♪ 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 together we're the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Undisputable.
- Undisputable, maybe.
- Maybe.
- It's getting there. - Right.
All right Brad, what do you wanna talk about today?
- Well, Bob, we're gonna talking about tennis elbow,
technically
- Lateral Epicondylitis
- Yeah, tennis elbow is a little easier to say,
makes more sense. People playing tennis,
The backstroke is where it comes from.
Not the front stroke.
I'm not a tennis player, whatever that's called,
but it's on this side of the forearm.
This would be the palm side, we're on the backside.
And it happens right where these muscles
connect to this bone.
That's the lateral epicondial. And-
- It can really happen with any gripping type,
repeated gripping type activity.
- Yep.
- Like if you're trimming the hedge.
- Yep. Yeah. It's amazing, people come in, you know,
to the clinic, one guy, he was doing the weed whacker.
- Sure. Yep. That'll do it.
- People using cordless drill or something, you know,-
- Sure.
- do a lot of that weekend warrior
or repetitive motion or a combination.
But what happens is you'll find a real tender spot.
- Oh, it's tender.
- Oh. And if it's really flare up,
I've walked through a doorway and just touched it and oh,
it makes you say bad words, at least me.
- Anyways, that's what we have.
And we're gonna show you a really nice technique
and a couple tricks along with it to get this
to settle down in a quick manner.
- Good.
- So the treatment is three minutes long
the primary treatment, but we're gonna show you
a couple little tips, for example, big thing,
this is kind of a common sense thing,
avoid the pain makers or anything that sets it off.
- Right.
- A lot of times-
- You gotta get it to calm down.
- Yep. I know with me personally, I had in both arms,
if I had a doorknob that was kind of hard to twist,
oh, would that flare it up.
So use the other hand, you know, in a case like that.
- When I was in school for PT, I actually got a case of it
and I would carry trays.
- Yeah.
- As a waiter.
- Yeah.
- And oh, that hurt.
- Oh
- Yeah
- So what'd you do make the customers carry it?
- That's right. That worked out really good.
- Yeah.
- I'd give 'em a tip.
Yeah. That's a good example of something you may not
think would get it going.
- Yeah.
- But it can, so if you happen to have a job
or something where you have to do things that irritate it,
I would highly recommend getting a strap.
- Right.
- Okay, this is a tennis elbow strap,
is what they typically call 'em.
They make a lot of different there's styles
- Variations.
I've always liked this one that has a air bladder in it.
- It's called Air Cast.
- Yep. Air cast
- Buy Air Cast.
- [Bob] I, too, had the best luck with these
if they're gonna work.
- Yep, so-
- [Bob] They aren't magic, but they help.
- So what I would always recommend for myself,
as well as patients,
is you're gonna put it not over the point, painful spot,
but just distal.
- Just a little bit towards the hand.
- Right. And then when you're gonna start using something
then you're gonna tighten it up
and it's gonna disperse the pressure
- Right. Puts more the pressure here than on the bone.
- Exactly. It's that muscle belly.
Now don't leave it tight all day long.
- Right.
- Only use it tight when you're doing that activity.
Hopefully, it's not for a long period of time.
And then simply loosen it up with the Velcro.
- Right.
- Leave it on.
So, I highly recommend that if you
cannot avoid the pain makers.
You know, if you want and it's really sore,
you can put a cold pack on there
- Right, always helps.
- Yep. It's always a good option.
Now the main treatment of the day we're gonna talk about is,
I don't even know if I need to sit here, get yourself,
- Need a butter knife
- A butter knife.
Okay, and you know, it's got some round ends.
We're gonna use the handle of the butter knife.
- Right, not the blade
- Not the blade, so forget about that.
You're not gonna use a regular knife, right.
Something that you can go like this
and you do not cut yourself.
- Right.
- Okay. Get yourself some, any kind of cream,
- Right.
- That is, you know, moisturizing cream.
Doesn't matter what it is
and we're gonna use that for lubricant.
Okay.
Now we're gonna take the knife and here's that painful spot
- Again? Handle.
- Yep. And we're gonna go, not on the bone.
It's gonna hurt if you go on that painful spot.
- There's the bone, right there.
- So I'm gonna go just distal
or a little bit away on the muscle belly.
- [Bob] A little bit toward the hand.
- Yep, and I'm gonna do this motion.
This is, if you're from the north
and you got snows, like a shovel.
If you go this way, we call raking.
So we're gonna shovel, we're not gonna rake,
- Not raking.
Yep and you go like this and you push down, not really hard,
but you're putting some pressure on it.
- Right.
- Now, it really helps out if you use a pillow or two.
- Sure. Keep it supported.
- Yep. Allows you to relax
- And put the lotion on first.
- Oh
- There we go.
And we're not gonna be stingy with it.
You know?
Get it on there.
Where's my-? okay.
Rub it around.
There we go.
- It's like you're frosting the cake.
- Yeah. There you go.
And so it's here.
I'm gonna not just go here,
but I'm gonna go over all those muscles
that we call the muscle belly.
You're getting red already.
- Yep. So what Bob's referring to is the red,
your skin will actually get red
- Yes.
- Which is a good sign
'cause that's being red from blood flow
and we're talking about more blood flow,
which is a good thing.
And we're relaxing those muscles.
We're increasing the blood flow and this is-
- It's quite often gonna leave a mark.
- Yeah. Now usually a couple, three minutes.
I put three minutes on the title.
That's probably the max, depending on hard you push.
- Sure.
- Now what can happen is,
Can you see that Tanner? Can you see that it's
getting a little red in the-
- [Tanner] Yeah.
- Okay. So once you start seein' that red, this feels good,
it'll typically feel like a good massage, then you're done.
Where's my towel?
All right. Make sure you have a towel handy,
so you don't have to make a mess
on the furniture and whatnot.
If this redness should go away within an hour or so
- Sure.
- Now it can actually stay red and look like it-
- For days after.
- Yeah, it can look like a bruise and it is
it's the blood flow and that means you overdid it.
- We are warning you.
- Yes.
- It's very easy to do this.
- Exactly. And some people like myself,
if a little's good a lot's better,
- Right.
that's not true.
So, you know, take it easy the first time,
- The Brad Heineck method
- No, we call it the Heineck maneuver.
- Yeah. That's right.
- So anyways, we're getting on with that.
- So would you do it every day?
- Yes. Every day, if, like I said,
the redness goes away the next day you can do it again.
And as it improves then you're gonna decrease
how much you do it.
- Sure.
- So as it gets better-
- Every other day.
- Yes
- Right.
- Exactly. If it is bruised the next day,
usually it's two to three days for that bruised look
to go away,
- Sure.
- then go at it again,
assuming you had good results with it.
- Right. Right.
- So there you go, Bob, that's a-
- Another option, Brad, is the massage gun, right?
- Right. If you happen to have one,
I don't know if I'd go out and buy one just for this
but if you happen to have one or a friend has one
- Or if you wanna use it for other things, I mean
- Yep.
- because it can be used anywhere on the body, obviously.
But Brad's method is actually quite ingenious.
He actually puts the ball on there. It has five attachments.
- Here's the other four.
- They just pop on
and pop off
and you hold it for three seconds to start.
- Yep.
- And now you don't go directly on the bone again.
- Yeah.
- You don't go direct,
like a you're drilling for oil here.
- Right.
- You actually wanna go in from the side.
- [Brad] There you go.
- And the same thing, again.
- [Brad] Yeah. Get a, get a pillow under there.
- [Bob] Yep.
Same thing again.
So, you're gonna saw back and forth
like you're-
like I got a piece of wood here.
- So, you know, this would be,
we talked about cross friction massage
of which have been done therapeutically for decades
and it works well and it's not too hard on the hand.
- Right.
- And usually you won't get that redness
or that bruising from this.
- Right. Plus you want to get the entire muscles.
- Mhm, yep.
- Because these all, if they're tight,
they're gonna put more stress on the lateral epicondyle.
- The more relaxed this whole muscle group is
- I might use this on the other side too, Brad.
- Yeah, yeah, yeah.
You can use it on your legs or-
And actually, you know, I do wanna mention this technique.
You can use it on other parts of the body.
- Sure.
We did do a video specifically on how to do it
on the quadriceps where it connects to the kneecap.
So you can look at that video as well.
- Yeah.
- But the concepts are all the same.
- Right. Very good.
- Very good.
So good luck with that tennis elbow.
We know how difficult and-
- Stubborn they could be.
- Yeah. Yeah. It'll last for months sometimes, but yeah.
- They're like a man in your life.
- I'm glad you brought it up about man
because we've been having comments about the
- Don't even say it, don't, men are the problem.
- Yeah. It's all our fault.
- All right.
- Take care.
- Thanks for watching.