♪ 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 we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- This is a remake.
We're gonna update this one.
This is tennis elbow, absolute best self treatment,
exercises and stretches.
- That's right.
- We did this one, how long ago, Brad?
Quite a while, I imagine. - Yeah, this was
about three, four years ago at least.
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You gonna bring the sign out, Brad?
- I just thought of something. (laughs)
Yeah, I'm going to.
- Go to the give away section
and we're always giving something away.
This week we're giving away
a Thermotex infrared heating pad.
This thing is awesome.
If you got chronic pain
or even if you even just have regular pain.
- Let's hold it upright there. - There we go.
So this type of infrared heat goes a lot deeper
than regular heat, 10 times deeper.
And you'll notice a difference, it get into the joints.
So you can also find it on BobandBrad Facebook.
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version of our program.
Alright Brad, what do you think of it?
Now you probably already forgot it.
- Well, I wanted to show the muscle
that causes tennis elbow pain on Sam.
- Oh sure.
- And I don't have him prepared
so we're gonna have to go without it
- That's alright.
- It is, it's not a big deal at all.
But we do wanna talk about tennis elbow.
It's really called lateral epicondylitis
in the medical terms.
Which all it means is you get a sore elbow,
as a matter of fact, this elbow, as I speak, has it.
I am feeling that bone right there,
if you get to that elbow bone right there,
that's your lateral epicondyle.
It's painful.
I have a real mild case right now.
- You've had full blown cases, haven't you?
- Oh yeah, I can push on there now, it's tender.
But if it's a full blown case, you go like that, ow.
And if you bump it walking through a doorway
or something, it really makes you--
I said bad words once.
- And you don't play tennis, do you Brad?
- No. (laughs)
- It really quite often is a gripping type
of problem, like if you are doing repeated--
like if you're trimming the bushes
and you're using the clippers, that would do it.
Just anything repetitive can bring it on.
- In my case, I was out in the garage doing some work on,
it's a long story, but I was doing work
on one of those tools,
which I don't do on a regular basis anymore.
- Tools and the vibrating component
of tools can make it worse.
- So anyways, it's that repetitive motion.
So the first thing you do if it is really sore,
get yourself a cold pack.
And put that cold pack on there.
It's nice if you can wrap it on
or you can hold it with your other hand,
but you really should
keep it on there for about 15 - 20 minutes.
Get a way to put it on there or hold it on there
with like ACE wrap or something of that nature.
You can also, which I did not bring,
we did this on the other video is a ice cup.
Where you fill up a Dixie cup,
a paper or styrofoam cup 3/4 full,
put it in the freezer overnight.
It comes out frozen, naturally,
and then you rip the edges off of it
and then you put direct ice right on there
for five minutes and that will be more
than adequate to get that inflammation down.
- Yeah, it's a lot faster.
If you're in a hurry you can use the frozen cup.
- It's a little messy cause ice melts
so get a towel to catch the drips.
Next one is what I'm wearing right here.
This is made by Aircast
but there's a number of different manufacturers
that make a forearm brace.
And this has a bladder in it,
that's why I do like this one.
But, the other ones
I've had success with too with patients.
Now, if it's right there
where you're gonna feel the pain,
you don't put it over the top of that painful spot,
it's typically just below it.
And it's over the meaty part of the muscle
and the idea is that when you tighten down on it,
like I'm gonna do here,
it spreads out the force so the force isn't going
into the injured area,
it spreads it out into the healthy tissues
and it's not so painful.
Typically what I do with this,
and I've had patients do,
is a lot of the times,
I found that when you use it and you bend your elbow,
if you're bending your elbow a lot,
it gets a little uncomfortable
cause it gets kinda caught on the crux of your elbow.
That's a little bit of a problem if you're doing that.
But when I'm using it or when I have my patients working,
then they'll tighten it up
and then when they're not working that hand,
loosen it up so you don't have a tourniquet on all day long.
- Yeah, that's good technique.
We should say what the reason,
the muscles actually attach here,
but they go all the way down into the wrist and hand.
So there's a whole muscle wad here
as they kinda refer to it
and these are the muscles
that are affecting the tennis elbow.
- Right, they're pulling on it and we're gonna have a--
- I mean you can see like when I grip like this,
do you see how they're working?
- Oh Bob, you've been working out, haven't ya?
- I don't know, do they show up?
- Oh yeah! - Okay. (laughs)
- I'm just saying it was, anyways,
we're gonna show treatment that we're gonna involve
that muscle, Billy, you just referred to.
But the next one, and this one has been a really
successful one with a lot of people,
not only our patients,
but we get a lot of comments on the cross friction massage.
- Cross friction massage, very helpful.
- You wanna go over that one Bob?
You did a good job with that.
- Sure, we're gonna go ahead and grab a pillow here,
cause I think one you wanna get your arm
in a comfortable position.
But you're gonna go ahead and you can take a couple fingers
or you could put one finger over the top of another finger,
- [Brad] Sometimes, I take three.
- Three fingers, yep. What we're looking for,
you're kinda finding the tender spot.
It doesn't hurt to actually work the entire muscle too
to be honest with ya.
But you find the tender spot
and you're gonna go across it
and you're gonna rub across it fairly aggressively.
You wanna go in as much as you can tolerate, in fact.
I'm not lightly just pushing the surface around here,
I'm getting deep down into the muscle and tendon
and rubbing against it.
What this does,
the theory is that as it starts to heal,
it's forming scar tissue.
And scar tissue is real erratic,
it can form like a spiderweb.
- Good description.
- So what you wanna do is rub over it
so that it heals stronger
and the fibers get more aligned.
That's what they're saying in theory.
I don't know what's happening in real life.
- All we know is we have good success with this.
- We know that it knocks the pain down,
it gets more blood flow to the area,
helps it heal quicker.
This is something you can do throughout the day,
because a lot of the times they recommend
that you could do like up to 15 minutes
and nobody's gonna be able to do this for 15 minutes.
- I usually go, myself or my patients,
go until your fingers get tired and that's good.
- Right and then a couple hours later,
you can try it again if you have time.
- You really know if it's doing well
is after you do it for after about 30 seconds,
if it starts to feel better or it feels numbish,
that's a really positive sign
that you're gonna have success with that treatment.
- That's a good point, Brad.
I failed to bring that up.
If you are rubbing it and it just gets worse and worse,
no, you're not ready for it,
go back to the ice
for a while. - Yeah, give it a break.
But if you can rub it and it starts to feel better,
that's a really good sign,
that means that you're gonna wanna continue to do it.
- The next one, Bob.
The door jam or the corner,
this is a mobilization that Mulligan came up with.
- The idea here is that the problem might not be
so much in the muscle,
it might be almost in the joint itself.
So, one thing you can do is you can go up to--
I had a golfer that had really good luck with this.
She actually used it for medial epicondylitis.
But what you can do is go up to the--
I've got the elbow beyond the corner here.
I'm not into the corner with the elbow.
The elbow is just situated beyond the corner.
So I'ma take the crook of my hand here,
between the thumb and my first finger.
Our first finger, what we call it, right?
The pointer. - The pointer.
And I'm gonna go ahead and push it in this direction.
And while I'm doing that, I'm gonna squeeze.
- [Brad] Like you're squeezing a tennis ball?
- Now, if this feels better, you keep doing it,
if it feels worse, then you're gonna go ahead and stop,
and you just don't do it.
It has to feel better while you're doing it.
- So palm is up.
And you open and close ten times or so.
- And I'm pushing, you can go one,
you can count to ten or keep a continuous pressure
on there while you're doing this.
I prefer this method, to be honest with you,
just applying continuous pressure.
- The next one, this is an interesting stretch.
If this is the elbow that's sore,
you go like this, grab your wrist,
and we call this supination,
but you're gonna bring your palm in this way
so it faces away from ya,
all the way up and stretch,
and just pressure on, pressure off,
and you can go both directions.
Try it the other way as well.
If it really irritates it in one direction,
you're gonna go the other direction.
And do that ten times.
- Eventually, you wanna get back
to that other direction though,
because the theory is that
maybe you're arm is not able to tolerate
going to the end range here,
so you wanna increase that end range if possible.
- So we get the full range of motion.
- If it doesn't wanna go this way,
work this way for a while, like Brad was saying,
but eventually, try to go back to that again.
Really important stretch to do.
I think that one can really save a lot of people, Brad,
if they go ahead and include that in their routine.
- Yep, I agree.
- I don't know that you have to do
all of these by any means.
I would do the ones that seem to be successful
for ya and stick with those.
- We're just gonna finish up with some strengthening, Bob.
When its feeling better and its not so tender
and you got normal or near normal range of motion,
you wanna work those muscles and strengthen them.
You can use a band like I have here,
with the handle--
this chair's a little high darn it,
I've got to get something different.
- Well, I can show them right here
when I'm going like this,
you were gonna mention this one right?
Just using a hand weight.
I'm gonna go ahead and work on it this way,
working on extension and again
you can see this is working the muscles.
I don't know if you can see that or not.
It's working the muscles there, the extensors.
- Oh yeah, it is very defined Bob.
I wish I had Popeye forearms like that.
- No, you got good forearms there, Brad.
- Oh thanks, Bob.
- (laughs) We're having a love fest here.
- Usually, ten repetitions of these are all you need,
if you can do like three sets of ten,
by that time you're getting strong enough
to get back out and play tennis again or whatever.
- Yeah, you don't wanna get things fired up here,
you wanna just gradually increase the strength of it
so that the tendon can respond to it
and get thickened
and be less likely to get hurt again.
- Right, you bet.
There you go.
That pretty much wraps it up in a nutshell.
- Alright, Brad and I can fix just about anything
- Except for
- A broken heart
- But we're gonna work on it, aren't we, Bob?
- I hope you finally start working on it, Brad.