♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ on the internet. ♪
- Come on down.
(hands clapping)
Hi folks I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- How to cure your shoulder, tendonitis,
bursitis, or impingement.
You're gonna talk about what the -itises are,
aren't you Brad? - Yeah.
This is the education of the -itis today.
And it won't be so scary to you anymore after that.
- Well, I'm glad that you think that Brad
because I am kind of frightened over this.
- Well Bob, I thought you were leaving the show.
- No. - What was I gonna do
by myself?
- We don't have a camera person here today,
so we're handling this our own.
I just flipped the screen around
so we can take a look at ourselves while we're doing this.
By the way let's take care of this, Brad.
- Yeah. Take care of business.
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- On with the program.
- All right. He is with the program.
- Okay. So cure your shoulder pain, tendonitis
bursitis impingement.
There's some really good news.
Typically as therapists regardless of
which one of those you have,
often time the exercises, the primary treatment
is gonna be very similar.
So that makes it much easier if we would-
- Yeah. Cause part, part of the problem is, Brad
that impingement often causes tendonitis and bursitis.
- Right. Yep
- So, If we can treat all three
- Right
- It's all gonna be very similar.
- They, they overlap
and the treatment, again, will do similar things.
And will get progress one way or another.
One thing to think about is tendonitis and bursitis,
If you break those words apart
into their components.
You have a tendon and -itis
itis is Latin for inflammation.
So you got inflammation of the tendon.
- Gotcha.
- Bursitis. Bursa, is a bursa sac.
We have bursa sacs in our shoulder and our knees
and our hips. - Fluid filled sac
- That helps the bone or the muscle rub over the bone.
Right? Or the tendons, - The tendon, Yeah.
It's a lubrication system.
So your bursa sac has got inflammation.
And impingement means where the two bones come together.
They actually, they're not, the shoulders
not working properly, and it pinches some tissues.
Typically it's a tendon.
And then that tendon gets inflamed-
- Causing tendonitis.
- There you go, so
- We're on the circle, aren't we?
- Yep. It all revolves around.
- Circle of, shoulder pain.
- So I hope you feel better about that now.
- Yeah - So how're we gonna treat it?
The very first thing, if it's all inflamed,
it's tender and sore.
We're gonna get the cold pack out.
So, you know, it doesn't matter what you use
for a cold pack.
You can have a bought one, you can make your own.
- Yeah. We did a video on how to make your own years ago.
It's been a while since we did that. Hasn't it?
- Yeah, it is. But you know, it's a nice.
I think we actually got two of 'em on there.
- So you can go "Bob and Brad cold pack, make your own".
- So you put it on me because,
- Eh
- That makes, you got a black shirt, so
- Yeah but I got a blue one here for mine.
So I'm gonna freeze as well, Bob.
Actually it'll feel real good on a sore shoulder.
- Yeah, it will.
- Yep. And you put it on for 15 to 20 minutes
and that'll really comb it down.
- You could take a bag of peas too.
- Yep. Frozen peas. Not warm ones.
- That's right. - Frozen.
(laughing)
Okay. So get the cold pack on there.
And typically the first range of motion exercise.
And oftentimes, you know
we get referrals from the doctor for shoulder pain.
The doctor will say do the pendulum exercise
until you see the therapist to get going on more.
And that's where you just bend over like this.
I like the support, so your back isn't getting stressed.
And just let that shoulder relax.
- You might hear it called Codman's too.
- Yep - 'Cause that's the name,
of the doctor that invented it, I believe.
- Yeah, but I'm think it might have been a therapist
but the doctor took credit.
(laughing)
I might get in trouble for saying that
but that's all right, you go right to left.
You can go forward and backwards. You can make circles.
This should feel like a nice, relaxing exercise.
It's just to get it moving.
- If you are going to therapy, you might wanna see
if they can do some phonophoresis on you or iontophoresis.
It's just a way of calming it down by putting
getting some medicine in the area.
- Right. - This is the ultrasound unit.
- And this is Ketoprofen is a medicine that we use.
And we just go ahead, and we put it on there
and it helps - right.
to calm inflammation down.
- So this is nothing more than ultrasound
that therapists or chiropractors use.
It drives in the Ketoprofen.
Reduces the inflammation.
It's a good way to start things, to get it moving.
- All right.
What's the next Brad - Now, the next thing
This is important because you can take three steps forward
throughout the day, doing the cold pack,
The phonophoresis, the Codman's.
And if you go to bed at night
and you sleep on that shoulder without knowing it
and you wake up laying on that side
and it's all sore,
you've just reversed
a lot of what you've done. So,
- Positioning is really important.
- Right. - Especially at night.
- Bob, shall we give him, show 'em the canal?
- Sure. Yeah. We're gonna-
We'll show 'em a couple things here, Brad.
Actually the first one is ideally
try to not sleep on that shoulder.
- Right.
So you can do that one of two ways.
You can sleep on your back,
and even when you're on your back
and you're laying down like this,
you wanna go ahead and take a pillow.
- Sure.
- And give that arm,
if this is the painful shoulder,
go ahead and give it some support.
- Yep. - Because it's down here.
It's kind of a little bit extended,
and it's just not in a great position, so.
- If you haven't done this,
you'll be amazed at how nice that feels.
It lets that arm relax.
When it's relaxed, it circulates better. Better healing.
- And make sure you experiment
'cause it may take a little bit to figure out
which position to put it.
Maybe we like it down here. - Sure
Maybe like it up here. - Yep.
- All right. If you can also, you can lay on-
let's say this is the painful shoulder now.
- Ow, ow.
- Same thing here.
- Sometimes people fall asleep with it up here,
'cause it gives us support.
But if you take two pillows, one here.
- Yep.
- And one here.
my voice just cracked, Brad.
- Yeah. Are you going through the change Bob?
- I'm going through the change.
(both chuckling)
- So we're gonna go ahead and - Wow
- and stick it under here like that
and that's gonna give it some good support.
- Yeah.
- It takes two pillows
but you know, it's worthwhile- - Right.
- finding that extra pillow because it makes a difference.
Now, if you just insist,
and Brad was just talking
about a patient he had just this week, right?
- Right - Or last week.
- Well, it was last week, but yeah.
He always slept on his right side.
He had a right shoulder problem and he said,
"I can sleep on my back, and then no matter what happens,"
"I roll to my right side when I'm sleeping."
- So in that instance, you want to go ahead
and take another pillow,
maybe a full pillow or a throw pillow.
I have a throw pillow on my bed permanently
And I just create a little canal here.
- Yep.
And you're gonna go ahead and lay in there
and this helps take pressure off the shoulder.
- Sure.
So now it's more on my head and my trunk.
- Right. As opposed to the shoulder.
And even if you lean back a little bit like this,
- Yep. - And even helps even more.
But now you're getting more onto the shoulder blade
instead of the point of the shoulder,
which really can give you a lot of pain.
- Sure.
Now should we continue?
- Yeah. - Okay.
So we got that taken care of.
Now the next thing is
to start getting the shoulder strengthened
with movement.
And the first thing is pretty subtle
but it's pretty important, Bob.
And that's simple.
- Yeah. - Retraction.
- We bring his shoulder blades together-
face this way a little bit more, Brad.
Okay.
And see he's bringing the shoulder blades together.
He's strengthening the core,
what we like to call the core of the shoulder.
If this isn't strengthened and in the right position,
you're putting the shoulder in a bad position,
and it's gonna be more likely to impinge
and it's gonna put,
which is also gonna cause more inflammation.
- Sure.
So we're just doing scapular retraction.
You can do this throughout the day.
You can do this every hour, if you'd like.
- Right.
- You can go ahead and,
just go ahead and rip off like 15 of them
and squeeze those shoulder blades together.
People are always amazed what a difference
that this one exercise makes.
- Right
Now if that's working well,
then oftentimes we'll add some resistance on there.
- I'm gonna go ahead and - Okay.
- grab the camera here, Brad.
- Right. So typically, you know, if you go to therapy
they'll give you some stretch band.
At home it's nice to buy the tubing ones.
We like the (indistinct) band because they're good quality.
And you know, you gotta find some place to put the band.
You can put it on a doorknob or whatever, a kitchen door.
We've got a nice wall anchor here that we do have.
And they work very well.
- Yeah. If you wanna make sure to take a look
at our products down below in the Amazon section.
Brad and I designed the wall anchor
and we found out it's really worked well with people.
- Oh, we really find 'em helpful.
As you can see, we got 'em all over the wall here.
But here you can do at this level,
you can go at this level, getting different fibers
to work that scapular,
so you have good mechanics.
And then you can go over the top like this.
This is gonna be more advanced.
This will probably be the last one you do, down the road.
- [Bob] What I like about the wall anchor, Brad,
is you keep a band, you know, on the wall like that.
It's a reminder, every time you go by it,
to go ahead and do it.
- Yep.
And then you go right to,
this is like the golden exercise,
- The gold standard. - Yep.
Is that external rotation. I got my elbow in here.
I'm doing external rotation
and we're gonna do 10 to 15 of these.
And then you can turn around and do internal rotation,
which I'm gonna show from this side so you can see it.
And you're pulling in.
And the wall anchor makes it really nice,
so it's efficient.
You can go this way.
You know, I always have patients do the other side too,
- [Bob] Sure.
- You might as well, it's very easy.
And then work this way and this way.
And then you can go right into your scapular retraction.
- Yep, you can. - It's all right there,
- [Bob] You can very easy to, - Exactly
- [Bob] perform all three exercises.
- If you don't have that, I'm gonna show you the option.
You know, get yourself a weight.
You don't need a weight actually,
especially if you got a weak shoulder.
You can just use a can of soup,
lay on your side-
Make sure I'm not wrecking my mic.
And then you do the exact same motion
and it works just fine, works good.
- [Bob] Especially as a starting point.
- Yeah, and again, 10 to 15 reps.
When you get up to three sets, go to a bigger weight, okay.
With using band you just step farther away from the wall.
Okay.
Well, Bob, I'm not done yet.
- [Bob] Okay.
- [Brad] Wait, should we cover the cross friction massage?
- [Bob] Sure.
- [Brad] I've had this where people,
they get so far in the treatment
and it's getting better.
They can lift up and out to the side,
but they're stuck a little bit.
And what we're gonna do is a cross friction massage.
You take your fingers and you put 'em together.
You can cross my top of each other.
- [Bob] Hold on a second, Brad.
I'm gonna go ahead and get it focused on you.
- Okay. Yeah.
- [Bob] Okay. Go ahead.
- All right.
And typically it's right here.
You're gonna go over that,
find that sore spot where there's scar tissue healing,
and we need to break it apart sometimes
to get to that next level.
And you're just gonna cross
and you're gonna work it deep in, back and forth.
And you can do this for, they say up to 20 minutes.
But you'll never get that far
'cause you'll wear your fingers out.
Usually, you know, three to five minutes at the very most
and your fingers will be tired.
And we find that that's normally enough to do the job.
- [Bob] Yeah. And you might even do it a couple times a day.
- Yep
- [Bob] If you're only doing a few minutes.
- Right. Now, the thing is,
if you go back and forth, it'll hurt at first,
but after 20, 30 seconds, it should start to feel good
or numb-ish.
If it continues to feel painful, it's not ready for it yet.
Just stop and give it a few days,
get the cold pack back on it.
- [Bob] And you really may want to have your arms supported
while you're doing that, Brad.
- Right.
- [Bob] I'd go ahead and put it up on a pillow.
- Yep, that's a good point.
- So we're gonna work it like this,
- [Bob] And then go ahead.
And so it's relaxed and now you can get in there
and do that cross fiber massage.
- precisely Bob. - So, okay.
- Bob, let's show the next trick.
And this is the one that you're so good at.
- [Bob] Sure.
There's a lot of different ways you can do this.
You can go ahead and do it with a pole,
or stick, or broomstick.
And what I'm gonna do is, I'm gonna actually,
I'm pushing down through the pole-
Do you wanna flip the camera, Brad so we can.
- Oh, sure.
- So I'm pushing down through the pole
while I'm going back like this.
So, help set the shoulder down into the socket.
- Right.
- And really it works well with impingement and tendonitis.
And now this should feel, it should not hurt.
And you want to go back as far as you can go,
and I might gonna even go back to this point here.
And walk back up again.
You can also go a little bit like this.
- There you go.
- I'm pushing down the whole way,
I'm pushing down while it comes back.
- Right. So you just make sure
that you're using a dowel or a stick that doesn't slip,
do it on carpet and it'll hold on the bottom.
- Yeah. And what's nice about this is,
if you look at this, it's a sneaky way of me getting motion.
'Cause look where I am at really here,
Now if I let go of this, I'm really this high.
- Sure.
- Already. So it's a way of getting motion
and setting the shoulder down where it should be.
- Again, that should be pain free.
If you do it and it's creating sharp pain,
it's not ready for it yet, You may need to wait.
- All right. Remember Brad,
we can fix just about anything,
- Except for-
You can put that heart right on here.
- Yeah.
- It'll be like a little holder.
- Yeah.
- Cool.
- Except for a broken heart.
- Oh yeah.
- But we're working on it.
- Yep. This could be a good start.
- Yep. Thanks for watching.