♪ 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 are the most famous physical therapists
on the internet.
- In our own opinion, of course, Bob.
- Top three tests and exercises for rotator cuff pain.
- Say no more, Bob.
- I'll tell you the Vikings quarterback
didn't have any rotator cuff pain
when he made that miraculous throw
and catch for the Vikings to win.
- Did they play this weekend?
(Bob laughs sarcastically) Oh, good.
(Brad chuckles)
- All right.
Sorry to the Saints fans that you know.
We've been there, we know what it feels like
and I'm sorry for people
who don't understand football, but uh...
(Brad chuckles)
All right, Brad.
So before we do go any further,
we got a few fans here.
- Oh, sure, yeah.
- If you are new to our channel,
please take a second to subscribe to us.
We provide videos on how to stay healthy, fit,
pain-free and we upload every day.
Also go over to the Facebook and like us
because Brad and I as children, it's a sad, sad tale.
We're not liked
and now we're trying to turn things around.
- Yes. - So like us.
- The rotator cuff, Bob.
- Yep, rotator cuff.
- So if you got shoulder pain
and you think, "Oh, you know is this rotator cuff?
Is it, what could it be?"
And then, "How can I make it feel better?"
You know?
So we're gonna show you a three nice little tips
on how to assess it,
three really good exercises on how to improve it-
- Yep. - And uh-
- There we go.
You'll be all set.
- Exactly.
- Common injury, very common injury.
And the reason being is you have
a short muscles and long arm.
- Right.
- So it's gotta handle that long lever arm, right?
- Right, I just- - Or leaver?
How do you say it, lever or leaver?
- Well it depends if you're from Australia or not.
- Okay. (Bob chuckles)
- Anyways, I just had a patient yesterday.
She had rotator cuff surgery
and I said, "Well did you fall on it?
What happened that you needed a surgery?"
She said, "I don't know.
It just started hurting and then it got worse."
And went to the doctor, they took a MRI,
and there she went for to have a surgery.
- Yeah.
- She never even had any therapy.
- Oh, wow.
- So anyways, so now,
now she's got a really stiff shoulder.
She can only reach it about 45 degrees
and we've got, we've got few-
- You've got some work to do.
- Yeah, we've got some work to do.
So what we're gonna, you know
sometimes these surgeries can be avoided
with some preventative exercises and assessments.
So first of all, if you're having shoulder pain
and let's say, you don't know why it happened.
That's not uncommon.
- No, it's not.
Cause it can be over time, it can be a progressive...
- Right.
And she works in a factory.
She was doing a lot of repetitive motion.
I'm assuming that's where it happened in her case.
- Just deteriorates over time.
- Right, right.
- Especially if you're in bad posture
or bad positioning of the shoulder.
- And she, you know, she was 45 years old,
so that all fits as far as age
and her work and whatnot.
But if you have shoulder pain,
a real common symptom if it's a rotator cuff injury
is you're not able to lift up to here.
- Right.
- Usually you get up to around 90 degrees.
You can get some sharp pain in there.
- 90 Degrees is a right angle.
- Right.
- Oftentimes you'll get pain in here
and if you get past that,
then it feels a little better up in here.
- Depending where the impingement is.
- Right.
- I mean, it can hurt, you know
and keep hurting all the way up here.
- Sure.
- Or it can hurt and then stop hurting.
- Right.
- But either way, it's kind of pointing to the rotator cuff.
- Exactly, Bob. - The tendons.
- The other thing is pain location.
Where does a pain hurt?
If it's to the side over here,
sometimes if it's a bad case going down the arm, possibly,
usually not out to the wrist, but sometimes.
But if you, that could all,
that's indicative of a shoulder pain.
My wife said that I'm supposed to look
at the camera more than you.
- Okay.
- So anyways, that- - She must be jealous.
- Well, no, no, yeah. (Bob chuckles)
Yeah, that'll go over good.
- Yeah.
- So then if you have pain back here,
my guess is it's probably not the rotator cuff.
- Less, less likely to be.
- Right, right.
And then I'm gonna definitely assess the neck
cause referral pain from the low neck
can go to the shoulder blade pretty, you know
more commonly of my experience.
- Right.
And it's been my experience as well.
- Right.
And if you reach back like this,
oh I can hurt right up in here.
- Yeah, especially you compare the two.
- Right.
- So you'll find out this is your involved side
and you know, check this and it only goes this far
but this one goes way up here.
- Right.
- There's your sign.
- There you go.
So do those tests and see what you got.
If it's a positive for, you know, it's a rotator cuff
then there's three more tests that we can do.
These are the ones I like to do,
although it's kind of hard to do on yourself.
One is the near test,
where you take the arm and you push it up in here.
And usually you can get up to about here.
And once you get up in here,
it gets to be some sharp pain.
That's a positive sign.
- And try to, if you're doing it yourself,
try to let this one relax.
- Right.
- Let this one relax and let the other one do the work.
- Precisely.
You got it Bob, good point.
The other one is simply go across.
And you know, these are actually impingement signs,
but one way or another it's the rotator cuff.
And so if this one hurts and this one hurts,
then I do another one called the Hawkins Kennedy.
90 degree bend in the elbow.
You're gonna support here.
This one's kinda hard to do yourself.
- And you're about 45 degrees here, right?
- Right. - Yeah.
- And here and sometimes-
(Bob scoffs)
Does it hurt Bob?
- No. (both chuckle)
- Yeah and I'm not pushing hard.
- No.
- This is a relatively gentle test.
So you know, if all three of those are positive,
there's a good sign, you know,
the rotator cuff is involved.
- Right. - So-
- We had another one where, I mean,
sometimes you just put your hand
on the opposite shoulder and go up like this.
I think that was also,
that might have been the end of the clavicle too.
Might have been. - Right.
You're working, you know,
they're testing similar structures.
- Right.
- So anyways, now the exercises Bob.
- Sure.
- The first one, if it's inflamed, it's sore,
we're gonna go to the Codman's right off the bat.
- Right.
- And this is a real common exercise.
Doctors give this to a lot of patients.
They do this one so it can settle down
and then go see your therapist
and they'll guide you on other ones.
So it's just simply leaning over like this.
I like to put my hand on something
so you can keep your back outta the picture
and rest your back and just let it relax.
Completely relax and get your body to move
so that that shoulder can go back and forth.
The idea is the weight of the arm
adds a little traction on the muscles,
get 'em to relax,
distract the joint a little bit,
get some motion in there.
You can go right to left as well.
If it's feeling better, you can do circles.
And the other thing is at this point
it kind of tricks the body.
Cause right here if I go up straight,
I'm at 90 degrees where you may not be able to tolerate it.
- Right.
- When you're, you know,
when you're standing up. - It might go further.
So I mean, if you're up to this point here
and you stand up, look how far you are.
- Right.
So it's a good way to kind of get
that range of motion without the pain.
- Can I show my variation?
- Say, say no more Bob!
The Bob was waiting for this one.
Cause it works. - Yeah, this is what I like.
- He's had some really good luck with this one.
We've had a lot of good responses.
- I'm just gonna go up on here.
Just a little- - Yeah, go ahead Bob.
- Make up a little bit- - Don't worry about it.
- All right, so.
Yeah again, what?
50 to 75% of the people seem to respond to this.
- Right. - Some people don't.
But what we're doing now is
we're trying to help set the head of the shoulder
down into the socket.
So you're gonna put your hand
on a surface like this and you're gonna push down.
- Gonna push this direction, right towards your knee.
- Yep, pushing toward my knee
and as I push toward my knee, I keep pushing,
I walk away.
- Look at right there.
That's a lot of shoulder flexion.
And oftentimes you can do it with that pressure pain-free.
But if you're going like this, it hurts.
- Right.
Or even if you don't push down
and you go back like this, it might hurt.
- Right.
- But if you don't push down.
But if you push down, you go back, it doesn't hurt.
So these always should be pain-free.
We don't want pain.
So the further you can go without pain, the better.
- Right. - I'm pushing down.
I push down all the way back, too.
- Good, so you got that force going into the-
- Yeah, all the way through and all the way back.
And I, you know, you can do a good five sets,
you know five repetitions of these.
- Sure.
- You can do these throughout the day.
- Right.
- You can do it every hour if you want.
- Right, as long as you can get that kind of response,
pain-free range, it's working.
Get that head of the humorous set where it belongs.
You know, if you don't have one of these tray tables
you can do it on a cupboard.
You can do it on a chair. - You can do it on countertop.
- Right, right. - Yeah anything.
I would say the next one's the same thing, Brad.
The scapular retractions. - Yep.
- I would do those throughout the day.
- Right.
- I mean they just help set the shoulder
in the right position and they make a big difference.
- So posture of the shoulder,
the mechanics of it, it's very critical.
So a lot of these exercises
what they're doing is getting...
Here let's get old- - Napoleon.
- Bone head in here.
We wanna get this ball set in the socket properly
as opposed to way up here
where it's impinging on the acromion.
So, thank you.
- And the same with the-
- You're welcome. - Yeah.
(Bob chuckles)
The same with the scapula, the shoulder blades.
We don't want them forward.
We want them back.
- Right, yep.
- So that's what this next one is about.
- Right.
So we're gonna retract the shoulder blade.
So actually you can do this without resistance.
- Right.
- And it's gonna be effective, but you do wanna-
- And so I'm just showing how the blades
are coming together. (Brad groans)
What I like about these is you can do 'em at your desk.
You do 'em all day long. - Right.
- You can do 'em every hour. - Right.
- And it's really, I advise you to do it every hour.
- You're not gonna do 50 of 'em every hour.
- Right.
- But you do, you know, five to 10, every hour-
- Right.
- Is gonna help that out. - Make a big difference.
- You can use some TheraBand or resistance.
- Tubing.
- Tubing!
There we go.
And it's the same motion
except for you have some resistance
and it works the muscles-
- Brad your collar's flipped up.
- My collar! Bob!
- Who dresses you in the morning?
- Well...
- Apparently your wife did not dress you this morning.
- No, she was...
Actually she got up earlier than I did today.
So we're working here.
Yeah, but we don't want people to talk about that.
(band snaps)
Whoa. Look at that, Bob.
- By the way, we gotta put a plug-in
for the wall anchor here.
- Oh yeah.
This is a wonderful device.
- This is Brad's and I, our invention,
and you can put 'em up on different levels
and these work great for exercise.
- Yeah, they do. - So.
- So, yeah.
You can use it, you know,
therapists, you always give out this stretch.
- [Bob] Stretch band, yeah?
- Yeah.
That works on here well. - [Bob] Exercise band.
- Yeah.
So and then the next exercise is the famous,
you know I would say everyone
who has a rotator cuff problem
does this one. - [Bob] This one, yeah.
- External rotation,
which also helps that humoral head
get back where it belongs.
And look at my elbow.
It's here and it's not this
and I'm not going down like this.
- Yeah, and some people have actually put a towel
in there just to maintain it there.
- Right.
So if you have that towel in there
and the towel falls out,
you know you got your elbow too far.
- You've done wrong. You've done wrong.
- Yes. That's the sign. - The indicator.
- The towel sign, we're gonna call that.
There we go.
- So he's just going to right across.
Now you can also do it
with the exercise tubing with handles.
- Yep.
And here we're just gonna use one.
That's the nice thing about this anchor.
You can, you know, use one and it's gonna lock it in.
Or if you wanna need more resistance
you can grab both at the same time.
- And that's a lot then.
- Oh yeah, that's quite a bit more.
And I feel that rotator cuff.
- That's how I do my biceps.
I start with one and then I go two...
- Pumped up strong, Bob.
(Brad grunts)
- All right, folks, I hope that all helped you.
- Right.
Cause you get these exercises,
three sets of 10 is the goal,
when you get to that point.
And as it's feeling stronger
you're gonna start to do this better,
scratch behind your head better,
maybe even get to throw in that baseball.
- Yeah or that football.
- Oh yeah, yeah.
That football.
- Where's Alex? I can hit him.
- And then the Vikings fans are just pumped up
because they finally made it to the playoffs.
- Yeah. (Brad laughs)
We're beyond all playoffs.
Thanks.