- So Brad, the rotator cuff is four muscles
and they're really important for the shoulder.
- Yes they are.
- So we got the Supraspas
- Super. - Supra.
Infraspinatus.
- So one's above, one's below.
Yep. Subscapularis.
- That's on the other side of the scapula.
- And Teres minor.
- Teres minor.
It's not like a miner, like mining for gold.
- Right.
- It's minor, like minor, major league baseball.
- Right.
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So these four muscles have four actions.
One, they bring the arm out.
- Externally rotate. - Right.
They bring the arm in.
- Internally rotate. - Innies, outies.
And they bring the arm up, abduction.
And all four of them work together
to hold the bone in the socket.
This bone, humerus.
Into this glenoid fossa.
- Yep, so you got, it's kind of a ball joint.
Ball and then the fossa's kind of a cup,
but it's a shallow cup and the rotator cuff muscles
are incredibly important
to maintain stability of that joint.
- Yeah, we don't want it to slop around.
- Right, you don't wanna have a-
Look at this.
See how this is slopping around right here?
Without the rotator cup, this is what happens.
- Impingement, right. - Yep.
- Okay, you can use a dumbbell
or you can even use a can of soup.
- Yeah. - Yeah.
- Yeah, so you don't have to buy one.
And that usually is adequate for a lot of people.
- Yeah, these are small muscles.
So small weight. - Right.
- You won't go probably past five pounds.
- Oh, no.
Really, if you got a sore muscle,
you'll probably start at the 12 ounces at the most.
- Right, 12 ounces.
- So lie on your side.
You could do this in bed or on the carpeted floor,
even a hard one if you wanna take that on,
but it's important that your shoulder
is back and not rounded forward.
So we have good posture, elbow on the ribs
or the side of the body, grab here and simply move
the weight up as far as you can and back down.
If you get pain, when you get up here,
don't go that far, just bump into the pain
so it just tickles it a little bit and then go back down.
As it gets stronger and feeling better-
- [Bob] These are the outies.
- Yep, these are the outies.
You're gonna do sets of 10.
You may wanna rest to get it stronger,
maybe do another set of 10.
You'll feel these little muscles start to burn a little bit.
- [Bob] You could probably show the innies on that one.
- Sure, good idea, Bob.
I'm gonna finish my 10.
Okay. - Okay.
- So now the ones that go this way,
we're gonna work that muscle.
The Infraspinatus? No, the Sub-
- Subscapularis
- Yeah, wanna get that right.
You don't have to lay on your elbow,
you can pull it forward a little bit,
but keep your body sideways like this
and you're gonna go up like this.
This one's probably gonna need a little more weight.
- Right. - You'll find it's easier.
- [Bob] Got the pec helping you out and so...
- It's probably not quite as important as this one,
- Right. - In the big picture.
- [Bob] Exactly, I agree.
- But you should do it to be complete and make sure
you cover all the muscles on that rotator cuff.
10 of 'em that way, a little more weight if needed.
And you wanna show up each uppies, Brad?
- Uppies! - Yeah.
- All right, so you can do this seated or standing.
It's critical.
- [Both] Good posture.
- Shoulders back, - Get that scapula,
- Head back. - In the right spot.
- Okay, and we're gonna do this palm down.
Now you're actually gonna go thumb up.
And there's some variance between therapists and some...
- Little controversy.
- Yep, you need to do 'em.
The big thing is that you do 'em, it should not create pain.
So if you start to get up here and it hurts,
we're gonna stop, we're not going that far.
Oftentimes we stop at 90. - 90, right.
- 90 degrees.
There is something- - That's us.
Some people go all the way up.
- Yep, yep, exactly.
We recommend 90 and scaption, we're gonna go out this way.
Sometimes you can go forward. - A little bit forward.
- Yep, a little bit forward.
In the therapy world, we call that a scaption plane
that works a little bit different muscles
and isolates more to the rotator cuff muscles.
10 of 'em, no pain.
Do all three of those and it's a great start.
Okay, so with bands like we have here,
you'll get handles, you'll get usually four or five bands,
they're different colors, different resistances.
And they will give you a door anchor that looks like this
or at least make sure you get one when you order your set,
but I think they all do.
With the door to demonstrate it, you put it in there
and you simply close the door and oh, make sure,
that's a good example of what you wanna make sure,
the door is locked and then you can pull on this
and as long as no one walks through the door, you're safe.
It's gonna work out well.
Now you can do it at this level, you can do it
over the top of the door, and you can slide it
all the way down and do the same thing at the bottom end.
You're gonna find out why that's important
in just a little bit.
So let me just show you what it looks like
once we got it all connected.
Okay, so this is what it's gonna look like.
You have your bands, you put it
through the loop, closing the door.
Obviously I have at the high level.
There'll be some exercises from this level
that you can do and we're gonna go through
and show you how this works at three different levels.
Hold on, we'll be right back.
Okay, the next option is using resistance bands.
This is- - Which we love.
- Yeah, therapists usually do this 'cause it's easy,
- Right. - They're transportable.
The resistance is variable, which is very handy,
particularly with the rotator cuff.
We're gonna use the wall anchor.
You just saw a video on how to use this door anchor,
so you can do the same thing. - Right.
- Works well. This works easier.
I'm gonna go like this, okay?
And here's how the mechanics for the outies,
again, elbows here, good posture.
And we simply go out like this.
Look at my elbow, it does not go out.
- [Bob] Don't wing it.
- Yeah, no good.
This is good.
This is no good.
So we usually have people while standing take a towel roll
or a pillow or something and put it here
and it that falls to the ground,
it means your elbow came too far away.
- Bad. - Yes.
It's gotta stay there, then you know the mechanics are good
and mechanics are critical for rotator cuff.
- Look how Brad is keeping a right angle.
- Yep, right here.
- 90 degree angle.
- Again, this is what I have a lot of patients
come back the second visit and I have to reprimand them
and say bad, bad. - Bad.
- No, I don't.
I'm always nice when we joke about it.
And this is what you want, 10 of them.
Now the cool thing about this
is you can simply turn your body around.
- There you go.
- And do the innies. - You're all set.
- I'm going to show you from here so you can see it,
but the nice thing about the wall anchor
is you can just wrap that around
and then it doesn't slip and slide.
It's very convenient.
So here is my innie.
With the innies, it's not so important to have
the towel roll but you might as well keep it there.
It does help and guarantee good mechanics.
To the stomach and back.
Again, pain free.
I've had a lot of people do 'em this way
and early on in the pain, you know,
in the rehab, it hurts out here.
So I say, just do it the pain-free range.
As it heals, you can go out to normal range of motion.
- How about uppies, Brad?
- Uppies, absolutely.
Uppy duppies.
Did you ever have a guppy?
- No.
- We had guppies when I was a kid.
They're little fish.
- Yeah, they are.
(Brad laughing)
- All right, so simply stand on it.
One foot or both feet and then we can do the abduction.
I usually did thumb up.
- Yep.
- That's the way I was taught at UWL.
and I think it's consistent.
And again, the scaption here, here.
- Again, thumb up.
- Yep and there, you'll see people say thumb down
on this isolate the Supraspinatus.
You'll find out you won't go as high.
Watch the pain if you're doing it that way.
No pain should be- - No impingement.
- Right. - Right.
- So, very good, 10 repetitions of each.
If you want to go up as it gets stronger
go to two or three repetitions of each,
as it gets stronger depending on what-
- Three sets. - Three sets.
What did I say?
- You said repetitions.
- Three repetitions, thank you.
Three sets of 10. - Right.
- Wow.
See, without Bob here, I'd be talking about-
- I can't talk well,
- The man on the moon. - But I help.
- Yeah, absolutely.
It's all working together.
People are checking out now and we're babbling.
- Peace. - So take care.
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