♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the Internet ♪
- Howdy folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the Internet.
- In our opinion, of course, Bob.
- What is causing your shoulder pain?
Arthritis?
How to tell.
So we're gonna go through the symptoms that we believe
and signs, objective signs that may indicate
that you have arthritis.
- Right.
- So pretty common with shoulder arthritis.
Mind if we bring Sam over here?
- Bring him over, Sam, let's see what's going on.
- So you have cartilage that covers the humerus,
the ball here, and you also have some here
and you have basically a little thin piece of cartilage
going around in there, the labrum.
- [Brad] The labrum, yeah.
- [Bob] So this can, over time, it's like Teflon, you know.
And you know how Teflon starts to wear off your pan?
(Brad laughs)
You know what I mean?
- [Brad] You should throw your pan away by then.
- I know, by that time, yeah. (Brad laughs)
It starts to flake and it starts to wear down,
and eventually you get what is called bone on bone.
- [Brad] Yep.
- [Bob] And that's what you see quite often.
Obviously that can hurt.
- And sometimes, talking about it before, you know,
you can hear and feel people that have arthritic joints.
It's, it can be pretty significant.
- Really loud, on some people,
the grinding noise, clicking, cracking.
You can also get arthritis, by the way,
just as a thought here, in the acromioclavicular joint.
That's the clavicle, or the collar bone,
- [Brad] Yup.
- [Bob] where it attaches over here.
And this can give you some pain right in that area, too.
So just to let you know, I guess that's as an aside.
- Yeah. I dislocated that.
And my, the doctor said after this last visit,
he says, "Yeah, you're gonna have arthritis in that joint."
- Have you felt any yet? - Prematurely.
No.
- He is almost sixty.
- It will next year, probably.
Now that I mentioned it.
- It'll start up, yeah.
You can move that out of the way, Brad.
- All right.
- So, with arthritis, you know,
generally you can feel pain in the front,
the side, and maybe even the back a little bit.
- Mm-hm.
- It can refer down the arm a little bit,
but it's certainly not gonna go into your forearm
or hand or fingers, you know.
That would be more of a neck problem or a nerve problem.
- Sure.
- So, you might get, I'd say
you'd see referral down into this area,
possibly with arthritis.
- Yeah.
You may feel more pain when you're pushing
or bearing some weight through the arm.
- Yeah, 'cause you're grinding it, then.
Think about it, you're grinding that joint together.
- Yep, just kind of.
- So one of the habits that I'm into,
which you should try to avoid,
is I lean on one arm when I'm reading the paper
or eating my cereal.
- Sure.
- Or eating.
And you know, you're really leaning on that arm
and it's internally rotated, so that's even worse.
- Yep.
- So you wanna get out of those habits
of leaning onto the arm.
Some people often lay in bed too, you know,
in that propped up position.
- On their stomach?
- Yeah. Should I show?
- Well, it's like when you watch TV when I was a kid.
- That's what I mean.
Some people, I read like this sometimes in the bed.
- Really? - Yup.
- Oh, it gets my neck sore.
- It just, oh, it's good on my back, so.
- Oh, I see, yeah, yeah, yeah.
I can't do that one.
- Yeah, so.
The other thing, if you're lifting a heavy object
and the joint is really, you know, grinding together
to hold the joint in place, you could have pain with that.
Arthritis, it can start to even hurt at rest,
if you've been doing a lot during the day.
- Yeah.
- So.
But one of the telltale signs I think,
is that your shoulder becomes limited in motions.
- Right.
- And the motion that tends to be limited first,
and the worst, is external rotation.
And we're gonna show you how to measure that,
but that's basically turning your arms out like this.
So that, not out like this, elbow in, out like this.
That's the one that tends to be most limited.
Like some people you'll see,
they can't even go out like this at all.
- And this is something you have to actually think about,
because normally people don't do this in their daily life.
- Right.
It's all part of a complex series of motions, probably.
- Right. So we'll show you the way to assess it more.
- The second one that tends to get limited,
not as much as external rotation,
but the second in line, is abduction.
So that's just going up in this direction.
And yeah, you'll see a lot of people
that can't go any higher than this, and.
You know, it's not just a matter
that they're getting pain up here.
Like, they're limited. They hit the wall.
- Sure, yeah.
- It just won't go any further.
And the last one is shoulder internal rotation,
which is basically like this.
- Yep.
- And we'll show you how to measure all three of these
laying down on a flat surface.
- Right.
- So
- It's the best way to assess it accurately.
- So I'll do that.
And you can be like the interpreter.
- Sure.
- Like, you know how they have interpreters that-
- Ideally, you know, if we had a camera,
- A sign language interpreter?
- Yeah, if we had a camera up here looking down,
then you could see it,
but I'll be the camera, explain what it looks like.
- So I have elbows into my side, palms facing each other.
And then I'm just gonna let 'em go out like that.
And you're gonna see, is one tighter than the other?
Is your painful shoulder tighter than the other?
And that might mean
that you have some arthritis in the shoulder.
'Cause it's, the joint has tightened up on you.
The capsule.
- You may have to have someone else look at you,
'cause it's kinda hard to see, but, you know.
The distance from-
- If it's,
really,
is a lot,
I think you're gonna be able to pick it out.
How's it look now?
- You're a little higher on this one,
so the distance from this hand down,
if the bed came out, is a little higher than this one,
but it's pretty close.
- Now this one, you just put your thumbs up,
or you can actually put your palms face up
and just, you're gonna go out to the side like this.
I'm gonna run into the wall here.
- So he's doing kinda like that snow angel,
if you were in the snow.
- Now you can see on this one,
I have more trouble with this one, don't you see that Brad?
- Oh yeah, your right shoulder
is tighter than your left.
- No, my left shoulder.
- Oh, that's right.
(Bob laughs)
My right, your left.
- So definitely trouble that,
and I've had issues with that one.
I've had a muscle that got paralyzed, so.
Last one is,
you're gonna actually put your arms out to a T,
so straight across, palms forward,
and you're just gonna let it rotate forward like that.
- Yep.
- How do I look on this one?
- Pretty even.
From the camera angle, it's a very perfect angle.
You can see it, you know.
Do it so it wouldn't be even, just to make, you know,
so that one's down and this one's up high.
- Sure.
- This would be the tight shoulder.
So, yep. - Yep.
So that'll give you the idea.
With arthritis, we'll be showing you
some things you can do for it, but basically,
you're trying to regain that motion as much as possible.
That's the best thing for it.
Thanks for watching.
- Oh, that's it?
- Yup. (Brad chuckles)
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