3. How to fix rotator cuff pain – rehab exercises massage treatment


That does what’s called downward rotation.. backwards this way? It’s actually making the problem worse Again I would like to emphasise you shouldn’t stretch your tendon problems. Hi guys, Rehab safely. Mr.Physio here. I’ve done two videos so far about shoulder impingement and the rotator cuff muscles today is the third one about supraspinatus the victim of shoulder impingement. Okay, let’s get it supraspinatus sits on top of the shoulder blade. This is my left shoulder. There’s a Groove On Top of the shoulder blade and starting from here all the way to the tip of the upper arm bone So from here to there when it contracts it lifts your arm up like this. Okay, when you lift your arm up Deltoid muscle is the one that does the most of the activity. The primary mover of the upper arm bone is Deltoid muscles So when the deltoid muscles lift your arm up the rotator cuff muscles pull the head of the humerus downwards Again, when the deltoid muscles pull your arm up the rotator cuff muscles pull the head of the humerus downwards. without this action the humerus will definitely hit the undersurface of the acromion, which is shoulder impingement. That’s why the rotator cuff muscles is so so important the rotator cuff muscles including supraspinatus finetune the movement if the rotator cuff muscles don’t work properly the supraspinatus on top of the shoulder blade will get pinched all the time. Every every time you lift your arm up. That’s why it’s a victim of shoulder impingement. If you keep irritating the muscle, it can get tensed up so it gets quite tight. Let’s say when you watch a boxing game. So if one player keeps spitting his opponent that person who’s being hit keeps shrinking down like that. Shrinking down(?) protecting himself like doing this (Defence) your muscle is the same it gets tensed up if you keep irritating the muscle on top of the shoulder blade. Once it gets tight, it also has a secret function so this tissue muscle, attached like this. if this muscle’s getting tight in the middle. That’s pulling your shoulder blade towards the spine so that does what’s called ‘download rotation.’ So this is called upward rotation(away from spine). The opposite movement is called downward rotation. Remember? In the first video of the shoulder impingement. I told you your shoulder blade has to go out to the side(away from spine) every time you lift your arm up without the shoulder blade movement. You get stuck at 90 degree. You keep hitting that undersurface of the acromion, which is the tip of the shoulder. so to avoid impingement. you have to be able to bring your shoulder blade out away from spine all the time Every time you lift your arm up, the shoulder blade goes out to the side to assist arm movement, but now the supraspinatus tightens up in the middle. That’s giving the force to bring the shoulder blade towards spine we want that movement going out to the side, but it brings your shoulder blade inwards that way. To solve the problem that muscle needs to learn how to lengthen up while generating power which is called eccentric contraction. So that mucle is quite tight at the moment so if it contracts. at that lifts your arm up. That’s what it’s meant to do. But at the same time it actually brings your shoulder blade towards spine if it does the normal contraction, so we want to teach it how to lengthen up while activating. So when this muscle activates, it lifts your arm up at the same time that shoulder blade has to rotate out to the side it has to do the upward rotation so this muscle has to elongate while activating.. hope that makes sense. I’ve done a few videos about tendon Rehabilitation and this is also a tendon problem tendons attach muscles to bones and tendons don’t like compression and stretching if you actually stretch out your muscle like that. So some people do this kind of stretching or just a backwards this way. It’s actually making that problem worse So don’t stretch on the tendon if you have a trouble. I’ll give you a very simple technique to loosen up and evidence-based. Strengthening exercises for the supraspinatus to massage that muscle, you need to find this bony area. shoulder blade sits like that and this is the tip of the shoulder try to palpate along the bony area so once you find a bone, just bring your fingertips a little bit on the top of the bone Palpate the bone and bring your fingertips in there. so you have to press down like that. Okay? so I find a bone first and bring My fingers a little bit upwards 2-3cm and Just press down. Yeah from here all the way in and out we can press down and just go side to side(front and back) About 5 seconds here five seconds there all the way about 10cm (about your shoulder width) that’s where I’m pressing down. And next is different technique. you activate that muscle while pressing down. While massaging that muscle, you just activate the muscle Okay, press down onto the same spot and just lift your arm up about 45° out to the side In-N-Out initially maybe slowly and once you get better, you can go a little bit higher. When you do that, palms pointing the ceiling. palms Few spots maybe five times here. One, two three. 5 and maybe move on to the next. so few different spots maybe starting from here 5 * 5 * 5 * if you feel some areas tighter, you just do more massage on those tighter spots and then we’re going to finish with eccentric contraction again, I believe a lot of our muscles need to be trained in that way. Once they can do that, they can do normal Shortening lengthening exercise concentric and eccentric exercises at the same time that’s called isotonic. But for now in Rehabilitation your muscles are normally really really tight so it’s kind of forgotten how to be lengthened under loading. So I normally use this kind of loaded eccentric contraction at the beginning of the rehabilitation and then teach them how to shorten or lengthen while generating power(weight training) your muscle gets shortened when you lift your arm up and when you bring your arm down your muscle is being lengthened. so we’re going to use that muscle in that lengthening phase bring them out to the side a little bit forward about 30 degree and try to press down with the other hand while you are resisting with this right hand so your muscle’s activated when you resist your left hand and slowly go down (muscle lengthens). in that way, your muscle’s activated but lengthens as you bring your arm down push down with your left hand and the power is about 30-40% of your full power. Don’t push too hard and don’t bring your arm too quickly Nice and arms out to the side and 30-degree forward. Just press down so you can do them about five times to start with and then just start slowly build up 10 times 15 times two sets of 10 or three sets of 10, 15, even if you work at office, you can just do some repetitions when you have like free time and if you have mastered the slow movement, You can go a little bit quicker going down going up going down. I’m going up going down but still resisting with your hand. If you can do the fast movement, you can do some weight training. Okay, so I just going up and down going up and down 1kg..2kg.. you just slowly build up according to EMG study. This is the exercise where the most activation of the supraspinatus occurs. Please apply and leave comments. If you have any questions, and I will see you in my next video about infraspinatus most important muscle out of the four rotator cuff muscles. Rehab safely. Thanks for watching!

29 Comments

  1. 알려주신 방법대로 운동하면 극상근의 근력도 유지한채 길이를 늘릴수 있는건가요?

  2. 이분 영상은 시작과 함께 좋아요를 누른다 왜냐 너무 성심성의껏 가르쳐주거든 안봐도 알아 내가 유튜브영상을 매일 기다릴줄은 몰랐네 암튼 너무 좋은영상이네요 담에 이두건염과 회전근개파열영상도 부탁드립니다

  3. 드디어 극상건! 아킬레스건염도 초반에 알려주신 운동법으로 운동했더니 다 나았어요. 극상건염도 알려주신 운동해도 되나요?

  4. 좌측 승모랑 목선? 쪽이 고개를 돌릴때 한번씩 크게 찌릿찌릿한건 뭐가 문제인건가요?

  5. 한국에서 물리치료사로 일하면서 잘 보고있습니다. 저도 예전에 호주에서 워킹홀리데이로 지냈던적이 있는데 그 때 생각도 나고 업로드 해주는 자료도 좋아서 항상 잘 보고 있습니다. 좋은 영상 감사합니다.

  6. 선생님 제발 영상 내리지 말아주세요!! 정말 계속 보고 참고하면서 쭈욱 보고 싶어요👍👍 앞으로도 좋은컨텐츠 많이 부탁드립니당

  7. 항상 도움 많이 받고있습니다!!감사합니다!!

  8. I hurt the front part of the shoulder joint while bench pressing a few months ago, although im not sure about if It was tendon around the area or something else hurt, and the pain had been there and never gone until I stopped stretching my shoulder. Then I started working out with light and slow isotonic exercises recently after watching your videos, which made the shoulder much better and I dont feel the weakness in there anymore. Really appreciate it!

    Can you do a video about what I can do before chest workout if stretching is bad for everyone regardless of their condition plz?

  9. 정말 자세하게 그리고 쉽게 설명해주시네요 정말 감사합니다. 수영하다 어깨를 다친 뒤 mri 를 찍어도 이유를 모를 만성통증에 시달리고 있습니다 ㅜ 앞으로 남은 회전근개 영상도 기다려집니다.

  10. 선생님 궁금한게잇는데 이메일주소알려주시면 안될까요?
    왠지선생님이면 진짜아실거같아서요 다른병원은 불가능하대요

  11. Your videos are very nice!~

  12. 선생님 썸네일에 있는 스트레칭이 충돌증후군뿐만 아니라 유착성관절낭염에도 해서는 안되는 스트레칭인지 궁금합니다!

  13. 바로 선 상태에서 등을 전만을 시키고 날개뼈를 등쪽으로 ,위로 미는 동작을 했을때에 우측 날개뼈가 올라온 형상을 볼 수있는데요(마치 보디빌더가 완력기를 사용하는듯한 자세,검색해보시면 대충 아실듯 ㅠ) 이게 처음에는 날개뼈가 상방회전된줄알았는데 하방회전되어도 위쪽으로 튀어나올수가 있는거죠 ??, 그리고 이쪽이 날개뼈 윙잉이 있네요 ㅠㅠ 현재 전거근, 소흉근, 견갑거근 마사지를 많이 해주는데도 잘 낫지가않습니다 ㅎㅎ

  14. '수축이 되면서도 늘어나야 한다'라는 부분은,
    '수축된 상태로 해야 더 올바르게 늘어날 수 있기 때문이다'로 해석해야 할까요?

  15. 제가 오른쪽 어깨 가동범위가 약합니다.
    오른팔로 열중쉬어 자세 취하면 처음엔 팔이 많이 안올라갔는데, 극상근 스트레칭을 하면서 등상부까지 올라갈정도가 되었는데 아직 많이 뻣뻣해요. 극상근이 원인일까요? 이 스트레칭을 시작한지 일주일좀안됐는데 가동범위가 많이 나오고있거든요. 이 스트레칭을 하면 괜찮아질가요?

    건쪽에 기능 문제가 있으면 침치료도 도움이 될까요?

  16. 제가 자는습관이 옆으로 누워자는 습관이 있어요
    양쪽어깨가 아파서 병원가서 엑스레이 찍어봐도 뼈에는 문제 없다고 근육에 문제있다면서 체외충격파? 시술과 물리치료를 병행하는데 별로 차도가 없네요
    팔을 위로올릴때는 통증이 없는데 옆이나 뒤로 올릴때 힘을 줄때 통증이 심합니다
    영상에서 가르쳐주신방법대로 꾸준히 하면 효과가 있을까요~??
    그리고 왼쪽 엄지손가락통증도 심한데 왜 그런지요..특별히 손가락쓰는일은 없고 뼈에도 문제는 없습니다
    긴질문 읽어주셔서 감사하구요
    구독누르고 갑니다

  17. 오늘 처음으로 라텍스 밴드로 알려주신 운동을 해봤는데요, 상완이두근건쪽의 시큰한 통증이… 일단 이두근 마시지를 하고 회복후에 다시 시도해볼게요

  18. 다른 영상에서 어깨가 안좋다고 말씀드렸더니 이영상을 추천해주셨는데 잘따라하고있습니다!! 호전되고 있는것 같기도하구요 그런데 쇄골이 조금 결리는것 같다해야하나 통증이 미미하게있는데 왜그럴까요 ..ㅠ (원래 어깨통증이랑 쇄골통증이 동반되어 왔습니다!)

  19. 오른쪽 어깨 슬랩으로 고통받고 있네요. 주사치료도 여러번 했는데 다시 통증이 찾아옵니다. 특히 팔꿈치를 직각으로 들고 외회전 할 때 어깨 앞쪽이 많이 아픕니다. 누운 자세에서는 기지개 같은 자세를 할 때 아프구요. 어깨충돌 증후군과도 같은 증상이 있는 거 같습니다. 적절한 재활운동이 있다면 알려주시길 부탁드립니다. 슬랩과 어깨충돌증후군 재활이 다른지 설명도 부탁드리구요

  20. 회전근개부분파열로 수술 후 재활운동찾고 있었는데 좋은 정보인거 같네요

  21. 9:53 의 동작을 5초 정도 버틴 후에 컨트롤하면서 내려주는 운동을 반복한 후 팔이 정말 풍선처럼 가벼워지는 느낌을 받는데 좋은 느낌이 맞는지요? 그리고 한쪽 팔 삼각근부터 팔꿈치 끝까지 피부에 감각이 잘 느껴지지 않습니다. 힘도 다른 팔보다 덜 들어가고… 일상생활에는 전혀 지장은 없습니다. 이 운동을 하고부터 이런 증상을 느끼기 시작했는데 이런 경우를 보신 적이 있으신지요?

  22. 배드민턴 치면서 극상근 때문에 많이 고생해서 정형외과 염증치료 체외충격파로 한달정도 다녔는데
    이 운동도 같이 겸하면 되겠지요?

  23. 웨이트전에 스트레칭 하면서 극상근 마사지도 같이 해줘도 되나요???

  24. 선생님 궁금한게 저는 극상근건쪽에 찝찝함과 어깨를 올릴때 어깨 뒷쪽에 소리가 나는데 어깨통증 시리즈대로 재활운동과 마사지를 해도 되는걸까요?
    파열은 아닌게 어깨를 회전해도 불편함은 없습니다.

  25. 선생님ㅡ너무유익하게잘보고있는데요ㅡ올리신순서가잇더라구요ㅡ번호를 달아주시면 너무감사하겠습니다^^;;다른분들도 보실때 편하실것같아요

  26. 예방을 위해서 현재 건강한 사람이면 마지막의 운동만 해도 되는거죠?

  27. 너무 과한 압박 스트레칭을 하지말라는거에요 아니면 압박 스트레칭을 하지말라는건가요?

  28. 잘듣고 있어요 정말 좋은 정보 도움되네요

  29. 그런데 어떤부분이 너~무 뭉쳐있다면 일방적으로 풀어주는게 우선인가요??
    이런경우에는 마사지기계로 좀 세게 풀고 운동하는게 더좋은효과였던 경험있어거 여쭤보네요

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