♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet. ♪
- Hi folks.
I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- Again, we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Best three steps system to stop shoulder pain
for people who are doing overhead activities
or throwing, you know, especially
if you're one of those guys, a sheet rocker.
- Right.
- You're working overhead or a mechanic.
- Exactly.
- But also, like you said, a person that
you said you have a friend that yeah.
- Actually got a patient.
She takes a ball or her towel roll
and she's got a dog, they love to play,
and if you've got a retriever, that's what they love to do.
- Yeah constant.
- And you can throw and throw and throw
and they'll never get tired.
- They never get tired of it, do they, no.
- But her shoulder did.
- Sure.
- So that's she came in for was a shoulder problem.
- Shoulder gave out before the dog gave out.
- Exactly so this is for Roseanne.
I wanna make sure you watch this and anybody else
in a similar situation with shoulder problems.
There's certain rotator cuff strengthening protocol
that we're gonna show you.
Three steps to get you from working with your hands
in this level to overhead.
And if you work these levels, it's gonna help you
for that high level person who's really throwing
and you'll see how it relates to throwing so precisely.
- I see some people walking in with shoulder injuries, Brad.
- Oh yeah, a whole bunch of 'em.
- Welcome to our channel.
By the way, if you are new to our channel,
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- Oh, yeah.
- You're gonna like that.
So, all right, Brad, let's go ahead and get started.
- Always the pun on words, Bob.
- Yeah, that's right, it's lots of fun.
- One thing you're gonna do now,
if you just injured your shoulders, very sore.
You may not be ready for this yet.
This is after it's starting to improve.
You're starting to get some movement.
You may be able to lift it up about this high
and the first thing, and this is kind of a gold standard,
wouldn't you say, for most therapists
is the innies and the outies.
- Sure.
Do you wanna do a pendulum before that, maybe?
- Good, good point, Bob.
- And the Mulligan maybe.
- Yep, sure, so.
- Yeah, you show that.
- The pendulum one is when it is tired or sore
and you feel like you need to hold it like this,
or, you know you're rubbing it a little bit
is the pendulum is where you just lean over like this
and you let that arm swing back and forth
and just let the arm be completely relaxed.
Okay, and you go forward and backwards, right to left.
You can do some circles and typically I have my patients
do that for about 30 seconds.
And by then they had enough, you know.
You're not gonna do it for 10 minutes for sure.
- Sure.
- Or anything like that.
- All right.
The next one, we've showed this many times too
because a lot of often when you're getting pain
when you're going overhead,
a lot of times it's an impingement.
- Right.
- The tendon's actually getting pinched
and to help set the head of the shoulder down in,
what you do is you go ahead
and put your hand on a countertop.
This one works out well for me, 'cause I'm really tall.
- Right.
- But if you're shorter, you, I know a countertop
is gonna probably be plenty of height.
- If you're less than six foot, you'll be fine.
- Less than six foot six.
So what you're gonna do is, and we, again,
we show this many times, keep the arm straight
and you're gonna push down through the arm through.
If this wasn't here, I'd be pushing down like this.
- Right.
- I'm pushing the whole time.
And that's help setting that shoulder down in there.
And I walk back up again
and you can do a good three to five of these.
- Right.
- And you can do these every hour if you want.
- And you'll only do 'em is when you do it
it feels comfortable.
- Yeah, if this is causing pain, you don't do it.
- Right.
- If you can only go this far, just go this far.
If you can go all the way down like this,
go all the way down like that.
- Right, right.
- So.
- Yep and as that gets better,
you'll notice this will start to get better.
- Right.
- But then we really want to get that rotator cuff
and get that ball set in there with other activities
when we start to do the lifting and overhead activities.
- And as you were saying, Brad, external rotation
or what you call em these are outies and these are innies.
External rotation, that is the gold standard.
Like we usually start with the most people.
- Yeah typically a therapist will have you go like this
and do manual muscle tests.
And those external rotation muscles are the ones
that are oftentimes very weak.
So what works really good.
You can use weights for this
but actually I think a stretch band of some sort.
- [Bob] Attached to the wall.
This is where you're really gonna need to,
I think you, it's hard to get by without that.
- It works well.
So phase number, when we talked to three steps
this is the first step.
Once you get things moving with some of those tips
we just showed you is you're going to hook the band up,
you know, to the door somewhere in your house
or wherever you have the space to do it.
And you're gonna start with the outies.
So, if my left shoulders the ones.
- [Bob] Could you use your towel, Brad?
- Yep.
- [Bob] Okay.
- We're gonna do this.
But one thing's important
is that your elbow stays the right distance from your ribs.
So you take a towel roll like this,
put it there and you can start the exercise.
And if the tall falls out, you know your elbow went too far
away from your body.
So, keep that trapped in there.
Don't do this
or this.
- He's keeping the arm at a right angle.
- Right.
- [Bob] 90 degrees.
- Yep and I usually have people start out with 10
and if you're doing 'em like this,
like I can already feel that muscle.
I have no injury.
- [Bob] Yeah.
- It's working.
I do feel it.
- These are small muscles.
Yeah, don't think you need to have a lot of weight
or a lot of resistance.
- Right.
- [Bob] Because they are not big muscles.
And even on a big guy.
- Exactly.
- [Bob] You can get by with maybe a couple bands.
- Sure and you do 10 to 15 of these.
And then alls you do is turn around
and you get the opposite muscle group in this direction.
I'm gonna show you this way so you can see what I'm doing
on the other arm.
- [Bob] You're switching arms.
- You're just pulling in, but the exact same mechanics,
just the opposite resistance into the stomach.
One little hint.
And this happens a lot with people early on
in the recovery phase they can get out to about to here.
And then over here they get sharp pain.
- [Bob] Sure.
- So you're gonna work it in the pain free range.
As it improves, that range will typically improve
and get back to normal.
- [Bob] Yep.
- So three sets of 10 here or 10 here.
You're gonna turn this way.
Do a 10 here, that equals one set.
Do three sets of 10 of those.
When that gets pretty easy, then you go to phase two,
which is instead of the elbow with the towel roll,
elbow out to 45 degrees right there.
- Right so it's halfway between, this is zero,
this is 90, you're halfway in between.
- Right, exactly.
And then at this point, we can't go sideways
to where the post is, where the anchoring post is.
You face where it's anchored into, out to a 40,
and then you do your.
- [Bob] 45.
- Yep, 45.
What did I say?
- [Bob] 40.
- 40, yeah, 42, 42 degrees, anyways.
Halfway in between you do 10 that way.
And then it's the same concept, 10 this way.
- [Bob] And again needs to be pain free,
needs to be, you know, if this hurts, you can't do it.
- Right.
- [Bob] If you can only do external rotation
and internal rotation hurts.
- Right.
- [Bob] Just do that.
I'm just, I'm trying to tell you, find what you're able
to do and do it.
- Right.
- [Bob] And what you can't do.
- You might start out one set of 10
and you do the second set of 10 and it starts to hurt.
And it's like, oh, it's had enough, well stop
at one set of 10 and over time, over the next week or so,
it will progress.
When you get to the point where you can do 10 here, 10 here,
and you do three sets of 10, it's feeling stronger.
You find yourself getting farther away
with a stretch band increase in resistance.
Then you go to the grand finale.
- [Bob] The final one, yeah.
- Yep.
The way I like to work this,
and this is where we're gonna go at 90 degrees.
So, up here at 90, elbow's not moving.
Elbows stay stationary, just like all the other ones.
And then we're gonna go down this way
and I'm just gonna switch hands so that you can see it
in the camera and then pull up this way.
So, it's not this.
We're not doing that.
You have to be specific.
If Bob were to put his finger right there at my olecranon
or my elbow.
- Yep, I'm not moving it all
and he's spinning right on that axis.
And you know this, as you can see,
looks like he's throwing now.
I mean, now it's starting to simulate the actual motion.
- Exactly Bob, so this would be the wind up.
Okay and then when you turn around and do it this way,
I mean, you can clearly see this exact same motion
is throwing, except for we're not gonna let the.
- And if you're a real serious thrower,
you might even start from way back here, you know?
- Right.
I don't have that kinda range of motion.
- Right and pull the full range.
- Exactly.
One other thing I did wanna mention, Bob
was I was showing all of these, oh, I got this table here
for a reason.
When you get to the 90 degree,
instead of starting in a standing position,
get at a table and I'm using this here
so the camera can see it.
But if you sit down at a chair with a table
so you can rest your elbow
and then you do the exercise.
- Oh sure.
- And it takes the gravity off
and it's a good way to initiate.
- It's a good starting point, isn't it?
- Yeah, for this 90 degree,
'cause it's quite a bit of difference from here to that 45,
a lot more stress on the elbow.
You're gonna work that and you don't have to do,
I was doing 'em fast before.
Actually, you may want to start out slow
with good range of motion all the way down, all the way up.
Don't do these little things like this.
- As time goes on, Brad, too, if this gets to be too easy,
you could get a heavier thickness of band.
- Yep.
- Right, I mean you could,
'cause this is a fairly easy one to do.
- Right.
- You get up to the black colors or the gray,
usually those are thicker
and they're a lot more difficult to do.
- Yeah, or, you know, you can easily double these up.
- Some of those you can, yeah.
Some of they have clips.
You can double 'em up and it's not even a problem, so.
- And I'm gonna show this direction.
No, I've got a tight shoulder.
This is about as far as my shoulder wants to go.
But you know, if you're a thrower or you're flexible.
- Generally you're gonna have a lot more motion.
- Or you're 20 years old.
- Yeah, so.
- Yep.
Okay.
- All right, remember, Brad and I can fix
just about anything.
- Except for.
- A broken heart.
- But we're working on it, Bob.
Watch this Bob.
I'm gonna show you something.
Don't do the that.
- Don't do that at home.
- That's dangerous.
- Thanks for watching.