♪ 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.
- We are going over the top three exercises you can do
after a dislocated shoulder.
And this is Napoleon Bone-apart and I'm gonna show you
how this shoulder can dislocate
using his own shoulder. (laughs)
- Right, his dislocated shoulder.
- But before we do that if you're new to our channel
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- Right, what about the other two?
- Oh right, yeah, Instagram.
We got funny stuff on there, Twitter we're always talking.
Stuff is cool.
- Okay, well, just wondering Bob.
- Alright, so generally the way most people
dislocate their shoulder is what we call
the shoulder goes forward like this, anterior.
That's how is pops out on them.
- [Brad] Sure.
- And that's for often a throwing injury.
If you put your arm like this, believe it or not,
when I take it back like this.
The shoulder goes forward.
I just hit my mic.
- Yeah. (laughs)
- So, if I'm like this, and I go like this.
That's how, you know, it's called the apprehensive test even
when you - - Sure.
- If you take someone that's kinda got a loose capsule,
and you put your arm like this and you go like,
they get apprehensive, because they feel like
their shoulder's gonna pop out.
- Right, 'cause they have that happened before.
- They have that happened before.
So that's 95% of shoulder dislocations
happen just like that, forward.
5% go towards the back.
- Okay, so posterior. - Yup.
And another, I don't even know what percentage
it's so rare, can go inferior.
- [Brad] Sure.
- So that might even more be from a traumatic injury.
- Right, my mother had that happened to her.
- She fell down. - Of course she did.
An inferior one.
- The X-rays were clear, it was inferior.
- Okay, simple test to know.
And most of you are probably gonna know
if your shoulder is dislocated.
But if you wanna know, the simple test you can do.
If you can't take your opposite arm
to the opposite shoulder, it's dislocated.
I mean, that's one sign it's dislocated.
- Right, right.
- So, just a simple test.
Alright, when you first dislocate your shoulder,
and this is gonna seem a little bit strange to you
the sling is a little bit controversial
but these are the general guidelines for wearing a sling.
- Sure.
- The thing is, if you're younger,
you have to wear it longer.
And also, if you're younger you're more likely
to need surgery after dislocation than if you're older.
Because that's just your ligaments are looser
and means you could more likely dislocate again.
- Repeat it, yeah.
- Yeah, so these are the guidelines here.
- Doesn't mean you're gonna have to have it,
just you're more likely.
There are types of character. - Yeah, you're more likely.
Yeah, we did a video on that Brad actually,
do you need surgery or not after a shoulder dislocation.
- [Brad] Okay, so you can look at that.
- So, if you're less than 20,
three to four weeks they recommend wearing a sling.
20-30, two to three weeks.
Greater than 30, 10 days to two weeks.
And greater to 40, three to five can you read that for me?
That's Liz.
(Brad laughing)
If you're greater than 40, three to five days.
- And these are general rules.
- Yeah.
- It doesn't mean it's always gonna be that way.
You're almost certainly gonna see a doctor
if you got a dislocated shoulder.
- Yeah.
- But these are good ideas.
- So while you're in the sling you can go ahead
and do wrist range of motion and you can even do
a little elbow range of motion.
- Sure.
- And you can do some grip strengthening.
- Yep, have a ball to squeeze.
- You gotta turn on the light there Brad.
You have to show little fancy.
Oooh. - Oh, yeah.
If you wanna be - Disco!
- Entertained.
Or if you have a child that has it,
it makes it a little more fun to give him
something to work with.
- Alright, so then we're gonna start
with range of motion.
After that period of time, after you come out of the sling,
and if it bothers you to lift it, you can start off
with the pulley system.
These are really inexpensive, really well-made pulleys
called Range Masters.
I've got them in the link below, so you can buy them there.
They're like 10 bucks or something like that.
- I wouldn't say they're really well-made,
but it's good for the purpose.
- They're well made, enough.
You don't like the pulley - - They're good enough.
(Brad laughing)
- Yeah they're good enough.
They're not high-end pulleys right?
- No, but they are certainly great for this.
- Yeah, so you can go ahead, you can sit down,
you can actually face, it's normally what I do.
But you can start working on flexion.
And you don't wanna go above about 140 degrees.
- Alright, so if you look at it from the side,
and again, if you start getting sharp pains,
you're overdoing it. - Right.
- You need to work with in pain-free range
or slightly stretch pain but don't get
into that sharp pain range.
- Yeah, what's nice about the pulley system
is the opposite arm can do almost all the work.
- Right.
- So this is the arm that I'm stretching
and even if you have shoulder pain a lot of times,
just working the shoulder helps get
a little more lubrication in there.
- Sure.
- It's gonna feel a lot better.
So you're gonna do flexion to 140 degrees
and you're gonna do external rotation only to 40 degrees.
So that's about this far.
- Yup.
- Not any farther than that.
'Cause if you start going out here
your shoulder's gonna feel like it's gonna dislocate again.
We're doing the exercises
after you dislocated your shoulder forward.
Which is the majority of them.
- Sure.
- So 40 degrees, you gotta start doing that.
You gotta do that for a couple of weeks.
You can actually probably start
the isometric strengthening before that.
- Sure.
- I mean, along with that.
- So, if my left shoulder is the one that was dislocated,
sling is off now, we've been working some range of motion,
starting to feel good.
Then we're gonna work the muscles' strength
and without movement.
So that is isometrics.
The first one is flexion, the muscles that do this motion.
You can go up to a wall or in a doorway,
it's a good place for the door would be here.
And you're gonna push this traction
and you're gonna hold it.
I like to hold that for about six to eight seconds
for an isometric and then relax.
And you can do anywhere between five and 10 repetitions.
Okay, and then we also want to do
external rotation. - External rotation.
- That's this traction, where only up to 45 degrees.
But actually here we can go straight in front
of your elbow, would be neutral.
We're gonna move this traction but the wall,
- [Bob] Is gonna stop it.
- Yup, so I'm gonna be pushing it there
and push hold it again eight to 10 seconds and relax.
Then hold, and you're gonna do
up to 10 repetitions of those.
Again, they should not create any sharp pain.
- [Bob] Right.
- And if they do, then you don't wanna do them.
And they just wanna create fatigue in the shoulder, okay.
- [Bob] And the abduction Brad?
- Abduction, so now we go
- [Bob] So now he's trying to go out
Yup, you got it.
- There we go.
(Bob laughing)
- [Bob] I was on the camera.
- Yup.
And then I'm gonna go into the wall and again.
Same repetition, same length of time.
- [Bob] Eight to 10 seconds
is that you're recommending? - Yup, yup.
And relax.
- [Bob] And the final one is internal rotation.
- Coming in this direction.
- [Bob] Yup.
- Now this, I'm gonna be at an angle
but normally you'd be in here, but so you can see.
And then you're going this way.
You can put your palm right up against the wall.
- I'm pushing this way.
- There you go.
- But again, the wall is not gonna let me go.
- Right, so that's your isometric there.
Okay, good.
- So after a couple weeks of that,
you're gonna then start with actual weights.
And you can start with just a soup can.
I'm just gonna use a little one pound weight here.
It's Brad's weight they brought in.
This pink one.
- [Brad] Well, I've been using it for curls, you know.
- Yeah. (laughs)
So, we're gonna start with just straight flexion.
We're gonna do about 10-15 repetitions.
- [Brad] Yes.
- And that's just straight going up like this,
I'm not gonna go any higher than 90.
I'm just gonna go right up to 90 degrees.
So again, 10-15 repetitions.
And then you can also do what we call empty can.
It's like you turn the can upside down
and you're gonna go out about 45 degrees.
- Right.
- At the same, what we call scaption.
The same plane as the scapula.
And we go up to 90 degrees. - This is working a specific
rotator cuff muscle. - Yeah.
10-15 of those.
And then we wanna do what we call inies and outies.
And this you have to do laying down.
So if I'm laying on my side,
I'm gonna actually bring it out this way.
- Right.
So you can do this laying down the bed,
laying down the carpeted floor.
- Yeah.
And you can actually do internal rotation, inies.
But when you get to these, it would be really nice
to have the band set here.
- Alright.
- We got our wall anchors set upon the wall.
With all honesty, if your gonna do some rehab for a shoulder
you're gonna want to get the wall anchor
set along with some bands.
Because you can really get into more advanced strengthening.
- Right.
- Eventually and it works really well just to start
with this inies and outies.
- Yeah.
- And eventually you can start to even do P and up patterns
and you can work it all in different ways.
- In other words if you wanna get to your normal living,
if you're gonna - [Bob] Yeah.
- reach into the cupboard, throw a ball with the kids,
that kind of thing.
Or if you're in a sport even more important.
But here I put the towel here and that forces me
to keep my elbow in the right location.
Because a lot of times people would do this
and that's not what we want.
We wanna have it here,
so we work those specific rotator cuff muscles.
And 10-15 reps here and then if I turn around,
I'm gonna do it the other direction.
I wanna get internal rotation.
- [Bob] Yup, so you just switch arms then.
- So it's gonna come in this way.
So we got the opposite muscle group in that rotator cuff.
- [Bob] And that tends to be more of a powerful muscle.
- Yup.
- [Bob] So you may wanna use more resistance.
- Yup.
- You can double up the bands here.
with just two or - - There you go.
You may wanna go two this way and then,
- Just one that.
- Yup.
- On the other way.
- Yup, one this way.
You don't have to have a towel under
but really a good idea to start out with.
- And again, if you're continually dislocating
and you're younger you may be a candidate for surgery.
I hate to say it.
- Yeah.
- But that's just how it works in the world.
So, by the way, if you haven't already -
(Brad laughing)
Brad I can fix just about anything
- Except for. - If you don't know this.
- A broken heart.
- And some speech problem.
- That's right. (Brad laughing)
We could use some speech but we're working on it.
- Yeah, it is.
- We're going back to the heart.
We're working on it.
- I hope we got it up there this time, yeah.
Thanks for watching.