00:00Shoulder pain when putting on your shirt. In this video, I'll show you what might be happening.
00:05I'll teach you five tests that I do in my office, adopted so you can do them at home yourself,
00:11and of course I'll show you exercises that can help relieve the pain.
00:15At the end of the video, there's a step-by-step guide so you can put on and take off
00:19any shirt
00:20without moving your arm. This is important even for those who recently had surgery or for those
00:25who already have a torn tendon. A warning before we start. Each test, each exercise works differently,
00:32so do them all in the order I'm going to show you and stick with the one that gives you
00:37the most
00:38relief. Of course, in 20 years of practice, I've seen that three causes explain almost all the pain
00:45when raising your arm. The first cause is a problem with the supraspinatus. That little tendon on the
00:51top side of your shoulder, which might show up as tendonitis on your test results. Tenosynovitis,
00:57tendinopathy, and in more severe cases, even as a rupture. The second problem is the biceps,
01:03that muscle in your arm. More specifically, the long head of the biceps or the tendon of the long
01:09head of the biceps, which is the tendon that comes along the outside on the side of the shoulder,
01:13and that can also become inflamed. The third cause is bursitis and impingement syndrome.
01:20They are two things that are almost always together because they have the same mechanism.
01:26And now, Alexander, how do I know which of those applies to me, where my pain comes from? That's
01:31exactly what the tests will show. It's very important that you do all these tests, even if
01:36you've already had some imaging exams. First, because no exam shows everything. The denitis, bursitis,
01:43for example, don't show up on x-rays. And second, no exam replaces the clinical test. That evaluation we
01:49do in the office. Unfortunately, there are a lot of healthcare professionals who don't even
01:54touch you, don't even evaluate you. They just order the exam right away or just prescribe
01:59the medication. Am I right or am I wrong? For the first test, you're going to raise your
02:03arm with your thumb pointing down. You don't need to force it. Be careful not to move your
02:09arm straight out to the side or straight out in front. Keep it halfway. It's more comfortable.
02:15Raise it up to about 90 degrees roughly to shoulder height. The other hand supports ear near the elbow
02:21and gently pushes the arm down while the injured shoulder resists. Try to stay still.
02:28If you feel pain when you resist, a positive test points to problems with the supraspinatus,
02:34or inflammation in the bursa. Want to double check and be sure? There's another test. Same position.
02:42Turn your thumb up and repeat. If it hurts on the second and not on the first, the problem tends
02:49to be
02:49the supraspinatus tendon. That's where your pain comes from. The third test is for the biceps,
02:56for the long head of the biceps. This time, you're going to raise your arm here straight out in front
03:00of you and your hand will apply force, not near the elbow anymore, but near the wrist. If when you
03:08resist, the pain appears up here, it's a positive test indicating a problem in the long head of the
03:15biceps. Inflammation could be tendinitis, tendinopathy, or tenosynovitis. The fourth test is also for the
03:24biceps is to confirm the result. So keep your arms still right here close to your body, bend your elbow,
03:30grip that hand from above with your other hand like this. Look, hold your hand, push as if you want
03:37to
03:37turn your palm to the ceiling. And of course, the other hand won't let you. If when you push, trying
03:45to
03:45turn your palm to the ceiling, you feel a prick or a sharp sting here in your shoulder, it's the
03:51biceps again.
03:52The fifth test checks for a characteristic sign of bursitis and impingement syndrome. It's what we
03:58call the painful arc. It's when the pain starts and when it ends. If when you raise your arm,
04:04the pain starts around here and it hurts and hurts and hurts. When it gets up here,
04:10the pain goes away. And that's a sign that your pain comes from inflammation in the bursa,
04:16bursitis, or from impingement syndrome. This is the sign we call the painful arc.
04:23Do the five tests, tell me. Down here, which one bothered you the most? And if it matched what
04:29the doctor told you with what your tests showed, ma'am, ma'am. It's finally time to get hands-on
04:36to
04:36learn exercises for you to do at home without any equipment. It's important that you do all the
04:42exercises in the order I'm going to show you. When we combine relaxation, increased mobility,
04:48we can improve the shoulder as a whole. We can decompress almost the entire shoulder joint area.
04:56The first exercise is for the supraspinatus and it works. It can relax the muscle because we're going
05:02to deactivate tension points or maybe even trigger points. Using your fingertips, gently press the
05:09shoulder here from top to bottom on this back part. Let me get closer and see where you can see
05:16better.
05:17There you go. Look. Press from top to bottom on this part of the back of the shoulder. Go slowly.
05:25Try to find a tension point. Use little force. Let the weight of your arm create the pressure.
05:31You don't need to force it and hurt or tire your hand. Stay in this position, keeping gentle
05:38pressure for 30 seconds and see how you feel. If you want to take this to the next level, do
05:44something
05:45more in depth. Keep the same pressure and make small movements with your head. Looking to the sides,
05:54up and down, making circles. You'll feel something sliding under your fingers.
06:00This head movement along with the pressure helps relax the trapezius muscle, that big muscle that sits
06:08above the supraspinatus. You'll feel your fingers sinking in without hurting and without needing to use
06:16force. If you want to go even deeper and even further, you'll keep the pressure and now make small
06:25movements with your arm. You'll feel the muscle waking up under your finger. Keep going like this
06:31without hurting until you feel the muscle waking up, that the muscle fires up, starts working
06:37without pain. The next exercise is for the biceps and here the strategy is different. We're not going
06:44to squeeze the muscle. We're going to release the fascia. We're going to improve the sliding of this
06:49membrane, this covering that surrounds the muscle. That's how we're going to make it relax.
06:55Raise your arm here about at shoulder level. You're going to place your hand near the elbow, pull the skin,
07:02hold it. Don't let the skin slide and you're going to do five movements, bending and straightening your arm.
07:10If you want to do a release on this deeper fascia, do this movement. Look palm facing down. Then turn
07:18your
07:18palm towards you. The phone vibrated. Check the phone. Put it back. Do this movement five times.
07:28Then move up one hand's width. Pull the skin again. Don't let it slide underneath and you will repeat
07:36five more movements. You will feel the skin stretching, but you also feel something deeper
07:43stretching as well. That's the feeling of releasing the layers of the fascia. And if you can do it a
07:49third
07:49time, get even closer to the shoulder. Pull the skin and repeat five movements. It's so hard to care when
07:56you're this relaxed. Exercise helps create space inside the shoulder. This relieves bursitis, impingement
08:05syndrome and also improves movement. Hold on to the side of the chair, relax your shoulder,
08:12and you're going to lean just a little to the other side. You're going to feel like your shoulder is
08:18being pulled down, like you're decompressing. Go until you feel that light and pleasant sensation of
08:25decompression and then come back. The idea here is for you to make a rhythmic movement,
08:31a pleasant movement without rushing and without forcing it. It's 30 swings. To avoid getting tired,
08:39you can do three sets of 10 swings, three sets of 10 repetitions. Be careful if you have a dislocation.
08:46If your shoulder pops out of place, do this exercise with less range of motion. That's why I'm so
08:52cautious. Until the shoulder is 100% recovered, we need to stop hurting it. And putting on and taking off
08:59your shirt is one of the most common moments when we make an already injured shoulder worse.
09:05So let's learn how to do this without hurting ourselves. Okay? A button up shirt is pretty
09:10straightforward, right? Let me grab one here so we can do it quickly. Imagine that my right shoulder
09:15is the one that's in a lot of pain. It's the one with a torn tendon. It's the one I
09:19had surgery on
09:20recently and I haven't been cleared to move it yet. So you're going to take the shirt and start putting
09:25it on from the injured side. Pull it up as high as you can. Then just put your other arm
09:33through
09:34and button it up without moving your shoulder. Anyone can do this. Now, when we're going to put on
09:44a shirt like the one I'm wearing or a t-shirt like this, that's when things get tricky. So I'm
09:50going to
09:50show you the step by step so you'll never get it wrong again. And so you can even share it,
09:55pass it
09:55on to whoever needs it. Okay? This is a public health matter. You're going to start, first step,
10:02to put it on, start by putting the shirt on the injured side first. So you're going to take the
10:09shirt,
10:09put it on, pull it up as much as you can. Don't worry if you can't pull it all the
10:15way up. Okay?
10:17Second step, put your head through. Second step, put your head through. Third step, I was about to
10:23move the other hand here. Look, put the arm that you can move through and then you fix the shirt,
10:33even on the shoulder that's hurt. To take it off, it's not just doing the opposite. To take it off,
10:38there's also a specific step-by-step process. Start by lifting the shirt. As much as you
10:45can, then you'll put your hand behind your head. Hold on. Let me try to pull just one shirt.
10:54Roll it up here, see?
10:57And you're going to pull the shirt off over your head first. So pull here.
11:02And be careful not to take the glasses off too. There you go.
11:06Take out the injured arm and then take out the arm. That's okay.
11:12Then remember to fix your hair. Quick warning. Stretching your neck the wrong way can also hurt
11:19your shoulder. And I've already shown the three biggest mistakes in this video here.
11:23Just click here on the screen. Remember to share this video with someone who has trouble putting
11:29on a shirt. I'll stop here. Big hug and see you next time.
