Rotator Cuff Tear Evaluation with @orthoevalpal

Рет қаралды 128,187

4 жыл бұрын

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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Пікірлер: 96

@TES-bt8sv Жыл бұрын

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.

@yolandamendoza732 2 жыл бұрын

Very clear and I live you progress with your treatments as the patient feels

@badalkc4697 2 жыл бұрын

Paul your videos are great .simple assessment technique. and main thing is real pt. Thanks looking for more videos

@CardieTrick Жыл бұрын

Thanks for showing the video, I have the same injury. falling off a Bucking Bronco machine, fascinating seeing what I have done.

@marciaturley2850 2 жыл бұрын

Love this video ♥️ made me smile. So helpful!

@zahidkhan-dv8uc 2 жыл бұрын

V informative Thanks to u and ur patient patience he is a great man

@crosser8 4 жыл бұрын

Thank you again sir

@aleksandarmilanovic5697 4 жыл бұрын

Great and simple clinical reasning! Thank you for your all videos!

@kristimoore5807 3 ай бұрын

This was very helpful. Thank you!

@TheNilda437 2 жыл бұрын

Thanks so much Dr really good explanation God bless u and keep u healthy

@tncooks 2 жыл бұрын

Wish any of the 4 Orthopaedic dr.s I went to were that thorough. Ha rotator cuff surgery still pain under shoulder blade.

@tarasdeputat5343 3 жыл бұрын

This video is excellent!!!!

@OrthoEvalPal 3 жыл бұрын

Thank you Taras!

@richt6353 2 жыл бұрын

thank you!

@OrthoEvalPal 2 жыл бұрын

You're welcome Rich!

@trs1965 Жыл бұрын

How can you tell the difference between a rotator cuff tear and a frozen shoulder?

@briansundayatc 4 жыл бұрын

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!

@OrthoEvalPal 4 жыл бұрын

Hi Brian, So glad you are enjoying the show! Lots more to come. Spread the word. Best, Paul

@trevorn5116 3 жыл бұрын

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

@alonie5537 Жыл бұрын

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

@catherinemillard9623 11 ай бұрын

Excellent video! How long would you recommend physio for very limited ROM before MRI/CT Scan.

@kevinimmel197 11 ай бұрын

Very helpful video. Pretty sure this is my problem I will find out tomorrow

@OrthoEvalPal 11 ай бұрын

Glad it was helpful Kevin! Best of luck!

@xzx3 Жыл бұрын

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

@vbBegin1957 6 ай бұрын

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.

@aldrinrivera2276 2 жыл бұрын

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.

@NoOneInParticular88 2 жыл бұрын

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?

@OrthoEvalPal 2 жыл бұрын

Ouch! Probably. Don't let it linger too long though.

@sergiubot2923 Жыл бұрын

Paul ,can you tel please ; "Deteorated Supraspinatus Tendonitis " it is accepted as disability at the age of 60 ?

@RobertSander Жыл бұрын

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.

@OrthoEvalPal Жыл бұрын

Hi Robert, the repair procedures are different. Very different

@lilliconner6328 4 жыл бұрын

What is his bicipital groove tenderness attributed to? Thank you so much for the awesome videos!

@OrthoEvalPal 4 жыл бұрын

HI Lilli, the torn biceps, retinaculum and bursitis. He just had his cuff repaired 3 days ago and doing very well.

@lilliconner6328 4 жыл бұрын

That’s so good to hear and thank you so much for your prompt response!

@nofurtherwest3474 9 ай бұрын

Dr, is it ok to run with a partial tear? I play soccer and wondering if I can run while playing soccer.

@waynesinclair483 Жыл бұрын

Great eval from former M.D.

@OrthoEvalPal Жыл бұрын

Thanks Wayne!

@subbuxy 4 жыл бұрын

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.

@OrthoEvalPal 4 жыл бұрын

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.

@nano927 Жыл бұрын

The legend says he is still emptying that can

@stephenjohn904 2 жыл бұрын

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.

@OrthoEvalPal 2 жыл бұрын

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!!

@dorydiavelone3531 Жыл бұрын

I’m having severe pain when I sleep is the good news that I probably don’t have a tear??

@HektorBandimar Жыл бұрын

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.

@amarudieguez3124 Жыл бұрын

How did you get on?

@darylhudson777 Жыл бұрын

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.

@mohamedorayith4626 3 жыл бұрын

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?

@OrthoEvalPal 3 жыл бұрын

less of the tissue to tear more if it is a large tear. Good question

@DHMeister 2 жыл бұрын

@@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.

@salcruz8461 Жыл бұрын

That caught of guard as well.

@nasimgulsahak956 2 жыл бұрын

I have my shoulder pain for five years.

@mohamedorayith4626 3 жыл бұрын

Why does your passive movement not exacerbated the painful arc or the flexion of shoulder?

@OrthoEvalPal 3 жыл бұрын

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

@mohamedorayith4626 3 жыл бұрын

@@OrthoEvalPal Thank you very much

@linhthoaiong6837 2 жыл бұрын

Similar case. Could you please send me a link how to do phisiotherapy for this? Thank you so much.

@amitkumarsharmamaraal687 Жыл бұрын

Can I send you my MRI,Sir?

@randischlecht2437 2 жыл бұрын

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

@dingdong6005 Жыл бұрын

How are you doing now?

@randischlecht2437 Жыл бұрын

@@dingdong6005 doing good now

@dingdong6005 Жыл бұрын

@@randischlecht2437 how did you heal it ? I have rotator cuff injury it seems and it hurts even when lifting light .

@randischlecht2437 Жыл бұрын

@@dingdong6005 i went through physical therapy for a little while, slowly healed up

@kevinlapaiz Жыл бұрын

How slowly? How long did it take?

@ki8417 2 жыл бұрын

Sir do scar tissue form over time even without surgery?

@OrthoEvalPal 2 жыл бұрын

Not with rotator cuff tears.

@MariaHernandez-hv3wb 2 жыл бұрын

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

@helicart Жыл бұрын

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.

@nonyofyas 3 жыл бұрын

Why does he have tenderness in the bicipital groove?

@OrthoEvalPal 3 жыл бұрын

Lots of inflammation in that area.

@damodaranp7605 2 жыл бұрын

What is the immediate remedy if rc tear shows in mri?

@kalenaglory2483 Жыл бұрын

Immediate?

@damodaranp7605 Жыл бұрын

@@kalenaglory2483 I mean what is next step.

@tanyablair5893 2 жыл бұрын

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.

@kmsy200 2 жыл бұрын

Please go for Xray. Will show everything even if you have calcium build up . I pray for you

@CloverMeFireStone 2 жыл бұрын

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

@donjohnson8952 Жыл бұрын

@@kmsy200x-rays for bones what she wants is an MRI

@danbrown8310 2 жыл бұрын

What if you do have tingling

@OrthoEvalPal 2 жыл бұрын

Need to consider nerve irritation

@markharwell8793 2 жыл бұрын

@4:40 "Obviously I don't want to kill him... (Because his left arm and fist still work well!)

@GmanfromTexas Жыл бұрын

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?

@davidjitt8097 Жыл бұрын

Do you have Instagram?

@davidjitt8097 Жыл бұрын

Look up “Thephysiofix”

@GmanfromTexas Жыл бұрын

@@davidjitt8097 yes. I looked up thephysiofix. There are three accounts under that name. which one do you recommend?

@dingdong6005 Жыл бұрын

How are you doing now?

@GmanfromTexas Жыл бұрын

@@dingdong6005 I have recovered well. Did a cat scan and it showed a hairline fracture. Dr. Now says no surgery needed. Thanks for asking

@lawrencelebreton6720 Жыл бұрын

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

@Amy-wv1tq Жыл бұрын

Same with me....no test performed but sending me for MRI