When Guy Cisternino heads to the gym, it’s not just to exercise. It’s to prepare for his job. That’s because he’s a bodybuilder—and one of the best: an International Federation of Body Builders and Fitness (IFBB) professional who competes at the pinnacle of his sport.

The 37-year-old Branchburg, NJ, resident, whose amateur career began in 2003, turned pro in 2008. As of this writing, he has seven IFBB pro wins and multiple top placings. He is also consistently in the top finishers of Mr. Olympia (the most famous of whom is Arnold Schwarzenegger), an international competition which requires qualification.

As a result of lifting heavy weight and high volume, Cisternino packs enormous muscle on his 5’5 ½”, 206-pound competition weight frame. But a lifetime of intense sports and training have taken their toll on his body. A football player from youth through college, Cisternino took up bodybuilding his junior year in college. The years have resulted in enormous wear and tear.

“My career took off, but what didn’t take off is hitting with my shoulders every day in football,” he laments. “Altogether, my shoulders took a massive hit.”

His rugged regimen necessitated surgery for a partial tear in his labrum in 2008, and caused chronic and continual pain in the front portion of his shoulders.

To deal with that shoulder pain over the years, Cisternino tried it all: from cortisone shots, stem cell injections and laser treatments to what he estimates have been thousands of hours of deep tissue massage. Along the way, he sought multiple practitioners and popped scores of theoretically helpful supplements. But the pain persisted.

Cisternino has been philosophical about it. “I felt if I could train and compete with pain, it was better than not doing that at all,” he concluded.

Although he cleverly modified his training technique to alleviate some of the pain, he couldn’t escape the clear message his body was sending him.  “I couldn’t even sleep without pain,” he admits.

During yet another round of shoulder rehab, Cisternino was sent for an MRI. It was read as inconclusive. Eventually, however, like anyone with a job—let alone a passion—he finally had enough.

A Hunt for Relief

Cisternino went online to find an expert and landed on Dr. Christopher Doumas, a specialist in hand and upper extremity surgery at  University Orthopaedic Associates (UOA). He felt a special draw to Dr. Doumas.

“He was an athlete himself, an active hockey player, who also treated lots of Rutgers University athletes,” says Cisternino. “Being a pro athlete, sometimes doctors tend to make a situation worse than it really is, or the opposite, downplay it. I’ve been to many doctors who simply say, ‘Never lift a weight again.’”

When Dr. Doumas ordered Cisternino’s MRI, he told him, “I’ve been a doctor a long time, and I’ve never seen biceps tendons as swollen or worn as yours.”

Dr. Doumas told Cisternino it was a good thing the damage was caught. It was clear that if the bodybuilder continued to push through the pain, he would surely tear one or both of his biceps.

An Athlete’s First Question

Cisternino initially asked Dr. Doumas, “What do you honestly think my chances are of getting back?” If Cisternino closely followed instructions—did his rehab religiously and didn’t return to training too soon—Dr. Doumas told him, “I don’t see a problem.”

But surgery for Cisternino had a unique complexity. His sport required special consideration. In the customary type of surgery, the option for tenotomy can result in a deformity. However small, this can mean a bump in an arm or a slight discrepancy in size between arms. In the quest for physical perfection that defines bodybuilding, however, any deformity is out of the question.

Cisternino explains, “In my profession I have to care about this. It’s how I make my living.” So he chose a version of the procedure to have his bicep completely cut and anchored to the humerus, a biceps tenodesis.

Cisternino underwent two surgeries: one on his right shoulder on June 26, 2017 and the second on his left shoulder on July 31, 2017.

The operations consisted of debridement (removal of damaged tissue) with open biceps tenodesis (repair of the biceps tendons), as well as decompression surgery to relieve shoulder impingement.

The Road to Return

Cisternino started physical therapy when he was able to move his arms. In addition, he continued to do cardio work every day to maintain his heart health.

It took a total 17 weeks from the time of his first shoulder surgery to the day he returned to the gym to begin his customary training. But every job can benefit from taking a break.

“People often don’t realize going to the gym is my livelihood, like going to the office,” says Cisternino. “It wasn’t bad to have a mini vacation.”

It is well-documented that a compassionate and caring physician can affect a patient’s healing potential. Dr. Doumas fit that description for Guy Cisternino.

“Dr. Doumas was really very positive and motivational the entire time,” he says. Doumas encouraged him, “I can’t wait for your comeback, and I’m glad I could be a part of it. You’re going to show that even with surgery, you can be a professional.”

“He also kept me in check,” reports Cisternino. “When I returned for post-op care and shook his hand, he said, Whoa, don’t use your arm like that.’ It was too firm of a handshake. I may be a pro bodybuilder, but I’m human. We look at ourselves as superheroes, like we don’t injure.”

Living Up to High Hopes

Guy Cisternino resumed competing in the summer of 2019. “My shoulders look phenomenal,” he says enthusiastically. He took top honors in all five of his shows to date, and was first overall in his weight class at the 2019 IFBB Niagara Falls Pro in November 2019, which again qualified him for the next Mr. Olympia competition.

Dr. Doumas has stood by his patient the entire time. Concludes Cisternino, “He was so excited. He made me feel important. ‘Here’s my number; text me.’ He wanted to know about my shows. This is what separates him.”

Cisternino has already sent two other people (not athletes) to Dr. Doumas, and they’ve reported back he is “awesome.”

He also has high praise for the staff at UOA. “They were very good at calling me to review pre-op instructions, and very informative. I’ve had a lot of surgeries, but these two were the easiest. Everything went great.”

Most powerful of all is the realization of what a truly skilled surgeon, coupled with a compliant and motivated patient, can achieve. While Cisternino says other bodybuilders have had shoulder arthroscopy, he adds that to his knowledge, “I’m the only guy who has had the type of shoulder surgery I did and come back.”