day, I feel like a normal human being. For everyday tasks there are very few things I can’t do or where I notice the limits in my shoulder. I’m still very weak and my range of motion isn’t quite perfect, but my doctor was happy with it in my last visit. My shoulder is still tight, but with a really good stretch I can get my hand to the floor when lying down and trying to go full overhead. My external rotation is steadily improving, with thrower’s position still being around 30 degrees away from perfect. I’m continuing to stretch, but also beginning to strengthen. Gym phase will begin soon.
While I was stoked to have nearly full overhead motion at 12 weeks as my doctor had aimed for, I’m realizing how far I still have to go in the thrower’s/external positions. As I recall, my right shoulder definitely healed faster than this one, though it’s impossible to remember exact timeline. That said, I’m putting a lot of effort into getting my rotation back so that I can begin strengthening. Strength phase begins once I have full ROM, and fun activities begin once I’m strong, so I need my ROM back.
I’m now at the point where everything starts to feel so good that I forget I’m still weak and not normal yet. I’ll move quickly by accident and definitely feel it – my shoulder is not ready for anything remotely close to intense or quick, but it’s steadily progressing. Still not having full ROM at 14 weeks can be concerning, but my shoulder isn’t locked up – it’s still progressing, just slowly. My doctor did let me know this was a very extensive repair in comparison to most open Bankart repairs, so it’s not too surprising. One day at a time, working on it.
Gym time! Wow, it feels good to get some proper exercise again. I’m still about 10% shy of full ROM in the thrower’s position, but my PT is confident that it will come back with time and exercise, and I am too. I’ve started going to the gym and have been doing exercises specifically to get my shoulder strong. This primarily involves the cable machine (internal and external rotations, and then pulling both up and down in thrower’s position), though I have also been doing flys and pushups using TRX bands. The other day, I pounded out a whopping 13 standard pushups and 5 pullups. I sure was sore, but it felt incredible. I’m starting to feel like I’m getting close, and am also getting excited to ride again. It’s been far too long. It’s looking to me like I should be ready to go after a solid 5-6 more weeks of consistency as the gym.
My progress at the gym has been incredible and motivating. I’m to the point where I can feel where I’m still limited and weak, and know just the exercises to focus on. I’m up to 20 pushups and 10 pullups, and the amount of weight I’m using on the cable machine is steadily going up. I still feel very vulnerable in the thrower’s position. At this point, if I give it a really intense stretch I can pretty much get my arm to the ground in thrower’s position lying down. While it’s slow, I am definitely getting a few more degrees of motion every week and will undoubtedly have full ROM in the next week or two.
At this point it’s nice having my right arm as a baseline when at the gym; I can very clearly see which exercises I struggle more on and feel the difference in the same amount of weight on my left vs right shoulder. Thrower’s position exercises are still a combination of stretching and strengthening, so it’s definitely intense, but good. Every week I’m getting more excited to go ride and feeling better and better.
I saw my PT and he agreed that I’m in a position to continue going to the gym and no longer need to go to PT. Yesterday after the gym I was doing my thrower’s position stretch (lying down and pushing down with a ski pole) and got my entire arm to the ground for the first time. It’s still tight, but I can now reach full ROM and am just continuing on the gym grind. Another 4 weeks of working hard at the gym and it’ll be time to strap into a snowboard.
One thing my PT helped me focus on is ensuring I go all the way down to a full hang when doing pullups each rep. I wasn’t dropping all the way down, and that’s where it’s the most intense on my shoulder. With this change, I’ve dropped from 10 pullups down to 5, but they’re much tougher and more effective. I did 25 pushups today, so those are coming along well. Overall just going to keep up the consistency and go shred when my left feels pretty much as good as my right.
I’ve been super consistent at the gym and getting stronger by the day. I used to do standing backflips as part of my workout, and I’ve finally added those back in. I also went camping and shot a 12 gauge shotgun, one shot with a slug round. I sure was sore, but was able to do it. I’m now to the point where I feel like my limiting factor is the last bit of RoM in thrower’s position. While I can get it to the ground when I give it an intense stretch, it seems like it’s been tightening up back to about 15-20 degrees off every day. Being almost 5 months in, this is something I probably should have given a little more focus earlier on. I plan to focus heavily on stretching this area for the next few weeks until I have full range without a problem. I’m feeling overall very strong but still limited in some areas, and I think getting full RoM will make this last 10% of discomfort go away and allow me to begin trusting my shoulder once again.
I’ve transitioned from shoulder exclusive workouts to a combination of shoulder and full body workouts. I’ve been very impressed at how quickly my bicep and other muscles have returned, but there are many exercises where I feel the clear difference between my right and left. I’m definitely good enough that I’m feeling pretty ready to go snowboard or dirtbike, but plan to give it a few more weeks of hard work to ensure I’m as strong as possible and risk is minimized. I don’t expect my left to feel like my right, but I do expect it to feel as strong and as reliable, and I’m not quite there yet.
50 pushups! This has been a goal for months. At my final appointment with my doctor at the 3 month mark, we were discussing when I could get back to activity. He asked how many pushups and pullups I could do when strong and healthy, and I told him 50 and 20, respectively. He said as long as I was at least 4.5 months out and hit those numbers, I could go ride. I was so stoked to hit 50 pushups. I can do around 14 pullups, and am steadily improving. I’ve also been working hard on my stretching and am damn near full RoM; I’ll have it this week. Pretty much ready to go rip. Staying smart and working hard the next couple weeks to minimize risk as much as possible, but I think I’m ready. It’s been a long road.
I went snowboarding! For one hour… before the Coronavirus pandemic hit our local ski hills and shut everything down. That said, it felt great and I feel so fortunate to have gotten to ride before sh*t hit the fan. My shoulder was sore but felt solid. Extreme motions definitely were an intense stretch. I did 2 tamedogs (frontflips) and was stoked on that!
The following weekend I went dirtbike riding both days. My shoulder was quite sore due to the intensity dirtbiking requires, but felt solid and reliable. Overall I’m going to keep working out (from home now due to shutdowns across the USA) but plan to return to general activities again, with careful attention. It’s been a long road – stoked to be back, even in this weird time in our history. I hope your recovery goes smoothly and I hope this helps! Leave a comment with any questions.