Rotator Cuff Tear Evaluation with @orthoevalpal
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- Опубликовано: 29 сен 2024
- A huge Thank You to our patient Marc who allows me to video his shoulder evaluation. In this Rotator Cuff Tear Evaluation with @orthoevalpal I show some special tests, discuss injuries that can mimic a rotator cuff tear, do manual muscle testing and bring the evaluation to a conclusion with our diagnosis.
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Great eval from former M.D.
Thanks Wayne!
The 'hiking of the shoulder' was the most difficult issue for me to overcome with my pre-op and post-op process. Standing in front of a mirror and concentrating on my movements was crucial.
How can you tell the difference between a rotator cuff tear and a frozen shoulder?
Thanks for showing the video, I have the same injury. falling off a Bucking Bronco machine, fascinating seeing what I have done.
8:00 That caught me off guard
Why "the larger the tear, the less pain at rest"??
Shouldn't inflammatory conditions have pain at rest but ease off during activity?
less of the tissue to tear more if it is a large tear. Good question
@@OrthoEvalPal Same here. I had a complete tear and the surgery did not help. I was in more pain as it was in process of breaking down than I was with the complete tear. Now it make sense. Unfortunately, now a complete shouder replacement is on the horizon. Thanks for the knowledge.
That caught of guard as well.
Hello Doctor! I am 32 and I had a rotator cuff tear (or severe damage when I was 21). I kept up with resistance band exercises and have had dislocations every often. however, it's been a few months that I feel a very sharp and hard neck pain mainly on the affected side. first it happened after a normal dislocation while lying down and it got better after some days of caring and recently, it happened while I was working out in the gym, more specifically after rear shoulder barbell press. not immediately after that, but after one exercise after the rear shoulder barbell press (once I performed chest press afterwards and yesterday I performed Shoulder shrug heavy weighted afterwards). I am not sure if it's a muscle strain or a nerve pain. and I would appreciate a lot if you respond to this comment and help me knowing what is going on with my neck.
thanks
What is the difference between Bear Hug and Belly Press and Lift off tests when all three is for the same Subscapularis muscle? Please explain the subtle diffrence.
The Bear hug and Belly press are relatively similar. I think two different people wanted credit for a subscap test. The Lift -off on the other hand eliminates the other internal rotators such as the pec major, Lats, Teres major, and places the subscapularis in a more efficient position to internally rotate. Some people cannot get to the lift-off position because of arthritis or capsular stiffness so I fall back on the first two.
Paul ,can you tel please ; "Deteorated Supraspinatus Tendonitis " it is accepted as disability at the age of 60 ?
Three plus years ago I fell off my bicycle going about 25 miles an hour onto concrete sidewalk. It took a long time to raise my right arm and now I usually raise it up like they teach you in the military to shoot a rifle when I eat. Raising it up in front of me I feel like something jumping over something else. I've been to these so-called orthopedic doctors and surgeons and they've never told me what's wrong they looked at x-rays or whatever and I need some help but I only have Medicaid. I even went over 50 mi away to an orthopedic surgeon but he wanted to take more X-rays and acted like he couldn't get my x-rays from the city I lived in at that hospital. I just don't want to be x-rayed anymore because I've had so much I'm afraid I'm going to get cancer from the radiation. I don't know how I can be helped from posting this but I gave it a shot.
Wish any of the 4 Orthopaedic dr.s I went to were that thorough. Ha rotator cuff surgery still pain under shoulder blade.
Question: I had surgery back in July 2023. Visited physical therapist evaluated and undergone physical therapy for right shoulder supraspinatus and bicep tenodesis post op. Been in physical therapy for five months I was doing the lateral raise up to my ear and anterior raise by my ear as well. The lateral raise hear some clicks on my right shoulder. My therapist tells me its normal until i smooth it out during my therapy sessions.
What do you think.
Paul your videos are great .simple assessment technique. and main thing is real pt. Thanks looking for more videos
Yeah, why did My doctor not do these test he sent me to a physio person who then talked with there people who sent me to for an exray but none of these test were done
Same with me....no test performed but sending me for MRI
Dr, is it ok to run with a partial tear? I play soccer and wondering if I can run while playing soccer.
What if you do have tingling
Need to consider nerve irritation
You are amazing sir , Love from IRAN
Just need a good ultrasound...
Love this video ♥️ made me smile. So helpful!
I tore my right rotator cuff during a basketball tournament. It’s been hurting for 3 days. I made a appointment to see my regular doctor. I can’t sleep on the right side but it does hurt every time I use my right arm
How are you doing now?
@@dingdong6005 doing good now
@@randischlecht2437 how did you heal it ? I have rotator cuff injury it seems and it hurts even when lifting light .
@@dingdong6005 i went through physical therapy for a little while, slowly healed up
How slowly? How long did it take?
What is his bicipital groove tenderness attributed to?
Thank you so much for the awesome videos!
HI Lilli, the torn biceps, retinaculum and bursitis. He just had his cuff repaired 3 days ago and doing very well.
That’s so good to hear and thank you so much for your prompt response!
V informative
Thanks to u and ur patient patience he is a great man
Chiropractor here. Love the videos and find them very informative. Patient was in quite a bit of discomfort. What did you do for pain management and did patient not fair well with active care which led to the MRI referral and ultimate surgical repair? Thanks
great video! very informative, i had a nice little wreck over my handlebars the other day & have some stiffness & pain. I passed all these tests with only minor pain, able to raise it fine in all directions and resist force pressed against it. safe to say I have just sprained those muscles?
Ouch! Probably. Don't let it linger too long though.
Excellent video! How long would you recommend physio for very limited ROM before MRI/CT Scan.
Sir do scar tissue form over time even without surgery?
Not with rotator cuff tears.
Very clear and I live you progress with your treatments as the patient feels
My first time here.. what’s if my hand can not go behind my back and I’m in a lot of pain. Also my breast is swollen and behind my shoulder arm too. I also feel pain when I try to lift it up.
Please go for Xray. Will show everything even if you have calcium build up . I pray for you
See if you can unhook a bra or comb your hair. Maybe you have adhesive capsulitis or frozen shoulder. Although im not sure about the swollen breast
@@kmsy200x-rays for bones what she wants is an MRI
Why does he have tenderness in the bicipital groove?
Lots of inflammation in that area.
Was there a follow up video to this? I have full subscapular tear and partial supraspinatus. I have full range of motion but AC joint pain in actions and at rest.. Surgeon advised rotator cuff surgery curious to know if it's common to have surgery with full range of motion
I love your videos.
I have a left rotator cuff injury...its been 5 yrs. Went to 12 wks. Of therapy only missed 3 days..ot w better but starting to hurt again. A d my left .isveryvery painful..could I have Rotstor cups at same time
@4:40 "Obviously I don't want to kill him... (Because his left arm and fist still work well!)
Why does your passive movement not exacerbated the painful arc or the flexion of shoulder?
When you actively lift your arm, your deltoid superiorly migrates the humeral head which causes more impingement whereas passive ROM doesn't do that. Plus this guy has no rotator cuff to depress the head with AROM
@@OrthoEvalPal Thank you very much
This was very helpful. Thank you!
I’m having severe pain when I sleep is the good news that I probably don’t have a tear??
excellent presentation for rotator cuff exam and differentiating shoulder pain.
really brings out the flow of exam for quick shoulder and upper extremity exam. it looks like you missed the obrien's test for SLAP tear. probably ddint need it as his biceps test was normal.
Hi Stephen, I often test all of that during the first evaluation. When I have a diagnosis, I keep the video short and to the point just so it is not so lengthy for the patient. He did have surgery, RCR, no labral injury. Good Question!!
Thank you again sir
I have a very similar problem to the one you have just demonstrated in your video, but I had a lot of pain at night when I laid down, ( but eased it by resting my arm on a pillow for support ) I have had this problem for four years now, the night pain has ceased or abated quite a lot, but I have a lot of weakness, when I raise my arm away from my body, it will then become very painful and my arms strength will give out and just drop.
How did you get on?
The legend says he is still emptying that can
Can I send you my MRI,Sir?
Sir do you have a video how to proper bend my knee because its limited to 90 degrees after my leg operation i cant afford for a therapist hope you can help me sir thank you.
This video is excellent!!!!
Thank you Taras!
I have my shoulder pain for five years.
Very interesting, I am 75 years old and my left shoulder is much like the person you are working with. Sleeping was OK at first, my injury was 15-20 years ago I think. I saw a dr. at that time and he tried cortisone shots that didn't help at all so I had PT for 10 weeks but that didn't help much, paid for by employer health coverage. I then went to a dr. who measured for tissues at the bones and said I had arthritis, and said pain can be managed by analgesics until they don't and then shoulder replacement is recommended based on my pain level. Arthritis or rotator cuff injury the repair method is the same, surgery.
Hi Robert, the repair procedures are different. Very different
Great and simple clinical reasning! Thank you for your all videos!
Question: why have an MRI after the different treatment and not before?
Wouldn't be better to have the MRI first to see what is exactly the problem? I have my appointment with an orthopedic doctor soon, and I wouldn't want to go through all the treatments and then have to have an MRI. Please explain. Thanks
because 95% of the time cuff injuries are not serious, and settle with rest followed by appropriate exercise.
MRIs are expensive.
You are always free to put your hand in your pocket and pull out $3000+ for a MRI before physio treatment.
But Medicare prefers you get physio first.
thank you!
You're welcome Rich!
Very helpful video. Pretty sure this is my problem I will find out tomorrow
Glad it was helpful Kevin! Best of luck!
what's his MRI results??
Hi Samir, Just had MRI. Supraspinatus and infraspinatus tears and some tearing of the labrum.
Ortho EVAL Pal With Paul Marquis
Hi Paul , if there is something at teres minor?
Thanks for your amazing videos
@@OrthoEvalPal was the muscle itself torn or showed atrophy?
@@HeyIntegrity it was torn and then repaired
Athletic Training student here. I love listening to your podcasts on Spotify while I'm out on my morning runs. Thank you for the very helpful and interesting content!
Hi Brian, So glad you are enjoying the show! Lots more to come. Spread the word. Best, Paul
I had a stiff and painful shoulder. Orthopedic doctor touched my shoulder and had me do some resistance and said I need surgery for a torn rotator cuff. He scheduled an MRI. it’s been a week now and my movement is back 95% and no pain. No MRI yet.
Is surgery really needed at this point?
Do you have Instagram?
Look up “Thephysiofix”
@@davidjitt8097 yes. I looked up thephysiofix. There are three accounts under that name. which one do you recommend?
How are you doing now?
@@dingdong6005 I have recovered well. Did a cat scan and it showed a hairline fracture. Dr. Now says no surgery needed. Thanks for asking
What is the immediate remedy if rc tear shows in mri?
Immediate?
@@kalenaglory2483 I mean what is next step.
Thanks so much Dr really good explanation God bless u and keep u healthy
Similar case. Could you please send me a link how to do phisiotherapy for this? Thank you so much.
As someone who is really self conscious about their body, do you get to at least keep your socks and underwear on during surgery?
I have 5 tears…. I’d smack doc with good arm if he hurt me 😅 kidding doc ❤
He's a big boy. The doc ought to put him on a slim fast diet.
Oh brother.