♪ Bob and Brad. ♪
♪ The two most famous physical therapists ♪
♪ on the internet. ♪
- Hi, folks. I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
Together we are the most famous physical therapist
on the internet.
- And no pitying, of course, Bob.
- Is it dangerous if my shoulder clicks or pops?
Ankle pops?
And how to know and self-treatment to fix."
We're gonna cover all those things.
Not my shoulder, your shoulder.
- That's right.
And these are...
We're gonna show you why it does it
and some good doc solutions to correct it.
- But before we go on, if you knew our channel,
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- (chuckles) Win-win.
(both chuckle)
- All right. Should we carry on, Bob?
- Yes. - Shoulder clicking, you know,
this is not uncommon.
Usually when you get, especially when we get a little older.
But it happens oftentimes with some injuries.
The injury heals and then afterwards,
"Oh, my shoulder clicks and pops and it didn't before.
So is it a concern or not?"
That's what we're gonna do.
We're gonna talk.
But we're gonna try and answer that.
But, but, but.
- But, but but.
- This is but question, forget it.
Anyways, we wanna talk about why.
Why does it click?
Why does it pop?
We're gonna go through four different common reasons.
Number 1 is common arthritis.
- Right.
- Arthritis in the joint itself.
If we look here,
we've got a really smooth surface surface.
- And it connects with a smooth surface.
- Right. And you know, with a healthy joint,
as we age or an injury, we may have some problems.
We call them lesions or where it's not smooth anymore.
And as the joint slides over the area,
it's not smooth, it get-
- It can be kind of flaking down, flaking off.
Yep, they can call that crepitus.
It's grinding, kind of rice Krispies, makes that noise.
That can be one problem.
The next one is the labrum
which is like a collagenous material,
a tissue, not material.
- It's a round circle, basically.
Pull towards you in the external rotation, Brad.
- Yeah, We're gonna get at it here.
We've got to get the capsule out of the way,
right here where the blue tip of the bear,
Thank you, Bob, right here.
And that helps keep the joint stable.
- Yeah, holds it in place.
- Right. In effect, can be a tore.
It can have a piece ripped out of it, so to speak.
If there's a problem with it,
that can be a problem with-
- Not uncommon over time for that to wear out.
- Right.
- Just like any other thing in your body.
- I have a friend right now, Chris, actually.
He can do bench press without a clicker clunk.
But when he does pushups, his shoulder clunks all the time.
- Gotcha. - So he doesn't do
so many pushups anymore.
- Right. We all learn.
- That's right.
Sometimes tendons snappy
- Yep.
because we've got the biceps tendon here.
We've got a deltoid tendon,
We have all the rotator cuff,
lot of tenders in his shoulder.
And as they slide over the bone,
they can click and clack, can cause problems that way.
And then also, if you have a rotator cuff complex,
there's four muscles there
and one of them or more than one are either injured or weak,
some of the candidature are thrown off-
Yeah, the four work together
to help hold that bone in place.
- Exactly. I'm gonna throw one more in,
Brad.
If you have poor posture of the shoulder,
- Oh, yeah. - and the shoulder
has moved forward the humerus here,
has moved forward in there,
it can cause clicking and grinding
and it can cause arthritis.
- Exactly.
As a matter of fact,
that's the first thing we're going to address, is posture.
- Yes.
Regardless, you need to work on that.
If you got the shoulders forward,
one way you can check it if you're by yourself,
and you look in the mirror, you can check it out.
There's one of your thumbs are pointing inwards.
There's a good chance that your shoulders-
- They should pointing straight forward
if you're in good position.
But if you're in a poor position, they rotate in.
- Right. Oh, Sam's in there.
We're gonna go over to the wall.
Another quick check for good shoulder posture
is you just need a flat wall, stand like this.
And if there's a big gap between your shoulder and the wall
they're more than likely rounded forward.
Bring them back like this and feel the difference.
So you could feel the wall there.
And now I'm gonna show you some exercises
because we wanna actually strengthen it.
You can do this.
You can do the W exercise where you bring your arms out,
see if you can touch them to the wall,
and make sure you head's up forward.
Do that 10 times in a row, five times a day,
would probably be a good dress set.
- Throughout the day.
Do you wanna work some extra strength in?
You can use some bands, which we like to use.
So you get more strength,
more promotion of that good posture.
You just hook it around the door.
Now, we use a wall anchor, because it works really well.
And you pull back and squeeze on the shoulder
(talking over each other)
Oh, I'm sorry that-
You could see that he's squeezing
the shoulder blades together.
And it's...
I mean, for this reason alone,
you should have some bands like these,
just throughout the day, tighten them up.
And it reminds you where it should be.
Plus it strengthens the muscles
that are gonna help it stay there.
- Yeah, that's right.
And you know, do at least 15 repetitions of these.
- You can do more.
That's kind of a postural muscle as far as endurance.
- Right. So you can rip off more
if you like. - Sure, you bet.
- All right.
The next one is we wanna look at range of motion.
So we're going to look in in our posture,
we're going to work on that.
And then look at the range of motion.
Say one shoulder goes up to here and then it goes down.
Like Bobby could almost touch the ceiling. (chuckles)
- I can touch the ceiling.
And as the other shoulder say
"Can I touch the ceiling because it's lacking.
It only goes up this high versus this high."
We need to look- - I'm lacking some flexion.
- Yep. We need to work on getting that stretched out.
And of course, we're gonna do all these exercises
with good posture.
So show them the first one, Bob.
- Sure. Let's say you're missing flexion.
So our easy way to do this is just a,
I'm gonna go this way, Brad.
- Sure. So you can see.
You can actually just palm facing me,
palm out and I'm gonna work into flexion like this.
- Right.
So this would be the good arm
and the one that needs to be stretched just here.
And he's gonna...
The force of the stick is going to help that stretch there.
- Now you can also,
let's say this is the involved arm now,
and I'm lacking extension.
So I can actually just push it back down.
And this is very common.
You'll find it in a lot of people
that this is the one that they're having trouble with.
I think the arm doesn't go back very far
or they don't go very far up their back.
- Right.
- So they can work on extension like this.
Can also, this is where the booty stick is nice.
I got palm out. I got palm in.
And I can just work on bringing it up like this
and working on an internal rotation.
- This is one of those real functional exercises
that you can get your wallet in and out of your pocket.
Put your belt in, scratch your back, scratch your back.
(Bob laughing) Exactly.
Then the next one I do wanna mention, Bob, is...
Which one do I wanna mention?
- Do you wanna do the-
(speaking over each other)
Statue of Liberty? - The Statue of Liberty.
If this range, and you really need this range for work
or for whatever, you can do this seated.
You need a stick four or five feet long like this.
And we're gonna reach up here,
and it needs to build the stick on the floor.
- Right.
- If it's carpeted, that's fine.
Otherwise you'll need are a rubber tip down there
or something of that nature.
- What's nice about this
is you're actually getting some traction on the shoulder too
So you're stretching that capsule out.
This is so much more effective than just going like this.
I mean, it's a lot easier. - It's a lot easier.
- We have people with arthritis who do this.
They love it.
But don't let your hands slide down.
- Yeah.
- Don't let that happen. - Yeah.
- I made that mistake with one patient.
He was doing that and he said it's not getting any better.
I said, "Oh, I did a bad job of showing him."
Actually, you know,
if you get it up to the top, it's easier to-
- And I actually do out of the chair because-
- Yeah, you can. - Yeah, there you go.
Really tall like I am.
Yep. Oh yeah.
- So awesome.
- Get the range of motion for it's equal on both sides.
so it's functional so you can get up there,
and then strengthening can be a problem as well.
Oftentimes, with clicking-
And that's the rotator cuff. - You're right.
We want that rotator cuff working really well
to hold that ball into the socket saddle.
So I'm just gonna show one simple way to test this.
So Bob is gonna make a fists.
He's gonna have elbows in by his sides
and the fists are gonna be straight out.
Not in here and not out here,
but straight like you're running.
- Rocket sacrum robot.
- And now he's gonna stay still like a statue
and I'm gonna to push inwards.
- And I'm gonna resist.
- Right. So he's pushing.
Yeah, go ahead.
Let both of them go.
So I'm gonna push this way, but he's gonna hold.
Now, oftentimes, that'll happen.
- Right.
- And that, it's a very common.
It's probably the most common weakness
wouldn't you say about the rotator cuff?
- Yeah.
- So now this one works really well,
and I'd say most therapists will give their patient
a TheraBand or a stretch strap.
And they're gonna strengthen doing this-
- External rotation. - Yeah.
- Keeping the elbow into the side.
Sometimes we'll even put a towel there
to keep you from cheating.
- We don't want this,
we don't want this. - Yeah, you know, flying wing.
- This is a one that I oftentimes have to correct my-
- It's keeping a right angle at the elbow.
- Yeah. So I'm doing that, not this.
But we need to stand sideways.
And even if...
I always say, you know, do the weak one,
and then you might as well do the strong one
because the strong one could use some maintenance,
but it also gives you an indication, you know.
If you feel like it is five or six
and it gets kind of tired the other side and you turn,
you wanna work-
- You know how far you have to go.
- You wanna work with it until this five side
feels as strong as this side with that motion.
- Well, Bob.
- I think we did it finally.
- I think that covers most of it.
Again, posture, range of motion, real critical.
And then hit some strengthening exercises, just with that.
And remember, let's help everybody out there.
Let's help other people.
- That's right.
- Be kind.
- But what about our other conundrum, Bob?
This is something that we've been working on for years.
- We can fix this by anything.
- Except for-
- A broken heart.
- How'd you like that segue?
- Yeah. That's good.
Finally - Take care and enjoy.