I am doctor Heather, Moore owner of Total  Performance physical therapy.
  Tonight we're going to go over what's causing  your shoulder pain.
  And I want to say before we begin, um, I need  to kind of caviat this with generally.
  Um, it's not one thing.
  So we're going to go over several tests tonight  that you can do at home to kind of make up
  a differentiation on what's going on with  your shoulder.
  But a lot of times it's not just one thing.
  And what happens is is people ignore the little  signs that when they start when they should
  be treated.
  They've kind of brushed them off.
  Like maybe it hurts to put your jacket on.
  Maybe it hurts just to reach into the back  seat, but guess what?
  You can turn your body and you can reach into  the back seat or you can just turn your shoulder,
  get your arm in your coat without having it  to really affect anything going on in your
  everyday life so.
  You make adjustments for things and you change  how you do things, which then in turn allows
  you to be able to function for longer.
  And not have to do with the problem, but eventually  what you find is maybe it starts to hurt while
  you're sleeping now and now it's hurting when  it's overhead and you can't do everything
  you want to do at the gym.
  Then you know it really snowballs.
  And the more and more you ignore it in the  longer you, allow it to snowball.
  The worse it is , the more problems you're  gonna have.
  And so that's why it's really important to  understand that while you might do these tests,
  you may be able to fit yourself into all of  these categories, depending on how long you've
  let this go.
  So it's one of those things where, you know,  just to take this with a grain of salt, I
  am going to show you some things you know,  and if you wind up with getting positive tests
  for all of these, you really need to be treated  and you should have been treated in a long
  time ago.
  There's nothing really a home that I can say,  yeah, let's do that.
  And that's going to help.
  It's going to be more of a hands on approach,  you know, we need to get in there and really
  fixed all the dysfunction that's going on.
  So the first thing we're going to go through  is called a roos tests.
  And it's for, it's called thoracic outlet  syndrome.
  And this is something if you determine that  you have not a lot you can do at home for
  it.
  Um, some posture related stuff that you can  fix, but you really need to get in and get
  treated because it is affecting the nerves  and you want to make sure that you're able
  to um, recover.
  And then the worse you let this get you actually  can lose, strengthen your fingers, strength
  in your hands, begin to drop things.
  So you're going to start with your arms out,  elbows up at ninety degrees hands just like
  this.
  And all it is is just this, okay?
  You're just making a fist okay.
  You want to make sure that you're not dropping  below here, okay?
  And you would make sure your fingers are up  and you want to make sure that you do this
  for three minutes.
  Now you're looking for numbness.
  And Tingling every time I've seen this test,  honestly, within like the first minute, somebody
  goes numb or has numbness and tingling.
  Most people who have thoracic outlet do not  make it to three minutes joining us.
  Um, some of you may fatigue, some of you may  get burning in these muscles.
  If you're not working out or you're not used  to holding your arms up, some of you may get
  just some pain in your fingers for doing this  for three minutes but what we're looking for,
  numbness and tingling, and that's really the  caveat that's a positive task.
  Other symptoms, pain, uncomfortable, that's  not indicative of that.
  You've have thoracic outlet syndrome.
  It's really just this and you're gonna get  some numbness and tingling.
  The second thing we're going to go through  is, um, it's called the empty can test.
  This is going to test a specific muscle of  the rotator cuff to see if there's a possible
  tear there.
  And all you're going to do is you want to,  you're not going to go straight out, you're
  not going to go out to the side.
  you're going to go out at a 45 degree angle.
  What you want to do is you just want to turn  your thumb down so it's facing you and you're
  just going to raise up nice and easy.
  You don't want to go past 90 degrees.
  You're not going to go all the way up here.
  It's got a hurt up here.
  I don't care if you have healthy shoulder  and not get your thumbs down and you're all
  way up here, it most likely is going to hurt  so you stop at 90 degrees when you just want
  to go up and down nice and slow.
  All right, this is going to show that there's  a problem with the supraspinatus muscle, which
  is part of the rotator cuff.
  If you want to have getting a positive test  and will have a lot of pain on, people can't
  even do it.
  You need to seek some treatment for that.
  It could just be inflammation that we can  knock out pretty quickly, but this is definitely
  a sign that there is a problem there with  one of the muscles of the rotator cuff.
  The next one is a painful arc.
  So you're going to have your thumb up this  time and you're just going to raise it up
  overhead nice and easy.
  So this is testing for tendinitis.
  Now, one thing about tendonitis that you have  to understand is the tendinitis has multiple
  causes.
  So there's really a lot of issues going on  with your shoulder, but this just means that
  you're, there's an inflamed tendon and all  you're going to do is raise it up.
  And what will happen is right here.
  This can be great.
  Great, great.
  Ow, ow, ow. ow. ahhh ok so that's why We call  it the painful arc right about here to here.
  It's going to be painful once you get up here.
  Feels great down here.
  Totally fine in here.
  Hurts.
  Okay.
  That's the sign that there's inflammation  going on.
  If this is the only test that's positive,  this is a great time to get it treated because
  it means, there's not a whole lot going on.
  You do have tendonitis with the rest of your  shoulders intact.
  You haven't really torn anything yet.
  Um, that's substantial.
  There might be a small tear in there, but  you know you're able to do this and this is
  just painful.
  Um, that you, you know, we can treat that  pretty quickly.
  It's just a matter of correcting shoulder  muscle imbalances in your shoulder.
  And then the final test you're going to want  to do is for impingement.
  And a lot of this goes hand in hand with tendinitis.
  Um, and then this actually leads to a rotator  cuff tear.
  So if you test positive for this, this is  something you really want to get checked out
  and really want to get treated because the  next step beyond impingement is a rotator
  cuff tear.
  So this is kind of a fore warning of the cuff  tear means that one of your muscles are getting
  pitched, which is part of the rotator cuff  and will eventually become a tear if you if
  you if left untreated.
  So are going to do is take your arm hand rested  on the opposite shoulder and all you want
  to do is lift up, use your opposite hand to  lift up your shoulder.
  Okay?
  Don't lift it up like this.
  All right.
  Just use your opposite hand to lift it up  and lower it.
  If you get pain that's positive for an impingement,  again, it's something that it means there's
  an inflammation going on.
  The muscles being pinched if the muscle gets  pinched enough.
  It becomes a tear.
  And that's how the rotator cuff tear starts.
  So those are just a couple of quick, simple  tests you can do at home in order to be able
  to determine what the exact cause of your  shoulder pain as if you don't test positive
  test any of those.
  There are some more complex tests that are  a little bit harder to do on your own at home.
  Um, just because of those four were not positive.
  Doesn't mean that you don't have a shoulder  issue.
  It just means that those four things that  are easy and quick to test at home, we're
  not, uh, what you have.
     
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