Shoulder Pain First Aid

Transcript

Welcome And Shoulder Pain Goals

SPEAKER_00 0:00

Welcome back to the Hand to Shoulder Solution where we are the solution to your pain. Everyone, this is Pete. Pete, this is everyone. I want to talk today about shoulder pain, common causes, and easy remedies. First thing I want to state that there's no there's no substitution for going to your healthcare practitioner and getting a thorough exam, thorough diagnosis of finding out exactly what's going on. What I do in the office is empower people to get themselves better at home. And then when they're in the office, I'm doing things for them that they can't do for themselves at home. So let's talk about some basic causes of shoulder pain and things that you can do at home. With the videos here, I'm empowering you to have an awareness of your body, have an awareness of what might be causing this pain in my

Shoulder Anatomy And Impingement Basics

SPEAKER_00 0:47

shoulder. So let's go over some basic anatomy real quickly. So, Pete, if I may, um, there's two joints that comprise the shoulder. You have the shoulder blade on the rib cage, this is the right side. Um, I know Pete you don't like it when I take your arms off, so I'm going to use a different one. And I know how you appreciate that. So we have the shoulder blade. This is if I look straight in through the ribs, you have the front part of the shoulder blade, and then here's the back side of the shoulder blade, and this is the right arm. So the shoulder blade has to move on the rib cage as the arm comes up. So we all know about the ball and socket, and it and by the way, it's a very shallow joint, it's like a golf ball sitting on a golf tee. And that's how we can have so much range of motion, and it's the muscles of the rotator cuff, which I will show you in a moment, that keep the ball centered on the socket as it moves. But see this roof of bone that's called the acromion. And if the shoulder blade didn't move as your arm is coming up, the this part of the ball would strike that roof of bone. It would strike the acromion. And guess what's between those two areas? Muscles of the tendons that connect muscle to bone of the rotator cuff, they travel through here and they insert on the top of the ball. So we often get what's called impingement syndrome where these get pinched or impinged between these two bones if the shoulder blade isn't moving, gliding on the back of the rib cage like it's supposed to. So to recap, you have the shoulder blade on the back of the rib cage, that's one joint, and you have also the ball and socket. They must work in unison together as a team appropriately, otherwise, a lot of things start to happen. We're going to talk about subacromial burstitis. We're going to talk about biceps tendonitis. That's a lot of pain in the front of the shoulder. We're also going to talk about really tight muscles that fill these divots on the back of the shoulder blade, muscles of the rotator cuff, and surrounding musculature that just get knots in them. They get really, really tight. So then you have the knots called trigger points. And those knots in the muscle just have to be worked out or even at least just allowed to relax with use of a heating pad. We'll get to that too. But I want you to have an awareness of both of those joints have to work together as the arm is moving. That shoulder blade has to rotate. Also, there's arthritis occurs commonly. So you have the collarbone, and that collarbone meets up with the front part of that roof of bone, it meets up with the uh the shoulder blade, and that joint often becomes quite arthritic. We'll talk about that too. So let's

Bursitis Self Test And Ice

SPEAKER_00 3:35

take a look at a few different things. This area right here, this that's the acromion that we were just talking about, that roof of bone that's part of the shoulder blade. And below that, and on top of the ball, is a little flat water balloon. It's a little shock absorber. And the what the balloon part of the water balloon is living tissue. It's called the bursa sac. Itis means inflammation. So in previous videos, we're talking about arthritis, itis meaning inflammation, arthral meaning joint, tendonitis, itis meaning inflammation, tendon meaning the tendon that connects muscle to the bone. In this case, it's bursitis. So we got the bursa sac, the little flat water balloon shock absorber, and the balloon part of the water balloon is living tissue, and then the fluid inside is not living. That inflammation of that tissue, the the balloon part of the water balloon, can be reduced with applying cold. But how do you how do you test yourself for bursitis? It's so easy. You put your hand behind your back. So when you do that, when you put your hand behind your back, Pete, sorry, buddy, I gotta, I gotta put you in a I gotta put your hand behind your back. So when you do that, it rolls the ball forward, and then it exposes that low flat water balloon, it exposes the bursa sac. Then if you touch it and it's really sore, yeah, bursitis. So you put your hand behind your back and then touch this area. Oh, and you can feel like the top of the ball, and you can feel that roof of bone, and in between the two, you just touch that, and in the clinic, patients will you know they'll just come up a little bit and show how how painful it is. What you do with this is at home you put your hand behind your back to expose that bursa sack, and then you can use an ice cube. So I like there's a couple of different ways to do the ice cubes. I like filling a if you have a paper cup, you fill it with water and freeze it, then you tear the top of the cup off, and now you have a nice little handle. You you need direct ice on the skin. Or if you have a um uh a plastic cup, you just break off the cup, and then now you have a handy large ice cube that can just hold with a napkin or something, and then glide that on the front bony part of your shoulder. So, let me demonstrate that for you. Just put your hand behind your back, and then you take that ice that exposes that burst of sack. Now I'm gonna put the ice directly on my skin. I don't want to I don't want to press deep, no, no deep pressing because why would I want to rub a rock on this? It's already irritated. The goal is to get it cold. So I'm only gonna put barely touch the skin. I'm gonna go on here 10 or 20 seconds. That's deeply cold already. And then I might just warm it up a little bit with my palm. Say, okay, I'm not rubbing it. If you rub it, you're gonna increase the irritation. One more time, 10 to 20 seconds. You can even say it's a little bit red, it's deeply cold. That's cold enough, and that is reducing the inflammation nicely of that bursitis, so we can get that inflammation to go down. It takes a couple of weeks, all right. In the office, we can do red light therapy, we can do uh ultrasound. Um, but the ice I found the ice to really be the most effective.

Biceps Tendonitis Test And Icing

SPEAKER_00 6:50

Let's talk about biceps tendonitis, it's a very common one. So if you go like this and isolate your biceps and you push on your palm and you resist, and that hurts really bad right there, that's a positive test for biceps tendonitis. There's other ones to do, but this is it's called speeds, speeds test, and you resist and you have a lot of pain right there, and then if you rest your hand on your lap and you touch, see that groove, see that groove right there? So that groove is where that biceps tendon travels through the long, there's two biceps tendons, but this one it goes up here and inserts on the top of the socket. So anytime you have a tendon that goes into a joint, that's that's bad news. That's why it's so common that this gets aggravated. So that is exposed when you're just sitting there. So it's very common when the shoulder blade is not moving on the back of the rib cage, and this is getting all getting jammed in here. Guess what? They're getting subachromial bursitis and biceps, long head, tendonitis. So bursitis, tendonitis, all in the front of the shoulder. So all patients put the ice on with their hand behind their back and then lay their hand on their lap and then do the ice again. If you feel the front part of your shoulder, and it's not way up here like you you might think it is, that the head of the humerus is down a little bit lower, about there. And then if you touch that and that's and that's sore, and then you go like this back and forth. I can feel myself, I'm rolling over the tendon right now. Bump, bump, bump, bump. You can feel that on yourself. If that hurts like heck, you most likely have biceps tendinitis. Is ice gonna hurt you? No. I mean, if it's on for too long, it's gonna damn, you can damage tissues. You know, it's ice is ice, right? But this is a first aid type of thing. And then a lot of times the the biceps muscle is just really, really tight, in addition to the problem with the shoulder blade not moving. And then in the in the office, we'll we'll lengthen the tissue and restore the tissue length so it's not causing so much tensile or pulling stress on that tendon. So that goes back to I'm doing things for you in the office that you can't do for yourself at home. But at home, my goodness, the ice, how often? Lunchtime, dinner time, and and bedtime. Quick and easy, 10 to 20 seconds. So let's recap. You got the ice on there, hand behind your back for that bursa sack, hands on your lap, now it's on there again for the biceps tendon. All right.

AC Joint Arthritis Signs And Relief

SPEAKER_00 9:23

Um, let's talk about arthritis, where the collarbone meets the shoulder blade, and that's called the AC joint. So this gets very inflamed, it easily becomes rubbing bone on bone, and it gets very, very irritated. So if you just simply follow your collarbone over and you push on that area, especially if when you're moving and you feel it going, you get a lot of crunching, it's called crapitus. You get a lot of crunching and crackling, you can feel it right in there as as you're moving, and then when you go over here like this and it's jamming that together, and you're moving around a little bit, and that hurts right there where your collarbone meets your the other bone, your that acromion, that roof of bone right there. You can just follow that over and then ice that spot, just like I demonstrated with the ice cube, and get and get some uh get that deeply cold, and that's gonna relieve the uh the inflammation, and you're gonna feel a lot better. At least if you do it at lunchtime and at the end of the day or after work and then before you before you go to bed. In the morning, your inflammation is gonna be lowest because you've been resting all night. But then during the day, you're using it, aggravating it, irritating it. That's when you want to use the ice to literally shrink down the irritation, shrink down the inflammation.

Rotator Cuff Knots Heat And Release

SPEAKER_00 10:41

Now, what keeps the ball centered on the very shallow socket? Muscles of the rotator cuff, C U F F. It's a cuff of four muscles that keep that ball centered on that very shallow socket. Pete, you're doing a great job. Thank you for putting up with me. Now, these I found muscles. So here's the deltoid. Deltoid, let's take it off. So here's the left side right here. And uh Pete, you know what? Pete used to have muscles like this. On the back, let's let me show you the back. So here's the red of the muscle, the whites of tendon. These muscles go underneath that roof of bone we've been talking about, they're chromion, and they insert on the outside part of the the ball, okay? And that's the humerus. And these muscles sometimes can get really, really tight, especially the ones which are not shown, that go up here to the neck, and they keep the the shoulder blade up, and they get really, really tight, and knots will form called trigger points. Do not want to use an ice pack, no ice. So picture this the knot is the muscles already tight, it's all knotted up. What does cold do? Cold shrinks that will shrink that down and that'll knock that up even harder. All right. So, what do we do instead? A low electric heating pad. The trap of heat is that it always feels good when it's on, and people will use high heat, they use it way too often. Then they remove the heating pad, and now you have an inflammant inflammation response. The inflammation is now out of sight. You can easily, easily overdo the heat. So the electric heating pad should be right over the these thick group of muscles and right down the back, right behind all these muscles, on the lowest setting, not the not the heating pad you put in the microwave. You want an electric heating pad with a thermostat that you put on the lowest setting, the lowest setting for 15 minutes, not longer than 15 minutes. So then you you you put that on for about 15 minutes, just lean back. How often can you do the heat? Not more than three times a day. Starting in the morning is ideal. Your inflammation is lowest in the morning. What's the side effect of heat? Increased inflammation because heat expands. Start in the morning, get that, open up the vessels, more blood. Why is it so great to have more blood? More oxygen, more nutrients. Okay? And then it relaxes the muscles, and those knots relax. And you can do the heat two to three times a day without exacerbating or increasing inflammation. Now, there is a nice tool, you can buy these right on Amazon or any supply store where there's a couple handles, and then that allows you to reach the back. And you can find that knot in the muscle. Don't go on the bone, you'll know when you find bone, hard areas, and then just get in that. We all have trigger points back there. Okay, I found one. And I'm going to I'm going to press into that knot until it's tender. Yeah. There it is. And I'm going to hold that there until it starts to relax. I'm just going to breathe. It's nice to do this after the heat. And then as it relaxes, and this is this is solid plastic, you can take it right in the shower, even. As it relaxes, press into it deeper, and now it's tender again. This is called ischemic compression. Ischemia is a lack of oxygen. So it pushes the oxygen, the blood out of the knot, it starts it of oxygen, and it forces that knot in the muscle to relax. And then and that's it. That's your then you can do that to all your trigger points, or you can have somebody else do it with a massage tool or a knuckle or something. Don't use the thumb, it just beats up the thumb. It's not good for the wrist. Watch my wrist and thumb videos.

Get Evaluated And Simple Wrap Up

SPEAKER_00 14:34

Um, all right, so that's some that's some information to empower you to help yourself be more aware of your own body, what to do at home, some first aid kind of stuff. Get into the provider. Sooner is always better, okay? Get into your healthcare provider. Allow me to get my hands on you and figure out exactly what's going on. Let's nip the thing in the bud, show you exactly what to do at home. Not a bunch of long list of stuff, just a few targeted things to get you better in minimal time. Thanks for watching the Hand to Shoulder Solution. Rapin meets us match, and we are the solution to your pain.