♪ Bob and Brad the two most famous ♪
♪ physical therapists on the internet. ♪
- [Bob] Hi folks. I'm Bob Schrupp, physical therapist,
- [Brad] Brad Heineck, physical therapist.
- [Bob] Yeah. We are the most famous physical therapist
on the internet.
- Look what I did already.
- [Brad] Oh, Bob, in our opinion, of course.
- [Bob] Okay. Brad, today, let me, you know
do a little housekeeping here.
Today, We're gonna talk about this one
simple exercise that can help your tennis elbow.
And this is, you know, science says this, by the way
- [Brad/Bob] science says it.
- [Brad] I like to meet science.
- [Bob] Yeah. We're Mr science, Mr.
And Mr. Science.
- [Brad] Actually, we do have a nice study right here.
- [Bob] Yeah, we do.
By the way, if you're new to our channel
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like us because Brad and I, it's such a sad tale.
We, we cry just about every time we talk about it
we were not like this children
and we're trying to turn things around,
- [Brad] right? And it's working.
- [Bob] Allright, the study.
- [Brad] okay.
And this is not the first one of this Brad
but they're finding out a lot of times now
that eccentric strengthening is gonna help you heal tendons
especially like patella tendon, they're finding out.
pretty much anywhere you have a tendon.
And when you have lateral epicondylitis, tennis elbow
there is a tendon that's giving you trouble here.
- [Brad] Sure.
- [Bob] And it's on the outside of your elbow
and you don't have to be a tennis player.
Any, any gripping type of activity can often bring it on.
But this is a study that, you know, followed up on that and
and worked on, just was talking about this device here.
- [Brad] Sure.
So I'm gonna give you the title just so you have it
but this is something only a therapist could love
because it's
- [Brad] Go ahead.
- [Bob] Addition of isolated wrist,
extensor eccentric exercise
to standard treatment for chronic lateral epicondylitis
a prospective randomized trial.
And we got a bunch of MDs and PhDs
- [Brad] a lot of smart people.
They're they're way up there in
- [Bob] Smarter than we are.
- [Brad] the cerebral area.
But, but what are they talking about?
Wanna strengthen your elbow, the muscles in the elbow
in such a way that they get stronger
without being irritated.
And you mentioned the eccentric.
Yeah. So some people may not say, well eccentric, what
is he talking?
What, what do we mean?
- [Bob] So with concentric, the muscle is shortening
and you're strengthening it.
So that's normal lifting.
So like, if I'm gonna strengthen the bicep,
I'm gonna lift up like this.
- [Brad] Right,
- [Bob] If I wanna strengthen the bicep eccentrically,
I would start off with a weight up here
and lower it down.
- [Brad] Right.
- [Bob] But something else would have to lift
it up then for me.
- [Brad] Right.
- [Bob] Because I don't want to do it concentrically.
So I would lower it down like this and I'm strengthening it
while it's lengthening.
- [Brad] Right.
- [Bob] So we gotta strengthen this muscle while
it's lengthening, which is kind of difficult to do.
And this is kind of an ingenious way of doing it.
This is the can do twist.
And what is it?
Let's get it right here, Brad.
Twist and Bend bar.
- [Brad] Right? It's not really a bar.
They're rubber tubing
It's excellent.
I'm really thoroughly impressed on
how these work and how well
the resistance works with the wrists.
- [Bob] Yeah. And these are by the way, made out of latex.
So, if you are allergic to latex
you probably can't use this.
- [Brad] Sure.
- [Bob] I know you'd have to wear gloves or something.
I don't know, you'd have to use something
we're going along the resistance line all the way
from this is the least amount
of resistance and works all the way up
as it get the color gets darker to the most.
And this is a real bear to use on that one.
- [Brad] Yeah.
- You you're got some really good beefy, your
strong like bull. If you can use the
black one, big Popeye wrists.
- [Bob] I was surprised I saw some semi negative
reviews about, that they didn't feel like the
tension lined up with the colors
but I, I don't see it, Brad.
I mean, I went all the way through
and it gets harder and harder
as each color.
So I thought for the price,
it was a really excellent product.
- [Brad] Right. Are we done?
- [Bob] Yeah. Allright.
- [Brad] we're gonna show them the exercise.
- [Bob] we're gonna show them the exercise.
- [Brad] People are probably wondering what
how do you exercise with this rubbery
tube thing?
- [Bob] What I would recommend
and Brad, you thought the same
as you'd probably, especially
if you're having trouble
with a chronic problem, where you're having is
that you'd probably start off with this one.
- [Brad] The Lightest color. Yeah. Right.
- [Bob] And according to the study, what they did
I'm gonna grab the study again, cuz it tells on here.
So let, just let me set the stage for the study.
They took people that were on physical therapy already
- [Brad] For Tennis Elbow.
- [Bob] So you're gonna wanna
you can do physical therapy along with this, but they just
all they added is strengthening to the therapy.
Now they might have been getting ultrasound
or they might have been doing cross fiber massage.
We'll show that after this.
- [Brad] Sure.
- [Bob] But in addition to that
they did three sets of 15 of these.
- [Brad] Sure.
- [Bob] They did it every day.
They had a 30 second rest between each set
and they did it for six weeks.
six to eight weeks, I'm sorry.
- [Brad] People are just dying to know what these are.
- -[Bob] Yeah. But, the thing is
though there was a significant improvement on
the people that did this
versus people who did regular strengthening.
- [Brad] Okay.
- [Bob] I mean their, their pain levels were a lot less
and their strength was a lot better.
- [Brad] Okay.
- [Bob] So it, it really is worthwhile
doing this one exercise.
- [Brad] Okay.
- [Bob] So very simply what we're gonna do.
We're gonna let's show out a strengthen the left one first.
- [Brad] Right.
- [Bob] Do you wanna do the side view Brad or?
- [Brad] Sure. I'll do the, so this
the strap on here represents my sore elbow.
The one with Tennis Elbow.
- [Bob] I'm doing a little bit different than they did it.
Cuz I think it's easier.
I want you to put your hands on top of the
the bar, elbows into the side, Brad.
to the side of your body.
Well they're not to the side
I suppose, you're trying to show it, huh?
Like this is the side of the body.
- [Brad] Like this. I wanted so people can see
- [Bob] Right.
So I'm strengthening this one.
So I you're actually gonna twist forward with the right one.
- [Brad] So these aren't really bars they're rubbery
elastic things and they twist really nice.
That's why there's ribs on them,
so you get good grip
- [Bob] Twist forward with the right one.
And now I'm gonna count to 4. 1, 2, 3, 4
- [Brad] And let that one go.
- [Bob] And that one was strengthening the whole time
while I was doing it.
- [Brad] Okay.
- [Bob] I'm gonna release on both sides and reset.
And then I'm gonna do it again.
Twist 1, 2, 3, 4
release, release.
- [Brad] Oh Bob, your clipboard.
- [Bob] Yeah. Twist 1, 2, 3, 4.
- [Brad] Good thing that never happens.
- [Bob] Release, release, twist 1, 2, 3, 4.
- [Brad] So this is the eccentric part of it.
Cuz we're rolling this way and we're going this
is the eccentric strengthening.
We're not going back and forth.
It's that's why we let go.
We twist eccentrically strengthen the muscle
and then let go and go back to the starting point.
- [Bob] I don't know about you Brad, but I can feel it.
- [Brad] Oh yeah.
- [Bob] And I don't feel anything in this one,
cause this one's doing the twisting
- [Brad] right?
- [Bob] 1, 2, 3, 4.
I'm using the red one now. All right.
Let's say we're wanna do the right hand, Brad.
- [Brad] Sure.
- [Bob] So now we're gonna go opposite again,
both hands on top
and I'm gonna twist with the right one now
or the left one now and then this one's 1, 2, 3, 4.
So I'm gonna grab underneath,
twist 1, 2, 3, 4,
reset, Put 'em on top.
Twist it 1, 2, 3, 4.
- [Brad] I'm getting tired, Bob.
- [Bob] I know. (laugh) it, it, you know it looks very
subtle, but it does work. So again,
you'd start off. I would recommend probably
with this one.
- [Brad] Yeah.
- [Bob] Some people, like you said
this is about what you'd use for yourself right now.
- [Brad] Right?
- [Bob] Without a problem
- Right? Yeah.
- [Bob] So.
- [Brad] I'm getting a good fatigue with that.
- [Bob] These are getting beefy,
and we'll put a link down below
on how to purchase these.
Now, in addition to this
I, I'm gonna recommend that you might try some
of the things that we would recommend for physical therapy.
And one is we talk about cross fiber massage.
- [Brad] Sure.
- [Bob] So what we do
- [Brad] I really feel like hitting you with this Bob.
You don't yeah, don't do that at home.
- [Bob] You can really knock somebody around with that.
- [Brad] Wow.
- [Bob] So for cross fiber massage.
So in addition to do the strengthening, so you have
the lateral epicondyle right here, coming right off of it.
You know, you have the, the, the extensor wad
of muscles here.
You can actually massage these muscles too.
- [Brad] Sure.
- [Bob] Cause they often are tight.
- [Brad] And if They get tight, they're putting
stress on the sore tendon.
- [Bob] Right. In addition to that
you actually can take your fingers, come
off the bone here and rub right around in this area here
- [Brad] You see the direction he is going
the muscle fibers go this way.
He's going across.
That's why it's called a cross fiction.
- [Bob] You can find the tender spot and work on this.
And this is a very common way to treat tennis elbow.
What you're doing, what you're looking for by the way is
that as you start to rub after maybe 30 seconds
or so it levels out the pain isn't getting worse and worse.
And in fact it might even feel better.
- [Brad] Right. Yep.
- [Bob] If it just keeps getting worse and worse,
- [Brad] Then stop.
- [Bob] Yeah, you gotta stop and you're not ready for this.
You may have to do the icing instead.
- [Brad] Right? Give it more time.
- [Bob] Give it more time. Maybe start the
eccentric strengthening.
- [Brad] Sure.
- [Bob] If you can tolerate it.
But what you're doing is breaking up scar tissue.
Cuz a lot of times as tennis elbow develops over time
it develops scar tissue and it'll feel better.
And then all of a sudden you'll play tennis or whatever
and or do a gripping exercise and it breaks loose again.
- [Brad] Right.
- [Bob] So we're trying to, cross fiber helps
realign the fibers, so that they become strong again.
And now you can go ahead and, and do this for
I'd say maybe four to five minutes.
You can do it a couple times a day if you want.
- [Brad] Yeah. Yeah.
- Your finger gets, when your fingers get sore
from rubbing because of the pressure, you know
you had enough, that's kind of the rule I use.
- [Bob] I would.
- [Brad] that's usually about a few minutes.
- [Bob] I would also do the extensor stretch, Brad.
So maybe just go ahead and bend the wrist down
and turn it out like this.
- [Brad] Yeah.
- [Bob] So this is a good stretch to do.
- [Brad] It's not a real aggressive stretch
but if you've got tennis elbow, a sore tendon, you know
you'll feel it quite a bit more
than if you don't on one hand to the other
- [Bob] I'm also gonna show you one other thing, Brad.
Sometimes if you look at both of your elbows and one
of them doesn't straighten out as much.
- [Brad] Sure.
- [Bob] That can be what they call pseudo tennis elbow
false tennis elbow.
You're still having pain in this area, but it's really more
of a joint issue.
- [Brad] Okay.
- [Bob] And there's one stretch that works out
pretty good for that.
You're gonna find a table like this.
I'm looking at, this is the one I am having trouble with.
I put my fingers down.
So they're facing me.
- [Brad] Yep.
- [Bob] And I'm actually gonna take my hand right
below my the crook of my hand here
and right below the elbow.
And I'm gonna push it that way,
while the
- [Brad] So. away from you.
- [Bob] I'm putting a little weight on
1,
2,
3,
4,
5,
You know?
pressure on, pressure off.
- [Brad] And should that feel off good or painful?
It should feel good, if it doesn't feel good,
don't do it.
- [Brad] So it should feel like good pressure.
- [Bob] I'm gonna show this direction.
- [Brad] That's a good idea.
- [Bob] So here, I'm right here.
I'm again, grabbing below the elbow here.
Pressure on, pressure off.
And you can do it 10 times.
Pressure on pressure off.
Yeah. I'm I'm going in this direction.
- [Brad] Towards Me. So, Are you putting a lot of
pressure down or just enough to hold it?
- [Bob] Just enough to hold it.
- [Brad] Okay.
- [Bob] Exactly. Brad. That's precisely
- [Brad] Precisely.
- [Bob] My tie's in the way here.
- [Brad] Yeah. Well there you go.
I got the scissors back there.
- [Bob] Yeah, that would've worked too
but, pressure on pressure off.
It's surprising how often that'll work too.
The final thing we're gonna give a mention to
we just got sent these braces
and Brad and I are gonna give 'em a try.
- -[Brad] I've got one right here.
- [Bob] What are they called?
They're called the tendon track.
And, and it's an interesting concept that we're gonna
- [Brad] A little box.
- [Bob] Yeah. That we're gonna use.
So like most of these braces actually put pressure right
on the tendon to try to take some stress off the
where it attaches to the bone.
This has two little, what would you call those
- [Brad] Pressure pads
- [Bob] Pressure pads that go on each side of the tendon.
So you look at the redness here.
That's what it represents the tendon in the muscle.
- [Brad] Right.
The sore, the sore muscle in tendon area.
So I put one on each side and then I'm gonna take this
and tighten down.
And this is elastic with Velcro
and it puts pressure on the two,
adjacent to it as opposed to on top, which a lot
of the ones are.
So it's another approach.
And that's what we gotta find out is it's gonna be helpful
- [Bob] And they actually can use this
for Achilles tendon and also patella tendonitis.
- [Bob] Right.
We're gonna give this a try and see if it works.
I like how well it snugs up.
- [Brad] Yep.
- [Bob] What I didn't like is, I mean
it almost needed two people to first to set it up then to.
- [Brad] Right, cause you have to adjust these pads
- [Bob] Although you ended up doing it yourself, right?
- [Bob] Oh yeah.
And I did mine myself, but I, I mean
it's just a little clumsy to start.
- [Brad] highly talented individual Bob.
- [Bob] And he's highly humbled too.
- [Brad] Yeah. Could We, could we go home now?
- [Bob] Yeah. Thanks for watching.