♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the internet. ♪
- Hi folks, I'm Bob Schrupp, physical therapists.
- Brad Heineck, physical therapist
- We are the most famous physical therapists on the internet
- And on our opinion of course, Bob,
- We're going to talk about
what is causing your shoulder pain.
Is it a rotator cuff tear?
and how to tell
- Sure. - I'm sure
a lot of people are concerned
about that because they're pretty common
- Right?
- A lot of people call it rotator cup tear
but it is a cuff tear.
There are four muscles that make up the rotator cuff.
- Sure.
There are four muscles and I actually,
if you look at this skeleton right here,
here's the shoulder blade and the four muscles
actually attached to the shoulder blade.
- You're right.
- So you have a Supraspinatus, Infraspinatus, Teres minor
and then there's one underneath the subscapularis.
They're all attach by tendon to the bone,
to the bone
and they help hold this bone into the socket
and stabilize it.
- Right, they keep it in the right position
so you do not get impingement
which we're gonna talk about
shortly - Right.
And they also help move it too of course.
So most tears, when you, when you hear about a tear
it's not in the muscle itself, it's at the tendon,
- Right?
- Alot of times it's right where it could be impinged.
Do you want to show that Brad?
- At this tendon, the Supraspinatus tendon,
this, when we have pink or purple,
whatever it is, is the majority of the time,
- Yeah - The culprit
- The most common one by far.
So it happens by the tendon kind of gradually wearing
down.
You can do it through a trauma too
- Sure if you fall down.
- So let's talk about some of the common symptoms.
So quite often you gonna have pain right over
on the side.
Tell them Brad, where is it?
- Right, so right there,
you mentioned where that that patch would be
- Yeah if you have, if you're a boy scout or a cop,
- And you have a patch right there
- Right and you put a patch there on the service,
- My dad had, he was a Sergeant that bought a point
on the rocker, the rocker on top, anyway, right there.
I heard that many times when that patient's hurts there,
is typically a referred pain from twitches above from there.
- Yeah, The damage is in here.
The damage is up here, but they feel it down here.
- And that's common human body they refer to other areas.
- It's tricky, the body's tricky.
So you're also gonna have pain and weakness.
Very, very common with that.
You're definitely gonna have some weaknesses
and we'll show you with one of the tests.
A lot of times you're going to have pain
especially when it's just starting to happen
while even resting at night.
- Right?
- I mean, even just
- Particularly, if you happen to roll over and,
- Yeah if you'll lay on it,
then you're definitely gonna have pain.
- When you wake up with a lot of pain
in the shoulder and you find yourself laying on it
that's why
- Yap, you may hear cracking and popping sensations
Because, think about what's happening?
that shoulder that, that bone is not being held
in the socket as well, because one
of the muscles is bothered, you know, being bothered
- right.
- Or injured.
So it could, it's a sliding around popping
cracking, not, not being held in place like it should.
- Right, exactly.
- So the test, the first one, the common one
the one that everybody knows it seems is the drop arm test.
Now there's kind of two variations of this.
One let's say this is my painful shoulder arm.
I bring it up like this with the non-painful arm
or sometimes you just have people try to lift it
and they go like this.
- yap
- They can't lift it.
But the other variation they bring it
up and you just let it go and see if they can hold it up.
They can't, that's a real positive sign that you have some
some damage there even if they can hold it up,
sometimes we'll give a little push
on it and it just gives away right away.
- Right, yap it's a little painful it can be.
- Yeah.
- Next one, put both the elbows
at the side with a 90 degree angle
and then have someone push both arms at the same time.
So this is painful shoulder.
This is normal shoulder.
I'm gonna push
- And I'm going to resist I always tell
- Its weak, it's supposed to give away.
- Go ahead oh yeah.
So yeah I always tell my patients hold strong, like a statue
and I'll push in and this is very common.
I would say vast majority
90% that that injured side just goes in quite easily.
It's an uncomfortable, yeah, et cetera.
- But so um we were talking
about this, not as common to find this one involved
but you just take your hand, Palm facing
out and you can compare both sides.
I would, I'd be the same with this Brad.
I would do this to your good shoulder first.
Then non-involved
- Right.
- And see how that does.
See how well you're able to lift it up.
Then take the involved shoulder.
And you may not even be able to get the hand up as high.
- Right.
And then try to push it out
and you may not be able to push it.
- And if it's really, you know
like you said, sometimes it's hard to even get it in place
- It in place right - you know,
- You're here doing this and here it's like, Oh,
and if you help it, it hurts more.
You may get there, but it just doesn't go there.
All of these tests, we just mentioned
it's a good idea to do them on your good shoulder first
see how the mechanics are pain free and then
- yeah, Try it again on the other shoulder.
Okay, We're not trying to make you doctors
or physical therapists
but it'll give you an idea, you know
is it time for me to go see the doctor
- Right - Or my therapist
Because these are all positive
and, and kind of give you a start
on trying to get that shoulder better.
- And I do wanna mention if all the signs they're positive
and you go in, you get a confirmed by doctor
a therapist that you do have a torn rate, rotator cuff.
You do not always have to have surgery,
- No not by any means not even close.
- You can rehab that on your own
if you do the proper protocol and excercises
- Yeah there's a, there could be a partial tear
but if there's a full tear where it's completely severed
- Right,
- It's pulling away from the bone,
they're probably going to have to do surgery.
- Right,
But if there's a partial tear
or a pin sized tear,
- And that's the thing people don't,
aren't aware of that they say the yeah
the tear and they think, Oh, it must be torn apart
but it's not very, often times there's a partial tear.
- Yeah we actually have a video,
Brad you don't know this
but a video of questions, you should ask your surgeon
- Oh,
- And one of the first questions is could therapy
can I try therapy first?
- Right.
- And in some cases, they're gonna say no,
because if you wait too long,
they may not be all repaired and in most cases,
they gonna say yes.
- And we did a video
on a woman that she's like a 55 years old.
She was scheduled for surgery, never had therapy.
Finally she said can I try therapy,
within four visits of therapy, the surgery was canceled,
her shoulder started getting better
and it was a wonderful situation.
- Well you know, J,
- Oh
- That's how I met him.
- There is another patient of ours
- Yes he's a patient and he helped us invent something.
He had a torn rotator cuff
and he's a rock climber, as you know.
- Yeah
And he, I mean, that was crazy.
I mean, he was a full thickness rotator cuff.
- Yeah.
He's back up, he's strong, he's
- no surgery, - No surgery.
- There, he's
We're miracle workers.
Thanks for watching.
- Pat us off on the back.