♪ Bob and Brad, ♪
the two most famous physical therapists,
on the internet.
- Hi folks,
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Because we are the most famous
physical therapists on internet.
- In our opinion, of course, Bob.
- What you don't see before we talk,
is we do kind of warm up a little bit.
Gotta get the energy level up, right.
- Pumped up.
- Okay then, Brad, we're gonna talk
about 13 supraspinatus rotator cuff stretches,
and exercises that you can do.
I'm gonna assume, Brad,
that they know what muscle they tore.
We're not gonna go into that.
- The supraspinatus.
- Yeah. The supraspinatus.
- Most commonly torn...
- Tear happens a lot in people who are 80 and over.
Do you know that?
- I believe it, I've worked a number of them.
- 50% of the people are 80 and over.
- You have done your homework, Bob.
- Yeah, I did my homework.
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Okay. Let's start off with a test, Brad.
Oh, first off. Just one thing, Brad.
I was gonna mention,
when you have a tear, if you have a partial tear,
you definitely should do some rehab.
And if you have a tear that's less than one centimeter,
a full tear,
you're definitely gonna wanna, still try rehab.
If it's greater than one centimeter
then you're gonna maybe be talking to your surgeon about it.
- So, the only way you're really gonna know this
is through an MRI.
- Right.
- You've already seen the doctor,
they had the MRI, you've got all this information,
and it's time to make that decision.
- Right. So, here we're gonna start off with our exercises,
Brad, kind of some of the easier ones,
the stretches and then go into the strengthening.
- There you go.
- So, the first one, Brad, is very common.
It's called a pendulum exercise.
Every therapist knows these.
You basically, this is the involved shoulder,
the right shoulder.
You're gonna lean on a countertop or a chair,
and you're just gonna let your body,
kind of make it swing.
- Yeah. It's also called the Codman's because,
I think, Dr. Codman might came up with it.
I'm just gonna do one thing there, Bob,
that, some people, especially the therapists might say,
"oh, well you're not supposed to do this,
you're supposed to let the body get the motion going,
and the arm be completely flaccid."
Have you heard of that?
- Yeah, I have first to start,
but eventually you wanna start getting a little movement,
because that's building a little strength.
- I just wanted, wanted to clarify.
- And then you can do circles one way,
and circles the other way too.
So, the next one that I like to throw in,
is a technique by Brian Mulligan.
And I like this one actually better than the the pendulum.
There's a reason why some people don't
like the pendulum, Brad,
they feel like that it pulls the head of the humorous.
- Sure. Yep.
So, this is to help set the humeral head down
into the socket, which means nothing to most of you,
but it means something to us.
- You'll feel the difference.
- Yeah. So, you're gonna find a countertop,
or the back of a chair,
and now I'm pushing down into the chair.
Now all of these should be pain free, right, Brad?
- Right.
Should make it feel a little bit better possibly here.
- Yeah. So, again, my involved shoulder here,
I'm gonna push down the whole time.
- He's pushing that direction.
- Yeah. And then I come back up and I'm still pushing down.
- Right. You know, I've had patients,
and we've got a lot of comments, people do this,
and they're just, they got a smile on their face
because they can finally get a pain, free range of motion.
- Yeah. I've had a lot of people, Brad, that like this one,
there's a couple that don't.
But I have a lot of people that like it.
You can do a good set of 10 of those.
- Sure. It is gonna depend on the, the size of the tear,
you know, if it's complete tear this may not...
- May not feel good.
All right. Do you wanna show wand exercises, Brad?
- Well, of course I do.
I'll give you a wand exercise.
What are we gonna start first with?
- Flexion. And then abduction
- So, flexion is straight out in front of you, like this.
So, if this is my involved arm,
I'm going to use my strong arm,
to be the guide, that's gonna do the work,
this one's just going for the ride essentially at first,
you know, and you're gonna go up there
and try and get range of motion.
- Again, pain free. You don't wanna...
- Once it starts getting stronger,
you can give a little assistance,
so it becomes active assistive, we call that.
And you're gonna bring it up as far as you can.
If you start to get pain up here, that sharp pain,
don't go that high,
go just before it and then come down.
So, you're working that pain free range.
- No, that sounds good. Go right into abduction.
- Okay. Abduction is out to the side,
because you pull your arm away, it gets abducted.
- But keep your thumb up.
- Thumb up, yep.
Like you're doing a hitch hike up towards heaven there.
We're going up, like this, and down again,
this arm, initially, is this gonna go for the ride,
pain free range, if you get to here, it starts to hurt,
we'll go back down.
Don't push into that pain,
think that's gonna get better because it's not.
We just work it, and over time, you'll get it
up higher and higher and get normal.
You know, once you get up to here that that's high enough,
you know, unless you're a pitcher,
where you're gonna need that extreme range of motion.
- Or a basketball player.
- Oh, basketball, say no more.
All right. Now, next one, Brad,
is stretching into external rotation.
You guys are gonna like this one, cause this is,
I've never seen this one before. It's a new one.
So, you take the involved arm,
you put it in the crook of the elbow of the other arm.
- Sure, we'll call it a crook.
- Grab the thumb like this, and look at this,
you're pulling into external rotation.
- Plus you get a thumb stretch at the same time.
- Yeah. You're getting a double stretch.
- So, external rotation simply means,
the humorous goes this way.
- Yeah. Or it goes like this, hard to stretch this way.
But you can stretch like this. And I'm at end range now.
- Sure. So, again, that one,
maybe if it's painful, don't do it.
It should be a feel good stretch. Like it needs it.
- All right. Then we're gonna stretch
the back of the shoulder here.
So, this is a real easy one,
you just grab the wrist,
and you're gonna pull over like this.
Now, I was just reading on this,
I'm not really certain why,
but they don't want you grabbing here,
they want you to put a little traction on it.
- I'm assuming, Bob, you know,
I didn't read what you're reading,
but I bet you they're just trying to open
the gap up between the humorous and the coracoid process.
- I think you're right, because the other thing
they said along with this,
is you can even try to work on keeping
your shoulder blade down.
You know, keep it down while you're doing this.
And I think by doing this,
it's not pinching as much in here.
- Yep. Getting that impingement out there,
so, that he's pulling out this way,
little traction, and then go over.
Again, you'll know if it's right,
if it's gonna feel better with more range of motion.
- Number six is a chest stretch.
You know, one of the things that's bad,
when you're pinching your shoulder basically,
getting the impingement,
is sometimes your shoulders are internally rotating.
- Get poor posture.
- So, what you wanna do chest your stretch,
stretch your chest.
- Chest your stretch, Bob.
- So, you can go into a corner, into a doorway,
and you can lean in like this.
You can go like this too.
Just bring your elbows way back.
I dunno if you're gonna be able to do it
with your shoulder like that.
If you have a doorway right here,
if you go like this and you lean in like this,
that'll stretch that chest.
- Bob, I'm gonna make a doorway
on wheels here so we can do that some day.
- I know, we need that one a lot, don't we?
- A lot of fun with that one.
- All right now, we're gonna go into strengthening, Brad.
We're gonna start strengthening.
- So, the whole idea is, while Bob gets ready,
is you want to gain range of motion,
before you start strengthening.
You know, if you can't get your arm up to here,
you're not gonna start strengthening
until you can get it up to here.
- Now this one, Brad, you can, you know,
do this on the floor and put some pillows down,
so your arms raise up a little bit.
I'm just gonna show you the right side,
you can do this with both sides at the same time.
So, you're gonna go down like this,
and you're gonna have your thumb pointed forward,
- That right down here.
- And all you're doing is bringing it up like this,
and squeezing your shoulder blades together while you do it.
- So, up here is where the strengthening
we're really concerned about going on, is right here.
- I think we called it on another video, the core, you know,
we're strengthening the muscles around the shoulder blade.
- Yep. The ones that stabilize the shoulder blade.
Because if your shoulder blade's not stable,
the shoulder joint where the tear is will not...
- Now believe me on a weak shoulder, Brad,
this will be hard enough for you.
- Oh yeah.
It looks like a easy, simple exercise,
but you do it like this.
- And you do it a number of times,
you'll start to feel it.
The next one is, Brad,
you actually, thumb is toward you now,
and you bring the elbow up,
and then externally rotate like this.
So, elbow up, and then turn the arm like that.
- Thumb is here. I'm just doing it vertical.
- Yep. And again, I can start to feel that already, Brad,
in the external rotators that, it's working.
- Yeah. So, when he's saying "feeling it,"
he is not feeling a sharp, you know, bad pain,
it's muscle fatigue.
- Yeah. I'm starting, even despite the fact,
that I don't have a bad shoulder, I am feeling it.
- So, the muscles are working.
The correct muscles.
- Next one, very simple one, Brad,
you're just gonna go ahead and do basically like we said,
the empty can exercise, in what we call a scaption.
- Oh, Bob, just wait, your collars out, we can't have that.
- Oh, my gosh.
- We can't have that.
I wonder what would your wife would say?
- Yeah. How'd she let me out the door.
All right. So, very simple on this,
you're just gonna bring the arm forward
a little bit, like this,
you have the thumb pointed down,
and you're just gonna go up like this.
Just some repeated...
- So, that is actually what we call that,
in a therapy world, scaption.
It's not straight in front of you,
and it's not out to the side, it's kinda at an angle.
- 45 degrees or so forward.
- There is some mechanics that relate
to the shoulder blade with that,
but we don't need in there.
- Yeah, exactly.
So, all right, then you can take...
Oh, did we get...?
Oh, we did get two weights.
- Well, of course, Bob, I'm on the ball.
- Now you can just take two cans,
you can take two soup cans,
and you're just gonna start doing these..
- You know, these are five pounds weight,
if you got an injured shoulder,
you're not gonna start with five pound weights.
- Cans are gonna just be, you know, one pound,
and you wanna have really good posture
while you're doing these, really good posture.
- Right. So, even good give them the profile, Bob.
So, this posture, this way, the shoulders need to be back,
and you know,
that's just a common staple for shoulder health,
we talk about that all the time.
- All right. Next one is what we called, "outties."
You wanna get off?
- Like a belly button, outtie?
- You wanna get off?
- Oh, I'm sorry.
- After a comment like that,
I think I'll just have you leave the video here.
- External rotation of the...
- Yep, of the shoulder.
So, say again, now we gotta weight,
and we're just gonna go up like this.
You can even go up higher if you feel up to it.
Sometimes they put the pillow or the towel underneath it,
don't they, Brad?
- Sure, I was just gonna do that.
- Brad anticipates by every move here.
So, he's putting a little towel under here.
Gives you a little separation there.
- In theory, you need to be out about 20 to 30 degrees,
which that'll help do,
it's not a big deal, but it is helpful.
I think it's elite. It's more comfortable.
- I'll tell you with this one, with five pounds,
I feel that.
- Yeah, one pound with an injured shoulder,
is gonna be adequate.
- All right, next one,
you can do start doing external rotation,
with the Thera-tubing, or tubing, stretch tubing.
You just wanna be my anchor, Brad?
- Yes. There, see now, you know, I won't let go.
This is a safety thing.
- All right, so, we're just going,
I can do both at the same time,
you do an external rotation.
- Now, when you're doing these, you'll want to think
about your shoulder blades going back and down.
- Right, exactly.
You're squeezing the shoulder blades together and down.
Put 'em down into your pockets.
- 'Cause you don't want to go back,
and have your shoulders go up towards your ears.
- All right. The last one, Brad,
kind of secure that right there, would you?
I'm gonna go...
Just hold it really low.
- Oh, okay.
- So, we're gonna start down here,
and my thumb is up, and my palm is facing me,
and now it's facing away, that way.
So, I'm starting here, I'm going here.
This works on external rotation, flexion,
a little bit abduction.
So, it's a functional pattern.
- This a D1, is this a D1?
- I think this a D1, isn't it?
- Therapists out there,
give us a little comment, correct us,
if we're we're not right.
- I think this is D2, isn't it?
- The P and F patterns,
I've kind of forgot some of the details I noticed.
Inside information, just forget we said that.
- Very good. And that's the last one.
When you get to that point, you're doing pretty well.
- Excellent work.
- Remember, Brad and I can fix just about anything.
- Yes, we can.
But I'm going to use a red pointer here, here it comes,
except for that broken heart.
- But we're working on it.
- Exactly right. We're not gonna give up either.
We're not that way.
- Thanks.