♪ Bob and Brad ♪
♪ The two most famous ♪
♪ physical therapists ♪
♪ On the internet ♪
- Hi, folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Simple question today, Brad, how do knots form?
This is a commonly asked question
of physical therapists on Google.
- You mean like a square knot?
- No, no. - or a slip knot?
- We're talking about those knots
you get up here, you know.
- Ah-huh, in the muscles?
- In the muscle, you get them in a lot of different areas
but we're gonna talk specifically about the ones up here
because we're gonna give that as an example.
- And they're very common, yup.
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- All right.
- We don't miss a week, right, Brad?
- That's right.
- Go to bobandbrad.com.
Go to the give away section or go to Facebook, Bob and Brad,
and it's always pinned at the top of the page.
This week, we're giving away the wall anchor.
This is a product that we invented ourselves
and Brad's gonna show 'em.
Yup, you put it on the wall
and then you buy some exercise bands with it
and it's just really handy.
It can do a plethora of exercises,
wouldn't you say that, seems right?
- You can work head to toe, literally.
- All right, so what are these knots every is talking about?
So, it's a tender nodule you feel in the muscle.
It feels like a marble, doesn't it?
- Well, yeah, the muscle's literally knotted up
and contracted and tight, a trigger point is also--
- Yeah, it's called a myosheath,
myofascial trigger point or trigger points
and it can restrict the blood flow in that area.
And it also can build up the byproducts of metabolism.
So there's less oxygen, less nutrients there.
So it tends to hurt. - We did a video on that
using a sponge. - Yes, yes,
that was a good one that you did.
- As an analogy which I wish I could remember
the name of it off the top of my head, but anyways...
- Yeah, anyway, the cause, really,
of trigger points is a unknown.
And it's a source of great debate.
So there's two main camps, I would say.
One camp, people believe that the knots are caused
by a lesion in the muscle itself.
- In other words, an injury of some sort.
It's been injury, they're pulled, stretched or some trauma.
- And others believe that it's a side of refer ca-na-ni-s.
In other words, like for example,
you might have a problem with your neck
and that's sending pain down into your traps.
- Yeah, so the muscles are responding to the injured site
which may be further away from the actual knot.
- That's what makes it difficult to assess a lot of times
because people think, "Oh, I'm having pain."
You wanna turn around, Brad?
- Yeah.
- So a common area for knots
are the upper trapezius area here.
I was going to say knats but knots.
And a lot of times you are okay.
Well, we're gonna treat this area
while the problem might actually
be coming from the neck and posture
and so we really need to treat that area.
And that's what makes therapy and doctoring so difficult.
Is 'cause quite often where the pain
is at is not where the problem is at.
- Right, so there's referred pain.
It refers to other areas of the body.
And yeah, exactly, it can make it challenging for us.
- Yup, so I'm definitely in that second camp.
I believe that it's referred from somewhere else
and one way to test that,
there's a couple ways to test that.
One, there are upper traps.
If you shrug your shoulders like this know they're working.
- Yup, they're contracting.
- So let's see if you have knots in there.
He shrugs his shoulders up and I push on him like this.
So I'm making them work as hard as they can.
And if that doesn't hurt,
then the muscle itself is not injured
'cause it should hurt if I give resistance to it.
You could do the wall anchor too, Brad,
and work it, our posture muscles there.
- Yeah, so for example, if we're doing that upper trap,
maybe we should pull from the bottom.
See, let's get this sign--
- You're doing a housekeeping there, Brad?
- Well, yeah, you know, so we can see what's going on.
Now I'm pulling up and this is what I do at home.
- But he's working those upper traps,
great posture muscles and if he's got knots in there,
this should hurt if it's on the muscle itself.
But almost never doesn't.
- No, it's a fatigue and actually after I get done
doing these, those muscles relax and they feel better.
- They actually feel better.
So another thing you can try is
if you have knots up in here,
try moving your neck around in different positions.
Go down in deflection, extension
and see if that pain changes. - Right.
- Does it get worse, does it get better?
Does it even switch areas, you go into different areas.
- If it does, right there, there's your answer.
It's coming from your neck, it's not coming from there.
If it's a knots and it goes into different locations,
how would that be a problem with the muscle itself then?
You know what I mean, it disappears out of one muscle
and goes into a new muscle. - Right, exactly.
And I use that, screening all the time,
move your head often times,
people have a difficulty looking up and back,
and they said, "Oh, - Right, quite often
that's the one
that might bring it on. - "It hurts more over here
"or changes or moves it slightly."
- So Doctor Cyriax, James Cyriax
he was considered the father of orthopaedic medicine
and he was a big believer that this was a referred pain.
He actually thought it was from the dura mater,
the outside lining of the spinal cord.
So that's why Brad and I, and we're not going to give you
much answers today on how to treat knots.
We have a lot of videos on it.
- Yup. - Just go to Bob and Brad,
put knots in there and it'll come up.
But that's why we always focus on exercises
and movement and posture. - Right.
- And those are the things
that seem to take those knots away as opposed to
trying to do a trigger point therapy or massage.
- Which often time does release a knot
but if you go back to your computer
and have poor posture, which originally triggered it,
well, then, it's a continual cycle.
Get the massage, go back,
get the knot again, get the massage.
It makes the masseuse profitable
but it doesn't cure your problem or get rid of it.
- Yeah, you made a pretty good point, Brad.
I'll do trigger points therapy myself even
but it's just for a temporary relief of that problem.
But I gotta go to the source eventually.
All right, that's it in a nut shell.
Short question and for us, a very short video.
- A nut shell or a knot shell?
- Ah, good one, I like that.
All right,
thanks for watching. - Why Bob?
- Why Brad?
(upbeat music)