-Hi, I’m Bob Schrupp physical therapist
-Brad Heineck, physical therapist. And together we are the most famous physical therapists on the internet.
In our opinion, of course Brad, I think I figured out why the Vikings are having so much trouble at the quarterback position. -Because they suck? [laughing]
They suck, but maybe– maybe he has a rotator cuff tear If you have a rotator cuff tear, you can’t throw very well.
-Maybe we should talk to the trainer. Yeah, maybe we can give them some hints but– and that’s more to do with you today We’re going to give you three signs that you might have a rotator cuff tear If you’re having shoulder problems We want to show you three tests you can do to determine You know– if it’s a possibility
-Right I still could be other thing right, but this would help narrow it down First off, when you have a rotator cuff tear– Well what is a rotator cuff, first, Brad? Well the rotator cuff– so we have a video on the pronunciation, but won’t go into that but it– helps stabilize the shoulder joint into the socket.
-Exactly It’s a very shallow socket that–
-Four muscles. Four muscles that work together to hold the bone into the socket They also do certain movements, and that’s what we’re going to be testing. -You bet
-So if you tear your rotator cuff you’re actually tearing the tendons on it and you’re gonna probably have pain, first off– and you can do this, by the way, If you just want to know what leads up to a rotator cuff tear, it can happen over time, -A lot of them do -Sure
-a repetitive motion A lot of them happen if you are 40 and over, which fits right in our genre, doesn’t it Brad? Absolutely, 40 and over, subscribe right here.
-Yeah, if you’re 40 and over we’re gonna provide you videos on how to stay healthy and fit and pain-free
-You better believe it. Going back to what we were talking about, if you’re 40 and over, or even if you’re not, you could do it obviously with an athletic event but also, a lot of them occur over time.
They just get wore out. Your blood supply, as you get older, is worse to your shoulder, and that also makes it more susceptible. So, you’ve got the four muscles.
You’re going to have pain, obviously, a lot of times right in this area, and it can refer down.
If it goes past the elbow, it may not be it, It may be more likely a nerve problem
-Right So, these are the four tests that you want to do– three tests. I guess we have four -We’ll call it three… with a bonus
-Three with a bonus okay, so first one is– one of the first muscles– the most commonly commonly involved muscle is the supraspinatus.
You don’t need to know that but– and the way to test that.. Do you want to be the tester, Brad?
-No, you be the tester. Well, then you gotta stand up.
-Okay The supraspinatus, by the way, the muscle behind the supraspinatus is here. The tendon, comes right down in here
-And the muscle does this… -Right, elevates the arm So, Brad is gonna– Let’s say, we’re gonna say the right arm is always the problem arm -Sure
-Okay? Maybe turn a little like this.
So we’re going to have him put both arms up, turn it down, like you’re emptying out a can, That’s what it’s called, in fact.
Your arms are about 30 degrees forward And up to close to 90.
I think that’s where they tested. And all you do is have somebody push on here If you push right above the elbows… and push
Now this one gives way– Let’s do this arm because they can’t see– Okay, sorry. This is the involved arm.
-Right. Ow! I push on both equally, and that one just gives away.
Could be a rotator cuff, could be tendonitis or impingement, but it’s starting to give you a sign that it might be a rotator cuff. One you could try on your own, is, you can just take– if you have trouble with this arm, you can’t even raise it up, ake it, and use the other arm raise it all the way up…
and then start bringing it down. Let’s let it come down. Let it come down to the side, Brad, and if it gets so far and then it just drops That’s the drop arm test
That means that you most likely have a tear and it’s not holding up.
You have a rotator cuff tear. So I’m gonna bring it up, and then let it down, and see if you can let it down slowly and if it goes like that -Pretty good sign you might have a rotator cuff I know I had a patient, I’ve seen this in a number of patients with rotator cuff tear, you ask them to lift their arm and it’s so bad, they go like this…
-Yeah -They do substitution
-A lot of compensation -Hi Brad
[Laughing] Anyway, all right another test, now for a different muscle. This is the teres minor and the infraspinatus. Muscle here, and –they’re both down here on the lower part of shoulder blade, also attached here. So again, this is the weak arm.
Turn a little bit I’m gonna push in… like this. and he’s gonna hold it, with his arms at a
90 degree angle Push in.
If that arm gives away could be a rotator cuff tear. -And it usually hurts
-And usually it hurts along with it. Last one is the lift off test.
You can actually do this one on your own -Do you want to show it, Brad?
-Sure -So you just put behind
-Like this, like you’re going to scratch your back Instead of doing that, you lift your hand away from your back, like that. Maybe you could get better with this arm here. Well if you can’t lift your arm away, you may have a tear, because that’s not– -If you can’t
-If you can’t If you can’t lift it, you may have a tear. Okay, so just very quickly, the tears that usually happen, there can be a partial thickness tear and in that case, the tendon just looks like it’s been roughed up and probably that’s that’s not something you’re going to– You’re definitely not going to have surgery on you.
It’s just something, hopefully that’ll get better over time. Two, we can have a full thickness tear, where there actually could be a pinpoint spot, that goes all the way through the tendon
or a bigger, a larger hole and then there’s also the full thickness tear, with actually complete detachment This actually can show this on here. This is just–
We’ll take one of the muscles here Here’s the subscapularis, and you can see it attaches to the bone here. You’re gonna have to bring that in, Nancy. This is– the white stuff is the tendon.
The muscle narrows up to a tendon. And it actually completely detaches from the bone. And it could actually–
the muscle could actually retract away [Brad] Yeah, it’s no good. -So, in that case you’re gonna probably need surgery
-Right they’re gonna have to go in there and reattach it. But, so again, the three tests are– The first one:
The empty can test, ok Woop
Internal test The pull-away-from-the-back test
-And then the one you can also add in is the drop-down test.
-And let down, oh! -All right, good luck!
-Have fun with those tests, but be careful.