Bob and Brad, the two most famous physical therapists on the internet Hi folks, I’m Bob Schrupp, physical therapist, and I’m Brad Heineck physical therapist Together we are the most famous physical therapists on the internet, in our opinion of course, Bob. Today we’re gonna talk about what is causing your shoulder pain. You’re getting this shoulder pain. You’re upset about it We’re going to show you some tests you can try on your own, This is a little self assessment here, eventually and then probably need to see the doctor But this maybe gives you a little leeway into it so that you can say to your doctor I wonder if it’s this? They love that don’t they brad. Oh, yeah another one of those patients, all right we have ten and Most important is number seven so you better stick around till number seven right because it’s in our opinion the most common, all right number one is a ??. Bob, these big words. It’s ridiculous! It means that you’re getting some pain down your arm, from your neck, probably a pinched nerve in your neck One of the easy tests you can do for that First off, you may get numbness and tingling, these are some of the symptoms, all the way down into the fingers Especially all the way down the fingers, that’s when you start to think that it might be This sort of thing. So what you’re going to do is you’re going to turn your neck To the side that you’re having pain, turn and extend and then you’re going to push down Or, even better if somebody else would actually do it. So I turn, extend and then push down gently Now if that recreates your symptoms that means you’re pinching that nerve and that means you could possibly have a problem with your neck that’s giving you shoulder pain, and Then you better probably go in and have it looked at for sure Yeah, you can do the other side too. Rotate, extend, and then push down, and it doesn’t take much pressure And if this is it it usually triggers it, it’s pretty clear that. Oh no. It’s getting worse. Nerve pain hurts. Yeah nerve pain is some of the worst pain you’re going to get Second one is Thoracic Outlet Syndrome and in this case you’re getting some pinching up here in the neck and the shoulder in here, some of the muscles or Maybe over the first rib here. Simple tests called roos tests, you’re going to bring your arms up 90 degrees here, 90 at the elbow, stop, and you should bring it back a little bit, too but just back and then you’re going to just There’s people that don’t really know what they’re talking about. The chicken dance, you know this song right? Anyway, I’ve seen different amounts, what you’re looking to see if it starts recreating your symptoms They say to do it up for three minutes, some say a couple minutes I’m thinking three minutes is going to get anybody. So if they start showing up after about twenty seconds to a minute I think there’s a good possibility that that’s playing a role, all right number three Rotator cuff tear, okay a rotator cuff could even be a rotator cuff Tendonitis or kind of a injury of the muscles of the rotator cuff too I just want to say one thing on this if you try to lift your shoulder, and you’re going like this This is all the higher you can get it That’s making me think maybe it’s a tear. Oh by the way Brad if you haven’t already If you’re new to our channel, please take a second just to subscribe, we got a button right over here He was wondering where I was pointing I was pointing at them and we provide videos on how to stay healthy, fit, pain-free, And we upload every day right, so there’s a variety a lot, head to toe we work, alright next one So we’re talking about the rotator cuff tear Brad There’s a couple ways to test that, because the rotator cuff is four muscles So we want to make sure we’re testing them to see what their strength is You actually tore the tendon of the muscle, not the muscle You tore the tendon and one of the ways to test that is if you’re facing there Brad, you’re going to bring the arm out to the a little bit forward about 30 degrees, up about eighty degrees And then you can turn the thumb down and you should get a little push here. If it’s tore It’s going to just give away. You may not even be able to put it up in this position right or it’s painful there you can test yourself like that, now a lot of these rotator cuff muscles they take some experience, but you could try them here and get a feel. The other one is you could test the Infraspinatus and the teres minor, and I’m just saying that to impress you, you put your hands like this And you can actually put both of them like this brad and I can push them both in and if one gives way that might be a sign that you have a tear This one I see a lot in the clinic I’ll do this or you could do it on yourself If you can pull here and that one’s strong and this one’s like oh, it hurts it goes right in yeah It’s a pretty good sign something’s going on in that rotator cuff osteoarthritis, or just plain old arthritis of the shoulder. Now generally this could be for people who are older and it tends to be and if It’s catching or clicking, grinding. That’s kind of a sign. generally with osteoarthritis you start to lose motion in the shoulder too especially with external rotation Brad So if you kind of put your arms like this and like this one can go way back here And this one only can go this far, now I’m keeping the arm at a right angle, the elbow. It’s rotating like this So this one only goes this far, but this one goes all the way there Could be a sign of a little bit of arthritis, that’s a nice thing with all these tests is you got two shoulders If they were both reasonably healthy before the injury, You test from one to the other and say I’m not sure if that’s a good sign or bad sign. Test the good shoulder and see what happens on that. You certainly could get arthritis of both shoulders though. Well that is right. Okay, acromioclavicular joint. That’s the ac joint. That’s this joint right here If you look at the collarbone as it goes along and right as it attaches to this other bone Should we go a little closer Brad? Okay going along the bone right as it attaches to this other bone. That’s the joint right here Very common injury there if you fall on your elbow, a lot of football players have injuries in here Well if you fall on the point of your shoulder Weight lifters get this a lot. A lot of people who do a heavy bench press This is very common and they wear out the end of their clavicle. Very easy tests you can do One let’s do the most simple one you just bring your arm across like this and pull it across like this I call it the crossover test. Point pain right here That could be the acromioclavicular, it could be other things, too But we’re just giving you a couple tests to do Another one put your hand here and now you’re going to push up like this yep, that’d be another one that could bring it on, the last one is a pull apart test. Pull your arms apart, and I actually feel that a little bit on this one So you’re going to, one shoulder will be painful or hit the problem. I’m a little bit positive on here. Just a slight ac, which is a good point you may be positive on some of these tests And it may not be a problem. Positive means that you actually found a result. Positive’s not good. Bursitis number six This is kind of a tough one to test for, it tends to be very localized It’s not spreading out going down. The bursa is a fluid-filled sac here So you might have a little inflammation here, it might feel warm it might even be swollen And you can push on it. I used to test it by kind of bringing the arm back like that, that exposes the bursa a little bit and then I press on it And again you could have tendonitis, bursitis They present similar, you can have both, very common to have both actually impingement now This is number seven this is the one that’s the most Important because we see this the most often by far and basically what’s happening is your shoulder’s forward a little bit and it’s pinching on the tendons in there which can lead to tendinitis Which can lead to a rotator cuff tear. So this is the one that, by the way I’ll have to maybe link up to one of our videos on how to treat impingement, because if I were to take a guess if you’re having shoulder pain this probably is playing a role So just one simple test that you can do on your own is you put the arm here again But this time just bring the elbow up like this, and if that hurts and gives you a little bit of pinching, So you’re lifting with the other arm? Yep. Keep this one planted on. So you’re getting the chromium and the humerus to come in and pinch And that’s where it gets the name impingement because you’re internally rotating it so it’s pinching those tendons. So again that’s the most important one. Number eight which leads to tendinitis which we taught. This can lead to tendonitis, the impingement So usually what we see with this is like a painful arc we call it. We see this a lot. Yeah, like from here to here It doesn’t hurt but from here to here ow ow because it’s pinching and It’s pinching on that tendon and sometimes it’s kind of interesting where here to here it’s fine, and then ow it hurts and then they get through that and then up here it’s fine again. Right, it’s because the tendon clears. The part of the tendon that has the tendonitis actually cleared That’s a really good sign of tendonitis is if it hurts in a painful arch, and then doesn’t It’s one of a few things that does that Yeah, it’s kind of interesting, but we don’t want to get in the mechanics of it now But you know maybe we will in another video. Number nine if you have an unstable shoulder, now if you tend to be double-jointed in other joints like let’s say you can take your thumb and put it down to your forearm Elbows hyper extend or your knees are hyper-extended There’s a good chance that you might have an unstable shoulder because that means your shoulder is not stable either and we do the apprehensive tests which not a really easy one to do on your own, but we bring it like this and we go like this So if I do it on Brad, and I would push it this way He gets apprehensive about it because he’s worried It’s going to even pop out of the joint. So in other words there’s no pain, but it’s like just really afraid of letting go, you don’t like it being up in this position You can have an unstable shoulder without that being the problem, but It’s moving around too much, it’s sloshing around and giving you problems Number ten is fibromyalgia. Difficult one to diagnose, even doctors have trouble diagnosing this. Really often go by symptoms You know are you tired? Do you have a lot of trigger points, that’s probably the main thing. We have specific ones mapped out for people that are consistent with Fibromyalgia We’re not going to get into that It’s something that could be a possibility if you’re having pain in other areas besides your shoulder That’s something to think about so We hope that was helpful and remember, Brad and I can fix just about anything except that broken heart. I like the way you make that come in Bob, on the video I think I’ll put it over your face so they can’t see ya. Right down, I’ll open it up. Thanks for watching.