It's time for another episode of the FAKTR Podcast. I'm your host Jessica Riddle. Welcome and thanks for tuning in. Today we're going to pick up where we Left off with Dr. Tim Bertelsman and Dr. Brandon Steele, co founders of Chiroup.com we're covering part two of our deep dive into the latest clinical research shaping conservative care. In this segment we explore even more conditions and concepts that can improve patient outcomes, from thoracic outlet syndrome and proximal hamstring tendinopathy to the science of placebo. And we'll learn how it actually influences your results.

Plus, we'll break down the power of communication and clinical care, why sleep is an often overlooked component of recovery, and how movement is still medicine. If you're ready for another round of high impact evidence based insights that you can take straight into practice, you're in the right place my friend. Let's dive in.

So now we're going to dive into the shoulder. Here's all those slides. Also, with any kind of nerve mobilization or any kind of exercise, it's always good to have videos associated with this. So even if you have printouts of your exercises, still have a video backup because these exercises do take a little bit of nuance where you want your patients to understand. Now when we talk about rotator cuff, we the rotator cuff disorders as far as our aging population, very, very prevalent. So even though the rotator cuff may be the underlying tissue that's causing the problems, we still want to make sure we're assessing the nerves associated with the diagnosis. With any joint that we have in our body, there's always a continuum. Sorry for that being a little bit black there.

But in the shoulder, we often find patients with scapular dyskinesis, which Charles near said that 100% of the people with impingement syndrome started off with scapular dyskinesis, and 95% of people with rotator cuff syndrome started off with impingement syndrome, and the other 5% were traumatic. So you can imagine that when we move down this continuum, people are starting with the first one, and it's just unfortunately not being dealt with. And what we notice is that when people have something called scapular dyskinesis, this bone unfortunately starts to ride up into this bone, because you're not. You don't have very good stability, every glenohumeral joint. And now when you start to move this arm, you have to force extra range of motion out of your glenohumeral joint. You have a bone on top, you have a bone on bottom, and you have squishy stuff in the middle. And unfortunately, with scapular dyskinesis, or in some cases, a postural syndrome called upper cross syndrome, these big movers start to become a little more hyperactive. Your big movers are your deltoids, your big movers are your latissimus, your upper trapezius.

And those are your patients that, when they're moving their arm, it just looks like everything's kind of fused together. And unfortunately, your body can tolerate that for a little bit. But if you don't move with good range of motion and good quality, something will pay the price. And if you are forcing too much range of motion out of that glenohumeral joint, the muscles stabilize. That glenohumeral joint being the rotator cuff, need to start to work a little bit harder. So now you're starting to man more out of your supraspinatus. Your subscapularis infraspination, teres minor, coupled with the fact that this glenoid cubul joint now has to actually move more. And let's just say bad things happen to the rotator cuff.