- Greetings, greetings.
So today I'd like to talk to you about a real life patient
I had, made a big difference
in how I treat and or made a big difference in her life.
She came in with pain right here.
The doctor had x-rays, saw a hairline fracture,
but and you know hairline fractures
gonna take time to get better.
She had gotten better within one to two days,
much better as a matter of fact.
And it all happened as I start assessing her
within the first 15 minutes, I found one thing out,
actually two things that I knew the diagnosis was wrong
and she was gonna get better much quicker.
The x-rays I'm thinking weren't right.
- You questioned the doctor?
- Absolutely. Therapists always questions a doctor
because sometimes they're not right.
They're incredible people, they work very hard,
but there's always things that get by.
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- So Brad, how did you identify
that it wasn't the hairline fracture
and how did you actually fix her?
- Well, that's a good question.
There's three things that brought it all together.
Number one, there was no real obvious mechanism of injury.
In other words, she didn't fall, she didn't have any trauma
to her shoulder, which put a red flag on, number two,
it's not uncommon for the low neck to refer pain
to the shoulder, particularly the back of his shoulder.
And number three, when I had her do a range
of motion technique with her neck,
that's all she moved was her neck going back this way,
it made the pain worse in the shoulder
and the pain started to move towards the center of her neck.
So you call it centralization. That was the key thing.
And that also let me know that this is gonna get
better fast.
It's not gonna take weeks. And so we proceeded.
So yeah, the exercises, we want to get to that.
So let's hold on.
- So Brad, what does centralization mean?
- That's a good point.
Let's talk about that for a little bit.
It actually comes from Robin Mackenzie.
He's a therapist.
He's actually passed away now,
but he started a whole system and
it's actually a worldwide system,
and he actually came up with the phenomena
of centralization and he didn't invent it
but he kind of categorized it and made it universal.
And what it means is
if you have pain in particular in the shoulder,
the central part of the body is considered the spine.
So if the pain centralizes, it moves towards the center.
So in this case, when the head went back of my patient
the pain got worse and she said,
"Oh, it hurts more here in the spine."
That's centralization.
And when that happens, I'm feeling very good
about how to treat it and it's gonna get better quickly.
Now there are some patients that I'll do this
and it doesn't affect the pain at all
and it's like it's not centralizing.
In that case,
I'm going to share with you another trick I do.
I actually go to Rick Alderman, he's another therapist
he's still alive, he's writing books
and he's very good and he has a whole system
on how to test the muscular in the position of the scapula.
Then I go to that, but I'm not gonna go to that.
I have success here and I knew it was gonna go get well.
So let's go to the exercises on how it happened.
Alright, so here is the protocol to get
through this successfully and fast.
First of all, in a seated position, Mike is slouched now
which is part of the problem
and that's why his neck is hurting, his shoulder's hurting.
So we teach him posture.
So Mike, can you scoot your bottom back in the chair
head up and then bring your head over your shoulder.
And now the proper way to do a neck extension
is slightly a chin tuck first and then look back.
There we go. And actually this is true.
I'll tell my patients,
think of your head as like a dump truck
and you're trying to spill all the contents
out to the back of the thing.
'Cause we do want full range of motion,
visualization sometimes helps, come back up.
Now if Mike says,
and this is what my patient said, ow it hurts, it's more
towards the center and it's kind of uncomfortable to do it,
then I'll take a towel and I'll spin it up like this.
And it needs to be about this long.
A really big towel doesn't work
we just need some support low on the neck
while he does the extension, it makes it more comfortable
and it really can be a big benefit,
particularly early in the phase.
Now hold on Mike, I'm gonna,
you can hold either the towel down here or in here.
You're not gonna pull as hard as Mike is pulling.
Mike is ready to rip his neck off.
That's gonna make it worse. Just snug is all.
Okay, now do, and I'm gonna get this down lower.
So the key is, Mike, can you let up on it?
You know he's a weight lifter.
Light for him is like strong, you know,
so there if we can get it down here, that always works good.
Gentle pressure Mike and the chin tuck and back.
Doesn't that feel better with the support?
- It does because I actually have some pain
in my left scapula.
- Oh good. Let's do it some more, back.
Okay, now you're gonna do this 10 times.
Now you're gonna stop if the pain starts getting worse.
If every time you do it,
the pain actually feels a little better,
your range improves a little bit.
And more importantly, if the pain continues to feel
like it's in the center of the neck, that's a green light.
And that's the system I use with patients.
Green light means continue to do it, but stop at 10.
Oops, boy that made a noise, huh, Tanner?
Then also what we're gonna do is not do it once a day
but every hour.
Okay, that's real key.
And of course monitor your posture
while you're sitting all the time.
That's a life-changing postural event.
Did that come out right?
That's, you know what I mean?
All right, now you can
once it gets good with the towel, take your hands,
reach behind your neck
and pretend your fingers are the towel.
So get down as low as you can, Mike.
- I don't have that much shoulder...
- You've got way too much muscle here.
This sometimes works, with Mike, it doesn't work
'cause his hands don't get down.
If you can reach way down here with your fingers
some people can do that and then do that.
Mike is a big weightlifter
and he's just got a lot of bulk.
So, not flexible.
Yep. And so you can use this
you can use a belt actually works well
'cause they're thinner as you get better.
But eventually when you get
to the point where you can go all the way back, no pain,
then you don't have to do it anymore.
And that usually will take
if it on a good day, you know on, a really good situation
one to two days, in this situation it was that fast.
She was so happy.
Her fractured scapula was no longer fractured.
She was living life wonderful again.
And that's all. I saw her twice.
- You're a miracle worker.
- Well it was Robin Mackenzie and it was very simple.
So it's always nice to have a success
in the clinic and I hope that all
of you can carry on with the success here.
Mike, you said you can put a link down below.
- Yeah, so if you are having shoulder pain
and this is not helping,
we do have a video called 95% of shoulder pain
is fixed with these three exercises,
will link down below and it has a lot
of Rick Alderman's protocol and we'll also link his neck
and shoulder program down below.
It's all one part, it's called headaches
'cause it all relates in his system's approach.
- That's right.
So you've got really good odds of having shoulder
and neck pain resolved either this system or going
through Rick Alderman's and oh, there's one important thing.
- What?
- When things are good
you want to maintain that posture all the time
and do chin tucks while you're driving.
You can do chin tucks, eh, I'd do 'em.
People can look at me funny at the stop light.
You can put your finger there like Mike does.
But while you're at work, if you do work at a computer
then chin tucks 10 of them every hour or so become a habit.
It reminds you of posture
and keeps your neck where it needs to be.
Bob and I have talked
about chin tucks for the last 13 years on video.
All right. Good luck with your neck, shoulder
and enjoy your day.
- Goodbye.
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