♪ 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.
- In our opinion, of course, Bob.
- We're going to show you how
to heal tennis elbow with self-massage.
So tennis elbow is also known as lateral epicondylitis.
Quite a mouthful, Brad.
- Yeah, tennis elbow is a little easier to say.
- Right. So the lateral epicondyle,
that's that little bump you got here.
You got, you know, if you look on the bottom here,
you got the elbow and then you got two bumps on either side.
This is a bump that's on the outside of the arm
as your palms facing flat up towards the ceiling.
- Sure.
- So what do you have here,
is you have a bunch of muscles here that come along here,
narrow up to a tendon, and attach to that bone.
- Right there.
- So if you overused this muscle,
and there's also some restrictions
that possibly could cause this,
that we're going to talk about,
you can get increased soreness
and actually some micro tears.
- Sure.
- In the tendon or in the muscle itself.
- So tiny little tears. - Tiny little tears.
So what we're going to show you first is the massage.
Then we're going to show you
some exercises you can do at the end.
And we'll tell you why you want to do those,
because they can help prevent it
from coming on again or from it continuing to happen.
- Right, you'll have some good prevention.
- Probably need a pillow again, don't we Brad?
- Yeah, let's do that.
- Let's first we're gonna just talk about
massage right on the tendon itself.
So you'll find it's tender.
You've had this, Brad, you said?
- Oh yeah, a number of times.
- So here's the bump.
Usually it's right off the bump.
- Yep. - Towards the hand.
And you'll find the tender spot there.
And just lightly go over it to start.
I put finger over top of finger.
Gives me a little leverage.
- Now, if it's flared up, I know from experience
it doesn't take much, it's very tender.
And then you don't want to go over it if it really hurts,
you're going to go away from it more towards the muscle,
and work away from it.
And then you work your way towards it as it improves.
That might take a few days.
- This was a bad day to be doing this, Brad,
with your finger in the wrap.
- Oh, actually, it's kind of healed up already.
I will take that off.
- All right. So anyway,
what the the cue here is we're looking for is
after 30 seconds, if the pain is getting worse,
it's too early for this. - Mm-hmm.
- You just, you're not allowed to do that yet.
So if it is fine after 30 seconds,
it gets numb or it started to plateau,
you can keep doing it.
In fact, you could do this for up to 15 minutes.
Which most of you will not be able to do
because it's just too long.
But you can do it, spread it throughout the day.
- Yup.
- Another alternative to this, Brad,
would be just doing, this is the McKenzie method, here:
You actually just put pressure on the tendon,
and go like this, lift wrist up.
- Okay.
- And that's just starting to put some stress
on that tendon, without putting so much
that it increases the pain.
- So it should feel a little bit better
with the pressure on?
- It should better, it shouldn't make it worse.
It definitely shouldn't make it worse.
- Sure.
- It could be plateaued or the same.
But if you're too tender to do massage,
start with that first.
- Sure. That makes sense. - Go to the massage,
and eventually the massage you can do probably
every other day for 15 minutes, or like I said,
three times a day for five minutes.
- Yep.
- Brad, you want to show how to use a massage gun with that?
- Sure. Yeah, so if you happen to have a massage gun,
you know, one of these big ones is not going to work.
- Yeah, that's too much. - That's way too much.
This one might, but a smaller one.
This one may...
- Yeah, that's a handheld massager.
- Or, you know, this size really works well
for this particular injury.
- That's the Q2. - Yup.
- And we actually have a video,
and we'll mention this at the end, too,
how to choose the correct massage gun for your pain,
or for pain reduction or for healing or for muscle recovery.
- Right. So with this, you know,
you're not going to get and go straight in on it.
Now, these travel in and out.
- Yeah. They percuss.
- Yep. Ooh, that would really hurt on a flare up.
So you're going to actually go down.
I would start more in the muscle belly,
and not straight down in, but at an angle.
So we got going across the fibers, which run this way.
And then you can work that.
And you may find some of these muscles
actually getting knotted up as a result of this injury.
So you want to get those knots out.
And you know, after the longer you do it
you should feel those knots relax and release, we call it.
And work your way closer
to where the injury is, that tendon.
But it shouldn't get to the point
where you're feeling "ow!" pain.
You know, it should feel like feeling good.
It's kind of relaxed.
- Kind of a feeling good pain.
- Yup.
- Yeah. And that's, you know, pretty much in all cases here
you're going to want to work
on that extensor wad, they call it.
That wad of muscles there.
Because they could be tight, and if they're tight,
they're going to pull harder on that tendon.
- Now, this gun you could use,
but boy, I really think this one would be better.
- Yeah. And even the different heads
I don't think would work on that.
I mean, in that case, it is one of the, you know,
you certainly could use it on the muscle belly, this one.
- Sure. Yeah, right.
- But on the tendon, I think it'd be too much.
- Yeah, not working up there.
- So again, make sure you do the muscle belly.
That's going to loosen up the muscle itself.
And then, if you can, go over the tendon itself.
And that'll start to heal it up, get more blood flow to it,
and also break up the scar tissue.
- Right. Even without an injury,
that's just, it feels good right now, Bob.
You can just tell you've relaxed things.
- All right, I'm going to show you
a couple of exercises that you can do now.
'Cause for what we're finding is that, with a lot of people,
they're lacking internal rotation at the shoulder.
- Sure.
- And so like if you're playing tennis,
and you're doing a backhand,
and you don't have the enough internal rotation?
You're going to make up that somehow
by working the wrist harder and the extensors harder.
- Right. So you're compensating.
- You're compensating.
So you want to restore that internal rotation.
Brad's going to first show it with a strap.
And then if you want to show it
with the Booyah Stik, too, Brad?
- Sure. So let's say I'm right handed.
So it would be my right hand, more than likely,
would have that tennis elbow on it.
I'm not going to play tennis - Left handed?
- with a non-dominant side.
- Now you can do this with a belt,
you can just take the loop of a belt,
or you can take a strap, a stretch out strap.
And see how he's working?
That's actually internally rotating that shoulder.
And it's always interesting to compare one side to another.
Like you may find that your involved side
can only go up this high,
whereas uninvolved side can go up that high.
And that's an indicator right there that, yeah,
you're lacking internal rotation.
Or you might be lacking on both sides.
- So you just go pressure on and pressure off,
or just go up and hold it.
But you should not be doing this
where it creates any sharp pain anywhere.
It should just feel like a stretch.
A little stretch pain is okay.
- I would also recommend that if you have osteoporosis
or brittle bones, I wouldn't be doing any of these.
- Or hypermobile joints. - Or hypermobile joints.
- We don't want to have a dislocation accidentally.
- So you can, for all of these,
I would put out that warning, for all of these exercises.
- Right, sure.
- Should we show 'em with the stick?
- Yeah. - This, this is what I do.
- And this is what I did. - Yeah.
- Because this made a huge difference for us.
Brad and I both had impingement in our shoulder.
- Palm goes out here.
- The painful arm.
- Well, let's keep it the right hand.
- Okay, sure.
- 'Cause this would be the painful one.
- The painful arm, the palm goes out and low.
- Yep. So the back of your hand would be
up against your butt, and you got to grab it there.
- And the palm on the top is facing the head.
- Yup.
- Or a head. (chuckles)
- And then you just work it up.
- You can work on internal rotation,
just like you were with the strap.
- So we're using the Booyah Stik.
Works really well for this,
but you don't have to have one.
You can use a piece of dowling or a handle from a broom.
- PVC pipe.
- Yeah. But it needs to be smooth,
because it slides on your clothing really well.
You don't want to do this on bare skin,
'cause it will stick.
And that will be very good.
And then we go to the chicken wing.
- Yup. - Yup.
So, on this, I don't go way up, it's already tight.
All the tissues are tight, so I keep it down here.
- And he's leveraging it back.
That's really cranking on that internal rotation.
- Again, no pain though.
No sharp pain, just a stretch feeling.
- I don't know, I think there's a couple reasons
why this works so well.
I think it also kind of puts the scapula
up in the right position, but I don't know.
- Sure, yeah. - What do I know?
(chuckles)
- I think you're right, Bob, though.
I just know I've been doing my left one a lot lately,
and I have neglected my right,
'cause I don't have the problem here.
And now my left one's so loose,
I've got to catch up on my right.
- Sure, sure.
All right, the other thing is,
if you're lacking pronation,
or I'm sorry, pronation or supination.
You can check this out really easy too, Brad.
You put your elbows into your side,
and you might even take a ruler to go across, to show.
Because, you know, your hand might go like that,
but the wrist doesn't get all the way flat.
You want to get them almost flat.
And that'd be both ways, this way and this way.
If they aren't, and they're lacking, again,
your muscles got to make up the difference there
and they're going to be working harder.
So it's really easy stretch to do.
First one, all you do is bend your elbow
all the way up to flexion,
and then you're going to stretch it into pronation,
and you're going to stretch it into supination.
10 times.
- You don't have to remember
what's pronation and supination.
- Yeah, just turn it both ways.
- Yeah. (chuckles)
- Turn the faucet on, turn the faucet off, both ways.
- So you're trying to, you're not grabbing the skin.
You actually want a kind of good grip,
so you're grabbing the bone.
- Yup. And just gently apply the pressure.
But over time, hopefully,
you're going to increase the motion.
I'm going to show one more, Brad.
- With this? - The stool.
- Oh. Oh, yeah, this one.
- Yeah. So this is one, it's actually,
Balogun kind of did this, McKenzie did this.
These are therapist's terms that people would understand.
So you can take your hand,
you're going to actually point the fingers toward yourself.
So you're kind of doing a contortionist, here.
You take the crook of your elbow,
go right below the bump here, and you push it.
You're going to actually push this bone out that way,
out to the side.
One, two, you're gonna do a 10 times, three.
Now, believe it or not, that actually,
I had a tennis pro that, not tennis pro, a golf pro,
that actually, this took it away for her.
- Sure.
- And she had had it for a long time.
- And that shouldn't create pain, right?
It should just feel like...
- No, no. Pain-free.
- Oh, your wrists are really...
I can't believe how much you can extend your wrists.
- Can you do that?
- Well no, my wrists are tight.
No wonder I can't do push-ups without, I mean...
- Well, you're pretty close.
- It's really pulling here though.
- I'm gonna have to work on that.
- Yeah, start working on it, use the message gun.
- Yep.
- All right, thanks everybody for watching.
Let's mention the program though, Brad.
- Oh yes.
- These videos are part of a series of videos on massage.
And if you go to the bobandbrad.com,
go to the programs section,
you'll find the entire program on massage.
And it goes over every body part.
- Right, yup.
So you pick out the body part you want to message,
you'll see the titles, very clear.
Look at that video, get the information,
and the big bonus is there's a PDF printout,
which gives a review of the video.
So you can print it out,
you don't have to keep going back to the video.
And the beauty of it is it is all for free.
We don't ask for email or anything.
It just is our gift.
(cheerful outro)