In this episode, we discuss: 0:00:00 - Intro 0:00:08 - Alton’s path to orthopedic surgery 0:06:03 - Evolution of orthopedics and recent advances 0:11:21 - Anatomy of the upper extremities 0:20:12 - Rotator cuff injuries, shoulder joint dislocation, and more 0:31:55 - Peter’s shoulder problems 0:36:04 - The structure of the biceps and common injuries 0:39:20 - Labrum tears in the shoulder and natural loss of cartilage with usage and time 0:43:07 - Shoulder evaluation with MRI vs. physical exam, diagnosing pain, and when to have surgery 0:53:20 - How anatomical variation can predispose one to injury and how screening may help 0:59:36 - Pain generators in the shoulder, and the important nuance of the physical exam 1:10:22 - Frozen shoulder 1:16:54 - Shoulder pain that originates in the neck 1:22:22 - Shoulder Exam 1:33:37 - Surgical treatments for a labral tear, and factors that determine whether surgery is appropriate 1:48:11 - Repairing the rotator cuff 1:58:13 - Are platelet-rich plasma (PRP) injections or stem cells beneficial for healing tears? 2:06:16 - Repair of an AC joint separation 2:18:04 - Total shoulder replacement 2:29:21 - The elbow: anatomy, pain points, common injuries, treatments, and more 2:42:42 - How Tommy John surgery revolutionized Major League Baseball 2:48:03 - Elbow Exam 2:55:12 - History of hand surgery and the most significant advancements 3:03:30 - The hand: anatomy, common injuries, and surgeries of the hand and wrist 3:15:47 - Carpal tunnel syndrome 3:23:54 - Other common injuries of the hand and forearm 3:32:54 - Grip strength 3:37:55 - Arthritis in the hands 3:47:20 - Trigger finger 3:53:38 - Hand & Wrist Exam 4:02:20 - Nerve pain, numbness, and weakness in the upper limbs 4:10:54 - Nerve Exam 4:17:24 - The Musician Treatment Foundation 4:31:27 - Gratitude and rucking
Even great for the average Joe who can then have more informed and enriched conversations with their clinicians about their health, hopefully leading to better outcomes
I am a physical therapist of 40 years and I have listened to a lot of professionals convey medical information in continuing education courses I have attended. This was a very impressive presentation by both of you. Thank you very much. I would love to view/listen to a podcast on the lower extremity by an orthopedic surgeon especially pertaining to the foot. This was an excellent overview format which also contained fabulous gems of specificity even for those of us well versed in these subjects. Dr Alton’s enthusiasm for his subject was palpable and wonderfully conveyed. Very informative, I learned a lot.
I am an electronic engineer, nothing to do with medicine, you have entertained me for an entire hour, and I wish I would have studied medicine, there is so much to know there
I cannot believe it!!! I’m laying here w a heating pad on arms below shoulders. This man is so easy to listen to n very knowledgeable. This was helpful. You amaze me Peter.
i'm 7 weeks post bankart repair, and although my ortho is very patient and spends time with me i can't ask him all these questions. this has been enormously helpful and illuminating.
Thank you so much for this. I do chronic pain management as a clinical pharmacist and refer out to ortho very often. This will help me better explain to patients what to expect from ortho surg consults
This is fantastic. I'm a occupational medicine PA who sees a lot of upper extremity overuse and accidental injuries. This was super informative and a great resource. Would love to see lower extremity and spine! Keep more of these coming!
I’m currently 7 weeks post surgery for a Slap tear type III, torn supraspinatus tendon and proximal tear of long head of biceps. This information is excellent in describing exactly what these do. I’m a nursing student so I have a basic conceptual knowledge but to hear an orthopedist explain it clears up so many things. Thank you
I can’t ❤ this enough 😊 next time, let’s discuss the more neurological side of this discussion; spinal cord, nerve roots, brachial plexus (Real Texans Drink Cold Beers), plexopathy, peripheral nerve; common disorders, PLEASE! 🙏
I listened to this episode and then watched the whole thing as well. I don't have any issues with shoulder/elbow/hand (although I'm getting older....and certainly know friends who've had various problems discussed). I just found it really interesting, as a layperson, to have this accessible explanation of the anatomy and how things work and what can go wrong. Definitely came away with a new appreciation of the shoulder joint. I'd love to hear/see an episode or two like this for hips/legs/feet.
Amazingly good discussion. I came because of shoulder pain as well as a hand injury. This is what I was looking for but could not find anywhere. Thanks!
Fantastic! I’m a PT and have never witnessed any ortho doc in my area conduct this thorough a physical exam! Would have loved to see how Dr. Alton differentiates cervical spine from referred shoulder/upper extremity involvement. Thank you for this. Looking forward to LE
I'm 25 and tore my rotator cuff, I can't express enough how helpful this podcast has been. I'm incredibly grateful to you Peter for starting your own podcast. I found out about you through Joe Rogan and followed your work. God Bless you good Sir or should I say Dr.
This episode is why I joined. Amazing content! As an avid martial artist it helped me understand issues I've had from shoulder to elbow to wrist. I am amazed at how those simple diagrams were able to explain more than complex medical images.
Awsome!!! I wish I had this information before SLAP Tear & Adhesive Capsulitis Surgery. Developed CRPS. Back to 0. After 1yr of physical therapy I am still at 75% recovery. Thanks!!!
Love the developmental hip dysplasia insights! My team sees people who have this in their background. The brace is a wonderful advancement for the hip formation, but the immobilization for 6-9 months comes at a developmental cost. The core control for balance and the core rotation needed for efficient movement is largely skipped. It naturally would develop from tummy time transitions from the feet pushing to initiate ground based movement. (Many other relationships impacted which I won't outline here.) My Bridging Technique takes development into account in order to reconstruct the hierarchy of movement development and reset the related muscle relationships. Passive, gentle and long-lasting.
Simply outstanding! Thank you Peter and Alton for this extensive medical education! So thorough and informative. Sorry you didn't mention DuPuytren's contracture, but in fairness, that's not an orthopedic problem. but a disease of the fascia. Keep up the great work!
How fantastic would be if you could talk about connective tissue disorders and their orthopedic and neurologocal influences, as they are the most underrated and underestimated clinical entities with a huge spectrum from just ”loosy-goosy” to severe lifelong chronic pain, disability and immense suffering.
Me, Monday morning: "There's no way in hell a 4 1/2 hour long video is keeping my attention." Monday afternoon: "OMFG! I got no work done today! That was amazing!"
Dr. Barron thank you for a clear explanation of such a complex topic! A reminder for the doc, please watch your standing posture in the spine. The sway back is quite pronounced. I have been teaching human biomechanics to the lay community for 25 years and my eye naturally gravitate to posture and movement 😊
Regarding the shoulder something I would like to hear talked about--perhaps in an AMA--would be the claims made in the book by John M. Kirsch, MD "Shoulder Pain? The Solution and Prevention". The principal claim in this book is that a daily hanging protocol (hanging from a pull-up bar) could treat and heal specific issues relating to the "acromialhumeral" joint. Please and thanks :)
I have had rotator cuff surgeries on both sides due to bone spurs in the joints, basically sawing completely through the superspinatous tendons with partial tears elsewhere. I was in my early 60s. With diligent physical therapy, I have full use of both shoulders at 69 yrs old. I had a great surgeon, but recovery is basically up to the patient. It hurts. Do it anyway!
I find the revelations and discoveries that are being made with respect to the body, make me wish that I could go back and challenge my doctor on the traditional narratives I have been brainwashed by. From living with the pain of a miss-healed broken clavicle (apparently it is impossible to break and repair it properly) to "you're 60 what do you expect" "Dont't do squats remember your dad had bad knees, you dont want to end up like him" ... rediculous, I do 50 every morning. But allas my upper body strenth is ZERO -- I am highly active but doctors passively and complancently give up on their patients and the patient sadly follows. I find your channel enlightening. It shines a light on modern day health, what is preventable and what can be acheived.
I’ve listened to this webinar twice at least. Very solid stuff. I appreciate the great information. I’m getting ready to dive into your knee webinar. By any chance, do you have a podcast? I can find on Apple or Spotify? Your site is a great resource, for my other clinical colleagues, as well!
So that's what happened to me! I also subluxated my right shoulder doing military press (in middle school). Had it happen a couple more times in middle school and once while lifting a dancer. Luckily I've never done a shoulder intensive sport so it's never gotten worse. I generally avoid military press now; machines and barbells are preferred.
Had a subscapularis tear with bicep tendon slipping out the groove. Repaired five months ago. Still have that nerve pain in the bicep at times. At least not down into the palm. Just time I suppose?
How does Ehlers danlos play into this tendency of these injuries??? Personally struggling to strengthen all these muscles and tendons. Stability is my primary focus on this old athletic body. How does elders danlos play into tendons, cartilage and ect.??? Really trying to figure out how and what exactly is the goal with loosey-goosey joints. I'm just now learning how unusually loose my joints are and getting older is a big concern. I want to out- live and out- perform Dr Attia. No holds bar but pretty ignorant on this important topic!!!
Where can I find a hand surgeon who will use my own body for tendon graphs for repair of my thumb? I can no longer find one. Everyone now at Kaiser wants to use artificial implants . I have thinning bones at 80 and don’t want artificial parts.
In this episode, we discuss:
0:00:00 - Intro
0:00:08 - Alton’s path to orthopedic surgery
0:06:03 - Evolution of orthopedics and recent advances
0:11:21 - Anatomy of the upper extremities
0:20:12 - Rotator cuff injuries, shoulder joint dislocation, and more
0:31:55 - Peter’s shoulder problems
0:36:04 - The structure of the biceps and common injuries
0:39:20 - Labrum tears in the shoulder and natural loss of cartilage with usage and time
0:43:07 - Shoulder evaluation with MRI vs. physical exam, diagnosing pain, and when to have surgery
0:53:20 - How anatomical variation can predispose one to injury and how screening may help
0:59:36 - Pain generators in the shoulder, and the important nuance of the physical exam
1:10:22 - Frozen shoulder
1:16:54 - Shoulder pain that originates in the neck
1:22:22 - Shoulder Exam
1:33:37 - Surgical treatments for a labral tear, and factors that determine whether surgery is appropriate
1:48:11 - Repairing the rotator cuff
1:58:13 - Are platelet-rich plasma (PRP) injections or stem cells beneficial for healing tears?
2:06:16 - Repair of an AC joint separation
2:18:04 - Total shoulder replacement
2:29:21 - The elbow: anatomy, pain points, common injuries, treatments, and more
2:42:42 - How Tommy John surgery revolutionized Major League Baseball
2:48:03 - Elbow Exam
2:55:12 - History of hand surgery and the most significant advancements
3:03:30 - The hand: anatomy, common injuries, and surgeries of the hand and wrist
3:15:47 - Carpal tunnel syndrome
3:23:54 - Other common injuries of the hand and forearm
3:32:54 - Grip strength
3:37:55 - Arthritis in the hands
3:47:20 - Trigger finger
3:53:38 - Hand & Wrist Exam
4:02:20 - Nerve pain, numbness, and weakness in the upper limbs
4:10:54 - Nerve Exam
4:17:24 - The Musician Treatment Foundation
4:31:27 - Gratitude and rucking
This is great! would love a follow-up series-like for the spine, hip, knee/LL.
@@jessethompson6854
💯%
For the clinical side of your audience, more of these types of podcasts covering other medical topics in-depth would be greatly appreciated!
Even great for the average Joe who can then have more informed and enriched conversations with their clinicians about their health, hopefully leading to better outcomes
I am a physical therapist of 40 years and I have listened to a lot of professionals convey medical information in continuing education courses I have attended. This was a very impressive presentation by both of you. Thank you very much. I would love to view/listen to a podcast on the lower extremity by an orthopedic surgeon especially pertaining to the foot. This was an excellent overview format which also contained fabulous gems of specificity even for those of us well versed in these subjects. Dr Alton’s enthusiasm for his subject was palpable and wonderfully conveyed. Very informative, I learned a lot.
"you f
Cxf
I am an electronic engineer, nothing to do with medicine, you have entertained me for an entire hour, and I wish I would have studied medicine, there is so much to know there
This is a fantastic interview. I hope you do the lower body soon (hip and knee).
Let's not forget the Ankle as I feel the Ankle is lacking in medical progression compared to the Knee and Hip.
Awesome for doing this. I'm an Orthopedic PA who works at a major medical center and this is helpful in my approach
I cannot believe it!!! I’m laying here w a heating pad on arms below shoulders. This man is so easy to listen to n very knowledgeable. This was helpful. You amaze me Peter.
i'm 7 weeks post bankart repair, and although my ortho is very patient and spends time with me i can't ask him all these questions. this has been enormously helpful and illuminating.
Thank you so much for this. I do chronic pain management as a clinical pharmacist and refer out to ortho very often. This will help me better explain to patients what to expect from ortho surg consults
This is fantastic. I'm a occupational medicine PA who sees a lot of upper extremity overuse and accidental injuries. This was super informative and a great resource. Would love to see lower extremity and spine! Keep more of these coming!
I’m currently 7 weeks post surgery for a Slap tear type III, torn supraspinatus tendon and proximal tear of long head of biceps. This information is excellent in describing exactly what these do. I’m a nursing student so I have a basic conceptual knowledge but to hear an orthopedist explain it clears up so many things. Thank you
I can’t ❤ this enough 😊 next time, let’s discuss the more neurological side of this discussion; spinal cord, nerve roots, brachial plexus (Real Texans Drink Cold Beers), plexopathy, peripheral nerve; common disorders, PLEASE! 🙏
I listened to this episode and then watched the whole thing as well. I don't have any issues with shoulder/elbow/hand (although I'm getting older....and certainly know friends who've had various problems discussed). I just found it really interesting, as a layperson, to have this accessible explanation of the anatomy and how things work and what can go wrong. Definitely came away with a new appreciation of the shoulder joint. I'd love to hear/see an episode or two like this for hips/legs/feet.
This was the BEST podcast yet!! Can you do one like it on the hip/ lost limbs??!!
Since I work in imaging, this is absolutely the best one that I've watched on this channel. Second has been the about MRI
this is so good, love the physical exams and insights
What a program! As always worth every second. Amazingly clear and instructive guest, and really liked the long format.
Thank you for your efforts!
Amazingly good discussion. I came because of shoulder pain as well as a hand injury. This is what I was looking for but could not find anywhere. Thanks!
Fantastic! I’m a PT and have never witnessed any ortho doc in my area conduct this thorough a physical exam! Would have loved to see how Dr. Alton differentiates cervical spine from referred shoulder/upper extremity involvement. Thank you for this. Looking forward to LE
I'm 25 and tore my rotator cuff, I can't express enough how helpful this podcast has been. I'm incredibly grateful to you Peter for starting your own podcast. I found out about you through Joe Rogan and followed your work.
God Bless you good Sir or should I say Dr.
I have a lot metal in my wrist from an injury and have many of these shoulder / elbow issues as well. Thanks for another important talk
This episode is why I joined. Amazing content! As an avid martial artist it helped me understand issues I've had from shoulder to elbow to wrist. I am amazed at how those simple diagrams were able to explain more than complex medical images.
Awsome!!! I wish I had this information before SLAP Tear & Adhesive Capsulitis Surgery. Developed CRPS. Back to 0.
After 1yr of physical therapy I am still at 75% recovery. Thanks!!!
I dislocated my shoulder a week ago for the very first time. THIS was super AMAZING info!! Thank you!
Love the developmental hip dysplasia insights! My team sees people who have this in their background. The brace is a wonderful advancement for the hip formation, but the immobilization for 6-9 months comes at a developmental cost. The core control for balance and the core rotation needed for efficient movement is largely skipped. It naturally would develop from tummy time transitions from the feet pushing to initiate ground based movement. (Many other relationships impacted which I won't outline here.) My Bridging Technique takes development into account in order to reconstruct the hierarchy of movement development and reset the related muscle relationships. Passive, gentle and long-lasting.
Please, please, please do something like this for the lower extremities too. I KNEED this very much! Thanks!
Simply outstanding! Thank you Peter and Alton for this extensive medical education! So thorough and informative. Sorry you didn't mention DuPuytren's contracture, but in fairness, that's not an orthopedic problem. but a disease of the fascia. Keep up the great work!
This is fascinating! Love the content and thankful for this conversation, thank you!
This older arthritic fan who loves to exercise and be able to lift heavy boxes when she volunteers at the foodshelf thanks you. Very informative.
This is fantastic! Very interesting and very useful! I just wish that you had covered knees too, since those are also a very common source of trouble.
El mejor episodio en este canal en mucho tiempo. Gracias Doctor.
Great interview! Would love to watch this type of show talking about hips.
I'd love this same kind of deep dive into lower back \ hip area of the body
Fantastic explanations. Vignettes of cases really helped me understand as well. Thank you.
Thank you both for sharing your expertise!
Thank you for an amazingly educational podcast/youtube video !!!
How fantastic would be if you could talk about connective tissue disorders and their orthopedic and neurologocal influences, as they are the most underrated and underestimated clinical entities with a huge spectrum from just ”loosy-goosy” to severe lifelong chronic pain, disability and immense suffering.
Wondering what causes tremors in the hands when holding a light object with fingers?
Love this type of podcast.
Me, Monday morning: "There's no way in hell a 4 1/2 hour long video is keeping my attention."
Monday afternoon: "OMFG! I got no work done today! That was amazing!"
This is very interesting as ive had a bad left shoulder for a while and just had it operated on. This convo filled in some of my knowledge gaps
Dr. Barron thank you for a clear explanation of such a complex topic! A reminder for the doc, please watch your standing posture in the spine. The sway back is quite pronounced. I have been teaching human biomechanics to the lay community for 25 years and my eye naturally gravitate to posture and movement 😊
Regarding the shoulder something I would like to hear talked about--perhaps in an AMA--would be the claims made in the book by John M. Kirsch, MD "Shoulder Pain? The Solution and Prevention". The principal claim in this book is that a daily hanging protocol (hanging from a pull-up bar) could treat and heal specific issues relating to the "acromialhumeral" joint. Please and thanks :)
Yes, please. I’ve just started hanging, based on Kirsch’s book. Seems like it couldn’t hurt to try (in a cautiously progressive way).
I have had rotator cuff surgeries on both sides due to bone spurs in the joints, basically sawing completely through the superspinatous tendons with partial tears elsewhere. I was in my early 60s. With diligent physical therapy, I have full use of both shoulders at 69 yrs old. I had a great surgeon, but recovery is basically up to the patient. It hurts. Do it anyway!
I find the revelations and discoveries that are being made with respect to the body, make me wish that I could go back and challenge my doctor on the traditional narratives I have been brainwashed by. From living with the pain of a miss-healed broken clavicle (apparently it is impossible to break and repair it properly) to "you're 60 what do you expect" "Dont't do squats remember your dad had bad knees, you dont want to end up like him" ... rediculous, I do 50 every morning. But allas my upper body strenth is ZERO -- I am highly active but doctors passively and complancently give up on their patients and the patient sadly follows. I find your channel enlightening. It shines a light on modern day health, what is preventable and what can be acheived.
What an excellent podcast. If anyone watching this in New Zealand knows of an expert in shoulders, hands, neck in NZ of his calibre please share. 😊
NSAIDs and cartilage healing, Dr. just told me NSAIDS a detrimental to healing cartilage. Would love to get more on this!
I’ve listened to this webinar twice at least. Very solid stuff. I appreciate the great information. I’m getting ready to dive into your knee webinar. By any chance, do you have a podcast? I can find on Apple or Spotify? Your site is a great resource, for my other clinical colleagues, as well!
Ohh I was waiting for that one, as I also have a labrum tear and still considering having surgery (or not). Big thanks!
I love this doc.
Great lecture! Thank you🙏
Looking forward to this. I have a major impingement in my right shoulder, probably need surgery soon!
So that's what happened to me! I also subluxated my right shoulder doing military press (in middle school). Had it happen a couple more times in middle school and once while lifting a dancer. Luckily I've never done a shoulder intensive sport so it's never gotten worse. I generally avoid military press now; machines and barbells are preferred.
1:11:40
I love your podcast
Fabulous!❤
Had a subscapularis tear with bicep tendon slipping out the groove. Repaired five months ago. Still have that nerve pain in the bicep at times. At least not down into the palm. Just time I suppose?
How does Ehlers danlos play into this tendency of these injuries??? Personally struggling to strengthen all these muscles and tendons. Stability is my primary focus on this old athletic body. How does elders danlos play into tendons, cartilage and ect.??? Really trying to figure out how and what exactly is the goal with loosey-goosey joints. I'm just now learning how unusually loose my joints are and getting older is a big concern. I want to out- live and out- perform Dr Attia. No holds bar but pretty ignorant on this important topic!!!
I am confused - short head if the biceps never tears?
Where can I find a hand surgeon who will use my own body for tendon graphs
for repair of my thumb? I can no longer find one. Everyone now at Kaiser
wants to use artificial implants . I have thinning bones at 80 and don’t want artificial parts.
Peter those arms lookin a little swole 💪🏼
2:39:30 - isnt that what they used to do with horses?
Wow!
ya
So engineers make the best surgeons?
👊 Ｐｒⓞм𝕠𝕤𝐌
Maybe useful for health professionals but almost completely useless for patients. Also not useful is Peter's vanity checkup.
Follow him little sheep, follow him