\♪ Bob and Brad
\♪ The two most famous
\♪ Physical therapists
\♪ On the internet
(Bob clapping)
- Hi folks, I'm Bob Schrupp Physical Therapist.
- Brad Heineck, Physical Therapist.
- Together we are the most famous Physical Therapist's
on the internet.
- In our opinion of course Bob.
- How does my tie look?
- Your tie looks fantastic today Bob.
- Where's your tie?
- Well Bob, this is a fitted shirt.
I don't need a tie with a fitted shirt. (chuckles)
- Apparently not.
He's really proud of that fitted shirt.
Today we're talking about tennis elbow.
First thing you should try to help it heal
faster.
There's a lot of things you can do for it,
we've had videos on it.
But really the number one thing I want you to focus
on to help it heal, is what we're gonna show you today.
- So don't go away, but before more.
- Yeah, if you're already new to our channel
please take a second to subscribe to us.
(both chuckling)
Already new.
If you're new to our channel please take a second
to subscribe to us.
We provide videos on how to stay healthy, fit,
pain free.
We upload every day.
We got some social media channels here,
we got Instagram, Facebook, what is that?
Twitter and we got our website.
- Website.
- You're gonna want to join us 'cause we're
doing a giveaway again.
We're gonna try to do giveaways all year this year.
So right now what we're giving away is
"How to treat your own neck," by
Robin Mckenzie, and we got a cervical
roll, which they go together.
- [Brad] Right.
- So we give away five sets of these.
- Right, this neck book
they work together
both by Robin Mckenzie
is made for the layperson
not for a therapist.
- I would give it my highest recommendation.
- Right, although I've read it and really like it.
- What does that mean?
- Well, it's really a good book.
- Oh, as a professional you read it?
- Right.
- Alright, so Tennis elbow.
Generally what it is you are feeling pain
on the outside of your elbow
it is for a lot of those grip, type of sports
- Right.
- It could be at work to
if you have a job where it involves
trimming the hedges, or something like that.
- Sure, mmhmmm.
- I don't know, what other jobs..
even drilling or something like that.
- Right, and in mechanics you are gripping a lot,
you're working a lot with tin snips
those types of things.
- Ya, cuz the muscles they don't just start..
- the muscles for the hand aren't up in here,
they're actually here in the forearm
and they extend down into the hand,
and start right here on the outside
of the bone, and also on the inside
for golfer's elbow.
- Sure.
- But we are going to talk about
Tennis elbow today.
So if you want to know if you
have Tennis elbow
one way to tell is you feel pain
right here, on the outside.
- Yup.
- I've got my thumb pointing out this way.
It hurts here.
Also, if you hold the wrist up like this
and you pull on it.
- Mmhmmm.
- That generally will set it off.
Also, if you go radial deviation a little bit.
So, you turn your wrist toward the thumb
and push on it that way.
That often fires it up too.
This way doesn't hurt
if I try to pull up.
Or if I go this way
it doesn't hurt.
It doesn't hurt at the elbow either.
- Ya.
- I can do resistance at the elbow.
Straighten, or flex the elbow.
This way, none of this bothers it.
But as soon as you start doing gripping
things it bothers.
- And usually, I Know when I have patients
I go to that bone right there
and just come in from that bone a little bit
and usually will find a tender spot
the size of a quarter
or a penny depending on how severe it is.
And, you know, and Tennis elbow.
Why do they call it Tennis Elbow?
- Cuz with Tennis you're gripping the whole time.
- Right, and I think it's from that backhand.
- The backhand, right.
- That really puts a lot of force on those tissues.
- And you might have some minor tears
in the tissues.
- Yup.
- And that's why what we talk about today
can help.
So, the first thing we're going to do,
the first day, you are going to ice it.
The first couple days you are going to ice.
- Sure.
- And that's not helping it heal
but it's just making it feel better,
and it's not delaying healing.
- Right, and maybe a little bit of
inflammation control
- Right.
- and swellng.
So what you are gonna what to do is you
are actually going to get a pillow.
- Is this for me?
- That's for you.
- Excellent.
- So, let's say I'm going to work on this side here.
What you're gonna do is take the hand
and put the palm facing up like this.
- Okay.
- And now, what you're gonna do is
take your fingers,
you can take your one finger over on top
of the other, or two together,
or even three together.
And you're gonna find that bone
on the outside of the elbow.
- Yup.
- That Brad was talking about.
And you want to start moving towards the hand
a little bit, and you should find
a tender spot.
- Mmmhmmm.
- So.
- If it's not so difficult.
- When you find that tender spot
that's where we're gonna work?
- Yup, that's where we're gonna work.
You're gonna start really digging in deep,
and you're going across the fibers.
- So, the fibers, if you imagine
a line from your elbow to your hand
that's the direction of the muscle fibers
and the tendons, and we're gonna go this direction.
- [Bob] Yup, and you're gonna go across
and you're not just moving the whole thing,
you're getting deep down inside
and rubbing that tendon.
So what are you doing with this Brad?
You're actually getting more blood flow
to the area, hyperemia.
- Sure.
- Which more blood flow helps
- Healing.
- Helps healing.
- Sure.
- More blood, more healing is going to go on.
It also softens any scar tissue there is there.
Quite often what happens, and I think
people can relate to this.
When you have this type of thing,
it'll start to feel better
and you think "oh, that's over"
and then you'll do something
and it fires right back up again.
- Yup, for sure.
- And a lot of times it's because
there's scar tissue in there,
and the scar tissue heals in kind of
an erratic fashion.
- Right.
- By rubbing it, the theory is that
you are kind of realigning those fibers,
making them stronger
so that they'll heal better.
- You break up the mess and then as it
heals and you use it gently,
it lines them up.
- Right.
- Whenever I teach I say,
it lines them up like this
instead of a big mess.
- So you can do this rubbing.
What's nice about this it's easy to do
throughout the day.
Now, Cyriax, who invented this.
The Father of Orthopaedic Medicine,
James Cyriax, he would recommend
you could do this 15 minutes.
- Ya.
- But, I don't know of anybody
that could do this for 15 minutes.
You're other hand is gonna get sore.
- Ya, you'll get, you'll end up with tendonitis
in your other hand.
- Right on the other side.
So I would break it up
throughout the day.
I mean, you could do five minutes here,
five minutes there.
You know, because you are doing it yourself
you can do it, you know, anytime.
- Right.
One morning
and when I work with my patients on this, I'll
have them doing it.
I said actually look at a clock
and see how you can see seconds,
or if it's a digital or analog, whatever.
And after 30 seconds,
because it's going to be a little painful
when you start.
- Ya, when you first start.
- And after 30 seconds,
if that starts to feel better
or kind of a numb-ish feeling,
that's a green light, keep working it
until your fingers get tired.
The ones that are doing the massage.
I just had this with a girl
with tendonitis in her knee,
after 30 seconds it just continued to hurt,
in fact it was actually getting worse.
And what that means is it needed more
time to heal.
- And at that point, I'm so glad you
mentioned this Brad because I had forgotten.
But ya at that point you definitely want to
use ice then again.
- Yup.
- There's a time where you'll tell.
It's like, I've seen it a couple hundred times
- Yup.
- Where people say,
"no it's feeling better, or it feels numb"
or "I don't feel it as much".
Or when I'm doing it even,
I'll even start pushing harder
because they can tolerate it.
- Right. You can do this on any part
of the body.
I remember I had tendonitis in my
Achilles tendon, I was doing it
and it was like "oh".
- I did it on my shoulder at one point
ya, it works a lot of different ways.
You can use the Pure Wave too
If you um wanna have something to do
the work for you.
- Ya.
- They have different um
heads you can put on there.
This is like a soft air-filled.
- Yup, cushion head.
- And this one's actually the pointer.
Now this you couldn't do this over the bone.
- Ya that would be very aggressive.
- And to be honest, it's not even the
worst thing to massage the muscle too, the muscle
belly, because you're going to stretch
that out a little bit then.
You know what I mean?
- Ya.
- I mean, not put as much stress on the bone.
- And if that muscle has tightened up
as a result of the pain, it relaxes it
which also takes stress off that real
tender spot.
- Now I'm going to show you
also one stretch you can do.
- Oh ya.
- Because sometimes what is happening
it can actually be a problem
in the joint itself a little bit too.
- Mmhmmm.
- And so this is almost a self
joint.. I wouldn't say manipulation, but you
are stretching the joint.
So, let's say it's this side,
I'm having pain this side.
I'm going to go ahead, I'm gonna my hand.
The fingers are actually facing towards me.
- [Brad] Yup, like that.
- Yup, and what your gonna do is,
you're gonna take your other hand
and here's the elbow joint.
Right here.
You're gonna take your hand,
actually this way would probably be best
and I'm going to push the bone this way,
as I'm pushing down into the mat
- So below the elbow.
- Yup.
- So you're gonna push it in the
direction of your thumb
if you're looking in reference
to your hand.
- Exactly Brad.
- Mmhmmm.
- So I'm going to push
and I'm gonna go
pressure on, pressure off.
Pressure on, pressure off.
- And should this hurt or feel good?
- It shouldn't hurt to bad,
if it hurts a lot you probably
shouldn't do it.
- Right.
- It should be okay, you know what I mean?
- And this is one of those techniques
where after you're done
it should feel better.
- Right.
- If it doesn't, or if it hurts.
- Ya.
- Any sharp pain while you're doing it,
or if it's worse it's not ready for that.
- Ya, if it hurts during or after it
you probably shouldn't be doing it.
- Right.
- Um, especially after.
If it hurts during it a little bit
but afterwards it feels better,
- Yup.
- There you got the green light again.
- Right, so approach as one with caution
initially and see how it responds.
- Alright, remember Brad and I
can fix just about anything.
- Oh yes.
- In our mind.
(both chuckle)
- Except.
- Except that broken heart Bob.
Fear not, we will continue and relentlessly work.
- We will press forward won't we.
- Say no more.
- Alright.
- Say no more.
- Thanks for watching.