(quirky music)
♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- That's in our opinion, Bob.
- Does he agree?
- (laughs)
- All right today, Brad
we're gonna talk about shoulder dislocation.
The big question we're gonna ask today-
answer today is will it happen again?
And, the other second question is, do you need surgery?
- Sure.
- Cause we have a lot of people that are, you know,
make comments to us. They have had a dislocation.
- Right.
And are wondering what they should do.
Now, in this instance we're talking mainly about
anterior dislocations which means,
anterior means forward. - Forward.
- Yep.
- The joint moves this direction.
- That's the dislocation that happens 95% of the time, Brad.
- Sure. - So we're-
and basically what happens,
you got the humorous here
and you take it up into abduction
and then it brings back into the external rotation
and then this bone pops forward.
Okay.
The simple test to tell whether or not
your arm is actually dislocated, Brad?
- Sure.
- Is if I dislocated this one, I can't touch this shoulder.
- Okay. - That's the-
- You can't reach across.
- I can't reach across.
- Okay.
- And most of you I think are gonna know if you dislocated
your shoulder. - Sure.
- But that is the most simple test.
All right. Is it gonna happen again?
- Right.
- The biggest factor that determines that Brad is age.
The younger you are, the more likely
it's gonna happen again.
- Sure. - If you're less than 10,
a hundred percent chance it's gonna happen again.
- Really? - Yeah.
- Okay. - And I think it has something
to do with the stretchiness of the ligaments.
- Yep. - You know, as you get older,
you and I- - (laughs)
- There's no stretch left in our ligaments.
- Sure. Yep, we've tightened up.
- Yep. And so if you're older, you know, like our age
our chance is probably maybe about 20%.
- And I think we're probably less likely if we injured it
we're gonna protect it and not do those activities
that puts a vulnerability.
- Brad is exactly right.
When you're younger, you're more likely to participate
in those high demand contact sports that are gonna
put you more at risk.
So if you're less than 30, the one book I had read,
the chance was about 70% chance, even if you're doing rehab.
- Okay. Sure. - So.
This is something to keep in mind.
Another one I saw, if you're less than 20,
they pretty much recommend you may need surgery
especially if you're gonna do sports.
- Right. And again, this is something the surgeon's
gonna determine, and the therapists gonna put input
but it gives you some idea.
- So let's talk about the factors in which
you're gonna probably need surgery.
One, if you have a positive, what we call apprehensive test.
Apprehension test. - Sure.
- Let's go ahead and do that, Brad.
(wheels scraping)
Now this test can be done laying down or it can be
done seated. We'll do it seated right now, Brad-
- Sure. - Just so they can see it.
Why don't you- I'll do it on you.
- All right.
- We'll pretend we're testing this one right here.
What you do is you take the arm,
you put it at a 90 degree angle.
This is a 90, and the elbow at a 90 degree angle.
And all you're gonna do is bring the arm back like this.
And what you're doing, yeah.
You're looking for one, that he stops me, or two,
you're looking for the expression on his face or he says,
"Hey, hey, it feels like it's gonna go outta place."
- Right.
- So that's the apprehension test.
And I prefer to do it laying down.
- Right, right.
- It's just a little more control.
But if that's positive, he's more likely gonna need surgery
than not. It doesn't mean he's going to.
- Right.
And doesn't mean that if it's not positive
that you may not need surgery.
I mean, it's just, it's more of an indicator.
- It's just an indicator is all.
- Yeah.
If you are younger and you do wanna participate in sports,
it's a good chance you're gonna need to have surgery.
- Sure. Okay.
- If you've had already three episodes
of dislocation in a year?
- Ah.
- It's probably time.
- Those things are stretched out and they're just not
gonna tighten up with strengthening and et cetera.
- Whatever the makeup now is of your shoulder
it's gonna happen. It's just gonna keep happening.
- Right.
- If you have instability during sleep,
and I had a patient that this happened to.
- Sure.
- It went out twice on her during while she was sleeping.
And that started to indicate to her that
it's happening that easy, that means that you need surgery.
If you've had- you got the shoulder Brad?
What happened to it?
- What the shoulder?
- Oh, here it is. (laughs)
- We've lost our shoulder, Bob.
- We lost the arm.
- If you fractured like the greater tuberosity or
if you've got a fracture in the rim
(wheels scraping)
of the shoulder
or you tore this labrum
or you've tore the rotator cuff, or you tore the bicep.
I mean- - Some mechanical-
- Yeah. - Disruption.
- Obviously quite often, then you're gonna have surgery,
which by the way, is what happens to the older people
like us. - Right.
- Usually the rotator cuff tears
because we don't have any flexibility.
So the tendon of the rotator cuff tears.
- Sure. - So
So the thing you wanna take away from this mostly is that
if you're young and you're gonna do sports,
it's more likely gonna happen again.
And you're gonna probably need to have surgery.
- Sure. - So.
And remember Brad, we're not just pretty.
- We're pretty ugly? (laughs)
- That's- we're pretty handy and helpful.
- Handy, yes we are.
- So if you wanna make sure you subscribe to us
cause we're gonna help you out.
- Yeah. Hit the subscribe button.
Do all those things that make digital world happen.
- Yeah. - And we can help you out.
- Thanks a lot for watching. - (laughs)