Rotator Cuff Tear VS Shoulder Impingement VS Shoulder Tendonitis
Summary
TLDRDr. David Middoff, a specialist physical therapist, educates viewers on common shoulder issues: rotator cuff tears, shoulder impingement, and tendinitis. He outlines the differences, symptoms, and progression from impingement to severe rotator cuff tears. Emphasizing the importance of early intervention, he offers insights on natural healing and provides resources for home treatment and exercises to prevent surgery.
Takeaways
- 👨⚕️ Dr. David Middoff, a specialist physical therapist, discusses common shoulder problems and aims to help viewers avoid unnecessary surgeries and medications.
- 🤕 Shoulder pain can be caused by various issues including rotator cuff tears, shoulder impingement, or tendinitis, which can lead to difficulty in daily activities.
- 💤 Pain at night, especially when lying on the affected shoulder, is a common symptom for severe shoulder problems.
- 📉 Rotator cuff tears often present with a loss of motion and can be painful even at rest, distinguishing them from less severe issues like impingement and tendinitis.
- 🔍 The upper trapezius muscle can become tight or painful due to shoulder problems, indicating a need for proper treatment to prevent further complications.
- 🔴 Tendinitis is characterized by a specific, localized pain point in the shoulder, unlike rotator cuff tears and impingement which can have more diffuse pain.
- 🔄 The progression from shoulder impingement to tendinitis and finally to a rotator cuff tear represents a spectrum of increasing severity in shoulder pain.
- 🛑 Dr. Middoff emphasizes the importance of early intervention to prevent the progression from impingement to more severe conditions like a rotator cuff tear.
- 🏋️♂️ Conservative care, such as physical therapy, is often effective for rotator cuff tears, with research showing similar outcomes to surgery in many cases.
- 🔗 The video provides resources for home exercises to treat a rotator cuff tear and a playlist for shoulder and neck exercises and stretches.
Q & A
What are the three common shoulder problems discussed in the script?
-The three common shoulder problems discussed are rotator cuff tear, shoulder impingement, and shoulder tendinitis.
What is the primary symptom that indicates a shoulder problem according to the script?
-The primary symptom indicating a shoulder problem is pain, especially with reaching up, behind the back, and out with the arm extended, especially while holding something heavy.
How does pain at night relate to shoulder problems as described in the script?
-Pain at night, particularly when lying on the affected shoulder, can be a sign of shoulder problems like rotator cuff tears, impingement, or tendinitis.
What is the difference between pain at rest and pain with movement in the context of shoulder problems?
-More severe shoulder problems like rotator cuff tears can cause pain at rest, while less severe issues like impingement and tendinitis tend to be more painful with movement or activity.
What is the role of the upper trapezius muscle in relation to shoulder problems?
-The upper trapezius muscle can become tight or painful when there's a shoulder problem, and it's important for the stability of the shoulder joint.
How does the script describe the progression from shoulder impingement to a rotator cuff tear?
-The script describes a spectrum where shoulder impingement can lead to tendinitis, and if left untreated, can progress to a rotator cuff tear.
What is the significance of a focal point of pain in shoulder tendinitis according to the script?
-In shoulder tendinitis, there is typically a specific focal point of pain in the shoulder that is consistent and not diffused, unlike the more widespread pain in rotator cuff tears and impingement.
Why does the script suggest that surgery may not be necessary for a rotator cuff tear?
-The script suggests that research shows people who undergo conservative care, such as physical therapy, often have similar outcomes to those who have surgery, in terms of pain reduction and motion recovery.
What advice does the script give for treating a rotator cuff tear at home?
-The script recommends checking the description for a link to a video on how to treat a rotator cuff tear at home, suggesting that natural healing is possible.
How does the script connect neck issues to shoulder problems?
-The script explains that neck issues and upper trap problems can contribute to shoulder problems, emphasizing the importance of addressing neck and upper trapezius issues to prevent progression to a rotator cuff tear.
Outlines
🤕 Understanding Shoulder Pain: Causes and Differences
Dr. David Middoff, a specialist physical therapist, introduces common shoulder problems such as rotator cuff tears, shoulder impingement, and tendinitis. He explains the symptoms associated with each, including pain with certain movements and at rest. Dr. Middoff emphasizes the importance of understanding the differences to take appropriate action. He outlines the common symptoms like pain with reaching, sleeping discomfort, and pain at rest for severe issues. He also discusses how these conditions can lead to neck and upper trapezius muscle issues, which are often associated with shoulder problems.
📝 The Spectrum of Shoulder Issues: From Impingement to Tendonitis
Dr. Middoff uses a whiteboard to visually differentiate between shoulder impingement, tendinitis, and rotator cuff tears. He describes impingement as the initial stage where the shoulder's ball and socket space is reduced, leading to irritation and potential tendonitis. Tendonitis is characterized by a specific tender spot in the shoulder, which, if left untreated, can progress to a rotator cuff tear. The video explains how these conditions are interconnected and can escalate in severity, with the rotator cuff tear representing the most severe stage, often accompanied by a loss of motion.
🏋️♂️ Natural Healing and Treatment for Rotator Cuff Tears
The video concludes with a positive message about the potential for natural healing of rotator cuff tears without surgery. Dr. Middoff cites research indicating similar outcomes for those who undergo surgery and those who opt for conservative care like physical therapy. He provides resources for exercises and further information on treating shoulder and neck issues, emphasizing the importance of addressing neck problems to prevent the escalation to a rotator cuff tear. The video encourages viewers to engage with the content by asking questions and subscribing for more health and wellness tips.
Mindmap
Keywords
💡Rotator Cuff Tear
💡Shoulder Impingement
💡Tendinitis
💡Pain with Movement
💡Upper Trap Muscle
💡Spectrum of Shoulder Pain
💡Conservative Care
💡Physical Therapy
💡Loss of Motion
💡Natural Healing
Highlights
Dr. David Middoff explains the differences between rotator cuff tear, shoulder impingement, and shoulder tendinitis.
Pain with reaching up, behind the back, and out with the arm extended is common in shoulder problems.
Shoulder pain at night, especially when lying on the affected shoulder, is indicative of shoulder issues.
Rotator cuff tears can be painful at rest, unlike less severe problems like impingement and tendonitis.
Loss of motion is typical with rotator cuff tears, making certain movements difficult or impossible.
Impingement and tendonitis often result in neck problems and upper trap muscle tightness.
Shoulder tendinitis is characterized by a focal point of pain in the shoulder.
Rotator cuff tears and impingement can cause more diffuse pain that moves around the shoulder.
The conditions exist on a spectrum, with impingement being the least severe and a rotator cuff tear the most.
Impingement occurs when the space for the ball and socket joint decreases, leading to irritation.
Tendinitis is an inflammation of the tendon, often caused by overuse or compression.
A rotator cuff tear signifies a serious condition with a loss of motion and potential need for intervention.
Conservative care, such as physical therapy, is often effective for rotator cuff tears without surgery.
Exercises and stretches for shoulder and neck can help prevent progression to a rotator cuff tear.
Addressing neck issues and upper trap problems is crucial in managing shoulder conditions.
Dr. Middoff provides resources for home treatment of rotator cuff tears and other shoulder issues.
Transcripts
hey are you dealing with shoulder pain
right now and are you wondering
what the heck is going on in there is it
a rotator cuff tear could it be shoulder
impingement
or do i just have shoulder tendinitis
i'll be telling you the difference
between these three common shoulder
problems
so that you can have a good
understanding for what they are and what
to do next about it
my name is dr david middoff and i'm a
specialist physical therapist at el paso
manual physical therapy
this channel is dedicated to helping
people stay healthy
active and mobile while avoiding
unnecessary surgeries
injections and medications be sure to
subscribe
and turn on your notifications for this
channel so you don't miss any of the
helpful videos that we put out
every week i'm going to use this
whiteboard in a second to draw you the
differences and
how to understand and and get your head
around these different shoulder problems
but real quick let me just tell you some
of the common things that you'll find
with shoulder problems like rotator cuff
tears impingement and tendonitis
number one thing obviously is going to
be pain but specifically
pain with reaching up pain with reaching
behind your back
and pain with reaching out with your arm
extended especially while you're holding
something heavy
another time to get pain is when
sleeping at night
if you lie on that shoulder and compress
the shoulder joint sometimes
that can be very painful for these type
of shoulder problems
and the more severe shoulder problems
like rotator cuff tears
will even be painful at rest when you're
just doing nothing you could just be
sitting around
having a meal watching tv and it hurts
but the less severe shoulder problems
like impingement and
tendonitis tend to not be as painful
at rest they tend to be more painful
with movement or with activity
let me tell you about how they're
different with the rotator cuff tear
there's typically
some loss of motion it could be that
it's just painful
to get into certain motions like
reaching up or behind the back
it could also be that you need help like
if you assist your arm up with the other
arm
it will go up it just can't get there on
its own
with both impingement and tendonitis
it's common to get
neck problems and pain in this area or
knots in this area of the body this is
called the upper trap
muscle and that muscle can get quite
tight or naughty
whenever there's a shoulder problem
going on with shoulder tendinitis
there's typically a focal point in the
shoulder like
right here it hurts or right here it
hurts and it's not as diffuse meaning
it's not spread around or it doesn't
change too much it's pretty consistently
at one spot whereas rotator cuff tears
and impingement can be more diffused it
can move around
from the front to the back to the side
can run down the arm a little bit or it
can be a combination of all those
depending on how you feel and depending
on the severity severity of it that day
what i want to make sure you understand
today i'm going to use a white board for
all three of these problems a rotator
cuff tear
shoulder impingement and shoulder
tendinitis are on a spectrum
of shoulder pain and the reason why
they're on a spectrum is because they're
all related
one leads into the next one is a more
severe version of the one before
so on the left side of the spectrum here
what i'm going to put down for you here
is shoulder impingement
so just for short i'm going to
abbreviate it
shoulder impingement
in the middle of the spectrum you've got
tendinitis
[Music]
tendinitis then on the far end you've
got a rotator cuff tear i'm just going
to write rtc
there you go so on
shoulder impingement what's usually
happening
is the space where the ball and socket
live let me use my skeleton here for you
and take them off so you can see right
there
you this is the space where the ball and
socket is right under
this overhanging bone it's called the
acromion that's
the the area that commonly gets impinged
or pinched is another way to look at it
but that space somehow gets decreased or
pinched
and that's what sets up the tendonitis
in the area and eventually
a tear but what leads up to that some of
the symptoms that you'll see
is neck problems and
upper trap which is going to write up ut
tightness
just right tight and pain
and that will carry on all the way to
rotator cuff tear if you end up going
that far
now if this lasts for a while what
the symptoms that you'll see is it just
kind of aches and hurts certain
movements will hurt like if you're
turning
a doorknob or turning a key it won't
hurt all the time
a common experience that people have had
is they'll go reach for like a heavy
coat
and when they go pick it up it bites
them in that moment but picking up
something light you know like a pen or a
marker or something is no big deal
or also picking up something and turning
it or maneuvering it
away from their body that can be pretty
painful
and what you can gather from that is
that
this motion out here where you're
reaching out and picking up something
heavier turning
is just a lot of stress on the shoulder
and it's becoming irritated in there
it's usually the rotator cuff muscles
and tendons that become irritated
and that is what we would label an
impingement situation
the reason why people get pain into the
neck and shoulder in this upper trap
area
is because these muscles need to be
strong and stable in order for the ball
and
socket out here to work properly so
oftentimes these get achy because
they're
being overused or they're just not being
used appropriately
you can also have pinched nerves in the
neck that
set up weaknesses in these muscles and
the rotator cuff muscles that eventually
start to create an impingement situation
in the shoulder
joint and if that impingement lasts long
enough
it becomes severe enough then we
progress into
tendonitis so in tendonitis
i'll use pink here this is where you've
got a tender spot
tender
spot on the shoulder
it begins to form where usually you can
poke in there and find a
spot that just gets you if you and you
might even want to rub it out to get
some relief
and this will keep going of course into
rotator cuff tear
but that tendinitis what's happening is
at
the ball and socket joint where the
where the muscles
meet the tendons and then the tendons
meet the bones muscles connect to
tendons tendons connect to bones
that tendon gets overused or over
compressed or irritated
and it's just like if you rub your skin
really hard you know your skin's fine
normally
but if you rub it for a while you can
take it for maybe a few seconds maybe a
minute or two
but after a while it starts to get
irritated and red
it may not break you may not bleed but
it gets irritated and if you were to do
that for
an hour or if you were to do it several
times a day for you know a few minutes
at a time
you bet your skin will be irritated and
it would probably take a little while
for it to recover
maybe a day maybe even a few minutes
depending on how hard you do it
what you need to understand is with the
tendon it doesn't recover as fast as
your skin does
your skin recovers really really fast if
it gets irritated
as long as it's in a good healing
environment it should be minutes hours
at most a couple of days
tendons is more on the time frame of
weeks
to get over an irritation so that's why
tendonitis can last a while
and if you don't identify if you don't
figure out
what the aggravating motion is or what
the aggravating
thing is the thing that sets you up to
get it and remove it from your situation
it's gonna stay
irritated it's gonna stay tendinitis
tendonitis just means inflammation of
the tendon that's why
it gets irritated like i was saying and
if that persists if weeks go by months
go by like that
then eventually that tendon becomes so
irritated as if you were to be doing
this that it will break
it will break open just like your skin
will break open eventually if you were
to do this
you know i might get a blister at first
but eventually that blister will pop
open
and there could be blood under there
same thing with a tendon you don't get
an
actual blister on your tendon it just
starts to break down
and tear and that's what sets you up for
a rotator cuff
tear so when you have a rotator cuff
tear
typically let's use green here
you have a loss
of motion
and that's when it's serious because now
you know usually leading up to this with
shoulder impingement and tendonitis
people can still do stuff they can still
function they can get through their day
they can
clean the house they can typically work
just fine it might be concerning to them
that they have pain but they might even
be able to take a
pain medication you know a tylenol
motrin ibuprofen something like that
and deal with it but if you lose motion
if you just
can't reach back there anymore if you
can't reach up if there's things that
you just can't do
some people can't even wash their hair
or you know fix their hair
or cook a meal because of their shoulder
pain that's when it's serious and
ideally you don't want to get to this
point where you've got a loss of motion
you want to start treating the problem
when you've got just a tendonitis or an
impingement issue
but if you're at this point where you're
having difficulty moving your arm
it's pretty bad you make sure you do
something about it so i hope this makes
sense to you i hope you better
understand
what a rotator cuff tendon tear is
what an impingement is and what a
tendonitis is here
and how they're on a spectrum and as you
move along from left to right here
it gets more painful more limiting and
more serious
now the good news you need to take away
from this is that even if you've got
a rotator cuff tear and you're you know
concerned you're losing motion
you still have an excellent chance at
healing it
naturally without surgery the current
research shows this that people that get
surgery versus people that don't get
surgery and go through conservative care
which means physical therapy usually
they end up about the same six months
later and even 12 months later
they both get more motion back and get a
reduction in pain
and they're pretty good so why even do
the surgery now there are cases where
it's pretty severe and
there's it's been going on for a while
maybe it's not the first rotator cuff
tear where
you go get the surgery right away but in
most cases
you can get away with not having surgery
and healing this rotator cuff problem
naturally if you've got a rotator cuff
tear and you're looking for exercises to
do
i've got a video for you called how to
treat a rotator cuff tear
at home it's in the description below
you can find the link in there
and if you've got more of a tendonitis
or a
shoulder impingement problem there's
another link for our playlist covering a
bunch of shoulder
and neck exercises and stretches and
tips and advice as well
and the reason why there's neck stuff in
there is because as i said in this video
you can get neck issues
and upper trap problems that feed into a
shoulder problem so it's important to
get that
addressed as you're fixing yourself so
that you don't end up
taking it all the way to a rotator cuff
tear if you've got any questions on this
drop a comment below we'll get to it as
fast as we can
and i hope that you like this video if
you did give us a like give us a thumbs
up
and don't forget to subscribe and turn
on your notifications so you don't miss
any of the helpful videos and tips that
we put out each week have a wonderful
day guys
bye-bye
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