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Shoulder Reduction Techniques - Teaching Progression, Clinical Example
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- Опубликовано: 8 сен 2021
- This video demonstrates teaching progression from Cunningham to ER to Forward Elevation in a 47 yo patient who fell mountain biking and sustained a primary anterior dislocation. Reduction achieved without any analgesia. Large Hill Sach’s lesion on PR XR.
Also see: Dr. Mohr's Method - Anterior Shoulder Dislocation - Reduction • Dr. Mohr's Method - An...
For more procedural videos and point-of-care clinical summaries, visit: www.bcemergenc...
As a physical therapist I am impressed with his technique. I never see physicians use any type of manual techniques to reduce pain, It’s great to see.
Question do u PTs handle shoulder dislocation as well?
@@markgerald2035 Hi, german physiotherapist here. No, we just use stabilizing and pain reducing techniques after relocation. In Germany, only docs are allowed to relocate.
A Massage Therapist can do it with Myofascial release therapy, a massage therapist with two years instruction therapist.
@@markgerald2035 usually reduction is done by physician and then we see patient for follow up to stabilize and strengthen
@@markgerald2035an orthopaedician does it
What an art form that is. Passing on that lesson to another generation, very well done doc.
Absolutely correct but these techniques have been around for many many years. Just thank God for the internet to be showing it.
Just have to say this GOD bless you an use your special gift amen hallelujah praise GOD
,,
@@carsonfarist8590 00
Absolutely 30 to 40 days the shoulder back again normal . tehnique used as different ways
What a great doctor and teacher. Your bedside manner is what's missing from patient care where doctors are concerned. Excellence at its best.
What a beautiful and calm environment to need help in. Praising him for vocalizing what he needed was amazing. I wish that every single doctors office and emergency room was like this. A lot of us have suffered dearly because it’s not.
I did this on my own , in my room when i had no help to ask for and i was in tremendous pain... the key is to remain calm and not panic
😂
Me too scary as hell my shoulder dislocated causing my arm to go behind my back
Ended up having to relocate my knee cap by myself after getting hit by a car while on a bicycle. Was kinda painful but the adrenaline made it bearable and it didn’t take very long to do. Most definitely was sore for weeks after though.
Back in 1995 in rural Australia my arm was left paralysed after a dislocation was put back in by a deranged dr. I am ok today and have full use of my arm again but it was a long slow road to recovery. I am glad there are good Dr’s out there now.
I’m glad you got your function back 👍🏽
You do lose youraxillary nerve with anterior dislocation (which is a known morbidity of dislocation)
There are none with relocating a shoulder apart from hyppocrate method(not used in modern methods)
😐
Thank you so much ! Ortho trainee here and I must say you have changed my practice !. Tried using your techniques and advise . Worked as a charm - completely pain free .
I have been through an excrusiating pain today because of this. I was lucky to find a good orthopedist very calm and confident. I had a shot of morphine before he could touch my shoulder... It was such a relief to have both: pain relief and a great doctor.
Keep up with good work
Regards from Brazil
Jesus they wouldn’t give me morphine after I had an organ cut out.
@@isaacbundy5081 you do not get much after a c section either. Rotate 800mg ibuprofen and 600mg Tylenol 👁️👄👁️
@@isaacbundy5081 that’s ridiculous bro
What great doctors. I was, alone at home, many years ago, when I tripped an fell twisting my shoulder in such a way that I couldn't use it. It was painful, but not impossible. I knew it was dislocated, if that's the word. The only thing I thought to do was reach over with my other hand and place it close to my body and pull. Not sure why, but it popped and suddenly worked. I could have caused more trouble than help but glad it worked. Glad this worked for this patient too.
I had a similar experience (though I’m guessing much less painful) with my knee dislocating
After a moment of confusion and pain I popped it back into place, and started doing exercise to strengthen the muscle that holds the knee in place so it won’t happen again
I would want a Canadian doctor any day. (I'm an American) This doctor had the calmest way of teaching and I appreciate that.
No you don't
Calm visualization works wonders. As a layperson, I use this for numerous physical situations. Mind over body is a powerful thing.
Rather mind with body
Cliche Lol Mind over Matter “ pay it no Mind 💥 it don’t Matter
And that my friend is a key for the world (in all situations regarding anything to do with recovery, road to success, you name it: calm visualization + mind over matter = powerful results❗
👏🏼👏🏼👏🏼👏🏼
I’ve seen a lot of reductions and they all included lots of medicine and force. This was beautiful.
This is so cool to see. The manual manipulation of the dislocation and how it pops back in is impressive ❤
Wow!! This safed my Bf from going ti the hospital for the thousandth time!! I did exactly what you showed in this video to him and it rolled back in so easy and smooth and we were so relieved we didn’t had to go back again to the hospital! Thank you soo much for this great video!!!
Put a chair in the arm pit n sit down 🪑
Brings back memories of many years ago. In a span of 3 years, my right shoulder dislocated 5 times; at which time surgery was necessary. This patient is very calm; I was in excruciating pain each time and only found relief the moment the doctor fixed it.
Did the surgery solve your problems with instability?
Man this takes me back! Before I had shoulder surgery I probably dislocated my shoulder 11 times! Got good at popping it back in! The worst was when I slept with my arm up and when I awoke soon as I moved my arm popped right out!
Hey what kind of surgery did you get? Did it fix your shoulder completely?? No more dislocating?
I think I just dislocated my shoulder by watching this video.
😂
Me too 😅😅😅
Me too!
😁
🤣
Man that was amazing! Will definitely show the rest of my paramedicine class
I’ve brought patients to the hospital for this and the doctor just quickly “pops” it back in. Crazy! Lol This was a neat video.
Nice job Jordan Peterson! You stayed incredibly calm.
Outstanding. We love our Doctors. Bless you all!!!
Ive dislocated my shoulder 10+ times climbing, snowboarding, rope jumping into the river, doing pull ups, lifting but never gone to the hospital and put it back myself. But this morning at 3am it just wouldnt go back in for 20mins which was the longest time ever and I was sweating like a mf.. found this channel which saved my life.
I just want to say praise GOD I don’t have to worry about nothing because I’m saved and going home!!! Turn to the LORD and have all!!!! GOD is so good amen!!!! Keep doing for the LORD using your special gift amen hallelujah praise GOD!!!
Very cool! When I was about 5 yrs old I dislocated my wrist. My mother was a nurse. We were at our summer cabin quite a ways from town. She grabbed my forearm with one hand and my hand with her other hand, manipulated my hand some and quickly jerked and popped my wrist back into alignment. To me it was facinating. I know the shoulder is a much bigger joint with more involved but I am having shoulder problems now that seem to be a mild form of what just was shown here. I'm 70 yrs old now with chronic neck and shoulder pain. Where is my mother when I need her. Lol! JK. 😇
You need to find a good massage therapist. They can help you with that neck and shoulder pain.
I may have Ehlers Danlos Syndrome and there is some types of massage that shouldn't be done. My daughter is a massage therapist. I have many joints that come out of place or are unstable. Lax joints. My daughter was recently diagnosed with it and it's hereditary.
Our moms will always be missed!
G’nite, Mom!
Thank you for a great instructional video, from a physical therapist 👍🏼
Thank you so much! It worked! My dad managed to readjust my shoulder following the instructions in this video. Going to the hospital and waiting in the ER room for hours with this unbearable pain (again) seemed unreal to me.
Btw I’m an adult and it was my decision to find this video and try doing it at home so no child negligence occurred. I do not recommend this if going to the ER is not an issue for you.
Parabéns 👏 pra esses profissionais. Isso acontece comigo sofro até hoje 😔 aqui nunca vi um profissional com tanta dedicação.paraben mesmo 👏👏👏👏
Συγχαρητήρια πόσο θα ήθελα να βρω και εγώ έναν τέτοιο επαγγελματία υποφέρω χρόνια τώρα
Vdd
I have Ehlers-Danlos syndrome. My internal organs and my joints shred. I spent time at pain and torture, I mean physical therapy today, trying to get my shoulder to quit subluxating and dislocating. I would love to have you come over to my house, and just massage my shoulder every day to prevent the subluxations and dislocations. I am stuck in a recliner 24 hours a day with my joints propped up with pillows because I am much like a Marionette. All kidding aside, I would love to have someone come over and work on my muscles because I wake up sometimes and they’re out of their sockets and I have to do the gentle, breathing manipulation and meditation technique. Good job! God bless you guys!
Wish I knew about this technic when I dislocated my left arm literally a thousand times before I had a lateral jet surgery with a steel plate to hold my humorous in the socket. I use to just grab my left elbow with my right hand and pinch my left hand between my knees and stand up and let it pop back into place. It was such a relief when it popped back in. Sometimes it was hard to do it that way but I pulled thru the pain and pulled harder and pop. Health class is one class I'm glad I paid attention to in school. It helps a lot knowing the shapes of your bones and anatomy of the human body.
Is your surgery working well as if all movements in full range??
Have your feeling of getting dislocation during some movements is stopped??
This was amazing. Very ER should be trained in this.
Excellent Job Doc and trainee, I have recurrent shoulder dislocation for over 23 years now and never had specialist like you, Wish you were here In Kenya.
I have dislocated my shoulder twice and twice I have just put it back as fast as possible (less than a minute) just to avoid the incredible pain this causes, I am amazed this guy had the patience to wait for the physician massages and movements, etc, I have no patience just put that shoulder back in right ahead. Btw this guy looks like jordan peterson
Yeah I had a shoulder dislocate from a skateboarding accident, had my buddy pop it back in right on the curb, made the lady that stopped to see if I was alright scream at the sound hahaha. It hurt but I'm sure it would have been way worse if I let it sit dislocated for however long the ride to the hospital was and waiting for the doctor.
@@ausername7470 definitely! by the way I dislocated mine falling from my motorbike
My younger days I would dislocate my shoulder really easy due to loose ligaments. For me it was not to painful but annoying lol.
@@ausername7470 this usually the Chinese tradition ortho doctor way of treating dislocation. Fast and effective!!
Kudos to the doctor! Calm and described the technique very well. A mastet to his apprentice. Also the one who applied it. You listened and did it so well and reassuring.🎉
So nice to see an actual caring and knowledgeable doctor.
Thank you so much! This worked, poped right back in. Just need patience, move slowly, and maintain traction. Your teaching helped so much. Thanks again.
Fantastic to watch biomechanics being fixed with such relative ease and great technique. Relaxing the muscles to relodge that arm....WOW great video. Welldone to all involved.
Attempted Cunningham, then external rotation and a modified elbow extension. Very nice!
As a Martial Artist I see techniques like this used more than I ever have in hospitals nice to see it here.
I’ve dislocated my shoulder 8 times and only once was this technique used. It felt amazing because the pain if not treated within about 30 mins is excruciating.
Волшебство какое то.Низкий вам поклон дорогие.Спасибо за ваш тяжёлый труд.
Nossa, isso me lembrou quando fraturei o úmero, caí com o braço estendido, tive a sorte de encontrar um ortopedista maravilhoso que me recuperou sem precisar fazer cirurgia. Muito grata por isso.
Thank you so much, it is very difficult to find instructional material of this quality online. Specifically video of an actual patient. I have frequent dislocations due to a chronic injury and this is very helpful.
Doc knows his stuff
A master class! That was awesome to watch thank you
Such a good teacher!
Молодцы, высший профессионализм!
This is the peak of teaching hospitals 👍
Seriously
Did my own reduction after my shoulder dislocated from a fall from my horse.
Just gripped back of horse trailer and let my body go limp. Popped right in.
No doctor needed. Little to no pain.
Much quicker than all this
WOW! That was amazing! It was completely different than what is shown in movies!
Absolutely Brilliant Doc... You're very good.. Thanks for sharing.. 🙏🏾❤️
I have a history of over 10 years of recurrent shoulder dislocations with more than a thousand episodes. I independently learned this reduction technique based on extreme relaxation, elongation and slight rotation. in a few seconds the shoulder is fixed without trauma
I've dislocated my shoulder 7 times. I have had all 3 techniques done on me at various times. I've also been put under for shoulder reduction and also 1 other technique done as well.
I had a posterior dislocation of my right shoulder, it was out for about 3 hours before it was put back, very painful
Cunningham technique with a personal twist. Beautiful 🥰
Whaaa...he's not a: Rare Disease Patient with a genetic collagen disorder who gets major: dislocations regularly. He does fairly well, for the average Joe--haveta say! We Ehlets Danlos Sundrome folks usually take care of major dislocations, without all the medical personell nor even an A & E/ER visit, however...we re-set: at home, or wherever we are...& most of us keep going, when regular Joes haveta go to get help and coaching....thanks for this video--great instruction! (Especially for my: Rare Disease: Patient Population!)
I was a combat medic in a parachute battalion many years ago.
Saw my fair share of DZ dislocations and readjustments.
Things happened a bit quicker than in this video!
Bravo dottore per la premura la pazienza ha risolto il problema senza fare soffrire il paziente in Italià( al sud) sarebbe stato operato
Amazing, I just love the field of medicine. The human body is such a complex but simple system if you just listen to it!!!
Es mágico, si lo describiera el procedimiento que vimos sería aún más espectacular, gracias
As my experience dislocated my shoulder in the basketball it's like almost 30x and i never get surgery. The technique of that just sit up straight, chest out and put your hand in the abdomen and fucos on your breathing 👌
That is amazing. After seeing the literal tug of war my mum went through to get her shoulder back in. 3 Doctors & a heap of painkillers.!
Perfect technique.
Thank u very much sir ..I reduced a patient shoulder after seeing this vedio...
Went through this 3 times in my teen years as a rugby player.
Wonderful job relaxing hisself and it being slipped in.
Thank you so much. I put back my shoulder to it's place with this technique (to be exact at 04:50. I'm so excited
Amazingly. When l first viewed it, l hurt to even watch...simply amazing. Good job.
It is so easy to do aswell with practice and patience. A few things i do differently, i would have him sit on a chair, that way when the muscles are relaxing it is much easier for the individual to align their body, shoulders back, chest out, breathing, just keep that external rotation, massage the trapezius, the anterior deltoids, the biceps, and they will naturally hunch over, tell them to sit up, chest out and it will go in. It is like being a locksmith, it just takes time, patience and the right touch.
Oww I know this hurts and I know he was in a lot of pain but it popped back in place he feels so much better now and I know now that this can be fixed
You can see his shoulder go back in place at 5:56 great technique doc 👍🏽
Yep. Its all relaxing. But first time is terrible. After a few 10 times you learn and can do it by yourself
Awesome!!! It was a learning experience watching this video.
wow that was the most excellent technique I ever seen
Hi sir, can I get my shoulder reduced?, is too broad
Looking this up as I just had to do it to myself, while in the sea. What I did was grab my left wrist and pull it away at 90 degrees from my body, straight forward. It popped straight back in with no pain. Then I was able to get to shore.
It certainly looks easier with help, but you CAN do it by yourself if you are in a bit of a spot.
Is this a recurrent case because no pain at all
Wow,it's amazong to see the shoulder comeback to the original position
Could you imagine if psych doctors were this good. Lol. Really great job. Actually teaching and caring about the patient.
After having had a few shoulder dislocations, I was gritting my teeth the whole time. Every time you said 'pain free' i felt sick........ Dislocation was way worse than childbirth for pain. I admire people who can be reduced without pain meds...... So painful.
I worked in the er we would start a line use vec and an opioid and would use traction and force it always seemed traumatic and horribly painful. Never saw this before pretty cool.
I worked at a military Hospital, and a trainee came in. Very painful. The Dr. Tried 3x and couldn't get it
The Dr. Had his wife a pediatric Dr come down to the ER. She grabbed 2 towels and had it manipulated in 1 minute. It was amazing. This was originally very painful, the patient wailed like 3x. But after seeing the tiny female Dr he agreed for 1 more try. Human body is amazing.
Wow. Hope I'm that fortunate to have that type of care, if I ever have to have a reduction.
Amazing. I hace my shoulder that. I am going to show this video to my practioner. Many thanks for sharing.
A very interesting way. It depends on the patient's ability to relax. Can intranasal or intravenous pain relief help with this so that there is even more relaxation of the muscles?
10 cc of propofol and it’s done, 30 seconds, no pain
Might be a good time to intubate him too
with 10cc
Yeah, but for numerous reasons people can't just get 10 cc of whatever here and there. It's not about which is better it's about teaching the alternative. If all they ever taught people was to push injections everybody who can't have those injections is fucked. There is someone allergic to EVERYTHING. There are people allergic to water, allergic to the sun, allergic to their own sweat, there are people allergic to activated charcoal, which I did not know was possible, there's people allergic to cotton which is generally thought to be the most basic natural textile that there is. There's people allergic to semen. I didn't know that was possible either. Someone can be allergic to it, so you have to have an alternative that doesn't include medication, especially for something as simple and gentle as this.
@@taylorbraithwaite3337I still don't thrust women who say they're allergic to latex tho
Here in Indonesia, an expert who cure dislocation join us called as sangkal putung. That's good to see that western modern medication use the technique as well.
Wow, beautiful. Well done!
Wow
Great job 👍❤️
I cant imagine these guys would finally open their eyes to the reality that masking is not doing anything no matter how much u feel like a hero
Вроде бы это один из методов вправления вывиха плечевого сустава, описанный в мед. книге. Сгибаем в локте, затем поворот кнаружи, затем внутрь.
I just had this done and all I can say is worst pain ever and thank god my dr gave meds to make me sleep while they popped it back in place
As a future OT I'm blown away!!!!!!
Where was this Dr when I was having a fracture in my arm reduced by three male doctors basically on top of me! Not pretty! Didn’t work either because it was an open fracture for which I needed surgery anyway!
90% of doctors are bad...make sure to embrace that last 10% when you find them. They actually care for people
Well… not there, that's for sure. 🙋
This is a dislocation not a fracture, ans not every dislocation is treated the same way
@@jasonMB999 this was at. A teaching hospital so I really think they wanted a chance to “practice” their dislocation procedure. Because the bone wasn’t lined up properly they wanted to try to get it lined up before the fracture was repaired. There are different reasons to try to reduce a fracture or line up a break in the bone. These residents have a huge ego and love to try something and brag about it afterward! Just because I had medication on board doesn’t mean this isn’t going to hurt me!
@@donnadavidson3904 they abused you. You should've demanded anastasia
Props to the patient. I would not be willing to deal with a student doctor.
I can’t tell you how many times I dislocated my shoulder and put it back in place on my own. I eventually had surgery and no more problems.
The teaching Dr sounds like Rick Steves🙂. Well done.
Steps:-. Traction
External rotation
Abduction
Medial rotation
"TEAM"
How is this so comfortable? I've heard that putting a dislocated shoulder back in is extremely painful
I dislocated my left shoulder when I was 7YO. I was a tiny little girl back then when a big fat 6th grader fell onto me in the bouncy house during a fun fair at school. I didn't want to go to the hospital even tho I was in so much pain. One day my brother in-law said to me "Stop spoiling your pain just do it" just because I can't undress myself (Note: he didn't look at me when I'm undressed he just heard me because I was moaning in pain to my sister). But I did what he told me and I put my hand up and it popped back in place.
Amazing! I was gritting my teeth the whole way through. What a great job, and no pain! Wow.
I always liked the grunt and pull techniques
It’s really helpful, thank you so much ❤