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Say GOODBYE to Shoulder Pain!
- 7 hours ago
- 16 min read
This article is a transcribed, edited summary of a video Bob and Brad recorded in November 2024. For the original video, go to https://www.youtube.com/watch?v=39-d_cy_GwU
Brad: Well, today we're going to discuss shoulder pain with five actual viewers. They reached out to us, and we're going to give them options on how to treat it. Mike, do you have more on that?
Mike: We have carefully looked through their questions and decided the best options for them, so let's get to it.
Brad: Should we go to our first viewer?
Mike: Yeah, so let's go to our first question. So this comes from @rhondawatt9509. "What can I do at home to help my impingement of the shoulder, please?"
Brad: Well, that's a good question, Rhonda. And I really like your name. I was just wondering, Watt, is your last name because maybe it has to do with wattage, which is the electrical unit of power. She's a very strong person. Just making a little humor there. Rhonda, let's get to the problem at hand. Typical impingement symptoms. Let's talk about that first. Oftentimes, it's a single point pain where you can point to it, oftentimes, right there, not always, but it's pretty typical. Mike, another one?
Mike: Typically, what happens is when you start lifting your arm, and you get about level with your shoulder, either in front of you or out to the side, it becomes painful. Sometimes people can push through the pain, and then it doesn't hurt as much, and then when they come back down, it might kind of catch again, but then you go through, and it's not painful again.
Brad: Right. That's known as painful arc syndrome, quite common. Another thing, just reaching back to scratch your head or comb your hair in the back can be very painful. Now, a typical do-it-yourself treatment that we can do. We're going to talk about those. Should we go to the first one?
Mike: The first one you can try is called cross-friction massage. You can just use your fingers for this, or if you happen to have a massage gun or tool, you can use that as well. What you wanna do with cross friction is you find the tendon or the painful area if it's in your shoulder up here, and the tendons run down this way, obviously depending upon where they're going, but you're going to go the opposite direction. I'm pressing kind of firmly here, so it might be a little tender. You'll just do this for one to two minutes. You can go up to five and just kind of press. It's gonna be uncomfortable, but when you're done, it should feel better. What you're doing is getting a lot of blood flow to the tendons and your rotator cuff, which carry the nutrients to help heal it faster.
Brad: Right, now this is common with when you have that painful arc syndrome, that supraspinatus tendon is typically the one that we're dealing with. Your fingers will actually get sore, unless you have really strong hands. If you happen to have a massage gun, they work great for this particular treatment. Use the ball attachment. So I'm going to take that, and we're not going to go like this and beat into the tendon. We're going to go with the ball, you have to have the ball on, go sideways, and go across it like this. Feels good.
Brad: If it gives you sharp pain, you need to not do it. It's too early. Do this for a minute or two. You'll have a good response to it, and it'll feel good after you're done. Let's go to another common treatment.
Mike: Another option you can try is simply hanging. You can use a pull-up bar. These are hanging handles. Whatever you have around the house, you can grab onto comfortably, and what you're going to do is not hang all the way down, but just drop, stretch your shoulders above your head like this. Notice my feet are still on the ground. I'm getting a good stretch here. You can hold this for a time. You can go 15, 30 seconds if it feels too much, you can go up to two to five minutes if you really want, as long as it feels good, and just hang. Over time, if you feel comfortable and you're strong enough, you can lift your feet off the ground. You're going to get more stretching and distraction in the shoulder joint, but it's not necessary.
Brad: That's right. Again, I want to emphasize, just do that cautiously, particularly the first time or two.
Mike: We should mention, though, if you are short and you can't reach, just take a stick of sorts, we have the Booyah Stik, whatever you have at your house, and then reach up as far as you comfortably can with the painful side. Then just kind of lean into it. You can get a similar feeling. It's not quite the amount of force or pull, but we realize some people can't actually get their arm way above their head to start.
Brad: Right, now if you do use a stick and you find it slipping on the chair or whatever, simply take your shoe off, put it in there, and it allows you to grip. Really nice little solution. And lastly, we do want to talk about some of these. This is a typical therapy treatment that works on the posterior part of the shoulder and improves posture. You simply are going to pull back with your hands going down to your belt or to your belt line or just below the belt line where your pockets are, and watch me squeeze my shoulder blades back behind me and think about your chest going out. There we go. So again, posture and rotator cuff muscles, putting them back in place where they need to be, so the joint lines up to minimize that impingement. It's a nice, traditional exercise.
Mike: It's good to do all three of those because first is massaging, then we're stretching, then we're strengthening, which all work in conjunction to help with impingement.
Brad: That's right. Good luck with those, and I have a feeling you're going to find these very helpful.
Mike: This next question comes from Laura Johnson. We're going to condense it a bit because it's kind of wordy. Essentially, she was unloading some bark from her truck, and she started getting some shoulder pain. Now, whenever she reaches up into the cupboard for things or puts her jacket on, she's getting a lot of pain in her shoulder joint itself. Her pain is not in her shoulder blade.
Brad: Alright, Laura Johnson, sorry to hear about your pain. You have the typical what we call Weekend Warrior Syndrome, out working very aggressively on something you'll probably have a passion for, working hard, then you have the symptoms you talk about. Very typical. Alright, Laura, before we get onto the exercises that are going to help you out, I do want to address this for other people. If you do tolerate ibuprofen, I think a good way to approach it is take the amount for you, three times a day for three days in a row. I've talked to a couple of different doctors, and they really like that. I like it because you don't overdo it, and if it's going to do you some good, it will do it in that amount of time. Now, the first exercise, there are two ways to do it. Mike's going to show the option with a resistance band, and I'm going to show the same option with a dumbbell, lying on my side. So we're going to pretend that I have a right shoulder problem. Mike, are you going to do it with the left shoulder?
Mike: I'm going to do the left shoulder.
Brad: Go ahead. You show them your tips first.
Mike: So this is an often-neglected or weaker muscle group in your shoulder. We're going to work on external rotation. All that is is bringing your arm out to your side like this. Notice my elbow is staying tight. I'm putting a towel here so I don't cheat. A lot of people start doing this. This is not what we want. Keep the towel there. Rotate out. Any band you have will work. You can do three sets of 10 to 15 reps over time as long as this feels good, slow, and controlled. And do that every other day at least.
Brad: There you go. Nice job, Mike. Now, if you do not have that, but you have a can of soup or anything that weighs about a pound. I'm using the three-pound dumbbell here. That's probably going to be a little too strong for a lot of people, but the mechanics are like this: elbow against the ribs. Start down here and then come up with a 90-degree bend at the elbow. So we're not down here doing this or this. It's this. Clean motion, good control, again up to 10. You will feel these muscles right back in here. Those posterior rotator cuff muscles get fatigued. Again, there should be no pain involved with this.
Mike: The next tip we have is when you are reaching up into the cupboards to put something away, make sure the object is close to your body. Say, I don't know why you'd put a stick in the cupboard, but this is what I'm holding right now. If you're far away like this, going up, this is a lot harder and a lot more challenging on your shoulder. If you have it close to you and then you're lifting it up, it's closer to your center of gravity, making it easier and putting less strain on your shoulders.
Brad: That's right, you can actually do that when you're putting a cup into the cupboard. Try it closer to you and get it in, and then try it with an outstretched arm. Do it where it's much less painful. It's an interesting concept. The last thing is, this is one of Bob's. I think he actually invented this stretch. He had impingement, and he had extremely good luck with it. There are two different ways to do it. One is with the stick, a four or five-foot-long stick. Works well with something that's smooth that slides up against your back. Go ahead. You know the chicken wing?
Mike: I know the chicken wing.
Brad: Excellent.
Mike: So, what you're going to do if you're a beginner is to help if you struggle reaching behind your shoulder when you're putting on a coat, shirt, or whatever. So what you do is start low if you're on a stick. And the first trick is to just pull the stick up your back further, do what you can tolerate. Some people may be down here, others may be up higher. Once you're here, for more of a stretch, if you can get up here comfortably, is the chicken wing, which Bob does. So I pull the stick, and I'm getting more of a stretch. Really feel it in my shoulder capsule there, and it gets a nice, good stretch like this. If this hurts at all, you don't have to do it. Just working your arm up your back will help, and Brad will show another variation you can try.
Brad: That's right. Just make sure you don't do this if it hurts. This is one of those things that you need to, it has to be healed a little bit along the way. You can do this method with a belt. You put it and have a loop here. Put it on your wrist. And a shiny belt works better because it slides over your clothing, and then you work it up here. The left is my sore shoulder. Simply relax and allow it to slide up. A little stretch pain is okay, but no sharp pain, absolutely. We actually had a patient scheduled for surgery. We had her do this exercise. The surgery was canceled. It was very successful, and her shoulder got better. This wasn't the only exercise, but it was one of the primary ones that was working.
Mike: And you can do with a towel if you want. Like I was showing.
Brad: There you go. Excellent. Alright, good luck with your shoulder. I think we've got some good options for you. Again, remember, listen to exactly how we did it and showed you.
Mike: Our next question comes from @TheresaWagar. "My right shoulder is often sore when I wake up in the morning. How can I sleep differently as a side sleeper?"
Brad: Theresa, you're in luck. We have helped many people, side sleepers, get through the night with shoulder pain, and what you are going to need to do is have an abundance of pillows. So go to the store, buy some pillows, take them from your children, your friends, whoever it may be. You'll see you'll need three or four. When you're lying on your side, if you sleep... Let's see, does she say if she sleeps on her sore side or not?
Mike: Well, you can do both.
Brad: There you go.
Mike: So give me that pillow, though, because I want one for my head.
Brad: Yep.
Mike: So first off, you want to make sure you have an adequate amount of pillows to take pressure off your shoulder in general, even if this is your good shoulder. So, for example, if you were to sleep on your painful shoulder, correct the pillow height for your neck. This will be different for everyone. Maybe you need one, maybe you need three. Then we're going to create a little canal here, and this is where my painful shoulder is going to rest. Now, notice when I start rolling onto it, I feel more pressure on my shoulder. If I'm slightly at an angle, there's less pressure. This pillow helps take some of the pressure off the shoulder joint as well as these.
Mike: So if you need to sleep on that side for whatever reason, this is a way you can try. Another good suggestion is to have something under your knees, because that gets uncomfortable too if your bony knees are hitting each other like that.
Brad: Right, and a common complaint is with people, "Oh, when I lie on my side, I'll get uncomfortable after a couple of hours and inherently shift." But if you use a pillow between the knees, it's gonna allow you to feel more comfortable. It's amazing how much better that feels. Mike, I do want to give her one little tip. Now, if you do have the right number of pillows here, so your head is in a neutral alignment, and it's not tilting down, typically it's two pillows for a lot of people. That shoulder right here, I've done this with a lot of patients. I say just slide that shoulder like that. It tips you back that way a little bit, but it really unloads that shoulder joint. And then you don't have to make the Erie Canal with the pillow here. But try it both ways, see what works best for you, and I think you'll find this very, very helpful for your sleeping.
Mike: Can I have my pillows back?
Brad: Oh, sorry. Yes.
Mike: So, what you can do, because most side sleepers like to change sides, is you need to prop it up even when your bad arm is up top.
Brad: Oh, I forgot about this.
Mike: So, place one pillow under your arm, and you can put another pillow angled, get it kind of under your armpit, and this will help put a little gap in your shoulder there. Oftentimes, this can relieve some pain you may be having as well. Obviously, if you're comfortable like this, you can do that. But most of the time, people need a little bit of a gap in their shoulder there, and it makes it more comfortable.
Brad: Yeah, and that's with the painful shoulder on top.
Mike: Yes.
Brad: Yeah. And again, I always say put one between the knees too.
Mike: You're a pillow monster.
Brad: Yeah, so you've got one, two, three, four. Yeah, you'll need five pillows. Thank you and good luck. I really think this is gonna help you out.
Mike: Our next question comes from @bh-6. "My left shoulder/neck always seems to bother me, and I have knots. I'm right-handed. Lately, I've had higher area neck pain. I'm 47, play tennis, and I do lift boxes and move boxes at work from time to time. I go to stretch u and do stretch and cryo sessions once every other week." They would like some more suggestions.
Brad: Well, you're in luck. I think we've got some good suggestions for you. I picked you because I liked your initials. BH, you know Brad Heineck? Yeah, we've got something in common.
Mike: I think I've heard of him.
Brad: Anyways, your scenario, I really want you to stand up and turn around, Mike. We're going to have to do it on the right. But it's the other shoulder. I really think your shoulder blade is actually depressed, physically, not psychologically. It's down, and that's stretching out the muscles from the neck to the scapula. And what we need to do is elevate that shoulder blade, take the stress off of there, it's going to help with the neck pain.
Brad: Maybe you're having some headaches as well, and we need to stretch out the muscles here. So this is a nice problem because it's not really hard to fix. You just need to do these two exercises on a consistent basis. Mike is good at showing these, and I'll watch and keep my mouth shut if I can.
Mike: So we got these from our friend, Rick Olderman, who's a PT, so check out his work if you're interested more in this. The first one is basically a child's pose stretch. We call it a prayer stretch. What you're going to do is keep your shoulders in place, and then I'm going to sit my butt on my heels. Notice as I go into this position, my shoulders start naturally lifting above me, and I feel a stretch. If you're not feeling much of a stretch, you can extend your hands out more. Hold this for five to 10 seconds, come back up, and you're going to repetitiously keep doing that.
Mike: Now, if your left side is more painful, what you can try to do is reach over to your right hand and get a little more stretch there. I would do this 10 times each day.
Brad: Yeah, so, BH, just so you know, that stretch is, again, moving that shoulder blade upwards, stretching the tight muscles out down here, and then you do this one first, follow it up by the strengthening exercise that we call the pinky exercise up against the wall. Mike, help them out.
Mike: So, for this, you're going to need to find an open wall space, or you can do it on a closed door as well. So if it's just your left side, you can only do your left side. If you want to do both at the same time, it's not going to hurt anything. What you're going to do is pinky sides to the elbow are going to make contact with the wall the entire time. Now I'm going to slide my arms up the wall, and as I go up, I'm going to kind of shrug a little bit to help, and we're going to hold up top for five to 10 seconds, breathe, and then slowly come back down. Just make sure you're keeping contact with the wall the entire time. If you can only go a little way, then just do what you can and back down. Over time, you should be able to slide up more and really feel a stretch and activation of the shoulder blade muscles.
Brad: Right, that whole idea of getting that shoulder up towards the left ear to strengthen the muscles here, to get that shoulder blade elevated where it needs to be, and get you out of that painful syndrome. All right, very good. Simple exercises. Just make sure you do them at least once a day. After you've done them for a while, do them twice a day, morning and evening, and it'll help accelerate the healing process.
Mike: Our next question comes from @curiousone6129, "For what kinds of problems is PT preferable to shoulder replacement surgery? I have osteoarthritis."
Brad: Alright, I'm going to relate this to someone I know who has very similar symptoms. This person has bone-on-bone in one shoulder. They recommended shoulder replacement. He was not; he wasn't fond of that. Talked to me about it, I said go to the surgeon and talk to the surgeon personally at your next visit. They did. They came up with an option. Therapy exercises to strengthen the rotator cuff muscles and some stretches to help get that bone or the humeral head in position properly, along with an injection, that would be the surgeon's obvious discretion. In this particular case, the person, three weeks after the injection with therapy, is now doing very well. Swimming up to 2,000 yards, overhand. He was a very good swimmer to begin with. So it worked for that person. Doesn't mean it will work for you, but these are options. And if you're not happy with what your surgeon has to say, do not be afraid to get a second opinion. That is something a lot of people don't feel comfortable with, but I strongly recommend it. Get a surgeon who fits you and whom you feel comfortable with.
Mike: Most of the time, with any shoulder injury, trying therapy first is not going to harm anything or do any worse. If it helps, good. If it doesn't help, then you always have surgery.
Brad: Right. And actually, if you do have surgery, therapy before surgery is an excellent idea because it conditions the muscles and allows the range of motion, so you have better post-therapy results.
Mike: Yeah, you're going to have therapy after surgery, too.
Brad: There you go. Alright, good luck with your shoulder. I know arthritis is a big problem, and it's not fun to deal with. Alright, that was all five of them, Mike. Should we carry on?
Mike: We should. If you want to check out more videos on shoulder pain, specifically impingement exercises, you can watch "Absolute Best Shoulder Impingement Exercises (Self-Treatments)."
Brad: There you go.
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