- All right, we are absolutely honored
to have two guest speakers here.
They are students from my, I'm the alumni,
UW La Crosse.
- Yep.
- You know, about 100 years ago, I graduated from there.
These two people are gonna be doctors of physical therapy,
in about a year.
This is an absolutely wonderful thing for old therapists
like me to get fresh new information
from the research that has just come out.
And what's the video gonna be about, Kyle?
- Yeah, thanks.
Today we're gonna be looking at shoulder impingement.
Talking about what it is,
looking at the anatomy and what we can do for it.
- Yeah.
And really finding out
that maybe it's not actually the impingement at all.
Maybe it's just muscle imbalance.
- One way or another, we're gonna show you exercises
and techniques to get rid of it.
And I'm sorry, it's Kyle and Elisabet.
- Yes.
- Very good.
If you wanna go with your whole name,
that's up to you.
Because this is going out to the whole world, you know.
Wow, that's pretty dangerous.
But I'm Kyle Terhark.
- And I'm Elisabet Pietz.
- Very good.
We'll be right back and show you everything
you need to know.
(upbeat music)
All right, Kyle, can you give a little demonstration
on the mechanics of the shoulder pain?
- Yes, so we're gonna look at Sam here.
We're looking inside his shoulder.
And so what we're looking at with impingement or
what people think of impingement,
is there is something actually blocking.
So as this comes up, the bone actually jams in there.
- [Elisabet] Ouch.
- [Kyle] And it gets blocked from going up overhead.
- [Brad] What's your finger doing in there?
- [Kyle] This shouldn't be there, right.
That's just an impingement.
But this is the idea that there's something in there.
- [Brad] Yeah.
- And quite honestly, there's not anything in there.
There's something else going on.
- There's actually some soft tissue in there.
Maybe a tendon that's getting pinched
and it causes the pain.
- Right, that's the idea.
- Right.
- But more research is saying that's not
actually what's going on.
- Yeah.
So I wanna bust that myth for you guys.
So if you can try this at home,
if you have that shoulder pain that really hurts
when you get about here and it's, oh, ah.
If you try and move your arm up here and oh,
that's where that pain is,
try and take your arm and go like this.
Put it next to your body and raise it up.
If you're able to get your shoulder up higher
than you were out here, then what that's saying,
is them bones are going through the same thing
in both positions.
But the weight of your arm is heavier out here,
than in here.
So what that tells me,
is it might be a bit more of a muscle imbalance.
- So we can show them how to correct that.
- Exactly, yes.
- Here we go.
- We can, that's what we're gonna do today.
- Say no more, hold on.
Alright, so this is really exciting to me.
'Cause this recent research
shows that people oftentimes may not need surgery
on their shoulder.
And I'll just give it to these experts
'cause they have read the research in detail.
- Yeah, so there's some new research coming out,
that's pretty interesting.
And I'll put it right here.
(everyone laughs)
There it is.
And so it's basically a study where they looked at
people that had the surgery
and people that had a fake surgery.
And they looked at the difference between them
and there was very little outcome.
- So what do you mean a fake surgery?
- So a fake surgery.
So if we can pull your shoulder up here.
So Elizabeth's gonna draw essentially, the scopes.
So the scopes are just little holes they put in
to basically put a camera in or to put an instrument in
to try and work on either cutting,
cleaning, whatever they do.
So they put these little holes in there.
And so the fake surgery, what they did is,
they put these holes in and then they didn't do anything.
They just came right out.
They bandaged it up and put 'em down the road.
- And they sent the people home
and they didn't know if they had the surgery or not.
- But they did have the scars.
- Yeah.
They did add the scars, we found that, down the road,
the people that didn't have the surgery,
actually were doing better than those with it.
You know, it was just kinda one of those,
that's gym class for you, situations.
- So it's a placebo, AB,
type of.
- Right exactly.
- Right.
- So some people got surgery, some didn't.
And those that didn't, actually did better.
- Well that is amazing to me.
- Yeah.
So anyways, let's go on and show you some exercises
and some more information on how to improve your shoulder.
I'm feeling better already.
- Yeah, that's just the ink.
That's all that does it.
(Elisabet laughs)
All right, so this is gonna be a stretch
for the pectoralis minor.
And that muscle is a very deep muscle on your chest.
So it actually sits all the way against your ribcage
and attaches up to your arm.
So a way that we're gonna stretch it,
is if you have a nice home, you got a wall,
we're gonna put your arm up on that wall.
- Okay.
- And then you're gonna go ahead and either step forward.
- All right.
- To kinda stretch the arm back from here.
Or rotate your chest away.
So think about turning away from the wall.
- And Kyle, doesn't matter which leg I step forward with?
- It doesn't make a huge difference
but the one towards the wall would be better.
- Okay.
- Because it's gonna help get your whole body forward.
- Yeah, oh yeah, I feel that.
- Yeah.
- Right in here.
- Perfect.
And then why don't you flip around?
- Okay.
- Do it on the other side as well.
Good, so you're here, you step through it
and then you can rotate your body away,
to add more tension through that muscle.
- For students, what does the research say?
Hold it for 30 seconds?
Go on and off?
How long should this be stretched?
- You can go ahead.
- Yeah, usually I'll do it,
really what you're comfortable with.
So all of this is based on where you're feeling
those benefits and you're feeling that comfort.
Usually I start with 30 seconds on each side
and go back and forth like, twice.
- So listen to your body.
- Listen to your body.
- Right, it should not create any sharp pain.
If there's, it's a red flag, stop it.
A nice comfortable stretch.
Let's go to the next exercise.
- Yeah.
- All right, Kyle, so I wanna show you a good stretch
that you can do in the morning or in the evening,
to really just get some more motion going there
in that shoulder.
And it's called a sleeper stretch.
So what you're gonna do is,
you're gonna lay on the side of your painful shoulder here
and then you're gonna take this hand
and you're gonna move the palm towards the table.
Yep and then you can use your other hand
and add a little bit more pressure here,
just like with that last exercise,
you're staying within what is comfortable for you.
So don't push it down too hard.
Stay it where you feel that nice little stretch
and hang out there for a little bit.
And then you can come off and just take a little break
and move that shoulder around and go into it again.
- So the elbow, I'm sorry to interrupt but the elbow,
we want it here or out in front.
- [Elisabet] You want it out in front.
- [Brad] Okay.
- [Elisabet] So you want this to be like a right angle
with your body, arm straight,
away from you as far as it can go.
- What if it's his left arm?
Still a right angle?
- Still a right angle.
(everyone laughs)
- I had to get something in there.
- Alright, so, here's another alternative you can do
to those sustained stretches.
And that's using a tennis ball or a lacrosse ball.
We're gonna use a tennis ball here.
It's got a nice little squish to it,
so it's not very painful.
And so the way this is gonna work,
is you're just gonna put that tennis ball
right where the muscle is good, right on that pec minor.
And then using that fancy wall again,
you're just gonna go ahead and put your chest between
or against the wall there and just press into that ball.
And I want you to think about doing little circles
or go up and down along that muscle.
When you find a spot that's pretty tender,
just stop on that spot.
- I found it.
- You found it?
- I found it, Kyle, yeah, right there.
- Perfect, so stop on that spot and do small little circles
about the size of a dime, right on that spot.
- For how long?
- So that one, again, it's gonna be a comfort thing
but you know, about 30 seconds is great.
So this is just an alternative to stretching.
- I'm comfortably done.
- Good, yeah, you felt a good spot there.
And you can do the same thing right on the back side too.
So just like that sleeper stretch, we were working.
So you can just put it between the wall, in there.
- Let's show 'em.
Okay, so take your tennis ball, take your sock off,
put the tennis ball in your sock like that,
okay, now you see I've got matching socks and shirt,
you do not have to have matching.
But anyways, take the ball and we're gonna put it back here
so it's much easier if you just have the ball,
you know, it's hard to get it in there without dropping it.
So it's a good way to control.
There.
And right on the back side of the shoulder, how is that?
- That's perfect.
And so you're doing the exact same thing as you were
on that front side, of just looking for a tender spot.
Find it, stay on it and do those little circles.
- And actually, I'm gonna actually go in right by my spine.
I don't know if it needs it for the shoulder
but it sure feels good.
- Well, you've actually got muscles that connect
to your shoulder, that go all the way over to your spine.
So it makes sense that working on your spine
would help here too.
- Right.
- Why don't you point out exactly where we're, not exactly.
- Right, so we're working right here.
You basically take the shoulder, go up a little bit
and right on the back, that's where we're aiming for.
But feel free, go all the way along the shoulder blade.
Go right along the spine.
There's a lot of muscles that can get real tender here.
So hit all of those, it's not gonna hurt anything.
- All right, just go to the next one.
- All right, so one more muscle that we're gonna be looking
at stretching here, is called the serratus anterior.
Now it's a fancy muscle.
It's actually one of the coolest looking muscles
in the body.
But it grabs on from the shoulder blade
and wraps around onto your ribs,
just like, kind of a spider web or fingers coming around.
And so a way that we can think about strengthening this one,
is it's called a wall pushup.
And you're just gonna get into 90, 90 in front, on the wall.
So you got that nice angle.
We're not getting the shoulders coming
up very high when you do this.
We're gonna keep 'em down nice and low.
And then think about pressing elbows and forearms
through the wall
and think about getting your back as far away
from the wall as possible.
So you're really gonna be rounding your
shoulder blades around.
- Right, so this is a subtle movement.
And if we look at the shoulder blade or the scapula,
it's actually gonna slide on that ribcage
and work that those subtle muscles in there
that you really don't see.
Do you feel 'em working?
- Oh yeah, I feel 'em.
- Yeah, it's one of those exercises
that doesn't look like much but you will feel it work
and it's very important to keep that
shoulder blade stabilized.
- Exactly.
- Alright, Kyle, so for that strengthening exercise,
for those small muscles around your shoulder,
I'm gonna have you put this towel underneath your elbow
and wedge it.
Yep, wedge it between your body and your arm.
- Got it.
- And then you're gonna grab onto that band there.
Yep and then you're going to pull that hand away
from your side.
Taking care to make sure that that towel isn't slipping
or falling down to the floor.
- Sure 'cause if I let that elbow out and it drops,
that lets me know that I've flared that shoulder off.
- Yeah and that's telling me
that you're using the wrong muscles.
- Yep.
- Alright, so for this next one,
this is just a progression of that exercise
we just looked at.
And for this one, you're gonna take something
and you're gonna use it to support your arm,
so that it's straight out from your side.
So you could be sitting next to a table,
a pile of pillows underneath your arm
and that'll elevate it up.
And then this time you're gonna be bringing that wrist
up again, like you were bringing it out last time
but now it's gonna be raising up,
as if you're gonna be bringing your arm back
to throw a ball.
- And that one's a lot harder.
- This one is a lot harder.
So you wanna make sure you're good at the one
on your side first before you try and go up here.
Or maybe use a little bit easier of a band.
(everyone laughs)
- [Brad] How many reps did you say?
- So for both of those,
you're gonna wanna do eight of them, three times.
So three sets of eight.
- All right, man.
I'd really like to say thank you for coming,
for showing these excellent exercises and great research.
So you got the whole thing to yourself.
Say goodbye or say hi to anybody you want.
- Well thanks for having us.
This was so much fun.
And yeah, this was really cool.
And we just, hi mom, how are ya?
(everyone laughs)
- Yeah, I mean, always love talking about
the new research and the stuff that's out there,
so thank you so much, Brad, for having us.
- Absolutely.
Maybe we'll do one more video huh.?
- Oh yeah.
Yeah, let's do it.
(upbeat music)