♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, Mike Kenitz, physical therapist assistant.
- Brad Heineck, physical therapist.
- And together we're the most famous physical therapy team
on the internet.
- In our opinion of course, Bob,
- I mean, Mike! - Bob?!
- Bob is uh, he got the day off.
Today, we have the opportunity and the pleasure
to have Mike join us
and we're gonna have an excellent presentation
on advanced stroke exercises for the arm, the hand,
and for overhead work.
And this is at-home rehab for the craftsman,
someone who's been very active with their arms and hand,
with tools, this is gonna help them get back to work.
- Yes, before that, make sure to check us out
on all our social media platforms
Facebook, Instagram, TikTok and YouTube.
If you wanna short version of us,
go to Instagram - Oh!
- and Twitter, and go to bobandbrad.com
to find more about our giveaway.
- As well as - Facebook.
- Facebook. - It'll be pinned
at the top of the page.
- There you go, outstanding work.
- This week's giveaway is the Bob and Brad massage gun.
This thing's strong.
(laughter)
- Yeah, it is a nice gun.
I use mine daily on a regular basis.
We really enjoy it.
Otherwise, we wouldn't have put our name on it.
All right, enough of that.
- Okay.
- We're talking about,
now this video, I gotta be honest with you, Mike,
this video is for a friend of mine.
He's a contractor and he's done work on my house,
and he was supposed to do some work
on my house this year. - Yeah?
- Unfortunately, he had a stroke.
- Oh. - So obviously,
we're putting that work on hold.
But he's recovering well,
and so I thought, let's do a video for him as well,
I'm sure there's thousands of other people
who've had a stroke and wanna,
they're at the point where you can walk.
- Yeah. - Without a cane,
fairly stable, but the, and oftentimes the arm,
I think you'll agree with this,
the arm has, comes back a little slower than the leg
- Yep. - and in this case, it is.
So this video would be for you.
It could be a traumatic brain injury,
but the one side that the arm,
you need at least 50% strength.
So you're moving it, but not full strength,
and things are clumsy, yeah?
- Yeah. - Okay.
As well as range of motion, you need to build to get it up,
even if you help with the other hand, work this up there.
If you're about that position,
this would be a good video for you
to get more advanced rehab and exercise.
- And those fine tuning motor skills
your gross motor skills are probably there, usually,
- Right. - at this point,
but your fine tuning finger stuff.
- Right, maybe you can start to write a little bit
make some circles, that kind of thing.
Okay, so first of all,
you can actually start this as a whole program.
It'll take about 15 minutes,
depending on if you want to do things a little more,
and spend more time on it.
One warning though,
when we start to get to using the hand tools,
this is the biggest thing with a therapist,
you start giving someone the leeway and they want to,
instead of, they want to start running
before they walk. - Yeah.
- In other words, get the tools out,
put the jewel in it and go to work
and so that's a big, no, no, this is.
- Start with the drills before the saws.
(laughing)
No saws. - Yes, absolutely.
It's like when someone wants to get to driving.
- Yeah. - It's like, no.
- No, baby steps. - You might be able to do it
but you need to get to point B first,
- Yeah. - or point A, whatever it is.
So do what we do here.
Don't put a drill in and start drilling holes, et cetera.
We're just practicing, getting,
getting all of our safety motor control skills honed down.
Okay, so warm up.
Here we go, this is just something
to warm up in a seated chair.
You're gonna take your hands like this,
try and get out like this.
Yeah, you want to do a profile?
- Sure! - Thank you.
You could stand with this, but I'd prefer sitting.
Why don't you pull the chair over and have a seat
while you do it, Bob? - Ah, okay,
I'll do it that way. - Mike.
- [Mike] Bob?!
- (laughs) Sorry.
- Force of habit, huh? - Boy,
nine years of a habit there.
So, you can do five to 10 of these
but it's important that you pull the shoulders back,
good posture, and breathe in.
(gasping)
Get those lungs expanding,
you're gonna wake yourself up.
- These wake me up.
- Yeah, absolutely, they're wonderful.
They're W's. - That's true.
W is for wind.
W is for Wisconsin
- For Winona?
- (laughs) Oh, there ya go!
Okay, the next one hand, okay?
(clapping)
Yep, you can do this, and extend the fingers,
or you can do it however you'd like,
what I'm doing here or pull the fingers back,
get the hand and the wrist extended.
That's this direction.
Do that about five to 10 repetitions,
and then also, make a full fist.
If you're not, if you're having problems with that
you can take the other hand and stretch it this way.
Simple warm up,
this whole thing should take you about a minute or so, okay.
- Do you want to show the other one?
- Oh, good idea!
(clapping)
Hands together, and up like this, just like Mike's doing.
- So you use your stronger arm to help the weak arm up
if you're having issues with your range of motion, yet.
- Right.
If you're good enough to do it without your hands together
or just touching, or like this,
boy, that's great, go ahead.
Even if your weak one doesn't go quite as far.
If it only, if it doesn't go above 90 degrees,
put 'em together, help it out.
All right, now, I want to start with,
we talked about overhead activity.
Now, again, you're able to walk
- Yep. - without a cane
but probably not out in the yard yet,
- No. - on a flat surface.
So that leaves you, you'd be ready for this.
We need to get that arm up overhead for overhead work.
This is a nice way
- to get into that. - Get this out of the way.
- Mike's gonna demonstrate this for us against a wall.
Now, this works best with a bigger ball
but you can use a smaller ball, too.
Just bare with us
and you'll see what I'm talking about.
- There's a bear? - Bear.
- [Mike] All right.
- Why, why, Mike?
This is like working with Bob. (laughs)
- [Mike] Well, good.
- [Brad] Both hands first.
- [Mike] Oh, both hands first.
- [Brad] So, he's got nice posture.
Good, tall posture.
Now, the strong arm.
Okay, let's say the wrist hand is the weak side.
The right hand is helping.
- [Mike] Probably look more like this.
Your right arm would take over.
- Yep and you're gonna bear some weight into the wall
because that's gonna help the muscles
in the rotator cuff and the shoulder girdle contract.
There, you can squish that ball a little bit,
and then, do that five or 10 times.
And then, once you get it up as high as you can,
yep, you can start right to left at a low level
or at a top, and go right to left
- [Mike] You can even work your way up I guess,
if you're able to do that.
- What happened to that small ball, okay.
- It flew way over there! - Yep!
Now, when that feels comfortable, it's too easy,
then, go to the small ball.
Oh, I take that back.
- Go one hand.
Yep, one hand.
Then, just the week hand and see if you can do that.
- This is my affected side.
I'm just gonna try to go up.
You may be only get to here, that's fine.
Just do what you can, try to go up.
If you get closer to the wall,
you can typically go a little higher.
And your hand doesn't have to remain on the ball.
- If you do not feel steady with this, do not do it,
or have someone hold onto your belt or be here to help.
We don't want to have risk, any risk for falls.
If you're not a hundred percent steady, don't do it.
Or have someone, - Help you with it.
- yeah, an able-bodied person.
Now you can, if you don't have a big ball,
you can use a small ball,
but it's really hard to do two hands.
- [Mike] Yeah, it's kinda a little awkward.
- But you may be at the point
where you can just start with a small ball
and work it up like that.
- [Mike] It also kinda goes more on your forearm
with a small ball.
That's fine, if you wanna go that way.
You can also start doing side to sides.
You can also start doing circles.
- [Brad] Yeah, that's a little,
that's a little more challenging.
- [Mike] It's important to try to keep your arm
as straight as possible.
Try not to have it so flexed in.
- [Brad] Mm-hmm.
- [Mike] It makes you work it more.
- [Brad] Good point.
All right, now, we're gonna go to the fine motor skills.
- Okay. - All right,
you wanna grab your chair, Mike?
- Yep! - Get your claw hammer out,
could be a ball-peen hammer, it doesn't matter.
Get a hammer out 'cause we're gonna use that
for strengthening as well as just getting used to working
with your tools again.
So sit at a chair, at a table,
with your forearm on the table,
and we're gonna start supinating.
- Pronating and supinating.
- There ya go.
- You start in the middle like this
because the lever arm will be shorter,
it'll be easier to do.
You want it harder?
Grab it on the end.
- There ya go. - Just don't clunk yourself
in the leg with it.
- We have it stabilized, the forearm,
on the table because that isolates to the wrist muscles
and the wrist range of motion.
So that's a good thing. - Yeah,
I could start cheating up here
and working my shoulder into it like this.
So keep it on a firm surface of sorts,
whatever works for you.
- [Brad] Good point, Mike.
- And next, we have radial and ulnar deviation.
So that's kinda like hitting a hammer down,
- Yep. - hitting the nail
on the head.
- Very functional.
- And again, you could start more middle,
well, I guess you gotta start so far middle
for the handle to go down.
- And you can start with your smaller hammer.
I don't remember, I'm not a carpenter,
that is a 12 ounce or 16 ounce,
and work up to the larger, you know, you'll know,
'cause if you have different size hammers.
- If you have trouble holding onto the hammer,
maybe start with a really light one
and get your feet out of the way.
- Yeah, you may drop it. - So don't drop it
on your foot. - Right.
- Or start with a rubber mallet, maybe.
- Yeah, and don't do it over a tile floor
'cause if you drop it,
(Mike laughing)
you know what's gonna happen there.
Now, the next thing I want to get
into is a little more finer motor skills
using the drills, the cordless drills,
which are so popular now.
These are mine from home,
but I wanna have a warning caution here.
Is, you may experience some frustration
you may find that you can't hold
onto the hammer or when you start working with the drills,
something that you've done over and over and over,
you don't have to think about it,
now is gonna to take a lot of thought process
and things aren't working,
the hand is not listening to you.
Be cautious, take your time, be patient.
You may have to just stop.
Come back the next day. - Yeah.
- Don't get so mad that you're frustrated with yourself.
These things take time.
- Use both hands to start, Brad'll kinda show.
Use your good hand to help the bad hand out.
Don't just do it all with your good hand
'cause you want to train your weak side
to start working again.
- Exactly, good point.
So I've got my cordless drill and then my impact.
This one weighs more than this one,
plus I have the battery on this one.
Take the lighter one and just start passing it
from one hand to the other, right and left.
You're gonna find that clumsy hand is gonna fumble
around a little bit possibly, but that's okay.
This is all practice.
Back and forth, back and forth.
- That is a different way to do it. (laughs)
- Yep. - I guess,
if you're really clumsy,
you can try this with a little light dumbbell first,
but. - Yeah.
And then, you're gonna work on,
see how high you can lift it.
Now, you already warmed up from the ball up the wall.
You might get up to here.
If you can't get up, take the other hand
and give it a little assistance.
And down, up and down.
And if you're only going this far
and you're not strong enough yet, don't worry about it.
Skip this part.
Also go out to the side.
Typically, this is gonna go better than out to here.
It's just normal.
Most people are much stronger straight in front of you.
Work those, and all these are gonna do five
to 10 repetitions,
- Five to 10 repetitions of,
what do you call these, drill raises?
- Yeah, drill raise.
You know, it's a very functional way
in which people are gonna use these tools.
Okay, now, the next thing is,
can I have that one, Mike? - Sure.
- Is trigger control.
I've put some orange tape on the Chuck.
With the rotation, you can see it visually with the camera,
you don't have to do that at home unless you want to,
but can you turn it on and off at your command?
Very confidently, on, off, on, off,
without stumbling around.
Once you get that, then can you control RPM?
Slow, faster, faster, hold, and then let it off slow.
And you know the importance
of that. - Yeah.
- So work with that until you feel very confident.
And then getting, this is a little bit finer skill.
Can you get the battery in and out?
Yeah, that's a pinch grip and a sliding
and a moving all at once. - Right.
- That's kind of a lot of combinations.
So this is my good hand.
So this is not gonna be a problem
but you still have to control with your weak hand,
if my right hand is the weak one.
If that is easy, switch it around and then do it with your,
involve the weak hand,
and that's gonna be a big difference.
You've got, like Mike said,
- Pinch. - pinch, pull out,
and you might be fumbling with this,
but take your time.
If you drop it, don't worry about it.
Get an old battery. (laughs)
- This would be a good video for all the OTs in the clinic
working with those grumpy old guys that don't want to play
with your toys.
- (laughs) Mike, we're gonna get people mad at us.
- (laughs) Aw, we're just helping them!
- All right, now, as we do this,
this is finer and finer motor skills.
So what we're gonna do,
can I have that one? - Sure.
- You take the impact
that just has the quick disconnect thing.
Take a, the extension, the long one.
If you have a longer one,
it's easier to work with,
and see if you can get that in and out.
Again, you know, you have your own way
to do this from the past.
You're probably gonna have to modify
to make things work with the weak hand.
And that will work in fine motor skills.
This is gonna be a little different.
This is getting more and more difficult,
the finer motor skills that you have.
- Honestly, me doing this with my left hand,
my non-dominant, trying to get these small drill bits
out is kinda hard. (laughs)
Right, and if--
- So, just coordinating that,
for a normal person, isn't easy.
Well, this is a new set,
and they come in and out pretty hard.
So work with that.
Continue to work with this until you feel comfortable.
Again, you're not gonna start using these in practice,
drilling holes, putting in nuts and whatever
until you feel confident and you've mastered all of this.
- You should have someone supervising you
while you're doing this.
- Yeah, we need to be safe because, again,
people always like to get into the run mode
before you can walk.
So be careful, be safe, and don't overdo it.
Good luck with your rehab.
And Chris, we're gonna see you soon.
- See you soon.
He will, I don't know Chris.
(laughing)
(upbeat tone)