September 19, 2019
Rotator Cuff Shoulder Pain: Exercise is as effective as surgery.

Rotator Cuff Shoulder Pain: Exercise is as effective as surgery.


the shot is an amazing joint it does explosive activities we can wait there through our shoulders we can take a whole body weight through our shoulders we use our shoulders to position our hands to perform high precision activities the shoulders got more mobility than any other joints in the body it goes through more range of movement it can tuck our shirts and it can pitch baseballs at control cricket balls or conservative tennis it’s got more motor movement than any other joints in the body and it’s also got the fastest movement of any joint in the body so if you look at some sports such as baseball people can move through an arc of 80 degrees and up to 9,000 degrees a second so they’re moving with incredible speed 50 accelerating their shoulders at around about half a million degrees a second squared and this is all occurring in a joint that doesn’t have much bony stability so what’s really exciting from my perspective about the shoulder is a lot of the stability and a lot of the movement is totally dependent upon muscle function so a lot of people will be given a diagnosis of burr scientists or rotator cuff tendonitis or rotator cuff tendon appa the– which sort of implicates pretend and related structures but we don’t really know where a patient’s symptoms are coming from and it’s it’s hypothesized that it might be coming from the tendon tissue the bursa tissue and so there’s been an assumption for a long time that if you see a change on imaging it explained symptoms but it clearly doesn’t so we know that up to 96 percent of people who have no symptoms at all who have an ultrasound scan might have findings such as versal thickening tendinopathy partial thickness care support thickness tears label damage the implication of that is quite serious because what it means is that people who have positive clinical tests and positive imaging findings such as a tear might be recommended that surgery is a good option for them and in many cases it might be but the problem is if you’re making clinical decisions based on on imaging that can’t really tell us where the symptoms are coming from then a lot of people maybe 50% of people will be having operations on tissues that are not causing those that their symptoms so they think a whole battery of shoulder special tests that have been recommended for clinicians to perform these tests have been designed primarily on anatomical basis that in a particular position you might be contracting or compressing a particular tissue you might be stretching a particular tissue the problem of the special test that all the tissues around the shoulder are innervated they all have a nerve supply and that we’re testing multiple structures protesting the moment you’re testing more than one structure it’s very difficult to know what actual structure you are you are implicating and the other problem is the idea of the special tests are that they are designed to the rule in a particular structure or rule out a particular structure so the way that evidence-based practice is formulated is that when you’ve got a clinical test that’s positive you need to compare it to a diagnostic test so if someone had diabetes you’d be comparing the clinical signs such as fatigue and tiredness increased frequency of going to the bathroom against a gold standard test a blood test that would help the clinician rule in or rule out the possibility that the patient had diabetes the gold standard test in orthopedics are going to be MRI ultrasound x-ray or observation of structural failure during an arthroscopic procedure the assumption here is that the observation of tissue damage is where the symptoms are coming from so we compare a test for supraspinatus clinical test against a finding of an ultrasound that the supraspinatus is damaged or torn partially or completely but as I mentioned earlier there’s been now old wealth of studies published that showed us a very poor correlation between imaging findings and where symptoms are coming from so we don’t actually have a gold standard reference test to compare the clinical tests against and so in all honesty the special tests are not special at all so the special tests we could say as simply tests that might like symptoms but you’d be a very brave person to actually say you know where those symptoms are coming from we really need to be using careful language with our patients we need to be telling patients or the surgeons need to be telling patients that tears may be causing symptoms but they may not be causing symptoms that if we look carefully at the research evidence there’s an equal chance of getting better with an exercise based program for people who are diagnosed with impingement for people who are diagnosed with partial thickness tears that are a traumatic and full thickness tears that a dramatic as they would be surgery so we need to be telling patients that they need not to worry about the tear in many cases that it’s something that happens but doesn’t necessarily cause symptoms that exercise based approaches are just as effective as surgical based approaches for many conditions and that if a conservative based treatment of an exercise based treatment a non-surgical treatment approach isn’t helpful then of course then surgery is a very appropriate procedure to consider but not to rush to it just because of what the imaging identified in people without trauma [Music] you

100 thoughts on “Rotator Cuff Shoulder Pain: Exercise is as effective as surgery.

  1. Best exercise for the shoulder even when injured is to do static hangs from a lat bar! That's it. That's all you'll ever need.

  2. check out mark rippetoe and his view on the topic. overhead press is really good for the shoulders. the last exercise in the video is an overhead press but bodyweight is too much weight for rehab.. theres also an article by bill starr on the topic of overhead press you can find if you google

  3. I've been following the Kirsch Protocol ….. Same theory. I've been doing static hangs for 6-8 weeks and light dumbbell work and I'm basically pain free…..

  4. Someone doing the exercises doesn't really teach them. I was waiting for more details in sets/reps. What a shame..

  5. Great video! I suffered with reoccurring shoulder injuries for years. After each injury I was advised surgery would be necessary. After doing some research I realized that I needed to strengthen my shoulder muscles to protect the tendons. So far I have had great results. 🤞🏾👌🏾

  6. Very interesting video….true…no testing…MRI, XRay, ultrasound can "find" exactly what/where the pain is manifesting in many ways. Sometimes…like Tinnitus, I believe, it originates in the brain for one reason or another.

  7. it is so cool and interesting video. intensity and what type of exercise should be apply for treatment are not mentioned.

  8. For the latest research and treatments for rotator cuff pain, check out the full 40 minute interview with Dr. Lewis: https://fxnlmedia.com/2017/04/exercise-surgery-rotator-cuff-shoulder-pain

  9. I considered surgery 15 years ago, tried light machine overhead presses with light weight, 70 pounds. Seemed to improve. No pain in 2 months. Presses 150 pounds 3 reps after 1 year.
    Worked out 2 to 3 times a week, was patient

  10. Such exercises caused my rotator cuff problems (tendon tear likely, awaiting ultrasound ) in the first place. Actually I could not dream doing anything like that due to pain and lack of function and inability to rotate arm (thanks to those exercise, duh!).

  11. yes. neither solve anything. the most common cause of joint problems is neurogenic muscle weakness and elongation, and the only solution is to get the causal nerve interference corrected by an hio method chiropractor.

  12. Thank you doctor; amazing information. I got pain and I was sent to physiotherapist but I decided to learn by myself about arm anatomy and what I was diagnosed in order I contribute to my healing process. I have also been taking natural bromelain and turmeric anti-inflammatory.

  13. I need shoulder replacement on both shoulders my r.o.m. is.practically nil will stretching and strengthening help with my pain and r.o.m. ?

  14. Thank you. I injured my shoulder in April2017 and avoided orthopedic doctors just to do PT. Almost one year later and have regained almost all use and almost pain free.

  15. Interesting.. when you say a-traumatic, do you mean the absence of a severe injury such as a dislocation?

  16. I had my left shoulder (I'm right handed) labrum repair along with CV joint grinded down due to arthritis. I lived with the tear for 2.5yrs before going to the doctor. Had me do PT and there was no change. MRI showed the frontal labral tear and a cyst that the tear caused. Been 5 months now, range is 90% back, but i still have pain. I am working out again and strength is coming back. Had me start PT 10 days after surgery. Doctor said pain will be gone at the 9 month post op period. Now fun having this surgery, avoid it if not necessary.

  17. A Quick heads-up warning of Graphic Images before showing graphic images of cadavor muscles would be kind and respectful to the average non medical personel Thank You

  18. I have a pain that goes from the tip of my shoulder and it's a nerve pain that goes up to my neck to my ear what causes that

  19. hi everyone ,if anyone else wants to learn about shoulder pain help try Seans shoulder fixer ( search on google ) ? Ive heard some super things about it and my buddy got great results with it.

  20. FXNL Media. I know this is an old thread, but I just found you! I wonder if you can help me figure out my right shoulder… The 1st part is: I can lift my arm almost straight up with moderate pain and stiffness. I can put it down to my hip but to my back only with pain and assistance getting there. The pain isn't acute, just a feeling like I'm bending my shoulder way too far. The 2nd part is: If I hold my arm straight out in front of me and cross my straight arm over to the left it feels like my shoulder is coming out of socket to the right side. If, from there, I transition to the position with my elbow down to my side and my fist strait up, this movement is very difficult / weak and it feels again that my shoulder is unstable on the outside right. How can I stabilize and strengthen that better? And, how would you address the stiffness? Does repetitive stretching help ? My left arm is day and night different with no limitations whatsoever.

  21. i feel so much pain in my right shoulder when I threw cricket ball or throw javelin throw.
    please answer me reason.

  22. Perfect, the profound details are very much needed. My neck and my shoulder blade hurt from a fall, and they don't want to seem to address the shoulder.

  23. I injured mine doing flys 20 years ago. Now when wearing a t-shirt i can see my shoulder has rotated forwards.

  24. More than 10 times I got shoulder dislocation. lastly I had before 10 months . What can I do ? Any options other than surgery ? Can I cure this without surgery ? Please tell me sir

  25. That pitcher… move is not much different from the move I made last Monday and my shoulder went CRACK! Also felt like my shoulder jumped out of socket.

  26. put another way, both are equally useless. this is because the root of most such problems is something medicine has no knowledge or training whatsoever in, subluxation caused nerve interference, and unless and until this problem is corrected by seeing the appropriate upper cervical chiropractic specialist, there is no possibility of real resolution and healing of the affected joint.

  27. Bullshit. All you supposed professionals make it up.
    It's rubbish. You make up it all up to suit your fucken agendas. All to maintain funding and all to exploit patients.

  28. Sir I am suffering from hill sack lision and in India doctors are not that good to cure this
    I did therapy for about 8 months and after that when I play again the problem was still there
    I am suffering from imegment pain
    Can you help me and guide me sir

  29. specialist told me i had a SLAP tear, referred to surgeon who charged $200 for 3 mins check and said i wont be able to pull up again and even after surgery. Later i changed my mind and started light exercise then cancelled the surgery. Few months later i can do pullup again without pain and now almost 2 yr later i can do more pullups than before. Exercise does wonder, but yes the recovery is slow, but the main thing is to be patient and don't rush it.

  30. Fuck all this crap! Stop eating sugar, bread, pasta, rice, legumes, alcohol….. this will solve it all without exercise! Or keep eating this shit and continue to pay your doctor to treat your symptoms. Sad how easily lazy humans are fooled

  31. Oh! I liked everything that the Surgeon spoke in this video about shoulder problem diagnosis. It is an eye opener. This is Anthony from Santacruz, Mumbai, India.

  32. It is true!!
    I have suffered with a ripped rotator cuff for 6 years, I thought I would never work out again.
    I started of slowly and mild weights,
    I am so happy to say , it’s been 4 years with no pain at all .. I would say it’s like therapy…
    Just make sure you know what you are doing before you start, remember you want to make it better not worse. Have a nice day

  33. There was a lady doing shoulder exercises at the end of the video, how can I see the full version of it. Haven't seen those before.

  34. Started exercises and a minute each hour lengthening to 5 minutes, until I could do 10 minutes without causing pain. Simple ones from Robin MacKenzie. Worked a treat, can sleep again!

  35. I can't even wash my hair or put on a coat without nearly crying; even allowing my arm to swing naturally whilst on a gentle walk is enough to make it seize up later. Gentle stretches advised by a physio made it worse.The exercises here look pretty extreme. Are there any beginner exercises that don't involve curling, or hand stands? I think I might just die if I attempted anything here.

  36. If its the front inside of the shoulder its a LUNG issue.

    If its the top, its a LARGE INTESTINE issue.

    If its the back of the shoulder its a SMALL INTESTINE issue.

    This is true unless there is an actual shoulder injury. If you have the pain one day but it's gone the next day then it's not an injury if you have it for a week and then the next week it's gone then it's not muscular or structural. If it is muscular or structural than everything I said above is not true. If it is not muscular or structural what I said above is true. I have been treating people with non injury shoulder problems for almost a decade.

    If you learn the Meridian system of the body you can isolate and figure out what pains are actually signaling. The Chinese have known as this 3,000 years. They don't do surgery, they don't take drugs, they don't do any of the insanity that we do in the west and their medical system with few exceptions works much better than ours IMO.

    A good app to understand the Meridian system that I tell my clients about is Easy Acupuncture.

    When you figure out what organ of the body is failing and resulting in pain along its Meridian you can then address that particular organ. I address the problems with homeopathic, naturopathic, or plant-based remedies. No drugs, no surgery.

    This is just my opinion based on approximately 8000 hours of treating people. If you don't agree and have some type of hateful input please don't bother commenting. I won't read it. If you would like more information I can certainly steer you in the right direction. I don't do this for money, there's nothing I'm going to sell you.

  37. You have to eat right if you don't eat right it'll cause inflammation in the joints and I think that shoulder is one of the first joints to get inflamed next to the knees

  38. This will only agrivate the cuff if there are calcium spurs that need to be removed by surgery- Been der dun dat

  39. i am jansher from pakistan in my problem is my one shoulder is that porblem plez any idey in a besta doctor my number is 03464494423 plez

  40. What's with the girl exercising like she's training for the Olympics. She doesn't represent people with major shoulder pain. Good Grief.

  41. Ive just come back from the Physio and they told me my rotator cuff was damaged ( which was pretty bloody obvious ) then they gave me a series of exercises. No untrasound or X-ray just these exercises. Started them yesterday went to sleep last night as was in friggin pain most of the night. The pain was on it's way out until i started doing what they suggested.

  42. Thank you, seriously damaged my rotator cuff in a auto accident and after much pain with typical physical therapy I decided to not have surgery and work with a little bit heavier weights a little bit a time and got my shoulder back to 90%, after falling off of my motorcycle and hitting my shoulder yes the same one here I am again but improving much with exercise and so don't give up.

  43. I had a friend that his son always have problems with his shoulder,as he was playing prop in rugby.I start to think he was a shook,as everyone time the physio say he can play,he goes in and come out with the same injury.So the physio has to tell him to rest again.Usually rest for more than 4 weeks.One time he was only injured for one week then the following week,he was playing and to my surprise I thought he was not injured at all.I asked father,what happened that he last this game.He told me that a friend told him that his son was looking at having to operated on the should until this friend of his asked if he could have a look.He moved it around and massage it and told him his son can play in two weeks and since then have no shoulder issues.So this guy told me he took his son to the same traditional healer and that’s why he is good as the physio only say its the AC join and need rest.Since then my boys have shoulder injuries to and straight away I take them to this guy.The physio says rest for at least 4 weeks,the guy said once the bruise is good after icing them it’s all good as he has put back the tendons and muscles to their right positions.And the good thing is he does not accept payments as he believes it’s a gift given to his family to help others! I agree with this guy above,most just assume,but the guy I take my kids to move the shoulder around and feel the tendons and muscles even though it’s so painful .When I first took my son there,The doc say it’s not dislocated but slightly of by 5 mill but just rest and ice. I took him to this guy,and my son has not able to move the shoulder for a 3 days.The guy fiddle with it and all of a sudden he said to wait for the pop,the shoulder pop in and my son could rotate his shoulder as normal as it used to be.He told us to keep icing for the bruising to finish and play in two weeks,and it has been fantastic but he recommended to tape it

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