♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists on the Internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We're the real most famous physical therapist
on the internet.
- In our opinion, of course, Bob.
- Can I Heal My Torn Rotator Cuff?
By I we mean you.
- Oh, I thought you were asking me.
- So, we're going to go into the answers for this.
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- Right.
Rotator cuff, shoulder pain,
a lot of people--
- Very common. - Very common.
And this question,
do I need surgery?
- Right. - Right.
Or can it heal with exercises and some treatment?
So we went and did a little research, Bob.
- Right.
- And we found out the answer.
First of all, we do want to clear this up though.
If your rotator cuff is injured,
the vast majority time,
it is one tendon,
the supraspinatus tendon,
vast majority of surgeries happen on that.
And we're going to show you that first,
before we get to the answer.
And at the end, like Bob said,
we're going to show you some exercises.
- I didn't even say that.
But yeah, at the end,
we're gonna show you some exercises.
You do wanna hang around until the end,
because in case you do have a torn rotator cuff,
we're gonna show you ways that might help it.
- Right.
Things that we actually we use with our patients.
So here we look at the shoulder,
they got the humerus
and the scapula - Yeah.
- Or the shoulder blade
and the tendon for that supraspinatus,
it's suppose to like gets impinged.
That causes a whole problem.
We have it pink right here.
We got a little piece of pink Kinesio tape over it.
And the muscle for belly actually back up here, right there.
So, the job of it is to help position
the ball of the humerus in the right spot
so it functions properly.
If it's not functioning properly,
all kinds of problems, it can go wrong.
And that's where it all boils down to.
- And certainly can result in impingement where--
- Oh yeah. - The tendon gets pinged.
I'll go ahead and sacrifice, Brad, go ahead and bring it up.
- Oh yeah, here we go.
- Awh, awh, awh, awh. - Yeah.
- So eventually it wears it down,
and eventually it causes a tear.
- Right.
- So that's why impingement is not to be ignored.
- Exactly.
- You may have...
like you fall down and you couldn't,
you could injure it that way as well.
But oftentimes they come--
- Overuse. - Overuse, exactly.
Sam, out of the way, we've got better things to do with you.
All right. - All right.
So you've got some studies Brad?
- Yeah. Let's have a seat, Bob.
Let's talk about this. I'll get serious.
So these are the studies that I've found.
We're look the--
- Mike, do you want us to tilt this or it's okay?
- We got, it's not blurry. Okay.
Journal of Orthopedic Science, in 2013,
now this was a review of the literature.
So they went through numerous studies--
- Which I always think that it was a great studies. I mean--
- Right. it's nice to do that
cause you're not looking at just one.
I did pick one that they cited,
but there were a number of other ones
that were I found in there.
And they had similar results,
but this is an exact thing,
where they had 105 shoulders, patients with shoulders,
full thickness tears.
They were diagnosed full thickness tears.
- So it went all the way through with tendon.
- You're right.
The ages 44 to 80-year old. - Sure.
- So these weren't young athletic people,
but these were people that had shoulder problems
from overuse typically.
Six months of physical therapy exercises.
- Okay.
- And then they came back 12 years to 48 months
or 12 months, one year to--
- To four months, oh four years. (laughs)
- We sharp here.
- Right. So one year to four years.
- So we're looking over a span of how this,
recovered from the exercises.
If we look at pain level, just pain,
how do they result in pain?
50% of them reported pain free shoulder.
- Wow, wow.
- Which is good.
- Yeah. So 40%?
- And another 40% reported,
only mild pain that did not need pain medication.
- Wow. So 90%.
- Right. With pretty darn good results.
- Right.
- It's better than surgery.
Now function. Could they use it?
And this was subjectively taken.
75% of them stated no daily limitations.
In other words, they could...
Now I'm assuming these people probably weren't,
like drywall hangers, - Right.
- Where they looked overhead all the time,
but they could reach into the cupboard.
They could function a daily basis without problems.
- Sure. - That's pretty strong. Right.
- That's very good. That's very good.
- Let's go on to the next study by Kuhn Et Al in 2010,
this is just one study.
It wasn't the review.
We've had 396,
so it was pretty good-- - A lot of study.
- Full thickness tears once again.
And they had physical therapy treatment,
and six weeks of it.
- Sure.
- Six weeks later, 90% of them reported improvements.
10% did choose to have surgery.
- Got it.
- Okay. Then they went back two years later,
80% of them continued--
- To have improvement. - Right.
They did not have surgery.
Another 10% did elect to have surgery.
So it's still--
- Fairly close between the two studies.
- Right, right.
So a very good sign to say,
you might get some healing going on.
- Right.
You know, and the thing is,
if you decide to take the conservative therapy treatment
and it doesn't work out,
surgery is always an option. - Right.
- And stronger you get the shoulder before surgery,
the better the results are probably going to be afterwards.
- You can talk to your doctor about that too,
to confirm that every case is different.
- Yap, absolutely.
- So now you may be saying, what are the exercises?
We're going to show you a few of them.
There are-- - A lot of them.
- A lot of different exercises
and the therapist varies on the individual patient.
We're going to show you some of the ones
that we really like and have good succession.
- Sure.
- Wow.
- So we're going to start off with one
involving the Booyah Stik, or did you wanna...
- Oh, you wanna start with The Statue of Liberty?
Why, what did you wanna start with that?
- I'm fine with it,
but we've got to get this out of the way quickly.
- All right.
- Quickly, Bob quickly, these people are waiting.
Go, run, Bob.
Man, he works like an old man.
Let's get this out of the away.
- I wanted get out of the way.
- There we go.
All right.
So,
here we go.
Now this one I actually started,
I don't know if I invented it,
but I haven't...
- You invented it?
- But it came from another,
an orthopedic surgeon,
has a book written on rotator cuff treatment.
- And hanging.
- Right. Hanging.
- Dr. Kirsch. - Dr. Kirsch.
- Yeah.
- Yap. He's actually from Wisconsin.
- Yap.
- 30 miles from my hometown is where he lives right now,
but hanging, he has a whole book written on it.
We're going to talk about it a little later.
So this is based off of that treatment.
If you take a pole or a stick...
- Or a broomstick, even would work,
- A broomstick would work.
I've had people use that,
This is the Booyah Stik.
They work really well
because they're easy to grab onto
and you get your arm up about,
the arm can't be really sore.
This has to be where you can actually reach up.
Might be a little painful,
but not too bad.
- Well, you can reach up to start off
just as far as you can and then start moving forward.
- Right. So you can start doing this.
This is not, the true hanging.
- Yeah, you can do it on the floor.
- Range your motion.
And then, you know if he creates sharp pain with this,
it's too early,
it's not ready for you.
You need to heal a little more,
but as you get up taller or
as you can get where you can reach higher
with less pain,
but it's still not functional.
This is gonna create that gap, so that tendon,
does not gonna impinged anymore
And you just lean forward,
but don't let your hands slide down,
keep your hand gripped.
And the Booyah Stik really works well for that.
I've got it stuck on the chair.
So it does not slide.
So you have to have a little rubber cap
on there or something on the surface,
lean forward and stretch
and what I'm doing to distracting that.
And if it, again,
it should be pain free and you're going
to hold it for five to 10 seconds and go off.
- And the thing is, you want to do this throughout the day.
I'd like to see you doing this six to eight times a day.
- Sure.
- And it only takes a few minutes.
- Right.
So, it's something you can certainly throw in there
and you can work your way up.
You start off lower cause your arm only goes that far.
- Right.
- And I mean,
we've had people with arthritis that have done this
and they started way down low.
And by the time they come back,
the next time,
they're really proud. - Cause they're up further.
- They're moving up.
- So good judgment. Don't go too fast again.
It should not create sharp pain
and get it a little sore.
That means you overdid it
and you have to take a break for a few days.
- Sure.
- Next one. - Next thing I'm gonna show
you is based on the same principle, Dr. Kirsch on hanging.
Now you can hang on a pole of bar,
Brad and I wanted to come up with a way
that you could hang at home with a way
that's not that intrusive. - Right.
- So we have the wall anchors.
So we sell a kit that actually has two wall anchors
and two handles.
And the handles,
you got to get the anchors secured into a stud.
- Right.
- You have to put them in right,
- And then we have instructions on that.
- Right.
- I love these because not only do they work my shoulders,
they actually decompress my back too.
- And they help them with your posture.
- Yeah. So what I do is I actually,
take a break like every 20 minutes
or so when I'm working on the computer
and I just hang.
Now I'm tall, but I'm still putting a lot of pressure
on my shoulder
and I'm actually can lift up my feet all day completely.
- Yeah. When I do that,
I just put my legs out in front of me.
Yep. Relax them on the floor.
- Oh, like that.
- Yeah. - Yeah
- You can do it that way.
I prefer this way.
- Sure.
- Whatever works good for you.
I actually do some of these two Brad.
I actually retract my shoulders a little bit
when I'm doing this.
- Oh, sure. Yap.
Just to work on my shoulder retract,
which is good for that rotator cuff.
Yep.
Now again, if you've got to pull a bar at home,
you can use that and that works.
- You can hang on a branch.
I don't hang on anything that works.
If you've got some beams, you can hang.
- Yeah, we do have the book.
It's not a very expensive book by Dr. Kirsch.
- Kirsch.
- I'm sorry.
- So again, what's nice about this.
I have this just right by my office
and I could just walk out and do it.
If it's that convenient,
you're going to do it a lot more.
- Right.
- And it's going to give you more chance
for your shoulder heal.
- You wanted to show these
- Yeah.
Now some other more traditional exercises that,
at least for Bob and I, before we learned these newer ones
is you need a resistance band of some sort.
Again, I'm going to use the wall anchor.
A lot of times you'll see people on videos or therapists,
they'll say wrap it around a door knob,
which is fine.
- Or a bad poster.
- Yap, yap.
This works so nicely cause you can put them on off easily.
And we're going to start out with scapular retraction.
Bob you wanna show the main emphasis.
- Yeah. So what we're doing here is,
strengthening the muscles that hold
the shoulder blade in place,
which is really key.
Cause the shoulder blade has to be
in place for the shoulder to work correctly.
If it's not in place, you're gonna get that impingement.
- Exactly.
- So this'll make sure that you're not gonna
make things worse.
Cause you might have a partial tear.
You might have a full tear,
but you could keep tearing it to the point
where it actually retracts, the muscle retracts
and let's go over the bone.
- Yeah. That's an issue.
- Then surgery is probably gonna be around--
- Next surgery is probably gonna be around the bend for you.
You can also show external rotation.
- Yap. This is a very, very...
This is kind of like the go to exercise
or rotator cuff impingement issues
where you keep the elbow by your side,
move their arm.
- Now this is something that you would not do,
probably right away.
- No.
- This is something you have to be able
to do it pain-free and you gotta be able to do it.
If you have two week to do it,
you can came too early.
And that depends on the band.
And I got a red-band.
You might start with a yellow-band.
Repetitions of these,
you're going to tend to 15 of these
and then go ahead and do 10 to 15 of these.
And that might be enough for the first time
after a week or two, you may go two sets of 10.
And I have my patients go up to three sets of 10
as they get stronger, maybe a few weeks.
- Yeah, these are small muscles.
So we start off with small resistance,
- Right.
- And you don't normally end up hitting
that much resistance on these, obvious.
Cause again, they're small muscles.
Right. And we do have videos
on more exercises for rotator cuff strengthening,
just Google Bob and Brad.
- But gosh, we have videos on everything
only a couple thousand.
- Yeah, only a couple of thousand.
All right.
- Take care.
- Thanks for watching.