Top 3 Signs Of A Rotator Cuff Tear

Top 3 Signs Of A Rotator Cuff Tear


-Hi, I’m Bob Schrupp physical therapist
-Brad Heineck, physical therapist. And together we are the most famous physical therapists on the internet.
In our opinion, of course Brad, I think I figured out why the Vikings are having so much trouble at the quarterback position. -Because they suck? [laughing]
They suck, but maybe– maybe he has a rotator cuff tear If you have a rotator cuff tear, you can’t throw very well.
-Maybe we should talk to the trainer. Yeah, maybe we can give them some hints but– and that’s more to do with you today We’re going to give you three signs that you might have a rotator cuff tear If you’re having shoulder problems We want to show you three tests you can do to determine You know– if it’s a possibility
-Right I still could be other thing right, but this would help narrow it down First off, when you have a rotator cuff tear– Well what is a rotator cuff, first, Brad? Well the rotator cuff– so we have a video on the pronunciation, but won’t go into that but it– helps stabilize the shoulder joint into the socket.
-Exactly It’s a very shallow socket that–
-Four muscles. Four muscles that work together to hold the bone into the socket They also do certain movements, and that’s what we’re going to be testing. -You bet
-So if you tear your rotator cuff you’re actually tearing the tendons on it and you’re gonna probably have pain, first off– and you can do this, by the way, If you just want to know what leads up to a rotator cuff tear, it can happen over time, -A lot of them do -Sure
-a repetitive motion A lot of them happen if you are 40 and over, which fits right in our genre, doesn’t it Brad? Absolutely, 40 and over, subscribe right here.
-Yeah, if you’re 40 and over we’re gonna provide you videos on how to stay healthy and fit and pain-free
-You better believe it. Going back to what we were talking about, if you’re 40 and over, or even if you’re not, you could do it obviously with an athletic event but also, a lot of them occur over time.
They just get wore out. Your blood supply, as you get older, is worse to your shoulder, and that also makes it more susceptible. So, you’ve got the four muscles.
You’re going to have pain, obviously, a lot of times right in this area, and it can refer down.
If it goes past the elbow, it may not be it, It may be more likely a nerve problem
-Right So, these are the four tests that you want to do– three tests. I guess we have four -We’ll call it three… with a bonus
-Three with a bonus okay, so first one is– one of the first muscles– the most commonly commonly involved muscle is the supraspinatus.
You don’t need to know that but– and the way to test that.. Do you want to be the tester, Brad?
-No, you be the tester. Well, then you gotta stand up.
-Okay The supraspinatus, by the way, the muscle behind the supraspinatus is here. The tendon, comes right down in here
-And the muscle does this… -Right, elevates the arm So, Brad is gonna– Let’s say, we’re gonna say the right arm is always the problem arm -Sure
-Okay? Maybe turn a little like this.
So we’re going to have him put both arms up, turn it down, like you’re emptying out a can, That’s what it’s called, in fact.
Your arms are about 30 degrees forward And up to close to 90.
I think that’s where they tested. And all you do is have somebody push on here If you push right above the elbows… and push
Now this one gives way– Let’s do this arm because they can’t see– Okay, sorry. This is the involved arm.
-Right. Ow! I push on both equally, and that one just gives away.
Could be a rotator cuff, could be tendonitis or impingement, but it’s starting to give you a sign that it might be a rotator cuff. One you could try on your own, is, you can just take– if you have trouble with this arm, you can’t even raise it up, ake it, and use the other arm raise it all the way up…
and then start bringing it down. Let’s let it come down. Let it come down to the side, Brad, and if it gets so far and then it just drops That’s the drop arm test
That means that you most likely have a tear and it’s not holding up.
You have a rotator cuff tear. So I’m gonna bring it up, and then let it down, and see if you can let it down slowly and if it goes like that -Pretty good sign you might have a rotator cuff I know I had a patient, I’ve seen this in a number of patients with rotator cuff tear, you ask them to lift their arm and it’s so bad, they go like this…
-Yeah -They do substitution
-A lot of compensation -Hi Brad
[Laughing] Anyway, all right another test, now for a different muscle. This is the teres minor and the infraspinatus. Muscle here, and –they’re both down here on the lower part of shoulder blade, also attached here. So again, this is the weak arm.
Turn a little bit I’m gonna push in… like this. and he’s gonna hold it, with his arms at a
90 degree angle Push in.
If that arm gives away could be a rotator cuff tear. -And it usually hurts
-And usually it hurts along with it. Last one is the lift off test.
You can actually do this one on your own -Do you want to show it, Brad?
-Sure -So you just put behind
-Like this, like you’re going to scratch your back Instead of doing that, you lift your hand away from your back, like that. Maybe you could get better with this arm here. Well if you can’t lift your arm away, you may have a tear, because that’s not– -If you can’t
-If you can’t If you can’t lift it, you may have a tear. Okay, so just very quickly, the tears that usually happen, there can be a partial thickness tear and in that case, the tendon just looks like it’s been roughed up and probably that’s that’s not something you’re going to– You’re definitely not going to have surgery on you.
It’s just something, hopefully that’ll get better over time. Two, we can have a full thickness tear, where there actually could be a pinpoint spot, that goes all the way through the tendon
or a bigger, a larger hole and then there’s also the full thickness tear, with actually complete detachment This actually can show this on here. This is just–
We’ll take one of the muscles here Here’s the subscapularis, and you can see it attaches to the bone here. You’re gonna have to bring that in, Nancy. This is– the white stuff is the tendon.
The muscle narrows up to a tendon. And it actually completely detaches from the bone. And it could actually–
the muscle could actually retract away [Brad] Yeah, it’s no good. -So, in that case you’re gonna probably need surgery
-Right they’re gonna have to go in there and reattach it. But, so again, the three tests are– The first one:
The empty can test, ok Woop
Internal test The pull-away-from-the-back test
-And then the one you can also add in is the drop-down test.
-And let down, oh! -All right, good luck!
-Have fun with those tests, but be careful.

100 Replies to “Top 3 Signs Of A Rotator Cuff Tear”

  1. I'm sorry I was having pain and watching videos about rotator cuff problems, but I am so glad I saw this! You guys are hilarious! Thanks for your videos!!!

  2. Hello! Today I was wrestling with a mate and I got slammed on the ground and the back of my shoulder took all the force. I instantly felt a weird sensation go through my arm. Now when I do certain movements, ie touching the opposite shoulder once I get to a certain point I experience excruciating pain in my shoulder. Any ideas? And to get an idea of force, there is a 10cm by 5cm bruise on my shoulder. Thankyou!

  3. This video is a few years old, but impressive and maybe someone can answer my question. I had an MRI done and I have a 50% tear in my rotator cuff. I wasn't impressed with the quick explanation I got from my doctor and he didn't prescribe PT. He just gave me a super quick list of exercise to do and said I'll be back to "doing my hair" in no time. Well, I don't really care about my hair, I am an athlete and want to continue to run Spartan Mud Run races again, which requires pull-up strenth. When I told him I wanted to be 100% again and to do these races, he said I was too old and who would want to run in the mud anyway! (I'm 43) My question is, will PT resolve a 50% tear so that I can once again do pull-ups and push-ups without pain? Or, should I go to another doctor for a 2nd opinion? Thank you so much!

  4. What does it mean if, after lifting some dumbells, or even stretching my arm overhead, there's a slipping tendon or muscle in the shoulder. It slips out of place, cramps, and only slips back into place if I extend my arm in front of me and rotate my arm Inwards (thumbs down) then it snaps back into place and the pain goes away.

  5. Just wondered if anyone has had a grade 2 tear and surgery or healed via alternative care. I have recently had an US and I have a 12 mm wide 5 mm deep tear to right shoulder. Referred now to specialist who I am seeing in a few weeks. I want to try and avoid surgery if possible.

  6. about 4 and a half months ago I began having trouble with left shoulder, felt like trap was tight and wouldn t release, I was kinda going nuts with dips to work on upper body. Burning , heavy arm and an inability to turn my neck to the left. After ultrasound and xrays the diagnosed it as a " muscular contracture" .I went to a very well known PT down here in Ecuador and he worked with me for a week and a half and told me to keep doing stretches at home. There has been improvement but now when I try and get back into exercise the previous symptoms can be felt but less now. Could a contracture be for life or corrected with time and stretching??

  7. I have that same problem I always thought my shoulder was dislocated but a friend told me if you had a dislocated shoulder you wouldn't be able to move it that is true so I told him I always had a problem with throwing and I never had that problem before it was somewhere around when I was like around it 15 years old but it didn't happen right around at that time it happened later on down the line when I was 15 working out I stay fit I always worked out I'm lagging really badly now but but I can game back up real quick but it still didn't fix and I love doing push-ups and I and I basically love doing pull-ups with my favorite exercise to do I would do it every day every day you know I'll go outside you know when were in school like if we're going outside for Jim through my whole gym. I would just do pull-ups pull up pull up pull ups and I don't know if I strained my arms doing pull-ups but when I when I would do pull-ups I was just doing like they were nothing I don't know what it is but I'm used to pain I get used to pain real quick and certain pain don't really bother me it's really like nothing so but I have one of those problems but a fix for that I don't know working out working out that arm just ain't cutting it

  8. okay you said something about reattaching in your video mine detaches but I can reattach it it's not that painful I'm used to it cuz it happened so many damn times it's really not that painful all I got to do right when I feel that pain I'll walk up my arm so tight and move it right back and spot and it goes in just fine and then the pain just quits instantly I don't know how my arm got like that I don't remember doing any doing anything to entering my rotating disk or whatever it is and I always worked out so so lack of exercising just not an option because I always will you know stay fit and maybe I might have strained it and didn't really noticed it I'm not for sure cuz I could probably be at number reason why it could happen like it did but I always got to be careful of high throw and I always throw in a stiff position like I stiff my arm every time I throw I can't just randomly free free throw my arm and throw the football without it popping out or whatever it is that it does but one of my friends identify my problem quick but it's it burns you'll get used to it after a while you'd be surprised with your body can get used to but I know it's not a good thing having my arm like that but I always put I always put it back in or whatever going on inside the shoulder of mine or disarm but I use this are more than anything and I I'm right handed so you know but I'mma continue watching this video and learn more about it you know I'll look into some stuff and yeah

  9. I have both rotator cuff tear/ injuries from working most my life how can I get the pain to go away the pain is thers 24/7 the right are is the worst been like this for 4 to 6 years now give or take sine I was 16 iam 23 now i don't know if the history behind it helps but doctors keep on giving me a run around on what it might be and another thing my last boss has my problem said he had surgery for his arm and made it worse what to do

  10. I just passed all the tests. Range of motion is hindered in a few directions. I can do about 8 to 10 unassisted pull ups without any pain, until I wake up the next morning. After watching many of your videos I have a greater idea of what I can do to attempt fixing my shoulders. Do you recommend so form of ROM measurement? What can I use or do you recommend for tracking?
    Thanks for all the great stuff.

  11. All 3 tests have poor psychometrics. Expect for the fact that specificity of each test is better than it’s sensitivity. So, you cannot draw any definitive conclusions based on ‘+’ findings. To test teres minor you have to perform Hornblower testing. You all only tested the SS and IS. The cuff can test as weak and painful from c5-6 nn root pathology.

    We all have impingement as studies are showing. We really don’t know the pain generator at this time. Partial cuff tears can be more painful than full tears. If that is found to be the pain generator. That’s performed via cortisone injections as a diagnostic tool more so than treatment.

    Read research before posting blasphemous videos. You’re misinforming the public.

  12. I could do all the tests but I feel pain what is wrong with my shoulder? do I need to go to a doctor? or mabye it will heal by it self?

  13. I injured myself during a bench press. I came home to severe soreness however recovered well, the pain discontinued however I felt a tendon or ligament catching on to my shoulder, collar bone area when doing certain movements. Pain free just odd.

  14. I have the same problem. I was an amateur boxer during my teens then I quit after my left shoulder got this pain.

  15. I just started feeling pain in my left shoulder but it’s on my back kind of not on my shoulder. I have a sharp pain when I put weight on it. I believe I did this while weightlifting. Any ideas?

  16. 2 weeks ago i was doing upright rows. Which i know is stupid but it ruined my shoulder . rested for 5 days amd workout again. I can do all the test just fine no real pain maybe like 4/10 if any. However now when i workout chest or shoulders or do lat pull downs it flares up bad. What is this? A strain ?

  17. ok why would a shoulder surgeon want me to go het neck nerve ablations before revision of my shouldercteplacement for avn

  18. So my left shoulder popped out of place while I was bench pressing. I grabbed my forearm with my right hand and popped it back in place. But now I have a limited rang of motion and can't lift it up higher that marking my arm 45 degrees. The back/top of my shoulder really hurts in one spot with every test and my whole arm was shaking. Idk what to do please any one have any idea!??

  19. I'm 23 and i have pain in the part connecting the chest and the shoulder on my left side..so when and i fold my arm such that the elbow and shoudler are at 90 degree and twist it back it hurts and pulls me from taking it back…but on my right side this action has no issue..could u tell what might be my problem.Thank you

  20. When i rotate my shoulder i dont feel any pain. But theres a lot of popping. I did all the test on this video. All negative. This happened when i carried a heavy box.

  21. I am 21 and I had a Rhomboid Strain in March, I went and got my therapy and everything, but today I wanted to strengthen the muscle cause I thought it healed. Could I have possibly re-tore the muscles again?

  22. I experienced a loud pop with minimal pain while pushing off the ground about a week ago. I have minimal pain/pressure that seems to move from the front, side, and back of the shoulder. My daily activities are not impacted, but I have tried to reduce aggravating the joint and muscles. I’ve dine all the test without weakness and no/minimal pain/pressure. The two test that I felt minimal pain/pressure is the lift-off test and teres minor test. Thanks to you I’m not panicking while waiting for my appt that’s several weeks away.

  23. I think I tore my rotator cuff years ago. Baseball. Last game I think it happened I remember after the season trying to throw a football and worst pain of My life. The next baseball season I couldn’t throw hard anymore. I didn’t know what happened but I sucked. I couldn’t pitch anymore and it ruined my baseball career. I was good too. Pitching was my specialty. I don’t know how I didn’t realize I just had an Injury. It now causes muscle deformity in my deltoid, triceps, and in my chest. My chest muscle has much less strong muscle form on the side of the injury. It’s caused just muscular imbalances and idk what to do now. No good medical care. Just looking for answers. Anyone know any good exercises to strengthen?

  24. Sir my father arm cannot move forward and can move back side and doctors says that must be need to operate because shoulder muscle is torn(broken) .Now sir can u tell some treatment plzz

  25. Hmmm I did the tests so I guess I don’t have rotator cuff damage. I hurt my right shoulder somehow I guess lifting weights. My left shoulder hurts as well but not nearly as much as my right one. The movement that hurts is moving my right arm straight in and across my body towards the left while keeping my arm straight. Hurts worse if I rotate with my thumb down. It’s almost unbearable pain. I can’t lift any weight anymore bench press and I can’t even do a single push-up anymore. (I could do close to 40 before.) what do you think the cause is? I’ve been feeling this pain with no signs of improvement for over a month now.

  26. physicaltherapyvideo. I know this is an old thread, but I just found you! I wonder if you can help me figure out my right shoulder… The 1st part is: I can lift my arm almost straight up with moderate pain and stiffness. I can put it down to my hip but to my back only with pain and assistance getting there. The pain isn't acute, just a feeling like I'm bending my shoulder way too far. The 2nd part is: If I hold my arm straight out in front of me and cross my straight arm over to the left it feels like my shoulder is coming out of socket to the right side. If, from there, I transition to the position with my elbow down to my side and my fist strait up, this movement is very difficult / weak and it feels again that my shoulder is unstable on the outside right. How can I stabilize and strengthen that better? And, how would you address the stiffness? Does repetitive stretching help ? My left arm is day and night different with no limitations whatsoever.

  27. Hi, I was doing dumbbell presses last week and I felt a sharp pain in my shoulder, (I’ve strained it a few months ago) and I took the week off and still feeling a sharp pain in all parts of my shoulder including the back of it along with my tricep and a bit of my last or armpit area, any idea as to what it is? (I can lift my arm quite easily with only a bit of pain halfway through lifting it)

  28. I'm having issues with my right shoulder one trap is larger than the other. It's difficult raising the arm fully and when i stride while running my whole right arm has a numbness.

  29. I messed up my shoulder so bad in basketball. I feel like i teared it really bad but idk. I cant lift it up without crying in pain. I can still play xbox tho but i feel like that has nothing to do with my shoulder just my fingers and hand

  30. I can't turn my thumb downwards as described in 2:54. What does this mean? Also I can't put my arm behind my back as described in 4:49. What does this mean?

  31. WOW! You guys are great. This video is JUST what I needed to watch. I'm a 64 yo male and have always had rather weak shoulders. I strained my right shoulder and immediately felt a sharp pain. Your short < 7 min presentation helped me figure out that I have a supraspinitus (?) mild impingement and it does NOT drop. Yeah! This means it WILL heal over time WITHOUT any surgery. Fantastic! Thank you so much. I will be sure to watch all the rest of your videos to learn how to heal and/or prevent further injuries.

  32. Well I dont think I have a rotator cuff injury anymore. My right shoulders been tender and tight for a while, but its not really debilitating

  33. Great video helping many around the world for sure.

    Can you do a video on how the back adjusts for occupational needs and the hows, whats and whys to readjust the back, say when one retires.

    For women who wore high heeled shoes for decades; do ligaments or tendons shrink to adjust? Are there exercises one who wore heels can do to avoid feet and back problems immediately or even years after discontinuing heels?

    What do you think are the odds there are people in rest homes across the US, or the world for that matter believing they are permanently unable to walk who can be freed up from immobility (and the associated costs and restrictions) because of unnecessary and untreated back pain?

    Again, I really appreciate your videos. The great posture of both of you is your greatest "selling" point.

  34. What muscle is the issue during the drop arm test? And, what is the difference that you will see if you have a suprinatus tear, teres minor tear, infraspinatus, or subscapularis tear? I noticed they all categorize as a RTC tear, but what symptoms would each portray?

  35. You don't have to have pain or loss of range of movement, to have a tear. Ive had mine for a month but not much pain and no loss of movement, initially. A few weeks later i can barely pick anything up or move my arm without having to suffer for it later. Most doctors will just say you have an injury like a strain, if your able to move fine. However, this doesn't mean you don't have an issue or a small tear that's about to get worse

  36. I’m in Boxing, I did the test with no discomfort, but when I try to do a left hook I feel my shoulder loss and I can’t perform the punch correctly

  37. Hello I had undergone a rotator cuff repair surgery on 4/9/18 now doctor fix my arm at 30 degree to body to imobilize the arm with big cotton bag and bandages which looks really wired by the way my question is can I now wear a sling to hang my hand instead of the cotton bag ??
    Plz let me know if some one have some clue

  38. If you moved my arms firmly, like the guys are doing in their tests, it would send me into a tailspin. Gently… gently… gently. Thx for the info!

  39. 2 days of airport travel with a 25kg rucksack and then 30 minutes of basketball took me to bed feeling a little tender. Woke up unable to lift my arm. At all. Disabled and terrified i dosed myself up on iboprufen and waited two days before going to the doctor. By the time my appointments arrived my arm was basically fully mobile again, albeit with pain. X-ray and MRI results pending, from what I have consumed on the subject, I think it had a regular inflammation of the muscle. A swollen sack of 'body' juice jammed between the bone and muscle preventing movement. 3 or 4 days of rest and complaining was all it took.

  40. I’ve been injured for over a month now, left shoulder, it fucking sucks… can’t lift anymore really… I’m so disgusted, i pass all these test thank god tho…

  41. I have pain on my right shoulder hurts so bad. I’m seeing a therapist but, I’m also explaining that i have pain on the right side of my neck . When I turn it to the left it’s painful. The back of my right shoulder has a knot that’s hard and I’ve tried to have it massaged doesn’t work. My therapist says it’s a rotatory cuff idk anymore he has me doing some workouts and it’s not working. I was thinking of trying acupuncture I’m desperate. It’s been going on for a year now.

  42. My injury was actually caused by me doing an overhead stretch and I felt a pull and pop and it's been bad since

  43. Thanks guys for making and posting the video. You are making and creating love: help for those of us in need; I am truly grateful. I now know that my cuff (I always thought it was "cup") isn't torn. Just need to get to a PT. 🙂

  44. I've passed all of the tests and don't have a complete tear, for sure. My doctor recommended PT; do you think it's NECESSARY to have an MRI?

  45. You guys are hilarious. Cheers me up a bit about being a sedentary 30-year-old who somehow managed to fuck up his rotator cuff by partaking in absolutely no athletic activity to speak of.

  46. Hi everyone .i just clicked unto this video bcoz i need help .i am a 41 year old somalian, relatively healthy male with a history of playing both basketball & later on soccer /football from my early teens all the way to my mid 20z .i now usually do gym on and off .havent been for almost 11 months preceded by 7 months 3 days a week .and so now my problem which ive had since my early teens .is that whenever i extend my shoulders with force .ie if am making a block in basketball or even throwing a punch .wenever my shoulders are extended and either imparting force or receiving it .my shoulder just pops and i feel a swelling come down near the front of my shoulder .and that shoulder becomes immobile & i usually have to stop watever iam doing and keep gently rotating my shoulder until watever popped out of place goes back .there is usually a bit of pain wen this happens .along with soreness and discomfort in the muscles around the shoulder joint f several days afterwards .this is not limited to sporting /forcefull activities .if f example something of mine goes under a bed .and i have to kneel on the floor .with my head almost level with the floor and then i extend my hand to retreive said object .pop!!! and the same thing happens .it affects both shoulders but is more predorminant in the right hand as that is my primary arm .is there anybody out there who knows wat this is and could help ??? Many thanks GOD BLESS

  47. so based on what I had read elsewhere, I met the criteria for having a torn rotator cuff. But I passed all 4 of your tests. Is it possible I could still have such an injury even though I passed your tests?

  48. I was told i have a frayed tendon, does that fit your category of not requiring surgery? Mine occured after suffering a very hard fall on my right shoulder on an icy sidewalk. I also have fluid build up on the bicep muscle, which i assume is from inflammation from the fall… Any comments?

  49. Hello! Found your channel after having my baby. Shoulder/back issues. 9 months later, my shoulder pops, and has some random pain in the corner(?) of my shoulder. Also have some soreness on same side lats. I notice that the shoulder area becomes most aggravated also when I lie down at night. It feels a little loose and unstable in the shoulder, but my lats on that side also feel super tight. Would love any ideas!

  50. Looks like im positive for the 2:30 supraspinatus test. anyone have any suggestions? how long is the approximate healing time? thanks so much

  51. Hey, so I believe my rotator cuff is damaged however I can do all these tests and many others with slight pain. What should I do? I think I got it from lifting in the gym. Currently I am doing exercises for it and it’s helped relieve the pain a lot

  52. I Can perform all of these without a problem beside it being a bit painful, it happend out og nowhere, i was doing lateral raises with Light weight Like i have done for months and nothing have been hurting or anything, i even take Care of my shoulders Daily with bands etc, but Yesterday it just started hurting, after this video i dont know if its a tear or a bad inpincment

  53. Hi, quick question, I can resist the force in these exercises (as in my arm does not give way when someone pushes on it in opposite direction) but I do experience some pain (not excruciating). Is that indicative of a rotator cuff tear?

  54. couldnt do the pullaway with my right so most likely rotator, will this heal on its own? it has been like this awhile and with my work schedule it is so hard to see doctor! the pain has gotten less but my strength is certainly still effected!

  55. Sigh. I'm so disgusted right now. I've had surgery twice in 4 years. I know I tore it somehow again. I just don't understand why it keeps tearing?! I haven't slept for 3 days now from pain. I see ortho in 4 days. I know it's torn again. The pain is always the same. Horrific pain.

  56. Back in the mid 80-s I had my shoulder doing a snap each night while I slept on it, I'd be sleeping on it and it would go snap with a sharp pain. I've had very large shoulders since early teens and can only sleep on my right side now with my arm extended under my pillow as I have 11 collapsed disks in my lower spine and can't sleep on my stomach or back, left side a hour but can't stay asleep. I know this is more than likely watching your video a detachment but now getting allot worse. When I slide my sunroofs cover in my outback I have serious pain in that exact spot. I hate surgery after them botching my back operation in 89 putting me into serious chronic pain. Is there another way to heal this without surgery? I was doing alternative dumbell presses but am worried it was causing more damage? I'm 56. Thanks for the video

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