Shoulder Pain Keeping You Up at Night? Austin Orthopedic Surgeon Dr. Ben Szerlip Shares What to Do First

Layla [00:00:01]:

Welcome back to shoulderwise, the show where clarity, strength and care come together for every shoulder journey. Today we’re diving into the question almost every patient seems to ask Dr. Ben Szerlip, at some point, why does my shoulder hurt? It sounds simple, but the answer is anything but simple. Right, Dr. Szerlip?

Dr. Ben Szerlip [00:00:19]:

Yes. And thank you for having me again, Layla. I appreciate being here.

Layla [00:00:23]:

Awesome. So talking about how patients ask you this all the time regarding pain in their shoulder. So if someone is listening now, who’s experiencing this pain or a discomfort, maybe lying awake right now with shoulder pain, what’s the very first step that you would tell them to take?

Dr. Ben Szerlip [00:00:42]:

Yeah, I think all of us have been there and it’s definitely a common question. I would start by saying we all need to, and myself included, keep perspective. If you’re laying awake at night, we should probably be trying to get sleep and not letting our mind race and then not getting online or on our phones and then doom scrolling. But it happens to the best of us. But one of my favorite quotes of many is Arnold Palmer. He is a golfer, but he kind of said that the game of golf as well as I think the game of life is kind of played on a five inch course. And his whole point behind that was that it’s the space between our ears, it’s our brains. So the key to a game or key to life is mastering your own thoughts, positive self talk and then the mental strategy that we use to kind of improve most aspects of our life.

Dr. Ben Szerlip [00:01:40]:

So that being a game of inches, being controlled by our own mind, pain is a normal thing and we should reassure ourselves that pain can happen. And it’s actually our body’s trying to tell us that something may be going on and we need to do something different. But I think that my key or my job is to help patients understand and sometimes help myself or my friends or my family understand that well being or health is a direction that we go in, not a destination. And that wellbeing is kind of a course that we plot. Think of like a nautical course the ship would take. We can go off course and, and that’s going to happen. And then we use our knowledge or we use our other practitioners or other resources or information, different treatments to get back on course. So I would say that it’s kind of like saying, hey, wellbeing is a direction, not a destination.

Dr. Ben Szerlip [00:02:37]:

And it’s actually part of maintaining the course. So that’s okay. Essentially, be grateful for the bees and not just the honey is something I like to remind myself too.

Layla [00:02:47]:

I Like that. It’s definitely a good saying. And beyond that, you know, patients having that question for you about why my shoulder hurts. But what’s one question that every patient should ask their doctor specifically about shoulder pain that most people may not ask?

Dr. Ben Szerlip [00:03:07]:

I think that’s an amazing question. And each patient I see teaches me something different about shoulder pain. Oh, I never thought of that. I should have explained that. Or I think that’s really the key is communication. Right. In our relationships, in our lives and our marriages and whatever thing beyond that is, I think the doctor and the patient need to focus on their understanding of the goals that we have. What are our goals for this treatment? Because the doctor may have one, and the patient may have a completely different set of goals.

Dr. Ben Szerlip [00:03:39]:

Right. Or understanding or expectations. And I think that happens all the time. So, you know, are the goals focused around pain relief? Are the goals focused around improved function? So they can do this, they can play pickleball, or they can, you know, pursue sport that they always had in mind or get back to something else or just improving their overall weight? There’s also, can I avoid a surgery? Or how can I minimize future damage? So each one of these has a own subset of goals, but I think the doctor and the patient getting online saying, hey, if I pursue this treatment plan, how long will it take? What is it going to accomplish in terms of pain relief function or avoiding a surgery? Also, if a patient does get a surgery, I think that understanding how long the recovery period and some of the details around that are also really helpful to the patient. So they can understand what week one is going to look like and then what week 17 is going to look like.

Layla [00:04:39]:

Absolutely. No, that makes a lot of sense. I would imagine that a lot of patients going in with shoulder pain, whether they’re going to need surgery or not, they may be more focused on the current state of their shoulder or their pain and not always concerned about the longevity or, like, the future steps that you kind of touched on in terms of being able to communicate those things. I can understand and see how patients may not be thinking down the road when they’re currently in pain or currently nervous about a surgery.

Dr. Ben Szerlip [00:05:11]:

And. Go ahead.

Layla [00:05:13]:

No, go ahead.

Dr. Ben Szerlip [00:05:14]:

I think that that is, you know, each doctor, if you do get a surgery or you do expect a recovery from your baseline at that point, that essentially what it comes down to is we are all seeking people on this podcast or people in, you know, pursuit of. Of something beneficial or better. They’re looking at value. Right? And I think that that’s a Tremendous thing. I think that that’s what we should be doing. And we, as practitioners, should be helping patients find that value and helping them define what it is. And a lot of times in the medical field or industry, you’ll hear that value is the outcome divided by the cost. Right.

Dr. Ben Szerlip [00:05:55]:

And each one of us define that differently. So an outcome to a patient could be, hey, I want to be able to pick up my grandkid. You know, I want to be able to carry, you know, a bag of groceries, you know, five blocks to my apartment. And the cost would be saying, hey, it’s the time I’m going to invest in a set of exercise. It’s the money I’m going to spend on maybe a physical therapy or a gym membership. But each one of us defines that difference. So I think that helping the patient find their own sense of value and pursuing getting the most out of that is really the key. And it’s really nice to see that patient kind of understand their own sets of values and how they get there.

Layla [00:06:38]:

Absolutely. And then being able to communicate that with you, like you said, is crucial because I’m sure that probably helps you with creating a plan for them or helping them really figure out the best case scenario for their treatment. And whether there’s surgery, post surgery or things that you just help with in terms of their pain, being able to understand their why is, I think, very helpful. For sure.

Dr. Ben Szerlip [00:07:05]:

Absolutely. Yeah.

Layla [00:07:06]:

The shoulder itself, which I know you’ve described this previously as one of the most fascinating yet also misunderstood joints. So why is it that you think it is the most misunderstood joint?

Dr. Ben Szerlip [00:07:22]:

I think that it’s so unique in different ways, but there’s a couple, and that it affords us so much range of motion in the body. And there are many amazing joints. And I always tease my colleagues in the office or who specialize in hips or knees or spine, I kind of tell them, like, hey, you may think that that’s the most interesting joint, but you’re also probably wrong. But in general, I think that there is quite a bit of motion that we all expect and need in our everyday life to perform these. These activities, these functions. And so it gives us almost unlimited range of motion. But there’s also three joints working together in synchrony. There’s the glenohumeral joint, or what everybody perceives as the shoulder of the ball and socket joint.

Dr. Ben Szerlip [00:08:04]:

There’s also the acromioclavicular joint, essentially where the collarbone meets the scapula. And so, in general, there’s also the scapular thoracic motion. I’m just going to edit that out and take one more time because I blinked for a second. But I think that there is. The range of motion that we expect or we require of the shoulder is tremendous. It’s many separate planes and many degrees of motion. So we also have three joints that articulate there. And that is the glenohumeral joint or the ball and socket joint that everybody thinks of when they think of the shoulder.

Dr. Ben Szerlip [00:08:40]:

There’s also the acromioclavicular joint, and that is simply where the collarbone meets the shoulder blade. And then there’s also the scapula thoracic joint, which is essentially the shoulder blade moving on the chest wall or on the rib cage. And so those three joints afford us so much range of motion, so much function. I think there’s also an incredible amount of dynamic stabilization. So what that means is there’s the. Let’s say you have a deep hip joint, right? There’s more static constraints, the bone, the tissue and the structures, but the dynamic meanings. All these muscles and tendons and ligaments have to work and in coordination with each other to keep that balance of the ball and socket joint. It’s often described sitting like a golf ball sitting on a golf tee.

Dr. Ben Szerlip [00:09:28]:

So I think that those are all things that make it so intricate. And I think for a deeper dive on some of these, the patients can kind of look up and ask yourself, why does. Why can a human being throw a 100 mile an hour fastball? When chimpanzees rapes, they can not really throw at all. So it’s the kinematics is the way that our body moves and the way that our shoulder blades are placed that allow us to do those special things. And it’s kind of, it’s really neat and it’s fascinating.

Layla [00:09:58]:

For example, myself, I’m not in the shoulder world, so this is like news to me. I feel like at layman’s terms, people, you know, hear shoulder and they kind of just assume that it’s. It’s this without actually thinking about all the things that are connected to just what people think is your shoulder. It’s very intricate, like you said. So I definitely see how that’s misunderstood probably within even doctors and surgeons, but especially for people who are not well versed in the medical field and in the anatomy of the shoulder. It is super interesting to hear that and makes you kind of like think even more in depth about how everything really connects within your body. And I know some people who are listening might, you know, have pain and might be listening to this to learn more about their own pain, for example. So if someone is listening right now, how would you break down the most common cases in plain language without scaring them?

Dr. Ben Szerlip [00:11:02]:

Right. And that is, I think we all want the ability to be able to understand and organize our own thoughts. And there are probably 50 to 100 things that could be wrong with a particular joint. But I do want to, I try to help break it down in five main categories. I call it the Fab five. Right. And there is degenerative what most people think of with age related problems, but that can also be genetic. Right.

Dr. Ben Szerlip [00:11:30]:

Some of us will probably live to be 105 and others won’t. And that’s some genetic. But some age related changes and degeneration does happen and that patients will usually see that progression over time. Traumatic injuries are also the second one. And that’s fairly self explanatory. But trauma does happen to each and every one of us. But there can be traumatic injuries that we can avoid, especially if we’re doing, playing a sport or engaging in activity. We can modify those activities to decrease our chance of a traumatic injury.

Dr. Ben Szerlip [00:12:00]:

Right. As we all age, some people may not pursue downhill mountain biking, but most people will try to bike. Right. So that we can kind of modify some of those things. Uh, then the third category I, I kind of label is overuse or improper technique or deconditioning. And I think that every single one of us can identify with those. Um, if you have a favorite sport or I have young athletes playing year round sports, you’re certainly not, you know, you’re certainly more familiar with an overuse injury, the improper technique. As we’ve all kind of experience too, if you’re doing something wrong, it might have a compounding thing.

Dr. Ben Szerlip [00:12:36]:

You see somebody in the gym or you’ve had a gym injury yourself, or you’re like, hey, maybe I wasn’t doing the correct lift or having the correct form. Deconditioning we all probably suffer from is sitting at a desk for six to eight hours a day is what most people kind of have is an occupational hazard in their career. And then the, I think the fourth category right is the balance and alignment. I think we talked about this and it kind of lends to itself. If we’re, if we are hunched over at a desk, our shoulder blades tend to roll forward and the muscles kind of, that we usually work in the gym, they also pull the shoulder blade forward and that causes that balance and alignment effect. Think of like an irregular wear pattern on your car. So there’s also restrictions in mobility as we tend to age and work different muscles differently. The last category, the fifth one is biologic and that can be anything from metabolic issues.

Dr. Ben Szerlip [00:13:32]:

It could be how much a patient would involve like drinking or smoking. Body weight can play a role. Also incidences of like let’s say an autoimmune disorder like rheumatoid arthritis or infection, something like that. So you can kind of bottle most of patients, problems, symptoms or issues with those five categories.

Layla [00:13:54]:

And it’s definitely interesting that to think about. There are so many common causes that affect us on a day to day basis that we don’t particularly realize until we have a pain in our shoulder because it’s such a big part of our day to day usage within our body that we may not even think about that we take for granted. So that’s another way to even think about it. Even when it’s. When you mentioned sitting at a desk, I find myself sitting like this and luckily I’m not having any pain. But I feel like I’m so much more aware of that now, being that it can cause pain down the road, down the line even. And in terms of diagnosing shoulder pain, I know you’ve said before that diagnosing shoulder pain can almost feel like detective work. So knowing now what I know about all the different things that go into it, I totally see why you say that and how you can think about it like detective work.

Layla [00:14:55]:

So can you share a story where the cause of the pain maybe wasn’t as obvious and how you really went about figuring that out?

Dr. Ben Szerlip [00:15:05]:

Yeah, I think too what you mentioned, like, hey, we never think about these things. And the one small point is I always try to throw in Malcolm Gladwell Easter egg. So the tipping point can happen when you’ve done that thing you’ve sit at a desk every week, every month, every year, or we know that age happen happens obviously, you know, slowly but surely. But there is a tipping point so that something can have damage or something can eventually accumulate to where we just notice the symptoms. So people are shocked, they’re like, I don’t know if that could cause my symptoms. But just like if I was driving my car and all of a sudden a belt popped or all of a sudden a bridge falls over, or in a tragedy a building collapses. That probably didn’t happen that day unless there was some external factor that probably happened over time. But the diagnosing shoulder pain and the detective work, I think one of the most interesting cases was an innocent anatomy lesson.

Dr. Ben Szerlip [00:16:07]:

Right. So I’ll try to, you know, be brief, but there is a. There was a patient that was having posterior shoulder dislocations. So the most common by far is when patients have a dislocation, the ball and socket joint, the ball moves forward or anteriorly, but it can also move backward. And so understanding the anatomy and understanding the patient was key to this factor. But the pectoralis muscles and the latissimus muscles and a couple other major muscles around your shoulder girdle are very strong, and they overpower the others. They’re internal rotators. So in times of an electrocution or a seizure, those internal rotators can push the ball back onto the socket, and a patient can experience a post a posterior dislocation.

Dr. Ben Szerlip [00:17:00]:

So in that particular circumstance, the patient had undiagnosed seizures. And so nobody knew why this patient was having shoulder pain, but he was subluxing or posteriorly dislocating his shoulder out the back because of those seizures. So it was really interesting. And they were able to diagnose that appropriately with the neurologist and then also help his shoulder pain, too.

Layla [00:17:22]:

Wow, that’s interesting how those things can connect. I. I had a roommate in college who would suffer from seizures and would also mention having a lot of pain in her body from the seizures. But it’s. It’s even interesting to think how those two things can align and dealing with, you know, different patients who experience so many different things. I’m sure that over time, you’ve heard a lot of myths and a lot of misconceptions. So what would you say is one of the biggest myths or misconceptions that you hear from patients over and over or all the time, and something you almost want to put on a billboard to nix that misconception or myth.

Dr. Ben Szerlip [00:18:09]:

That’s a great question. I think there’s probably at least two or three or four or five, whatever that may be. But I would say that one of them is that most patients can get better without a surgery and that most doctors don’t recommend a surgery. Most surgeons don’t recommend a surgery. And so I think that. And I’m geared this way, too. In the United States, in this environment, in this society, we kind of all want a quick fix. It’s almost inconvenient when we’re in pain or we have an issue and we can’t do X, Y, or Z that we obviously took for granted.

Dr. Ben Szerlip [00:18:46]:

Right. So the biggest thing is that we. There is a key element, and this is where I. One of my favorite authors is Arthur Brooks, and He kind of tells us the difference between patients with learned helplessness or earned success. And the back to the billboard saying, hey, patients can get better without surgery. They can understand what’s going on with their own pain. They can understand a base foundation on the anatomy. And, and they can usually do things like exercises, stretching, range of motion, you know, working with a physical therapist, even doing injections or medications and get their pain better.

Layla [00:19:25]:

And that’s interesting, too, because like you said, it can almost be an inconvenience to be in pain and then also have to go through surgery, especially when life is so busy, you almost can deprioritize yourself and pain sometimes just because it can, like you said, be an inconvenience. But for example, for those. And to nix that misconception that you need surgery to feel better, do you happen to have any recommendations of like, like you said, stretches or things that can make people feel better without having that surgery if it’s something that’s not necessary?

Dr. Ben Szerlip [00:20:01]:

Mm. I think that that particular problem is usually I’m going to harp again on this, but the muscles behind the shoulder blade of the exercises, understanding that the. And I’m going to kind of explain this, but the lower trapezius muscles and the rhomboid muscles are the muscles behind the shoulder blade. And we can kind of highlight in that video or the, the picture right there, but it, it allows the shoulder blades to go back and it allows the, the scapula to be kind of compressed up against the chest wall. And that allows us forward flexion. And so if we are able to focus on those muscles, it would be. A lot of patients are like, they completely understand, oh, if I have back pain, I’m going to strengthen my core. I’m going to stretch out my hip flexors, which have been bent or constricted all day by sitting in a chair.

Dr. Ben Szerlip [00:20:53]:

But we don’t have that same kind of natural, intuitive understanding of the muscles behind the shoulder blade. So working those muscles. And sometimes that does benefit from working with a therapist or our goal is even to, on this website and this podcast, have exercises where we’ll talk with a physical therapist on these exercises that we can do to kind of one, assess the range of motion, assess any restrictions in that range of motion. And then the strengthening part, too.

Layla [00:21:21]:

Absolutely. And I know, again, you’ve seen so many patients and have probably seen it all, but was there ever an instance or someone that may come to mind where they may have come in and thought they were convinced and they knew the cause, but the real Answer was actually something different that was causing their pain.

Dr. Ben Szerlip [00:21:45]:

Um, I do. I do think that there is many patients and. And they have this idea that they. They need a surgery to get better, and it’s funn. We’ll have to talk them out of it. So they convinced. They were convinced they had a problem and that we needed to solve it with a surgery or a quick fix or a medication. But in reality, if we undo that restriction or we improve the alignment or we improve the range of motion, that over time, that did get better for the patient, and they were pleasantly surprised.

Dr. Ben Szerlip [00:22:19]:

So I just encourage patients that, hey, they kind of come in and they say, look, therapy doesn’t work for me, and this is how it is, and this is the problem. And then I kind of convince them or maybe forced them to try a couple sessions, and they were like, oh, my gosh, it totally helped this. And they helped my knee pain or and they helped my back, and I learned how to do this. Not only is that helpful now to get us out of pain, which is obviously what we want, but it’s important for the long run. Right. We need to be able to kind of heal ourselves. We need to be able to understand how to improve things in the future. All the patients that I’ve ever met, that’s what they want.

Dr. Ben Szerlip [00:22:55]:

We are all going to experience pain, but in order to understand something and then. And then really believe that we can get on the other side of that. I think that resilience is. Is really is really helpful.

Layla [00:23:07]:

Absolutely. That resilience and also having that resource within yourself to know that you can make yourself feel better, especially, like you said, even if it helps other parts of your body as well.

Dr. Ben Szerlip [00:23:22]:

Yeah. That earned success is, I think, key to patient satisfaction and all of our satisfaction.

Layla [00:23:29]:

Absolutely. And on the flip side of that, has a patient ever taught you something about shoulder pain that may have changed how you explain it or how you think about it, or even how you treat it?

Dr. Ben Szerlip [00:23:43]:

I’m not sure if I can say that I think I knew everything coming out of med school. I know it all. And all joking aside and doctors, I think we learn something new every day with our patients. And oftentimes it’s humbling, but also really exciting to understand that. So I think that doctors do need to take the time to listen to the patient, ask them specific questions. We tend to see hundreds of patients and then kind of lump them into categories or put them in identifying a factor where we’ve already seen 10 times. So I think helping a patient tailor the treatment plan and that’s what they’ve taught me. So I’ll have let’s say a 75 year old grandmother who wants to do X, but then I also have a 75 year old patient who wants to run a marathon or even do an ironman, which is if people aren’t familiar, that’s a, an ironman is a marathon.

Dr. Ben Szerlip [00:24:39]:

I think it involves over. Well, we’ll cut that part out, but it’s, it’s extensive part. So let’s see. We also have patients that want to do an ironman or they want to, you know, do a specific sport at, you know, a very high level. So patients will teach me that we need to help tailor the treatment plan or the level of function to their specific needs and their specific wants. So I really do love telling or learning how each patient defines success. Right. And they define what their value that they’re going to get out of that.

Layla [00:25:17]:

Absolutely. And, and having that insight and the willingness to, like you said, not group patients together and really understand each individual case. Because like you said, it could be, for example, two 75 year olds and they can have different levels of being active or different lifestyles or whatever the case may be where you can’t just say, you know, let’s look at a group of 75 year olds and have a recommendation based on that, really understanding who they are and the specifics and the details. I’m sure I give each and every patient that tailored experience, but also their own lease on life again, because being able to tailor it specifically to who they are and going back to their why and whether it’s they want to, you know, carry groceries or lift up their grandchild all plays a big part in it. Sounds like the treatment and the diagnosis of everything that you do, really. And beyond that, beyond shoulder pain even, we know that from listening to you. And what you’ve taught us so far is that shoulder pain isn’t just physical, it also impacts other parts of your life like sleep or work, even relationships. So what’s a moment that you’ve seen where solving someone’s shoulder pain really transformed their whole life?

Dr. Ben Szerlip [00:26:39]:

In general, I do think that all of us, or I know that all of us have experienced some kind of pain or musculoskeletal problem. And they. We’ve also seen how it impacts sleep. It affects your performance at work and it affects your ability to socialize. Right. If you had a really fun time being on that soccer league or if you’re trying to just ride your bike with your kids or, you know, you Fill in the blank from there. It’s important for us to kind of connect those dots. And I think the best, you know, explanation is we can talk a little bit about the Harvard study.

Dr. Ben Szerlip [00:27:14]:

And for those of you who don’t or are not familiar with it, it’s actually one of the world’s longest running studies on human happiness and wellbeing. And it was started in 1938. It was a study done at Harvard, but there was 268 Harvard sophomores and there were 456 young men from disadvantaged Boston neighborhoods. But then the study just kept propagating and it’s almost 100 years old. And now they’re following nearly 3,000 people, including family members, kids, grandkids, that study. So the, the point of that study is that there were several main factors on that, you know, that that kind of showed that a good life, pe people’s well being. Most of it was around relationships. But four main categories they said was, hey, you know, one is maintain a good body weight.

Dr. Ben Szerlip [00:28:09]:

Two is don’t smoke. You know, it was as simple as that. Three is moderate. You’re drinking, if you drink at all. And the last one was make sure that you get exercise, make sure you’re exercising on a regular and even daily basis. So I think that the shoulder pain or any kind of musculoskeletal pain, if there’s one of the biggest and best studies out there that kind of say, you know, four top factors are related to physical health. It’s kind of. It really helps connect all the dots.

Layla [00:28:43]:

Absolutely. And it’s. It’s one of those things too, where I feel like you wouldn’t particularly think about how that can really control all these other factors like happiness and sleeping and having positive relationships. But it’s true if you’re not doing well and you’re in pain, it can definitely stem into other issues, especially if you’re not sleeping well or experiencing any discomfort. So it’s definitely something to think about too, in terms of, you know, beyond just, oh, I’m having this pain, maybe I could ignore it, maybe I might need surgery. So it’s definitely makes it a bigger picture, if you will.

Dr. Ben Szerlip [00:29:23]:

And yeah, and I think that too, that it’s also, we. I see a ton of patients and I see myself, if I get injured, I’m like, hey, I’m gonna push it off or do something. Or let’s say somebody does need a surgery or they do need to pursue therapy. I think that we should all treat ourselves and some of the parents out there, we should treat them like we treat a close friend, a loved one or a child. I can’t tell you how many patients I have that say, hey, I know I need to do this, but I’m just going to push it off a couple months to get over this or that. And I know that we all think those things are important, but I think we do underestimate the value of, like I said, all those things, being able to participate in certain activities or get more sleep, which affects every aspect of our day, or being able to exercise, which keeps our blood pressure down and our weight down. It also allows us to keep up with, you know, like I said, whatever hobby that we have as a, as a mental stress outlet too. So it’s all connected.

Layla [00:30:22]:

Absolutely. And you know, for you, for someone who values staying active and staying active with your kids specifically, do you ever think about your patients through that same lens? So helping someone really get back to throwing a ball or carrying their grandchild, is that something that you think of through the same lens when it comes to helping your patients?

Dr. Ben Szerlip [00:30:44]:

Yeah, I absolutely do. And an author that I really enjoyed, and he’s a local Austin guy here too is Peter Attia. And in the book Outlive, he kind of talks about that quite a bit. And I think everybody listening to this, you know, is, is kind of saying like, hey, there are people in their 60s and their 70s. They want to be able to do things that are, are probably indicators for well being and health. It’s. And he kind of lists those things. It’s walking 1.5 miles on a hilly trail.

Dr. Ben Szerlip [00:31:20]:

It’s, you know, getting up off the floor with just the assistance of one arm or less. And he, this is coming straight from outlive or carry groceries up to five blocks. Lifting a suitcase, we over £20 into an overhead bin when they travel, balancing on one leg for 30 seconds, climbing a set of stairs, even opening jars, even as senior citizens, they want to be able to have active sexual life in their marriage. I think that all those things are people that come in the office in their 30s, 20s, 30s and 40s. They never consider that. But in order to do those things in your 60s, 70s and even 80s, everybody says, Hey, I know I want to do that. That’s not even a question. It’s a no brainer.

Dr. Ben Szerlip [00:32:03]:

But the data shows, and he kind of does a good job of elaborating that in the book, that not everybody gets there unless we’re able to do certain elements of exercise in our 40s, 50s and 60s.

Layla [00:32:16]:

Of course, those elements now are going to be what carries you through getting older and having that mobility later on in life where it’s good to start thinking about it now for sure. So it’s, it’s more proactive versus being reactive in a way. And I know absolutely if you could just sum it up, for example, what’s one thing that you wish everyone really understood about shoulder pain and coming to ask you why shoulders hurt?

Dr. Ben Szerlip [00:32:49]:

Yeah. I think that to sum it up we have to be kind of keep perspective, understand that pain is going to happen to us and that it’s going to help us keep us on that navigational course to overall health and well being, that most pain can be treated without surgery and that most problems can be addressed with things like physical therapy addressing the balance and alignment of the shoulders and the shoulder blade. And that we should all probably be investing more value upfront, more time and energy up to in. In terms of increasing our function, increasing our longevity over time too.

Layla [00:33:32]:

Absolutely. And I guess I have one question to piggyback off of that as well. In terms of starting younger and being proactive, what’s something that you think people who are not yet experiencing pain can incorporate on their day to day life or on their regular habits to feel good? I know you mentioned exercise and walking but is there anything specific that kind of comes to mind with that or a specific exercise, something that people can just incorporate regularly?

Dr. Ben Szerlip [00:34:05]:

I love that question and I think that some of my guys, my guy patients roll their eyes at it. But yoga, anecdotally yoga is one of the exercises out there and it can be done at different levels. It helps with the range of motion, it helps with stability. There’s a lot of groundwork. I think there’s a lot of mental health benefits in there as well. And one of my. This is not sponsored. This is not anything but I enjoy the Peloton app.

Dr. Ben Szerlip [00:34:30]:

You don’t need to buy the bike, but it’s an app that is available for everybody. All you need is your yoga mat and some time in your home. I do think the resistance training is also really helpful. There’s a lot of data to show that it improves our bone density. It improves well being just past that isolated workout in terms of burning calories and building lean muscle mass which was what we are finding out that what we do need an older age to do those activities that we discussed. So I think that yoga, I think resistance training and the other key to that and they’ve showed this many times in weight loss studies or any kind of physical fitness. I would say it boils down into habits and routines. It’s not just the knowledge.

Dr. Ben Szerlip [00:35:14]:

We’re saying, hey, yeah, I know that I should save more money than I spend. I know I should eat. You know, I should eat less calories than I burn. But it’s. It’s how to. To kind of do that as. As a habit and routine. So I think that if we set ourselves up for 45 minutes of exercise at least three to four times a week, and it could be walking, it could be yoga, but something that we set timeout and carve timeout for, I think those are the things that are gonna get the lasting results and benefits.

Layla [00:35:46]:

Absolutely. Like you said, knowing it versus applying it can be totally different. So you could think about, oh, I should do this. But like you said, even just having that set amount of time, 20, 30, 40 minutes, a few times a week, to really just focus on your health and your mobility, to prevent, you know, pain and issues down the line, is something that should really be at the forefront, I feel like, of everyone’s mind. So hearing that sometimes we could think about it, but actually hearing it, I think is helpful in terms of making that a habit and making that part of your routine. For sure.

Dr. Ben Szerlip [00:36:19]:

Yeah. The other things that the resources I want to. I just thought of is there’s one of my favorite books. It’s called Rebuilding Milo, and it’s a phenomenal book. Anybody trying to get into resistance training should check it out. There’s also a book called how to Become a Supple Leopard. I know it’s not an odd title, but Kelly Starrett wrote it. It’s the ready state is that he has.

Dr. Ben Szerlip [00:36:44]:

So there’s a lot of good books and websites that I think are geared towards patients that they can kind of get the basics in 101, and they can also work with local therapists or other trainers to kind of solidify that knowledge base. So we’re being active, but also decreasing our risk that we’re going to have an injury or a problem later down the road.

Layla [00:37:01]:

Absolutely. Awesome. And we’ll make sure to include those books mentioned. We’ll include them in the description as well for anyone who does want to read those or take a deeper look into any of those resources provided. I think that’s super helpful for anyone who wants to know more, whether it’s out of curiosity or out of pain or any really reason. Any people who may be studying this for their future careers are currently surgeons, so definitely helpful. So thank you so much for. For always providing great quotes and great work resources.

Dr. Ben Szerlip [00:37:36]:

Yeah. Thank you. It’s my pleasure.

Layla [00:37:38]:

Absolutely. And thank you so much. That’s it for today’s episode of Shoulder Wise, where we ask one of the most important and common questions in orthopedics. Why does my shoulder hurt? So today, Dr. Ben Szerlip reminded us that shoulder pain isn’t just about the joint. It’s about everything that the joint allows us to do. Simple daily tasks to the things that give us joy and really everything in between. So if this conversation helped you see your pain a little differently or opened your eyes to any of the conversations and topics we spoke about, make sure to subscribe so that you don’t miss what’s coming next.

Layla [00:38:14]:

Make sure to send it to someone who you think can benefit from it or share it to anyone you love, because I think anyone and everyone can benefit from this knowledge. So thanks for joining us on Shoulder Wise, because better movement starts with better understanding. Thank you so much. And we’ll see you for the next episode.

Dr. Ben Szerlip [00:38:32]:

Thank you.