Got shoulder pain or bursitis that just won’t quit? Dr. Alexandre Mota is here to break it all down with simple explanations and easy exercises you can do at home. Find out why your shoulder hurts and what really helps! Don’t forget to subscribe for more health tips and let us know in the comments which tip or exercise helped you most. #health #shoulderpain #bursitis #exercise #wellness
👉 This channel was created in collaboration with https://www.youtube.com/@dralexandremota
0:00 - Introduction and Patient Questions
1:00 - What Is Bursitis?
3:07 - Anatomy of the Shoulder and Bursitis
4:52 - Symptoms and Diagnosis
6:46 - Main Causes of Bursitis
10:02 - Exercises for Shoulder Imbalance
14:34 - Impingement Syndrome and Hooked Acromion
22:19 - Medications, Heat and Ice, and Final Advice
👉 This channel was created in collaboration with https://www.youtube.com/@dralexandremota
0:00 - Introduction and Patient Questions
1:00 - What Is Bursitis?
3:07 - Anatomy of the Shoulder and Bursitis
4:52 - Symptoms and Diagnosis
6:46 - Main Causes of Bursitis
10:02 - Exercises for Shoulder Imbalance
14:34 - Impingement Syndrome and Hooked Acromion
22:19 - Medications, Heat and Ice, and Final Advice
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LifestyleTranscript
00:00Hello, welcome to Dr. Alexander Mota.
00:04Today I'm going to answer some questions, things that a lot of people ask me.
00:08Maybe it's your question too.
00:10Today we're going to answer Pedro's question first.
00:13Pedro says, I've had bursitis for a long time.
00:16I've already gone through like 3, 4 or 34 treatments with anti-inflammatories, but nothing works.
00:24I feel like the nerves in my arm are shrinking.
00:27It makes it hard to move.
00:30And I have a lot of pain.
00:31I don't know what else to do.
00:32He asks, good evening, doctor.
00:35I feel a lot of pain in my shoulder.
00:37I have tendinitis and bursitis.
00:41My arm is atrophying.
00:44I'm doing physical therapy, but I'm not seeing any results.
00:47I feel so much pain that I get to the point of crying.
00:51Yeah, bursitis usually does that, especially when we don't understand what it is and we can't deal with it in
00:59the best way.
01:00So, first things first.
01:02What is bursitis?
01:05In our body, there are some small fluid sacs that help with movement.
01:10Every time there's a structure like a tendon or bone sliding close to another, there can be a bursa, which
01:18acts like a little shock absorber.
01:20The same fluid, the same grease, so to speak.
01:24That's inside the joints and helps with movement, is also found inside these little sacs.
01:30In the shoulder, there are some of these sacs that can get inflamed.
01:36The main one, picture this for a second.
01:39I have here the acromion, which is the bone that's part of the scapula.
01:47And we have, I'll draw it here in another color, the humerus, which is the bone of the arm.
01:58Okay?
02:00In this space here, look, between the head of the humerus and the acromion, the hook of the acromion, there
02:09are some structures.
02:11The supraspinatus tendon.
02:14And there's also the bursa, which is this little sac filled with fluid.
02:20Okay?
02:21There's another one, a little further forward, and either of them can get inflamed.
02:30Just imagine that every time you move, you're compressing it a bit, causing friction and rubbing that bursa.
02:39Yeah.
02:40When there's some imbalance in the shoulder, that bursa or the tendon itself, like Jesse said, gets inflamed, has a
02:48reaction.
02:49Okay?
02:49It's like injuring that bursa, which then turns into bursitis.
02:56Or it injures and inflames the tendon, which is called supraspinatus tendonitis.
03:01So let's understand better here, with these images, what bursitis is.
03:06Okay?
03:07Here you can see the neck, the chest, and this is the shoulder and arm area.
03:13We have the arm bone, the humerus, this one that's in green.
03:21Now, we have that little part, that little bone I told you about.
03:26Look.
03:27Let me bring it over here.
03:28There you go.
03:29Look.
03:30Here is the arm bone in green.
03:32This whole head here is the arm bone.
03:34It's the humerus.
03:36And here we have the acromion, this little bone that's green now, right?
03:41This space between the head of the humerus and the acromion has these two little sacs.
03:49Here, look.
03:50This is the subacromial bursa, which is under the acromion.
03:55And this other one is the subdeltoid bursa.
03:58Actually, we consider bursitis to be the inflammation of either one of them.
04:04If we look here from the side, here is the deltoid bursa and another bursa.
04:10There are two bursae that are responsible for bursitis in the shoulder.
04:15And down here is the muscle.
04:18Let me show you a little bit here.
04:21I'm going to remove a little of this bursa here.
04:23And you can see here that there's the tendon of the supraspinatus muscle.
04:29So, that's why when there's inflammation of the bursa, it's usually hard for us to tell
04:38if it's just the bursa or if there's also tendonitis of the supraspinatus, okay?
04:45So, let's just talk about the bursa here.
04:48Okay, but Dr. Alexander Mota, how do I know if I have bursitis?
04:52How will the doctor know?
04:54What might make me suspect bursitis?
04:57If you have shoulder pain that gets worse, especially after you raise your arm above
05:04your head, in other words, your arm goes past 90 degrees or that little pain that gets worse
05:10depending on the position.
05:11Sometimes you wake up with pain.
05:13It could be that you have bursitis.
05:14You go to the doctor, the osteopath, the physical therapist, and he will do some tests
05:19to find out if it's bursitis.
05:22He might order some tests to tell the difference because in Jessie's case, for example, she
05:27has both bursitis and tendinitis.
05:31Sometimes it's hard just by looking and doing some tests for us to know if the problem is
05:36the bursa or if the problem is the tendon, right?
05:40Actually, it's not a problem at all whether the inflammation is in the bursa or if the inflammation
05:43is in the tendon, and the doctor may order some tests for you.
05:48Most commonly, he may order an ultrasound which will show how the tendons are, how the bursa
05:56are, and the best test, right, is the MRI.
06:06Magnetic resonance imaging.
06:08What are you going to see, right?
06:10What image will show that you have bursitis?
06:13Normally, bursitis shows up like this here.
06:17All the structures are black, and there's white, like it's liquid in this region here.
06:24Exactly between the humerus bone, between the arm bone and the acromion, okay?
06:29This means that the bursa is inflamed.
06:32There's a lot of fluid in it.
06:33And Alexandra, what causes bursitis?
06:37Come with me.
06:39Bursitis usually has three main causes, okay?
06:46I'll tell you each one of them and explain ways we can use good movement to improve this.
06:56The first and most common cause is imbalance.
07:05Mechanical imbalance, movement imbalance, tension imbalance.
07:10You talk a lot about these imbalances.
07:13What are they?
07:14How does that work?
07:17Imagine that several muscles attach to your shoulder.
07:19There are several lines of pull reaching it, okay?
07:25Singes, pus, rumines.
07:27When there's an imbalance, it's like some muscles get tenser and pull more to one side,
07:33while others become weaker and pull less.
07:37We can think of it like a car wheel or a motorcycle wheel.
07:41When the wheel, the tire, is misaligned, what happens?
07:47With the movement it has to make, it starts to wear out more on one side or the other, right?
07:53And it's the same thing with the shoulder.
07:56Whenever there's this misalignment, this imbalance, some muscles pulling more than they should and others pulling less than they should.
08:05What happens is that at some point in the joint, it's going to wear out, it's going to have more
08:10friction, it's going to rub more, and it's going to get inflamed, right?
08:15And when we talk about the shoulder, bursitis, for example, this imbalance, the muscle that's pulling more or pulling less,
08:24it can come from the cervical spine, from the neck, it can come from the thoracic spine, it can come
08:30from the ribs,
08:31it can come from the lumbar spine and the pelvis.
08:34The latissimus dorsi muscle starts there and extends to the arm and shoulder, okay?
08:39But it can also be closer.
08:41It can be an imbalance in the scapula, in the clavicle, or even in the shoulder itself.
08:48So pay attention because there are several muscles, look, several little attachment points,
08:53several cord-like connections attaching here at the shoulder.
08:56There are muscles connecting the shoulder to the scapula.
09:01Suprespinatus, intrespinatus, teres minor, teres major, subscapulares, which is a very interesting muscle.
09:08We have here, I've already made several videos talking about the subscapularis muscle.
09:13There are muscles that connect the shoulder to the clavicle.
09:22There you go, look, that connects the shoulder to the clavicle.
09:26And there are also muscles that connect the shoulder.
09:30Look how cool this is.
09:33This is the latissimus dorsi muscle, which connects the shoulder to the lumbar spine and the pelvis.
09:45That is, imbalances in the lumbar spine, imbalances in the thoracic spine, the ribs, the neck, can destabilize and misalign
09:55the shoulder.
09:56And how can I improve this?
09:59You can try to improve this right now.
10:01Now, I'm going to show you some exercises that will even serve as a test, okay?
10:06The first exercise, we're going to improve the movement of the shoulder blades and the collarbone.
10:13So, if the cause, the origin of this imbalance that caused your birth sit is in the collarbone or in
10:21the shoulder blade,
10:22this exercise will help you.
10:24It will relieve your pain, all right?
10:27It's a simple exercise.
10:29Here's what you're going to do.
10:31Raise your arm here up to 90 degrees.
10:33Put your fingertips on your shoulder and only go as far as you can without pain, okay?
10:37Dr. Alexander Imota, if I raise it to 90 degrees and it hurts, lower it.
10:42Go a little bit lower as much as you can without pain.
10:46Put your hand here.
10:47And from now on, you're going to move by making circles with your elbows, like this.
10:54Make backward circles as wide as you can without causing pain.
11:0110 times backwards, then 10 times forwards.
11:07If you're doing this with me, you can feel how much your scapula is moving back there.
11:13It's like Daniel-san, wax on, wax off.
11:17That's exactly the movement your scapulas make back there.
11:21And at the same time, your clavicle here in the front moves forward and backward.
11:26It rotates forward and backward.
11:28It goes up and it goes down.
11:31So this simple, silly exercise improves the movement of your scapula and clavicle.
11:39And if the clavicle or scapula are the cause, if they are the ones causing this imbalance on your shoulder,
11:46you're going to do it 10 times forward and 10 times backward.
11:50My God, it got better.
11:52It's magic.
11:53This exercise will improve the movement of the cervical spine, thoracic spine, ribs, and also the lower back.
12:01All right?
12:01So it's a simple exercise.
12:04You'll need a chair and the backrest should be about the height of your shoulder blades.
12:10All right?
12:14You will sit with your pelvis well-positioned, your buttocks touching the backrest of the chair and your spine resting
12:25and pressed against the backrest.
12:27Okay?
12:28You shouldn't let your lower back lift away from the backrest and you shouldn't sit away from the backrest.
12:32You're well-positioned in the chair.
12:35From here, interlace your fingers.
12:38Lace your fingers together.
12:40Bring them behind your neck and bring them together a bit.
12:44Try to bring your elbows forward.
12:47This is important because if you don't do this movement or if you just place your hand anyway or with
12:52your elbow open,
12:53what happens is when you lean back, you'll end up moving more with your neck and less with your chest,
13:03with your torso.
13:04Okay?
13:05And besides that, when you interlace your fingers like this, this hand even helps to pull to gently stretch your
13:11neck as if you were doing a stretch.
13:12So look.
13:14Interlace your fingers.
13:16Support them on your neck.
13:20Bring your elbows forward.
13:22And you're going to lean back as far as it's comfortable.
13:27Lean back.
13:28Exhale.
13:30And return.
13:32You're going to do this ten times.
13:34Okay?
13:34Lean back.
13:37And return.
13:39Lean back.
13:41And return.
13:46Fourth time.
13:48Exhale.
13:49And return.
13:56Tilt.
14:00Tilt.
14:03Tilt.
14:04Tilt.
14:05Exhaling is important because it helps a little to improve the movement of your ribs.
14:12And when you improve that, you stretch your diaphragm.
14:15So you stretch your diaphragm here with all the muscles in front of your spine.
14:21And you exhale.
14:23It's like you're doing an extra stretch.
14:28After you've done the ten movements, retest.
14:31Move your arm again.
14:32And see if it feels better.
14:33And maybe now you're saying,
14:36Dr.
14:36Alexander Mota.
14:37I did it.
14:38And it didn't really get much better.
14:40So there might be another cause, another specific type of imbalance,
14:44which is the second cause of bursitis here.
14:49Which is shoulder impingement syndrome.
14:56I think you've already heard this term before.
14:58If you follow our channel regularly here on our social media,
15:02I think you've already heard about it.
15:04But let's go.
15:06Every time I raise my arm, this bone here, the humerus, it rotates and it slides downward.
15:16Think about this with me.
15:18Here I have, look, my arm bone.
15:21This is my right arm.
15:22Look, the arm bone.
15:24It articulates here with the scapula.
15:27And up here is the acromion.
15:31So for me to raise my arm, it has to roll and slide downward.
15:37Do you see?
15:38If it doesn't have this downward sliding movement, it just goes up and hits.
15:43Impact squeezes, reducing the space where the tendon passes through.
15:48And there's also the bursa.
15:51So impingement syndrome is exactly that.
15:54Cac.
15:55Pisa si.
15:56You have reduced movement in the shoulder itself.
16:00And every time you move, you cause this impact.
16:03It's that simple.
16:05To improve this, to test if you have impingement syndrome or if this is the cause of your bursitis,
16:11you are going to do it like this.
16:13Pro braço.
16:13So to test, to improve this issue of impingement syndrome in your shoulder,
16:17you will need a chair.
16:19You will hold here.
16:20Look, on the seat of the chair.
16:22Preferably, don't use those chairs that have armrests.
16:27Otherwise, you might hurt your arm here or if you grab it from the outside, it might hurt here.
16:32Okay?
16:33A chair without armrests, without arm support, hold here on the seat of the chair with your spine well positioned
16:41comfortably.
16:43You're going to relax, relax your shoulder, relax your arm.
16:46The only strength you're going to use is in your hand, just to keep your hand from slipping.
16:51Okay?
16:52Hold it.
16:53Lean to the other side and come back.
16:56You're going to do this movement 30 times only as far as it doesn't hurt.
17:01Right here.
17:02Ouch, it hurts.
17:03You're going too far.
17:05Go only as far as it's comfortable and then come back 30 times.
17:10The important thing here is the movement.
17:15It's the rhythm you set.
17:17If you keep your shoulder relaxed, when you lean to the other side, you're sliding.
17:21Remember the little movement I mentioned, see?
17:24You're sliding the humerus down.
17:26You're putting grease, so to speak, in the shoulder joint.
17:30And you're creating space between the acromion and the arm bone.
17:35Right?
17:38So, the important thing is the rhythm.
17:43One, two, three, tres.
17:47And staying relaxed.
17:49Okay.
17:50And not how much force you use.
17:52You don't need to force it to try to go farther.
17:5630 times.
17:59After you've done it 30 times, move around.
18:02See if your shoulder feels lighter.
18:04If you can move your shoulder more without feeling pain.
18:08And so far, I'm sure most people have already felt relief.
18:13And you've already started to realize that a pain or a localized inflammation in your body
18:20may actually be caused by something in another part of your body.
18:24Right?
18:27And there's a minority who say, Dr. Alexandre Mota, I've already done the scapula and clavicle
18:33exercise.
18:33Dr. Alexandre Mota, I've already done the chair exercise, the spine extension, one.
18:39And I've already done the shoulder sliding exercise to improve impingement syndrome.
18:45And I'm still feeling pain.
18:47There hasn't been much improvement yet.
18:50So, let's go.
18:52So, you might be part of the minority that has what we call a hooked acromion or a hook on
19:00the acromion.
19:04Some people have a different acromion.
19:07Instead of being straight here, it has a little point going down here.
19:16And then you can imagine, this little point going down here already doesn't cause it, but
19:23it can make that space narrower and for it to rub against the bursa or the tendon.
19:31In other words, people who have this anatomical variation, who have this slightly different
19:36acromion, are more likely to develop bursitis and supraspinaris tendinitis.
19:44I'm not saying that people who have a hooked acromion, who have this, will have to learn
19:49to live with the pain.
19:51We never need to.
19:52We should never learn to live with pain.
19:55Right?
19:55We always have to understand better or the problem, in quotes, that we're feeling that's
20:02causing the pain or better understand our body so we can improve, avoid or eliminate
20:11pain.
20:14Alexandre, I have a hooked acromion.
20:16I've already had tests, x-rays, ultrasound, MRI, and it showed up.
20:22The doctor already told me.
20:24What can I do?
20:26All these exercises we taught here today can help you.
20:31You will have to be extra careful to always have good movement in the clavicle, in the
20:37scapulas, in the cervical spine, thoracic spine, in the chest, in the ribs, in the lower back,
20:44and in the pelvis.
20:46Physical activity itself, when it is properly guided, is already a great way to help prevent
20:53shoulder pain.
20:54Even if you have a hooked acromion, there are countless, there are countless exercises and
21:02ways that you can improve, and that will help your case.
21:06Because every body is different.
21:10You should look for an osteopath who will evaluate your whole body, understand how your body is
21:18functioning, and figure out what is contributing.
21:21For your bursitis, for your bursitis in this case, and then he will correct and improve this movement.
21:28He will align your shoulder, and he will keep your shoulder healthy.
21:34He might even give you some exercises to do at home.
21:38Look, all the exercises can help you, but this one, in your case, is the best for you.
21:45Or you have to do this once a day, or you have to do this before.
21:53I don't know, like before you go to work, right on the board.
21:57Since you do that impingement movement a lot, right?
22:00Do this exercise both before and after.
22:03So, these guidelines will help you not feel this pain, not develop bursitis or tendinitis.
22:13Or even if you do, it will be mild, and you'll be able to control it.
22:19And now another question here, from Jaime, Jaime Schuchman, from Jaime.
22:25Doctor, is there any medication to take to relieve the pain from bursitis or the inflammation?
22:30So, my arm has limited movement.
22:35Here's the thing.
22:36I'm a physical therapist, an osteopath.
22:38I don't work with medications, okay?
22:41Normally, in the case of bursitis, whether it's due to any of these three causes here,
22:47medication helps reduce inflammation and helps reduce pain.
22:52Now, we have to find the cause of bursitis, which is the hardest part.
22:57But it's also the part that gives the best and most lasting results and treat that cause, okay?
23:05But the medication helps reduce the inflammation, right?
23:11So, if in your case, anti-inflammatories and painkillers aren't working,
23:16many people even end up getting injections.
23:19In other words, applying the medication directly inside the bursa or near the bursa.
23:25If that doesn't help, it's because you're not correcting the cause.
23:29Do you understand?
23:30It's obvious.
23:31To me, it's very clear.
23:31It's very logical.
23:33If you took the medicine, which is supposed to reduce the inflammation,
23:38and the inflammation didn't go down, it's because you haven't found the cause.
23:42There's something else in your body, usually an imbalance of movement, tension, or mechanical imbalance.
23:49That's causing or contributing to this pain.
23:53And until you align your shoulder, so to speak, it won't get better, okay?
23:59The medication won't work.
24:02You understand?
24:05There's something else that I'm sure maybe someone has already mentioned here in the comments.
24:10Alexandre, should I use a warm compress?
24:12Should I use ice?
24:13What should I use on my shoulder?
24:15Let's go.
24:18Classically, what doctors, orthopedists, and conventional physical therapists say is,
24:24use ice.
24:26Because if bursitis or tendinitis is an inflammation, by applying ice, I help reduce the inflammation.
24:32That makes sense.
24:34What I advise my patients and what I advise you to do.
24:40Try ice and try heat.
24:43Now, think this through with me.
24:46Ice helps reduce inflammation, just like an anti-inflammatory, okay?
24:51If, in your case, just reducing the inflammation doesn't help, then ice won't help either.
24:59Besides that, ice also helps contract the muscles.
25:04If you have any imbalance, any misalignment in your shoulder, if you have impingement syndrome,
25:14the ice will tighten it.
25:15It will make this imbalance worse.
25:18So, it's like this.
25:19The doctor or physical therapist told me to use ice.
25:23But when I put the ice on and then take it off to do my things, it hurts a lot.
25:28So, in this case, ice is not recommended for you.
25:31On the other hand, a warm compress, when you apply it, relaxes the muscles and increases blood circulation.
25:38In other words, the body is able to fight this inflammation better.
25:43And the joint itself moves more easily.
25:47So, heat the warm compress, it helps to reduce imbalances and impingement syndrome, right?
25:57So, if that's your case, if you use ice, it's going to get worse.
26:01Either while you're using the ice or afterwards.
26:06And it will get better with heat.
26:08Or in cases like a hooked acromion, where there's already a very intense inflammation.
26:15In those cases where inflammation is the main thing, the most important factor, ice, will be better.
26:23So, try ice.
26:25If it gets worse, use heat.
26:27If it gets better, it seems like the shoulder is looser.
26:31Or the opposite, you used heat.
26:33And the pain got worse.
26:37Maria, it feels like my whole arm is throbbing.
26:41It's uncomfortable.
26:42Put ice on it.
26:43What a relief.
26:44So, each person is different.
26:46It depends on the cause.
26:49Agreed?
26:51So, leave a question here in the comments about bursitis, about the shoulder, about any part of your body.
26:58A condition, a disease that you want me to talk about here.
27:02And who knows, maybe the next Alexandra Answers might feature your question.
27:07I'll stop here.
27:09Big hug.
27:09And see you next time.
27:10Big hug.
27:10Big hug.
27:11Big hug.
27:11Big hug.
27:11Big hug.
27:11You
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