Learn how posture effects shoulder motion and alignment, and how poor posture contributes to shoulder pain. Hosted by Dr. George Best.
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Hello! I'm Dr. George Best at Best Health and Wellness in San Antonio, Texas. Today, I'm going to share with you some little-known information about rotator cuff problems that even a lot of doctors and physical therapists aren't aware of. I think you will be surprised by the effects that other things besides the shoulder have on the rotator cuff. So I am going to cut away, change into something more comfortable, and we'll show you a little demonstration I think you will find rather interesting. So let's get started. I am going to demonstrate now the effects that posture have on shoulder mobility, and explain why shoulder mobility is tied in with those problems with rotator cuff and different types of shoulder pain. What a lot of people don't realize, including a lot of doctors and physical therapists, is that the shoulder itself, in a lot cases, is not really the reason why the shoulder isn't moving properly. I am going to do a little demonstration here for you. First of all, I'm going to start out standing up nice and straight with good posture, and I am just going to raise my arm up straight to the side. You can see I can get my arm up pretty good. I can get it all the way, to where it actually touches my head without doing any strange contortions to get it there. I don't have any shoulder pain, so this maybe a little different for you if you are having shoulder problems. But I am going to show you now, what happens if I just slouch a little bit. I am starting to just kind of loosen up. Here I am going to just kind of let my shoulders drop down some, let my upper body slouch forward just a little bit. And now, I am going to do the exact same range of motion, and that's as far as I can go. I could probably force it another few degrees, but that's as far as it's going to get. You can see, and I am going to stand up straight again, you can see what happens when I stand up straight. I am going to slouch forward a lot, because I see a lot of people that will actually slouch forward quite a bit more than I showed you the first time. They will actually come in really slouch forward, there head is kind of shifted forward, their upper body is really kind of leaning and I am going to do the same range of motion once more. I'd really have to strain to get any higher than that. So the shoulder range of motion is drastically affected by your posture, how upright your spine and the alignment of your rib cage and your spine and your head, all affect the range of motion in the shoulder. So what does this mean as far as shoulder problems in terms of pain, and in particular, rotator cuff injuries? Well, what happens is that, when your posture is not good, there is a subtle shift forward of the shoulder, it rolls forward. I am going to show you in a model in a moment, what exactly is happening with that. But basically, what's going on is if there is any forward shift, any forward rolling of the shoulder, because you can rotate your shoulder in and out if you do it consciously, what happens is the rotator cuff tendon, in particular the supraspinatus tendon comes forward and it starts to get pinched in between the bone surfaces. And your body is not going to let you go much further than where that tendon is starting to get pinched. But for somebody who has this problem, who has this postural distortion and the shoulder is rolled forward, what happens is that just through normal life and using your arm and that type of thing, there is a lot more mechanical stress and actual friction and rubbing on that tendon. And what happens is that because the shoulder is rolled forward and because that tendon is rubbing up against the bones and ligaments, which I'll show you on the model; it's kind of like taking a rope and rubbing it across the rock, repeatedly. So overtime, what happens is as you get these little, basically, abrasions which then turn into fraying of that tendon and that produces inflammation. So then it rubs even more, you get even