Vielen Dank. Ihr seid hervorragend. Ich bin Physiotherapeut und ihr seid mir eine große Inspiration. Gibt kaum ein Patienten, denen ich euch nicht empfehle!
This and the last video on subacrominal impingement (subacute) are gold. Way to synthesize the evidence and present it in sensible way. Must have been a great course.
great to now have some vids on Subacromial-Syndrome, too. However, I'd like to add that the subacromial-s. I used do have was partially caused by regular lateral raises (regular gym style - thumbs neutral and not in the scapular plane) and also by a "slightly hooked" acromion (so I guess they meant type2 with a hint of type3-acromion). So my point is you have to perform lateral raises in the proper way (scapular plane, thumbs up/humerus in lateral rotation), else you worsen your shoulder health Btw: i do my shoulder rehab exercise in the style of that the vid shows at 2:10 - I call it the push-outi-pull
Happy you like our videos! You are reasoning from an "impingement Theory" view, which has been rejected by different facts from the literature: 1) Most of the rotator cuff tears we see are on the underside of the supraspinatus tendon (Payne et al. 1988) 2) There is no significant association between acromial morphology and rotator cuff pathology in patients > 50 years (Gill et al. 2002) 3) We have learned from the large CSAW trial that acromion resection does not perform better than sham surgery (Beard et al. 2018) Still we agree that in a rather acute phase, the lateral raises we prescribe are in the scapular plane - should pure abduction be too provocative in this phase.
I'm not a physiotherapist, but keep in mind that my MRT-diagnosis specifically says "geringe formvariante (angedeutete hakenform) of the acromion with suspicion of subacromial inpingement". Not only was my Supraspinatus in bad shape (even partially frayed), but also the subacromial/subdeltoid bursa (bursitis+barely any liquid), the subacromial fat was interruptured, the subscapularis was partially ruptured (not just a muscle-fiber-rupture), the infraspinatus-tendon had muscle-fiber-ruptures, I had a slight tendinopathy of the long arm-biceps tendon and I had a slight SLAP-Lesion. My AC-joint also was slightly damaged (Sklerosierung and slight inflammation), and it says my anterior and anterioinferior joint-capsule was thickened. all information combined from my 2 shoulder-MRTs done in 2-2015 (left arm) and 1-2016 (right arm); nowadays most of this stuff is cured; I'm doing Medical Training Therapy (MTT))
Great video! What I've found is that ER in neutral is better tolerated than in 90 degrees abduction due to pain through the arc. Also, I'd argue overhead shoulder press should be left until later stages due to it being in that position of maximal impingement/instability. Thoughts?
Great videos! Very good exercises. The one think I don't recommend is at 3:10 of that arm position during shoulder presses. It puts your shoulder in a pretty dangerous position. Instead I would keep the elbow before the shoulder line.
@@Physiotutors in the sense that it does not leave enough room for the rotator cuff to do it s job and if you are a beginner and fatigue you can easily internly rotate your shoulder. But yea i guess if you only use very light weight it should not be that dangerous. Correct me if I am wrong.
Thanks Harrison! Reason being is that 0 degree compresses the tendon of the supraspinatus on the humeral head, while in 90 degree the compression is absent. Have a look at this paper from Jill Cook: www.ncbi.nlm.nih.gov/pubmed/22113234
Great video as always! I have a doubt on the progression though. Aren't the tendons of supra and infraspinatus more compressed on the humerus when the shoulder is rotated internally? Shouldn't the rehab program be more centred on the eccentric control of the internal rotation?
I have pain in supraspinatus from past 1.5 years. It hurts 10/10 when i try to reach out my back with affected arm(internal rotation). It's now causing pain in neck as well as in posterior upper arm and radiating down to hand. Can i follow this series ?
Hello PT ! First thanks again for your videos, it really helps me through my (very) beginning career as a physiotherapist. I have a biomechanical question : Why does the external rotation exercices done in 0° position (2min43) puts more compression on the rotator cuff than the ones done in 90° position ? And also, how do you determine when to start intermediate phase ? Thanks bye !
![3 Keys to Rehab a Rotator Cuff Tear & AVOID Surgery [UNIQUE EXERCISES]](http://i.ytimg.com/vi/o9fiTFfW4uU/mqdefault.jpg)
Vielen Dank. Ihr seid hervorragend. Ich bin Physiotherapeut und ihr seid mir eine große Inspiration. Gibt kaum ein Patienten, denen ich euch nicht empfehle!
Had saps in my physio prac exam, your videos helped me attain 92%. Thanking you 😆
Awesome congrats 🎊
This and the last video on subacrominal impingement (subacute) are gold. Way to synthesize the evidence and present it in sensible way. Must have been a great course.
Thanks Charles, great to hear! We can really recommend to attend a course from Adam!
YES! More of these! Would love to see a 'treatment' series!
We are busy filming more an more videos of this kind!
great to now have some vids on Subacromial-Syndrome, too. However, I'd like to add that the subacromial-s. I used do have was partially caused by regular lateral raises (regular gym style - thumbs neutral and not in the scapular plane) and also by a "slightly hooked" acromion (so I guess they meant type2 with a hint of type3-acromion). So my point is you have to perform lateral raises in the proper way (scapular plane, thumbs up/humerus in lateral rotation), else you worsen your shoulder health
Btw: i do my shoulder rehab exercise in the style of that the vid shows at 2:10 - I call it the push-outi-pull
Happy you like our videos!
You are reasoning from an "impingement Theory" view, which has been rejected by different facts from the literature:
1) Most of the rotator cuff tears we see are on the underside of the supraspinatus tendon (Payne et al. 1988)
2) There is no significant association between acromial morphology and rotator cuff pathology in patients > 50 years (Gill et al. 2002)
3) We have learned from the large CSAW trial that acromion resection does not perform better than sham surgery (Beard et al. 2018)
Still we agree that in a rather acute phase, the lateral raises we prescribe are in the scapular plane - should pure abduction be too provocative in this phase.
I'm not a physiotherapist, but keep in mind that my MRT-diagnosis specifically says "geringe formvariante (angedeutete hakenform) of the acromion with suspicion of subacromial inpingement". Not only was my Supraspinatus in bad shape (even partially frayed), but also the subacromial/subdeltoid bursa (bursitis+barely any liquid), the subacromial fat was interruptured, the subscapularis was partially ruptured (not just a muscle-fiber-rupture), the infraspinatus-tendon had muscle-fiber-ruptures, I had a slight tendinopathy of the long arm-biceps tendon and I had a slight SLAP-Lesion. My AC-joint also was slightly damaged (Sklerosierung and slight inflammation), and it says my anterior and anterioinferior joint-capsule was thickened.
all information combined from my 2 shoulder-MRTs done in 2-2015 (left arm) and 1-2016 (right arm); nowadays most of this stuff is cured; I'm doing Medical Training Therapy (MTT))
Great video! What I've found is that ER in neutral is better tolerated than in 90 degrees abduction due to pain through the arc. Also, I'd argue overhead shoulder press should be left until later stages due to it being in that position of maximal impingement/instability. Thoughts?
Does SAPS involve increased scalene involvement in shoulder movement?
What of early stages?
Great videos! Very good exercises. The one think I don't recommend is at 3:10 of that arm position during shoulder presses. It puts your shoulder in a pretty dangerous position. Instead I would keep the elbow before the shoulder line.
Thx, dangerous in what sense?
@@Physiotutors in the sense that it does not leave enough room for the rotator cuff to do it s job and if you are a beginner and fatigue you can easily internly rotate your shoulder. But yea i guess if you only use very light weight it should not be that dangerous. Correct me if I am wrong.
Great Videos! Quick question. Why would you start ER @ 90degrees abduction versus 0 degrees abduction?
Thanks Harrison! Reason being is that 0 degree compresses the tendon of the supraspinatus on the humeral head, while in 90 degree the compression is absent.
Have a look at this paper from Jill Cook: www.ncbi.nlm.nih.gov/pubmed/22113234
Great video as always! I have a doubt on the progression though. Aren't the tendons of supra and infraspinatus more compressed on the humerus when the shoulder is rotated internally? Shouldn't the rehab program be more centred on the eccentric control of the internal rotation?
I have pain in supraspinatus from past 1.5 years. It hurts 10/10 when i try to reach out my back with affected arm(internal rotation). It's now causing pain in neck as well as in posterior upper arm and radiating down to hand. Can i follow this series ?
Hello PT ! First thanks again for your videos, it really helps me through my (very) beginning career as a physiotherapist.
I have a biomechanical question : Why does the external rotation exercices done in 0° position (2min43) puts more compression on the rotator cuff than the ones done in 90° position ?
And also, how do you determine when to start intermediate phase ?
Thanks bye !
Got the answer for this?
Shoulder presses is a dumbbell floor press exercise? For Pectoral?
We are showing different exercises under the header "shoulder presses".
@@Physiotutors lat machine and Vertical traction technogym are good?
Does the pain scale apply only to the Early phase? If yes, is there a paper on this?
Silvernagel et al work a lot with the pain scale. It's a balance act and a rough guide to help with dosing
sir did u turned on monetization ? plz dont mind.physio tutors is already my fav channel
We’ve had monetization enabled since we started the channel
Physiotutors ok sir , :) i just saw it toays thats why was asking, your work is amazing :) keep going