♪ 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.
- Today we're gonna go over one critical step to cure
shoulder tendonitis, bursitis, impingement, all of them!
One thing.
- Well it's a, it's a common denominator
and you gotta get this
before everything else comes along with it.
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- There ya go!
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- There ya go, Bob.
Okay, let's carry on!
What's the number on critical thing?
First we need to do a little bit of education
on body mechanics with the shoulder.
Sam is gonna be our helper, and here we go.
Let's look at this once, Bob. - Sure.
I got a different pointer.
We usually use a pen,
but we're gonna use a Phillips screwdriver today.
If you look at the shoulder, the impingement part,
which is very common throughout all three of these,
but it happens right here with the acromion
and the humeral head.
If you look at this pink; is this pink?
- Yeah that's pink.
- Purple? This represents the tendon that is,
80% of the time, involved with--
- The supraspinatus tendon.
- Yep. So when you lift you arm up,
look at it, it gets pinched in there
if the rotator cuff is not working properly.
It needs--
- Or if this one critical factor is affected.
- There ya go, Bob.
So what is that critical factor that pinches,
and maybe some of the other tissues in there, too,
the capsule, the bursa, which is right there.
- Cause bursitis, tendonitis, and tears eventually.
- Exactly right.
So, there we do that.
Now because this is a model,
it doesn't allow us to show the whole movement,
so I'm gonna show it myself.
So what happens
that irritates us consistently is,
simply, posture.
- Yeah.
- Poor posture.
It allows the mechanics not to function properly,
and here's a good example.
If I stand and I slouch
and I lift my shoulder up as high as I can.
- This is it.
This won't go any further.
- And I'm, you know, I'm probably to, maybe,
100 degrees flexion or so, if you could measure that,
but if I stand up, open my shoulder blades up,
lift the chest out, good posture, all of a sudden--
- Look at that now.
- You know 170, 180 degrees is very free, very open,
and that's what we need to do, is focus on that.
- So poor posture, it's pinching.
- Right.
- Normal, good posture, it's no longer pinching.
- Right.
- There's room for the tendon,
so we gotta show you things
that are gonna improve your posture
so that there won't be any of that pinching going on,
and it won't go into that deterioration.
- Now, don't get us wrong,
this isn't the only thing we do for these.
There's other exercises,
but the exercises you do to help that rotator cuff
have to have good posture - Posture first.
While you're doing them.
- Yes, all right.
- Okay, so, one thing you can do.
We're gonna start from seated, standing,
as well as laying in the bed,
'cause there's posture in your bed we must address.
- Sure.
- All of these.
So if you take a ball, it's a squishy one,
about a six or eight inch diameter ball,
you know, if you got some children at home,
take it from them, or maybe the neighbor's got one.
- Yeah, just make them--
- You could go by one, I suppose--
- Yeah, a big ball store.
- There-- (laughter)
That's the box store.
- Oh box store, yeah.
- And you put the ball between your shoulder blades
in a firm chair like this,
and then you simply arch back, and it stretches--
- Yeah, look at how this opens everything up.
It externally rotates the shoulders,
it's stretching the pectoralis major and minor,
it's leaving room in there for that shoulder to work.
So it's just a great stretch to do,
and what's nice about the ball,
you can move it up and down that back
so you can get different areas.
It's great for the back, too, the mid-back, especially.
- So you do this throughout the day
about five to ten repetitions, you know,
up to five times a day, or more if you'd like to.
You can't really, hard to overdo it.
The next thing you can do, if you don't have one,
you can do it without the ball,
Bob's doing the W stretch.
- Yup.
Like that, squeezing things together.
You can bring the arms up and, you know,
Bob's, I like it, calls his padded alleluia stretch here,
brings your hands back like this.
And you can do it that way as well.
So, the next thing, standing,
you wanna look at your posture.
- By the way, with this one, you're not only stretching,
you're also strengthening. - Oh, sure.
You're strengthening the muscles, you know--
- Right there.
- Along the shoulder blades.
All right, next one.
- Standing. If you have a standing job,
or you're, you can do this, you do this while your walking,
don't you, your, you bring your hands behind your back--
- I do it right when I start walking, I stretch out,
I go all like this.
I grab one arm first, I stretch, then I grab the other arm.
- Oh, so you're going hand to wrist.
- Yeah.
- Now if you're got tight shoulders like me, I can't reach.
So what you can do is, you can use a towel
or if you happen to have a stick,
we got the Booyah Stik, I'll demonstrate with--
- Yeah if you win the Booyah Stik, there ya go.
- There ya go, and this,
and I like this because I can move my hands out or in,
depending on the stretch.
You can work back and forth a little bit.
- The same thing with this again,
you can strengthen those muscles while you're doing this.
It's stretching and strengthening at the same time.
- There ya go.
And we really need to address sleeping posture.
If you're a side sleeper,
it can really take that shoulder pain--
- Put a big toll on your shoulder.
- Yeah, but it doesn't matter if it's bursitis,
impingement, or tendonitis, this is gonna irritate ya.
- So number one, we're gonna recommend, highly recommend,
you don't sleep on the painful shoulder.
- Right.
- If you have to, you just have to--
- Because--
- Maybe they're both painful.
- Right, or you've been sleeping on your right side
for your whole life and it's hard to change.
- We've done mentioned this many times,
you gotta create the canal.
So my wife, as much as she's having shoulder problems,
and she thought this was the canal for some reason.
- She didn't have the other pillow.
- No, no, and I went, in the middle of the night,
I went and got her one, she goes, oh wow, that really helps.
So, you're gonna have the two pillows here,
you're gonna lay on your side,
and look at this, now I'm taking pressure here, and here,
on a throw pillow-- - Right.
and not as much on the shoulder.
It really does decrease the shoulder stress.
Now ideally, what I'd rather have you do
is sleep on the opposite side.
Let's say this is the painful shoulder,
and what I'd rather have you do is sleep on the side
and support that shoulder. - With pillows.
Yeah, so this is painful shoulder--
- Right there.
- If you go like this, it's still kinda,
see how its turned in, Brad?
- Yeah.
- It's internally rotated,
it's not comfortable.
Ideally what you wanna do is put one here
and put another one right there,
and it really is supported.
- Right.
- It makes a big difference to have two pillows
versus no pillows or one pillow.
- Now if you don't have the pillows,
why don't you lay down, if you just have one pillow,
and you're not gonna go through that type of effort,
simply rotate your shoulders, there ya go.
- Is this the painful one, you mean?
- Right, if that's, and then you're
off of that shoulder joint,
and it just kind of a way to modify--
- Yeah, you're off the point of the shoulder.
- Exactly.
- The other point is, let's say this the bad shoulder,
you don't have pillows,
you just rest it all the way along your body.
- Right.
- Yeah, I've done that before, Brad.
- Sure.
- All right.
- You actually can stick your hand down your pants--
- Bob!
- It just stays, just stays in place then.
- Not everyone wears their pants to bed, Bob.
Let's go on.
We've got bonus here. - Okay.
We're gonna show some exercises
that are quite simple and we've had really good luck
with these with our patients over the last few years.
You do need to have,
we're using a Booyah Stik 'cause it really works well,
or you just need a stick
that's five foot long, approximately.
A bigger diameter helps lots and the ends,
you know, a little rubber thing like this works well,
or something that doesn't slip or poke or jam.
So the first one, you show the first one, Bob.
- Well the first one,
you can do it a number of different ways,
but it works well to have a chair,
and you're gonna grab as high as you can--
As far as the shoulder'll take you.
If you have trouble, just creep your way up the,
up the pole and while you're in this position,
you're gonna lean forward, and I'm putting a great stretch,
and getting some distraction at the shoulder.
- Right.
- And it's creating some space.
You know, over time, if you do this enough times,
it's creating a little more subacromial space.
- You can do it even on a--
- High up.
- On a cupboard like this.
Now one thing, if you're shoulder's really sore,
and you can't get your arm up, it's just painful,
it's way too early, you know.
- Well, you could start down here.
You can start lower.
- Right, but you may not be able to get that stretch.
I'm just saying, where, wherever you start,
if it's really painful
because it's just a really bad shoulder,
you might have to put a cold pack on it
and give it a few days of...
- It's just interesting though,
I've had people that could only bring their arm up this far,
and I've had them start right here.
- Oh really?
- And go like this.
It's the progression, you've mentioned this, Brad.
You came up with this.
- Right.
- The progression, you just work your way up.
To tell you how much I believe in this,
I just got my, both of my neighbors a Booyah Stik.
- Oh you did?
- For this issue.
- Oh, no kidding.
- But I wanna mention, too, Brad,
people complain about how expensive these are.
They are expensive.
The problem is it costs, you know, Brad and I,
it costs $15 to mail these to some location.
- Yeah, they're expensive.
- Plus, Amazon charges a huge amount to store it.
Brad and I, after it's all said and done, we make $6.
Not $6 each.
$3 apiece.
- So we can buy a beer each.
- Yeah, well, let's get down to the exercises now.
- Well I just want to mention--
- I know, Bob.
- I feel like people think we're overcharging them.
- I know.
It is good that we get that out of the, out of there.
What about the Mulligan technique?
- The, well, I think this is kind of
like the Mulligan technique.
I'd skip that one, Brad.
- Okay, we'll skip that one.
- We'll go to the Statue of Liberty.
- Yes, the Statue of Liberty.
- All right, you want me to show it?
- What was the Statue of Liberty?
- Oh no, the chicken wing.
- The chicken wing, okay.
- So we're gonna stretch, I'm stretching this one.
- Do the other one, it's a lot easier to see.
- So I'm gonna stretch this one.
- So this is the shoulder that has the problem.
- This one right here.
I got the lower hand, that palm's facing out.
The upper hand, the palm is facing forward.
- Yeah.
- Okay. In this position, I'm gonna,
and one thing I just showed my neighbor lady this,
this is what she wanted to do. She wanted to go like this.
- Yeah, the bowing.
- No, what you're doing is you're just moving the arm.
You keep your back in this, you know,
in good posture.
It took me a long time for her to get ahold of this.
I understand this, so I, I can see.
- Well, it's natural for us, Bob.
- Yeah, she just wants to go like this,
and that still would work, to some extent.
- Turn, turn around once so we can see.
All the way around once, yeah.
So this is the shoulder.
Now this is probably when the shoulder's feeling,
if it's really sore, it may not able to do this,
but as it improves, kind of toward the end of it.
- Yeah, for some people this might even just be enough.
Just grabbing on below here and working it up like this.
- Yeah.
- Working up into internal rotation.
- Yeah. Now this one, if you don't have the stick,
you can take, like I have a towel roll--
- And pull up like that, or a belt.
- Yeah.
- But you go up and then you could go out like this,
and I, the reason I'm such an advocate of this one, Brad,
is because I, this is the one that really helped me.
And it helped me fast.
You know, I, you do pressure on, you do like 10 repetitions,
do it a couple times a day.
I mean it, my pain was fairly severe, and it took it away.
It just knocked it right out and, you know,
when it works for you, then you become a great advocate,
disciple of it.
All right, so that brings us to the end, right, Brad?
- I would say, Bob, good posh, good luck on your posture,
and get those shoulders feeling better.