Rotator Cuff Tears: Everything You Need To Know To Understand & Fix The Root Problem

Painful rotator cuff tears are scary to deal with because they cause pain with everyday movements. Sometimes they don’t let you sleep at night. And if it gets really bad, your doctor might recommend surgery for your rotator cuff tear. But there’s good news in nine out of 10 cases, it’s possible to heal your rotator cuff tear without surgery.

In fact, research shows that people going through rotator cuff repair surgery and then the rehabilitation process afterwards, do about the same as people who never have surgery and just rehabilitates Naturally, this is research that’s come out and just in the past 10 years, so your doctors probably not going to be aware of this. I’ve linked some research studies that talk about this in the description below.

Now, there’s a lot that most healthcare providers aren’t going to know when it comes to helping somebody heal from an rotator cuff tear naturally. In this video, I’m going to tell you everything you need to know to understand and begin to fix the root problem of rotator cuff tears. What is a rotator cuff tear, let me give you some basic anatomy about the rotator cuff muscles and tendons so that you can understand what a tear is.

So here’s the shoulder blade bone, and around all around the shoulder blade bone, the scapula is what it’s called, are muscles that are that make up the rotator cuff. There’s four muscles, there’s two down here below this ridge of the bone. One is called the infraspinatus. And another one’s called teres minor and those muscles are right here and they come and attached to the outside part of the upper arm bone.

Then there’s one that sits up here on the top part of the shoulder blade, and it runs under this overhanging bone. This is important I’m going to talk a lot about this later on. This bone right here is part of the shoulder blade, but specifically it’s called the acromion. Well, that supraspinatus muscle, the rotator cuff muscle comes this way. And it’s tendon runs over and attaches to about the top part of this upper arm bone in under here between the ribs and the shoulder blade.

But attached to the shoulder blade is the biggest rotator cuff muscle called the subscapularis and it sends his tendon out under this way onto the front part of the top of the upper arm bone. This arm called this arm bone here is called the humerus. It’s these four muscles that all work together. And they come out here in form what’s called the rotator cuff tendons, they call it a cup because it’s it just goes around over the top, the front, the top and the back. And its main job.

This is extremely important because it sets up the root problem that I’ll speak to towards the end of this video. Its main job is to compress the ball into the socket, its stability. And now this is where things get confusing because it’s called the rotator cuff. And so it’s a misnomer, meaning it’s not named properly.

They think that in the medical field, they at large, the general health care professionals out there they’re thinking about the rotator cuff is that it provides rotation to the ball and socket joint. But in reality, its main purpose is to provide stability to the ball and socket joint because there’s bigger muscles all around the shoulder.

Like the pec muscles, there’s bigger muscles back here, the lats there’s, I can go on about all the different muscles that helped to create rotation in the ball and socket joint. But those deepest muscles are rotator cuff muscles and their tendons that come out here. Their main job is to suck that ball into the socket.

And it’s so important because if you just look at the ball and look at the socket surfaces of the bones, the sockets are really really small compared to like the hip joint, the hip joint socket is almost covering like half of the ball of the ball and socket joint of the hip.

So you don’t need as much muscular intendant stability in the hip joint because the bone provides a lot of stability. But up here in the shoulder, there’s not as much bone stability, so you need a lot of muscle and tendons stability that comes from the rotator cuff. And the body is designed this way to allow a lot more flexibility in the shoulder joint.

Obviously your shoulder should be should have a much larger range of motion than your hip joint. So you need smaller bones stability to offer more mobility, but that mobility needs to be controlled by your rotator cuff muscles. It needs to be stabilized by your rotator cuff muscles and then control Bally other muscles that can move your shoulder joint.

Then the most common torn rotator cuff muscle and tendon is the supraspinatus the one that runs right through the top of the bone here and it comes out the top and attaches to the corner out here on the upper arm bone. There’s all these medical theories on why that one gets torn or why any of these get torn really. And the main theory that you’re going to hear if you visit your doctor if you do research online is that there’s pinching of the tissues, the muscles, the tendons.

There’s other things in here besides muscle and tendon, right here between this chromium, this this part of the shoulder blade, and the upper arm bone. And so the theory is that when you come up that you pinch the tissues there too much. And over time and repetitive stress, it begins to fray the supraspinatus tendon, one of the rotator cuff tendons, and eventually causes a tear.

Now, I’ll tell you more about the types of tears in just a moment. But first, let me talk to you about what it feels like to have a rotator cuff tear, the symptoms that you’ll feel are going to be pain in the front of the shoulder, it could be pain right on the top of the shoulder, sometimes it’s on the back of the shoulder, that really depends on which rotator cuff, muscle and tendon is affected.

There’s many nerves in the area, all the nerves that come off the neck, they go under the collarbone right here, and several of those branch out and go in different directions all down the arm all the way down to the hand. But there’s one nerve in particular, it’s called the real nerve, it runs through the backside of the joint here and down the outer part of the arm and then down to the elbow.

Well, that nerve frequently gets irritated with rotator cuff tears. And he can cause pain in the outer part of the arm. About right here, like where the policeman would have his patch, they often call this a policeman patch sign. And that’s it’s mistaken. Often even medical professionals think that that’s where your rotator cuff is that because that’s where pain is in many people that have rotator cuff problems.

But that’s actually referred pain from that radial nerve, because the rotator cuff muscles are way up, up here, not down here, the tendons from the rotator cuff muscles do not go past this point, they’re in your shoulder blade, and they come out here than any pain down away from that area is going to be for another from another part of the body.

Now there may be pain at rest. And usually there’s even more pain when moving especially when reaching up overhead. And behind the back like this. Like if you have to scratch an itch, adjust a broad get a belt on your pants, that motion tends to be very painful in the shoulder, there could be increased popping and clicking happening in the shoulder like if you’ve been sitting for a while without moving and then you go to move it pops and then it feels a little bit better.

And that’s consistent with the rotator cuff problem because you lose stability in the joint because the rotator cuff might be torn. And so you’re not able to get the best stability possible. And that popping or clicking will happen as a result of that because the joint mechanics are off. Very often, people with a rotator cuff tear have pain at night, especially they lie on the side that’s affected.

So in this skeletons cases, the left shoulder, if this skeleton were to have a rotator cuff tear, well they wouldn’t be a skeleton anymore than have muscles and tendons. But they would have pain on this side because the stability is off, and the body weight of your body against the bed starts to push on that shoulder joint. And that loss of stability causes the bad forces to happen at the shoulder joint.

And that leads to waking up in the middle of the night with intense pain and you have to shift out of that position. And many people can’t get comfortable in any position even if they’re lying on their other side that may not bother them. Just finding a comfortable position for their shoulder is extremely difficult.

In extreme cases. Because of the nerves around the area and the loss of stability in the ball and socket joint here. It can lead to numbness and tingling in the hand and pain in the hand because the nerves get very irritated up in the shoulder joint. There’s two main types of rotator cuff tears the big picture, there’s acute tears, which means you had an accident of some sort.

 You know, God forbid you’re ever in a motor vehicle accident, a motorcycle bicycling accident or some sports accident where there’s an obvious injury that happened there was a time a trauma that happened that could cause a rotator cuff tear. But we’re talking in this video about the second type which is degenerative tears.

Now there’s two types of degenerative tears. One is a partial thickness tear, and the second is a full thickness tear. I’ve drawn this with my super artistic skills here. So here’s a partial tear. And what you can see in the picture below in brown is the outline of the scapula and the humerus. So here’s the upper arm bone, and here’s the shoulder blade.

And in red here is the supraspinatus muscle and then in black is a tendon and there’s a little divot, a little hole in the tendon. That’s a partial tear. And here’s a zoomed in version of the tendon. That right there as the tariffs should be complete, without any sort of cracking it or tear or fraying is what they usually will say like in an MRI report. Now that’s a partial tear and a complete tear a full tear because they use different terminology, but it’s kind of the same thing.

The tendon is completely torn, it’s disconnected. And it would look kind of like this, if you were to take a peek at it and be frayed all the way through. Now the big scare is if you have any kind of tear, whether it’s a partial thickness or a full thickness tear, the big scare is that you’re going to need to have surgery to repair it. But like I said, at the very beginning of this video, even with a full thickness tear, it’s possible to heal it naturally and get your function back.

Now, I’m not claiming that the tendon itself is going to rejoin, we don’t have solid research that shows that the tendon rejoins itself, what we show in the research is that people can reduce their pain levels and get function back in other words, be able to raise their arm and reach back and sleep and do all the normal things that they want to be able to do without having surgery despite having a full thickness tear.

And the reason for this is because that tendon isn’t by itself in your shoulder, it’s surrounded with other rotator cuff tendons, there’s other tissues, other there’s fascia and other things that are holding it in place. So even if the tenant is torn all the way, it’s possible that that MRI didn’t fully see that there’s a few threads of tendon holding it together and you’re getting a false positive on him or an on an MRI.

Meaning the MRI may not be 100% accurate, because it’s a picture of the inside of the body without actually looking at the tendon. And then the tendons is right next door to other tendons, the other rotator cuff muscles, the infraspinatus, teres minor, and the subscapularis muscles. So all those are still helping it to remain in place, and potentially giving it a shot at healing back together.

And at the very least, if it never heals together, it can get support from all the other rotator cuff muscles so that you can function without a connected supraspinatus tendon or the rotator cuff tendon if you tear it. And you can still go on in life without ever having surgery.

And should you get an MRI, if you think you have a rotator cuff tear, if you go to the doctor with your shoulder pain, and they’re suspecting a rotator cuff injury, they’re probably going to ask you to go get an x ray first, just to make sure that none of the bones are involved in any way, in a classic rotator cuff injury, the X ray will look normal, there won’t be much going on there.

But then they’ll say go get an MRI. And if you go to the MRI, then they’ll be able to see on the MRI that there’s something wrong with one of the one of the rotator cuff tendons. Now because of the nature of an MRI, they’re not looking at the inside of your body. That would be the gold standard. By the way, when they’re doing MRI studies to see how accurate they are they compared to the gold standard, which is surgical visualization of whatever they’re studying.

So the gold standard would be to go in with surgery and look at the tendon itself. But obviously, there’s all these complications and risks to doing that. So MRI is pretty good because it doesn’t open up your body and expose you to all the risks.

But you can still get false positives, meaning the radiologists report from the MRI might say you have a rotator cuff tear, and you actually don’t or the other way around, they may say you don’t have a rotator cuff tear and you actually do so you can’t 100% trust the MRI, but it’s a good starting point as to how to proceed.

Now I’m going to give you some tests in just a minute that will help you self diagnose if you have a rotator cuff problem, because it’s pretty straightforward to diagnose. I mean, I see them here in the clinic all the time. And I do a handful of tests. And I can tell people with pretty good certainty that they would likely get a rotator cuff tear. I always say I’m not an MRI machine, and I’m not looking at the inside of your body.

But these tests are pretty good at identifying if you’ve got a tear. And if you do have a tear, then we start treatment for rotator cuff tear to heal it naturally. And if they get better, well, I think we’re right. But let me tell you what treatment would look like for rotator cuff tears. If you go the normal health care routes, you probably see your physician first your general physician, and they’re going to make the recommendation of just resting your shoulder.

In other words, you’re going to say, just don’t use your arm very much. And they’ll do activity modification as well, which just means change what you’re doing so that you don’t aggravate your shoulder problem more. So they’ll make comments like this that make me laugh because patients come in, they’re like, how am I going to do that? They’ll say Don’t raise your arm over your head, because that’s what hurts, right?

So the doctor will say, Well, don’t do that. But that’s just impractical. I mean, you have to move your arm over your head to take off your clothes and put on your clothes and how you going to take a shower without picking up your arm. There’s just so many reasons for you to lift your arm in normal everyday motion that it’s nearly impossible to completely avoid that.

So my treatment approach involves moving your arm overhead in a safe way, but that’s what doctors will say. Then they’ll prescribe you medications. We’ll start with over the counter medications Of course they’ll say you know go to the local drugstore and you don’t need a prescription for this just go get Tylenol get out you’re profaned, see if that helps calm down the pain so that you can sleep at night and get through the day.

And if that doesn’t work, then they’ll say, Well come on back into the office, we’re going to write your prescription for prescription strength, pain medication, so that you can get sleep and do all those things. And if that doesn’t work, then they’re going to say, let’s do an injection, we can stick cortisone in there and get you some longer lasting relief.

Now, during this time, they might have referred you to physical therapy. So you might be experiencing pain as you’re doing physical therapy. And so taking the pain medications is their goal to reduce the pain so you can do the therapy. And in physical therapy, physical therapists are excellent at helping people recover from a rotator cuff repair or other shoulder surgeries.

But they typically don’t help people who have not had a surgery yet. And they’re looking to prevent having a surgery like a rotator cuff repair. So they don’t always know what to do, they’re usually unsure I I’ve particularly trained therapists in this. And I always find problems in the treatment approach, they usually tend to do the same treatment on somebody who has not had surgery and has a rotator cuff injury, they do the same treatment that they would somebody who had surgery.

And it’s not the same things that should be happening, there’s a completely different approach really a different specialty, helping somebody avoid surgery, versus helping somebody who just had surgery, there’s different things to worry about, you can’t address the root problem, the freshness of the injury matters a lot that there’s different stages of the rotator cuff healing, and that needs to be considered.

And so you can’t just do post surgery rotator cuff exercises on somebody who has not had surgery. So as a result of that, very often, I find that patients that are coming in to get help with a rotator cuff problem, they’ve gone through therapy, and it didn’t help at all, or some in some cases, it made them worse. And every now and then it does help. I’ve seen people that have said that they got better after normal physical therapy.

But there’s usually a root problem that hasn’t been addressed. And they’re having a recurrence of their shoulder pain, or they ended up tearing the rotator cuff even worse. I’ll speak more about the root problem in just a moment.

But let me tell you what the what your doctor will do. If physical therapy and medications aren’t working and injections, then they’ll say you need to go talk to an orthopedic surgeon. And the orthopedic surgeon might try different types of medications, different types of injections. If that doesn’t work, we’ll give it about a month or two, this whole process, by the way, because you’re probably wondering, how long does it take the rotator cuff to heal, it should take anywhere from six to 12 months total, according the timeframes that I use.

But very often in a normal doctor’s office, they’ll give you a pain medication or an injection. And then they’ll say come back in a month, and they’re expecting within that month for you to be showing improvements. And then within two or three months to be done with this problem. And so if you get sent to the surgeon’s office, once they start working with you, they’ll start that timeframe over again.

And they’ll say, alright, well, here’s this payment occasion, here’s this injection, let’s give it a month come back in a month. And at that point, they’re recommending surgery, and very often it’s not been enough time for the rotator cuff to heal. If you’ve been doing the right things, if you haven’t been doing the right things, and your timeframes are going to get elongated even more.

So many people I find get kind of rushed into doing a shoulder surgery like a rotator cuff repair. And they really need to give it its due diligence as far as the right exercises, fixing the right problem, the root problem and making sure that they’re seeing consistent progress over time. And what the surgeon will do is a rotator cuff repair.

That’s the classic surgery that’s done for a rotator cuff tear. And they go in arthroscopically, meaning they make little holes so they don’t open you up all the way. That’s how it used to be done back in the day. But they found that there’s a lot more risk when they open you up more. So they use little holes, little ports is what they call them, and they can sew the ends of the tendon back together.

And they usually tighten it up really good to offer better stability because that’s the job of the rotator cuff. And the other surgery they may do at the same time as a rotator cuff repair maybe apart from it is what’s called the subacromial decompression where they’re talking about the acromion.

So subacromial means below the acromion decompression means they’re usually scraping the edge of this bone here because of that theory that the ball is butting up against this bone and fraying the tendon. So they’ll shave this off and clean it up is what they will often say to you know keep it in simple terms.

So you’ll get this operated on as well. And two other surgeries they’ll do is a biceps tendon repair because the biceps tendon goes right over the ball of the ball and socket joint and it may be involved somehow. And then in an extreme cases, they’ll look at doing a total shoulder replacement.

Obviously this is for somebody who’s older, somebody who’s got massive arthritis in their shoulder in addition to the rotator cuff tear. Usually they’ve had a rotator cuff tear for a long time before they’ve developed arthritis and then they ended up getting a shoulder replacement. Now rehab habilitation after surgery is usually recommended that three to six months, but I find that it often takes the better part of a year you’re looking at nine to 12 months.

But they’ll do rehabilitation or physical therapy in the first few months just to get the basic movements back. But getting strength just takes many months after the simple movements of comeback. That’s usually why it’s a better part of a year. And it varies depending on what your fitness level, which is strength levels, we’re going into the surgery, obviously, the more fit and healthy you are, the quicker your recovery is going to be.

So there’s a big range. And doctors surgeons, they tend to give a kind of a cookie cutter range to people who say Oh, and two or three months will be just fine. And you need to reset your expectations triple whatever they tell you, just so that you’re not trying to rush the rehabilitation and potentially causing a problem which leads me to the complications of surgery.

Because if you do end up getting a rotator cuff surgery, you’re considering it, here’s what you need to know you’re at risk for infection. If your surgery becomes infected right after it’s done, you’re in huge trouble, you’re going to be on antibiotics for probably a month, they might need to go back in and revise it, they need to cut the infection out sometimes which leaves you worse. So you got to consider that part.

Now the infection rates have gone down tremendously since we’re doing arthroscopic surgery now, but that’s still a risk. Another complication is nerve injury, there’s tons of nerves in the shoulder. And sometimes inadvertently, they’ll precedent or too long during the surgery or even cut one. And that can leave you different after surgery.

What I have seen more commonly is frozen shoulder after surgery, frozen shoulder or adhesive capsulitis is another condition where the ball and socket joint stiffen tremendously in the shoulder. And it’s not always associated with a rotator cuff tear, but it can be. And but I’ve seen many patients after having had a rotator cuff repair and up with frozen shoulder.

Now frozen shoulder tends to get better on its own, it usually does. But it’s just a pain to deal with. And it can last a year or more in some cases. And then another common one is accidentally returning the tendon right after having it repaired because they overdo it somehow or people take an accidental fall and they put that arm out. And their tendon that was just repaired is healing still. And they’ll put too much force in the area and retire it and though they might have to go in and redo the surgery.

Now my advice to you in finding a physical therapist is talk to your physical therapist first in your area in your city, before going through treatment with them so that you can make sure you’re working with somebody who knows how to handle a rotator cuff tear before surgery, go into the clinic.

And if they can’t really verbalize to you that they competently handle people that have not had surgery, for rotator cuff problems, then just look around the clinic and in even talk to the patients that are there, go up to them and ask them, hey, are you here for your shoulder? Did you have a shoulder surgery if you find people in there that have had shoulder surgeries and that physical therapy clinic likely specializes in helping people after surgery.

And especially if you start going to treatment there and you see that same person or you get to know people along the way. And you’re doing the same exercises that the person who just had surgery is doing, that’s a red flag that they’re probably handling you inappropriately unknowingly, they’re doing the best they can and what they know, but they just don’t always, they’re not always aware of how to treat somebody non surgically.

Physical Therapists aren’t always aware of how to treat a patient non surgically to help them recover from a rotator cuff tear versus somebody who’s had surgery already. Some common treatments that physical therapists will do that are not the best for somebody who’s trying to recover naturally from a rotator cuff tendon is where they’ll put them against the wall, put their hand flat like this, and then they’ll have them turn away to stretch the front and side of the joint here.

Or sometimes they’ll go into the corner of a room and put their hands this way and then lean their head and body towards the corner and stretch both sides. Those are not good and you had a rotator cuff tear. Other ones will do is where they use a band or sometimes a cable with some weights, and they’ll do this kind of a motion.

Sometimes pulling in is the harder part or sometimes pushing out with the band going this way is the harder part. Those types of motions are also inappropriate because like I said at the beginning of the video, you don’t need to work on rotation that the rotator cuff muscles are misnamed.

They’re not rotators. That’s not their primary job anyway, they can rotate, but their primary job is stability. So there’s different exercises that need to be done. And doing these rotational type exercises tend to make the problem worse. And there’s other versions of this like somebody will standing against the wall and you’re not really moving but you’re pressing into a wall this way to activate the shoulder muscles are going this way, or pushing into the wall or backwards on the wall and just holding.

Those are all motions that feed into the rotation concept of the row. tearing off muscles. And they’re not appropriate to do at every phase anyway of the rotator cuff rehabilitation process. And another common one is behind the back stretches like they’ll, they’ll tell you to reach up this way and force into a painful stretch, or going down this way too.

Sometimes they’ll say reach your hands behind your back. And if you’re not very flexible, or one side doesn’t come up very good, like the other side, they’ll have you pull a rope or a pole or something to force stretching in that direction. And that’s just not the best thing for you. And let me give you some basic tests that you can do to figure out if you’ve got a rotator cuff tear, the first one is super easy.

If it hurts to come up like this, if you feel pain, at a certain angle, usually above about 90 degrees and higher, that’s probably a rotator cuff problem, it’ll be painful on the way down to not just on the way up, but on the way down. Because the painful arc, it may even get better as it comes higher. And then there’s an arc of motion within this whole arc of motion that is painful and uncomfortable.

Another sign is tenderness, just past the corner of the bone here in the in your shoulder. So that’s on the acromion that that piece of the bone that’s hanging off the shoulder blade, if you just find where it’s hard on the top of your shoulder here, and then where your shoulder starts to fall downwards. Just past that edge of the bone is where the rotator cuff tendons are if you just poke around the edge of the bone and compare it to the your other side.

If it’s tender on the side, that hurts your shoulder. And it’s not on the other side of maybe Tinder on both sides. But if it’s particularly tender on the side, that’s hurt, that’s a big sign that you’ve got a rotator cuff tear. And then the other one is reaching behind your back if you put your hand behind your back like this, and it just starts to hurt your shoulder almost immediately. Don’t force it by the way.

But that’s a sign that you’ve got a rotator cuff problem as well. Now, let me tell you about treatment for rotator cuff tears. If you have a fresh one or one that’s very aggravated like it’s hurting you a lot, you need to get a brace like this. And this is just a standard shoulder brace. This is the one that I’ve that I use here, I’ve got it linked in the description below.

And all you got to do is set this up on yourself with the intent of making your shoulder go up as high as possible your elbow go up as high as possible. So you put it on just like this gets your elbow in the corner of the pocket there. And then it’s got a little thumb thing right here, then you’ve got to pull this strap here to shorten the brace. And the goal here is to get your elbow to shove your shoulder up.

Because if you can do that right there, then you bring the edges of that tendon together and provide a relief and everyone that I’ve given this to as an initial treatment just to get the pain to flare down. They’re like wow, it’s like night and day, I can actually feel better throughout the day. And I tend to feel better at night too.

But that’s the trick is you can’t just put the sling on, it needs to be shoved up so that your shoulders up like this. And these braces are cheap, you can find them at your local grocery store, you can find them at big department stores like your Walmart and Target those kinds of places. I’ve got mine off Amazon, and they’re actually a little bit cheaper than some of those places.

So I’ve got it linked in the description below. And how I would wear this is I put it on for most of the day, I wouldn’t sleep in it necessarily. Some people do sleep in it, they find that they sleep better with it, that’s fine. But two things happen when you put on this brace one, you bring those edges of the tenant together and to you let other people around, you know that you’re injured just by wearing this.

And so they begin to help you out, which helps you avoid using the arm. And you don’t have to have this on constantly while you’re awake. What I tell people is put it on what you’re doing things where you’re likely to use your arm. But if you sit down and have a meal, if you are going to relax and watch YouTube or watch TV for a while, then you can go ahead and take it off. You can use your arm within motions that feel comfortable, but you’re going to feel the weight of gravity pulling down your arm.

So you want to rest it on an armrest on a table. Try to get some pills under to shove it up. But you still need to be able to use your arm. Now that sling is great for when you’re very flared up. But once the shoulder starts to flare down, your rotator cuff tendon is feeling better and you can begin to move a bit better but you’re still having trouble reaching up.

Then you need to be using a device like this. This is a shoulder pulley and it’s designed so that it’s got this strap and it’s got this hard plastic thing. You put this over your door you open your door up, you put it in the door, and then the door shuts make sure your door shuts securely and then it hangs from their catches on the other side so that these pulleys hang, once you have that set up let me show you how this works.

So you get your setup just like this. Went over the door. Shut the door. Make sure it’s secure then you say In front of the door, grab onto the handles like this like so. And just so you know, I’ve pulled this string through and tied a knot to shorten the length of the rope, it doesn’t come like that I did that because the person that I was last using it on, they got more shoulder motion, and we had to shorten the rope for them to get higher.

Then let’s say it was my right arm here that I’m worried about, what I got to do is pull with my left arm to help my right arm the one that I have the rotator cuff tear on, I’m pretending. And as I come up, I have to shrug my shoulder to get it to come up to a pain free zone. So if it hurts about right there, no need to push into it, then relax the shrug. And you can come up with the other side, if you want, you can just focus on the side that’s involved.

But every time you come up, give it a shrug. And then relax. And I’ll tell people, you need to be practicing this lots throughout the day, if you can do it at least three times a day for five minutes. That would be fantastic. But if he can go every two hours, just putting some shrugs into it, maybe just a few minutes, like two, three minutes, practicing the shrug, because the shrug is fixing the root problem of the rotator cuff tear.

Very often people aren’t shrugging adequately when they come up. And so the ball runs into the socket part of that in that acromion and it starts to fray the shoulder. And it happens almost instantaneously. When people start to shrug. I’ll tell them first. Okay, pick up your involved arm and they’ll say, Oh, that hurts right there.

So I’ll take a measurement, we’ll say it’s 90 degrees. And then I’ll tell them, Okay, you’re going to start to struggle, you do this and they shrug and you’re like, oh, wow, I can tell them going a lot higher. And I’ll take a measurement where they go pain free. And literally from one moment to the next without having done any sort of manual therapy treatments, any sort of like joint popping things, any massage things that we do here, just showing them how to shrug their shoulder when they move up.

People with the rotator cuff tears instantaneously get 10, 20, 30 in some cases, 50 or 60 degrees more weather coming up almost all the way without having done anything else just simply shrugging properly. So let me make sure you understand the root problem of rotator cuff tears with degenerative rotator cuff tears.

When you’re coming up right here, you’re pushing the ball up against the acromion. And that’s where the rotator cuff lives. So you’re potentially fraying it. But in order to fix the root problem, you’ve got to get that shoulder blade up. And luckily our shoulder blades have tons of movement, you can shrug, you can move them back and forward.

And so if you practice reaching up and shrugging at the same time, like with that pulley, then you can begin to train your body to move more appropriately to offload that tendon here. And there’s another root problem that addresses the structure of the bones here. And I learned about this through John Kirsch Dr. John Kirsch. And he wrote a book on the topic.

It’s called shoulder pain, the solution and prevention and I’ve interviewed him here on the channel. I’ve linked the video interview down in the description below, and you should get his book and consider learning about it. It’s fantastic. I think this idea is just breakthrough, that once your rotator cuff tendon pain flares down, you can get that arm movement up overhead, then hanging as the girl in the book cover here is doing is likely the next step that you’ve got to take in improving your rotator cuff tendon health.

Just keep in mind that healing your rotator cuff tendon is a process it doesn’t just happen with a few exercises. It’s a series of exercises and progressions over time. In order to heal naturally and avoid surgery. You can’t rely on medications, injections, or procedures even because if you end up having rotator cuff repair surgery, and you learn how to move your shoulder blade properly.

Or if you have that decompression surgery, the subacromial decompression surgery because possibly the structure of your acromion has changed, then you need to make sure that you’re doing the right things to address the root problems of your rotator cuff tear so that it’s not recurring because I have met many people over the years that have had more than one rotator cuff surgeries on the same shoulder because the root problem has not been properly addressed.

So surgery is not the final solution. You’ve got to address the root problem. Hey, hope this video was helpful for you. If it was give it a thumbs up. Please share this with somebody that you know is suffering from a rotator cuff tear. And please subscribe to our channel and turn on the notification bell so that you don’t miss out on any of the helpful videos we post every week. I’ll see you in the next video. Bye