In this episode of the Rehab Science podcast, Dr. Tom Walters, DPT, breaks down everything you need to know about rotator cuff tears—from anatomy and injury mechanisms to decision-making around rehab versus surgical repair. Dr. Walters explains the role of the four rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) and why the supraspinatus tendon is most often affected. He also discusses the difference between partial and full-thickness tears, and how imaging findings don’t always predict pain or function.

Listeners will learn when rehabilitation is the preferred approach and when surgical repair may be necessary. Drawing on current research and clinical experience, Dr. Walters emphasizes the value of progressive strengthening, scapular stabilization, and load management—highlighting that most people can recover full, pain-free function without surgery. The episode concludes with practical advice for restoring shoulder strength and confidence through movement.

• 📘 Rehab Science: How to Overcome Pain and Heal From Injury

• 🎥 Rotator Cuff Rehab Exercises on YouTube

• 🌐 Rehab Science App

In this solo episode, Dr. Tom Walters breaks down thoracic outlet syndrome (TOS)—a condition caused by compression of the nerves and blood vessels as they pass from the neck into the arm. He begins with an introduction to the condition and explains the difference between neurogenic and vascular TOS, highlighting key symptoms that require urgent medical referral. Dr. Walters then discusses how to differentiate TOS from cervical radiculopathy, a common source of confusion in clinical practice, focusing on symptom distribution, aggravating positions, and relevant clinical tests. Finally, he outlines the most effective physical therapy interventions for neurogenic TOS, including postural retraining, mobility work, scapular strengthening, breathing strategies, and activity modification.

This episode is ideal for anyone interested in learning more about the anatomy, diagnosis, and rehab management of TOS, from clinicians to patients dealing with upper extremity pain and dysfunction.

Rehab Science Book

YouTube video

References

1. Illig KA, Donahue D, Duncan A, et al. Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome. J Vasc Surg. 2016;64(3):e23-e35. doi:10.1016/j.jvs.2016.04.039

2. Povlsen B, Hansson T, Povlsen SD. Treatment for thoracic outlet syndrome. Cochrane Database Syst Rev. 2014;(11):CD007218. doi:10.1002/14651858.CD007218.pub3

3. Gillard J, Perez-Cousin M, Hachulla E, et al. Diagnosing thoracic outlet syndrome: contribution of provocative tests, ultrasonography, electrophysiology, and helical computed tomography in 48 patients. Joint Bone Spine. 2001;68(5):416-424. doi:10.1016/S1297-319X(01)00331-2

4. Balci AE, Balci TA, Cakir O, et al. Surgical treatment of thoracic outlet syndrome: effect and results of surgery. Ann Thorac Surg. 2003;75(4):1091-1096. doi:10.1016/S0003-4975(02)04603-0

In this episode of the Rehab Science podcast, Dr. Tom Walters, DPT, breaks down one of the most common sources of neck and shoulder discomfort—trapezius myalgia. Often experienced as persistent tightness or aching in the upper trapezius muscle, this condition affects individuals who spend long periods sitting, working at a computer, or holding static postures under stress.

Dr. Walters discusses the underlying anatomy and biomechanics of the trapezius, highlighting how postural overload, fatigue, and nervous system sensitization contribute to chronic discomfort. He explains why passive strategies like stretching alone may be insufficient, and emphasizes the role of progressive resistance training in improving muscle function and reducing symptoms. The episode concludes with practical movement strategies, rehab principles, and key behavioral tips for lasting relief.

• 📘 Rehab Science Book on Amazon

• 🎥 Rehab Science YouTube Channel

1. Andersen LL, Jørgensen MB, Blangsted AK, et al. Effect of physical training on pain sensitivity and trapezius muscle morphology in females with trapezius myalgia: randomized controlled trial. J Appl Physiol (1985). 2008;105(4):1128-1134. doi:10.1152/japplphysiol.90391.2008

2. Larsen CM, Hansen M, Hansen EA. Effectiveness of strength training versus stretching exercises for the treatment of trapezius myalgia: a randomized controlled trial. Scand J Work Environ Health. 2013;39(2):143-150. doi:10.5271/sjweh.3320

3. Blangsted AK, Søgaard K, Hansen EA, et al. The effect of physical coordination training on posture, muscle activation, and musculoskeletal symptoms in office workers. Scand J Work Environ Health. 2008;34(1):55-65. doi:10.5271/sjweh.1194