Review assessments on the go with our e-book or app and solidify your clinical reasoning in our online course: Course: bit.ly/PTMSK Book: bit.ly/GETPT App: physiotutors.com/app
I've been watching your video's for over 2+ years now for medical school and just wanted to say they have been amazing and such a huge help! Thank You!
This is by far one of the best, if not the absolute best, channel on MSK assessments. I teach medical students at University of Toronto, Canada, and I am always looking for great videos to demonstrate proper physical exam. The exams and interpretation is clear backed up with evidence from the literature. Absolutely fantastic. I will make sure to share your videos with my students and will ask them to subscribe. Very well done indeed. Thank you!!
In Magee it is "elevate arm in scapular plane", in your video it is "elevate arm in flexion". Is your video demonstrating a different version from Magee? Is there any difference between these 2 variations?
Neer (1983): "The impingement sign is elicited with the patient seated and the examiner standing.... Scapular rotation is prevented by one hand as the other raises the arm in forced forward elevation (somewhere between flexion and abduction), causing the greater tuberosity to impinge against the acromion. This manoeuvre causes pain in the patients with impingement lesions of all stages"
Hey Ruben, you're right. It's a phrasing issue. You are of course flexing the shoulder which mandates movement of the entire shoulder girdle and not just the GH joint! Good observation!
+wasima faz officially it's a test for subacromial impingement. However that's an old term which doesn't really describe properly what's happening in the shoulder. It's better to use the term subacromial pain syndrome which describes rotator cuff tendinopathy with or without bursitis
Static Stretch: Moving into the stretch and holding it in end range position Ballistic Stretch: Actively moving the limb/muscle repeatedly in and out of the stretch position Example (Hamstrings): Static: bending over to touch the floor with the hands with the legs extended until you feel stretch in the Hamstrings. Then hold this position for a period of time Ballistic: Swinging the extended leg back and forth in standing position exerting a stretch at end range
Hi Kelly, as Google and Apple are responsible for the sales process we are sticking with their terms and conditions. This means that you can return the app within 48h of the purchase. No exactly sure what you mean by web-based platform. The content is drawn from our webserver and continuously updated, while the videos are loaded from UA-cam.
What if the patient is negative on Neer test, but if you rotate the arm externally (thumbs up position) and perform same test, there is severe sharp pain?
In general, one test doesn't say much. On the other hand, internal impingement could be another hypothesis that you might want to include. have a look at this article, maybe it's helpful in your case: www.ncbi.nlm.nih.gov/pmc/articles/PMC5155252/
Hii..I got a neck injury during a gym accident 5 yrs back ....x ray showed that the cervical spine is slightly straightened coz of which I have neck rotation problems ..I feel relaxed when I wear the cervical collar but only for some time ..doctor only gives painkillers and pain relief ointment but there's no relief so far ...pls help me doctor
+Beshr Elaser We are specialized in Ortho and a little bit of neurology that is important for musculoskeletal conditions. We are in touch with other physios who are specialized in other areas. So it's in the planning but we cannot promise anything yet.
Absolutely, does not make a big difference. Only more functional to test in sitting or standing as this is the position in which the patients is also experiencing his complaints.
If you fixate the scapula correctly, you shouldnt be able to flex the arm of your patient over around 90 degrees, the glenohuneral joint alone only allows this amount of flexion
Hi guys. Thanks for the video. Just going off the topic,, can u pls list the precautions/restrictions status post total hip arthroplasty for anterior approach vs posterior approach?? I know hip flex beyond 90 and pivoting on the operated hip are not allowed in both but is there anything else??
Ur welcome! Generally, the restrictions are less for the anterior approach, but in our experience it totally depends on the protocol each hospital applies. Some only forbid running, others apply the same restrictions like with the posterior approach. The question is if precautions/restricions should be given in the first place: www.ncbi.nlm.nih.gov/pubmed/25834275
+Donn Hey Donn! With one test to be negative or positive you can never be 100% sure. Therefore a good patient history is really important! I would recommend that you also do the Hawkins-Kenendy as well as the Emtpy Can / Jobe test and see if these are negative as well. Then you can be relatively sure you don't have impingement. Be aware though that these are passive tests and should be performed by a qualified physiotherapist or musculoskeletal expert.
what kind of pain will the patient feel? is it radiating?deep?difffuse? and where does this type of pain originate? will there be any nerve affectation also?
Hey Madelle, with this test you are looking to reproduce the patient's familiar pain which is sharp, sudden, local, mechanical pain due to the encroachment of the the rotator cuff tendons and/or bursa between the roof of the acromion and the head of the humerus in subacromial impingement and the head of the humerus and the glenoid rim in internal impingement. So the pain will not be radiating like when a nerve is affected, not deep like in osteoarthritis or diffuse like in referred pain. When a nerve is affected, patients usually complain about numbness, tingling, and/or shooting pain in the distribution of the affected nerve.
One more thing, is the type of pain in your Neer test same to your Hawkins-Kennedy test? Coz I was thinking that the involve structures in Hawkins are same to the Neer Test which are the supraspinatus and biceps tendon.
Yes, the mechanism of provocation is similar. They are general shoulder impingement provocation tests and not specifically targeted at only the supraspinatus. However, neither of them tests the integrity of the biceps tendon. The biceps tendon is best tested with the Speeds, Yergason's, Biceps load II or O'Briens Compression Test.
9 Physiotutors . This test is clearly shown by the graphics here. great. I am a footballer and I need, now, the break of the period to regain shape and relieve the disorder of the supraspinatus tendon of the left shoulder. #gaz ®️ #gaz_oren ®️ #gaz15 ®️ #gaz_15 ®️ #otticagazzera ®️ #paegz ®️ #pls ®️ #nike ®️
![Lp. Сердце Вселенной #60 РОЖДЕНИЕ ЛОЛОЛОШКИ [Финал] • Майнкрафт](http://i.ytimg.com/vi/YoR0pAV9FVQ/mqdefault.jpg)
Review assessments on the go with our e-book or app and solidify your clinical reasoning in our online course:
Course: bit.ly/PTMSK
Book: bit.ly/GETPT
App: physiotutors.com/app
it makes me mad that these dudes don't have more likes. They deserve way more recognition based off their view count.
It’ll come with time 😊
I've been watching your video's for over 2+ years now for medical school and just wanted to say they have been amazing and such a huge help! Thank You!
This is by far one of the best, if not the absolute best, channel on MSK assessments. I teach medical students at University of Toronto, Canada, and I am always looking for great videos to demonstrate proper physical exam. The exams and interpretation is clear backed up with evidence from the literature. Absolutely fantastic. I will make sure to share your videos with my students and will ask them to subscribe. Very well done indeed. Thank you!!
+Sine Qua Non wow! We feel humbled! We would love to have your students as subscribers :) thank you for sharing our videos! There is lots more to come
I love your videox, they are really helpful, love and blessings from Pakistan...😇
Glad to hear Ayesha! Greetings back from Amsterdam!
Thank you, you guys have the best videos out there!
Thank you So much for this channel!! This really helps me!
More easier to be medicine student with you two, thanks
Happy to hear Aysenur! Good luck with your studies!
this is a great help for me as a student.thank you
+jp aquino cool! Glad to hear and thanks a lot for following!
love your videos...really helpful....from Bangladesh
Can you explain the difference between a subacromial impingement and an internal impingement?
Same question
Through site of the pain , if in anterior = subacromial impingement , if posterior pain = internal impingement
Hi... Very precise, quick and easy to learn and well explained videos. It's a good work! Easy to adopt in everyday clinical practice 😊
Hey, thanks for the compliment and for following. What you describe is our goal, so good to hear!;)
Thank you
I think you meant the oppositte in your final assessment??
thank u so much .this is very helpful. Plz include mangement section for different pathologies
+muhammad uzair khan thanks. This will come in the future! Stay tuned and make sure to subscribe so you don't miss any videos!
Thank you!
Thank you! your videos are so helpful! =) clear instructions and well executed!!!!
Ceci Lopez thanks
Thanks for you videos, they are helpful and descriptive. Good job bro.
Glad you like them Matt!
0:33, skip the extra stuff.
In Magee it is "elevate arm in scapular plane", in your video it is "elevate arm in flexion". Is your video demonstrating a different version from Magee? Is there any difference between these 2 variations?
Neer (1983): "The impingement sign is elicited with the patient seated and the examiner standing.... Scapular rotation is prevented
by one hand as the other raises the arm in forced forward elevation (somewhere between flexion and abduction),
causing the greater tuberosity to impinge against the acromion. This manoeuvre causes pain in the patients with
impingement lesions of all stages"
thanks for your videos.. these are helpful.. from Pakistan
+Sidra Aslam Glad you enjoy them! Cheers back to Pakistan!
Thanks :-)
thank you very much . i hope you write the instruction down.
+Haider Alyassin you´re welcome. How do you mean that?
Great video's guys! Learned allot!
Glad we could help Willem!
Thanks a lot for the video. It helps a lot. One question: what is the difference between internal impingement and subacromial impingement?
See our comment in the HK video.
So how is it possible to passively flex only the glenohumeral joint to 160/170 degrees without moving the entire shoulder girdle?
Hey Ruben,
you're right. It's a phrasing issue. You are of course flexing the shoulder which mandates movement of the entire shoulder girdle and not just the GH joint! Good observation!
Thanks for your reply! Keep up making these videos :) It really helps me in the working field!
Ruben Philipse good to hear! And yes we are uploading two videos per week! Tuesday's and Friday's
very nice thank you
Ur welcome Rafael!
Really helpful 😍
Thank you so muchhhh..!!!
its help me alot.
Happy to hear! You're welcome and thank you for following us!
+Physiotutors please help me out with thz too..
hawkins is for subacromial or for rotator cuff?
+wasima faz officially it's a test for subacromial impingement. However that's an old term which doesn't really describe properly what's happening in the shoulder. It's better to use the term subacromial pain syndrome which describes rotator cuff tendinopathy with or without bursitis
+Physiotutors okay..!!! thank you so much.
hey plz tell about difference between static stretch and ballistic stretch
Static Stretch: Moving into the stretch and holding it in end range position
Ballistic Stretch: Actively moving the limb/muscle repeatedly in and out of the stretch position
Example (Hamstrings):
Static: bending over to touch the floor with the hands with the legs extended until you feel stretch in the Hamstrings. Then hold this position for a period of time
Ballistic: Swinging the extended leg back and forth in standing position exerting a stretch at end range
thanks
+Brian Hawthorne You´re welcome Brian!
Is this test has resisted elevation during shoulder flexion? And thank you for this video
No, completely passive
Thanks 🙂
Considering purchasing your app, do you provide a 30 day free trial? Is this supported by a web-based platform?
Hi Kelly, as Google and Apple are responsible for the sales process we are sticking with their terms and conditions.
This means that you can return the app within 48h of the purchase.
No exactly sure what you mean by web-based platform. The content is drawn from our webserver and continuously updated, while the videos are loaded from UA-cam.
What if the patient is negative on Neer test, but if you rotate the arm externally (thumbs up position) and perform same test, there is severe sharp pain?
In general, one test doesn't say much.
On the other hand, internal impingement could be another hypothesis that you might want to include.
have a look at this article, maybe it's helpful in your case: www.ncbi.nlm.nih.gov/pmc/articles/PMC5155252/
thank you very nice from saudi arabia
+امل الغامدي Thanks a lot from Amsterdam!
thank you from Afghanistan
+greenapplejuice23 wow! Thanks and all the best to you
i'm dial up internet trying to study right now
Hii..I got a neck injury during a gym accident 5 yrs back ....x ray showed that the cervical spine is slightly straightened coz of which I have neck rotation problems ..I feel relaxed when I wear the cervical collar but only for some time ..doctor only gives painkillers and pain relief ointment but there's no relief so far ...pls help me doctor
are you have a coolection video in other branch es?
Not sure if we understand your question? Are you asking if we have videos about something else than physiotherapy?
something else as ortho or neuro
+Beshr Elaser We are specialized in Ortho and a little bit of neurology that is important for musculoskeletal conditions. We are in touch with other physios who are specialized in other areas. So it's in the planning but we cannot promise anything yet.
Hello, does this have to be done in sitting or can you do this in supine?
Absolutely, does not make a big difference. Only more functional to test in sitting or standing as this is the position in which the patients is also experiencing his complaints.
If you fixate the scapula correctly, you shouldnt be able to flex the arm of your patient over around 90 degrees, the glenohuneral joint alone only allows this amount of flexion
i like the initial music ...charging before learning test :D
Thanks for your video. I will like of make a job like this in brazil.
Do you mean a portuguese physiotutors or physiotherapist in brazil?
Hi guys. Thanks for the video. Just going off the topic,, can u pls list the precautions/restrictions status post total hip arthroplasty for anterior approach vs posterior approach?? I know hip flex beyond 90 and pivoting on the operated hip are not allowed in both but is there anything else??
Ur welcome! Generally, the restrictions are less for the anterior approach, but in our experience it totally depends on the protocol each hospital applies. Some only forbid running, others apply the same restrictions like with the posterior approach.
The question is if precautions/restricions should be given in the first place: www.ncbi.nlm.nih.gov/pubmed/25834275
] does it have strong clinical value?
No it does not
If i dont feel any pain doing this does that mean i dont have any impingement?
+Donn Hey Donn! With one test to be negative or positive you can never be 100% sure. Therefore a good patient history is really important! I would recommend that you also do the Hawkins-Kenendy as well as the Emtpy Can / Jobe test and see if these are negative as well. Then you can be relatively sure you don't have impingement. Be aware though that these are passive tests and should be performed by a qualified physiotherapist or musculoskeletal expert.
Спасибо.
what kind of pain will the patient feel? is it radiating?deep?difffuse? and where does this type of pain originate?
will there be any nerve affectation also?
Hey Madelle, with this test you are looking to reproduce the patient's
familiar pain which is sharp, sudden, local, mechanical pain due to the
encroachment of the the rotator cuff tendons and/or bursa between the
roof of the acromion and the head of the humerus in subacromial
impingement and the head of the humerus and the glenoid rim in internal
impingement.
So the pain will not be radiating like when a nerve is affected, not deep like in osteoarthritis or diffuse like in referred pain.
When a nerve is affected, patients usually complain about numbness, tingling, and/or shooting pain in the distribution of the affected nerve.
OK THANK YOU SO MUCH!!! This is really helpful😌
+Madelle Rose Anajao You're welcome! Thanks for following!
One more thing, is the type of pain in your Neer test same to your Hawkins-Kennedy test? Coz I was thinking that the involve structures in Hawkins are same to the Neer Test which are the supraspinatus and biceps tendon.
Yes, the mechanism of provocation is similar. They are general shoulder impingement provocation tests and not specifically targeted at only the supraspinatus. However, neither of them tests the integrity of the biceps tendon.
The biceps tendon is best tested with the Speeds, Yergason's, Biceps load II or O'Briens Compression Test.
Çok yararlı bir video ♥️👏👏👏👏
Teşekkürler, teşekkürler!
please upload joint glides videos.
Manual therapy videos will be uploaded in the near future!
Thank you so much for your freaking absolutely amazing videos.10/12/2018 😃😃
0:45 using all his strength to lift his tree trunk of an arm XD
helpful
Good to hear, thx!
shashank mittal thanks
I swear I'm going to have to look this up throughout my career. Just doesn't stick in the brain.
9 Physiotutors
. This test is clearly shown by the graphics here. great. I am a footballer and I need, now, the break of the period to regain shape and relieve the disorder of the supraspinatus tendon of the left shoulder.
#gaz ®️ #gaz_oren ®️ #gaz15 ®️ #gaz_15 ®️ #otticagazzera ®️ #paegz ®️ #pls ®️ #nike ®️
Would have been nice to see what depressing the scapula looked like
I'm more interested with your vedio,
0:36
❤️
Anyone else thinks the thumbnail looks like a Dirty Dancing scene?
Haven’t watched the movie 😬
desquised bro
פריצת דיסק
love your videos...really helpful....from Bangladesh
Happy to hear, regards to Bangladesh from Amsterdam!
Love your videos so much. So helpful💯
0:29
0:42