Hi 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,
Brad can you heal your injured rotator cuff? That's the question of the day, and we have that question a lot in our comments
Yeah, I mean it's a good question because it can be a rather severe injury
But you know are we gonna cut right to it Brad? The answer? Yeah,
Well the answer is of course it can heal yeah, we can't guarantee 100% of them are gonna heal
But a lot as a matter of fact
We were just talking beforehand right off the top of our head Bob thought of one person, was he scheduled for surgery? They were if
Therapy didn't work he was going to have surgery and it depends on the grade of the tear too, sometimes
It's just a little hole through the tendon sometimes it's a partial tear
You know if it's a complete tear or rupture where the muscle is actually starting to retract obviously
That's the case where it's not going to heal, but our movement's gonna be almost nil
But we had a woman that she was scheduled and the doctors didn't offer therapy
And she had to ask for therapy, and she ended up having full recovery without surgery, so it's definitely worth the try
And we want to give you some hope, again with Jay
I'm sorry maybe shouldn't say his name, hi Jay
He actually
Really had a great recovery. I mean he's a rock climber so
Anyways there's seven steps, and if you can get through some of those, well there's people first
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Okay, so there's seven steps if you can get through these first seven steps
There's a very good chance you're gonna have a full recovery, okay, so I'm not going from
After the injury to throwing a hardball
But we're doing the most critical
Aspect of it and initially when you have that injury the first thing you need to do if it's in pain
And you got pain going down the arm, and there's some swelling in there is get a cold pack out yeah
There's inflammation so you want to knock that down
You may want to do some ibuprofen if that works well for you
Cold pack and rest just give it a few days to settle down
and then
Once you start feeling a little bit better then
This is probably the first everyone agrees with this is Cadman's or the pendulum exercise
If this is your injured shoulder you're gonna get over and just let gravity
Stretch it out a little bit get it moving forward and backwards you know and you can work right to left
You can work circles
okay, but you're gonna get over because this position here if
I look at it here
I'm actually raising it this high and oftentimes the injured shoulder, it hurts to get that
Elevation that much flexion and motion and actually if you go a little bit further I mean if you get it swinging this high
You're already that high so keeping the motion while it's healing
You want me to show the pillows Brad? Yeah
The next rule is you got those are the first two ice and rest, get it moving with the pendulum exercise
And this kind of all fits in the same time ranges, avoid sleeping on it which can be a real problem
Yeah, so first
I mean ideally you're gonna try to sleep off the shoulder, so let's say I injured this one
I'd rather be sleeping on my good shoulder and
Then you can actually support this one and actually put one by the side and one underneath the arm
You want that shoulder in that loose pack position, it's gonna heal better. It's amazing how much more comfortable
You'll be if this is the injured shoulder and you put a few pillows to
Support that arm and get it in the right position and even if you're laying on your back Brad
You're gonna want to make sure that you have a pillow underneath it to keep it supported, now if you just cannot
For some reason you feel like you have to sleep on that shoulder you've been doing it for a hundred years, right?
I just had a patient like that he
He'd fall asleep do his best and then he'd wake up and shoulder was killing him because he would just
By habit in the middle of his sleep turn over and then the pain would wake him up. Oh yeah exactly
So what we're gonna do
Is we're going to create the canal so you're gonna put a pillow here
Maybe a smaller pillow here you got your head pillow here
You might even have two
And you just go like through this and here's my painful shoulder
And now I'm not laying it on the shoulder and you can even lay back a little bit like this and get off the
point of it
And it's just gonna be a lot more comfortable
You got to allow that shoulder to heal so you got to make sure it's in a position so it can
Yeah, if it's allowed to be in the comfortable position
24/7 versus
Healing and doing the right thing in the day, and then irritating at night by sleeping right on it and grinding it out
That's no good. You know Brad with the Kadman's too do you mind if I mention the Mulligan one?
Probably the back of a chair so
You know after you've been doing the Kadman's for a while and things have calmed down you can also do this one
Just because I want you to make sure that
That we're no longer getting that impingement that might have caused the tear in the first place
So you're gonna find a chair you're gonna push down against the chair
And you're gonna keep pushing down pushing down pushing down and then come back up again
And that's trying to help set that shoulder down in the socket
So that it's not putting as much pressure on the tendon anymore
This one when you do it should feel better as you're doing it. It shouldn't create any sharp pain
Just in case there's something else going on but
You'll know it's the right thing
It's like oh now I can move it it feels better with this and this one along
Once you're doing the Kadman's once you're doing this one,
You can do these every hour, this isn't something you do once a day
I want you to try to do this five to ten times an hour, and then you're gonna see some results
Oh, yeah I meant five to ten reps an hour
Every hour I mean maybe eight to ten times a day or whatever you got time for
So all right next one Brad. Oh by the way, Kadman's it's the same as the pendulum
I know I called it a pendulum before but therapists kind of do that with that particular exercise
Next thing is to start strengthening
Once you get some movement, and we're going to start strengthening and we oftentimes will start with isometrics
You could go up to a wall
And here's the motion, we call them outies or innies and that works the rotator cuff muscles
If you go up to a wall, I'm gonna go out you go up to a wall
You can push there, and there's just an isometric and hold it for about six to eight seconds, and then do the other direction
Here if you happen to have
some tubing
You can do it like this get some strong tubing if you got a
Something to hold it like a wall anchor, and I'm just gonna hold it here
And I'm gonna come over this way and hold it here, with tension on it
That's a good point so
So you step out a little bit even and hold it. Yeah. I'm not gonna just hold it here
With tension and just hold it and that's a real nice way to start because once you get strong enough the very next step is
get some tension off of there and
Start working this exercise and internal rotation probably is going to be the easier one to do to start
So this is the outie one, I'll do it on this arm so that you can see it better
That's a really good idea
To make sure your mechanics are right you take a little towel roll or something of this and you put it right there and
That forces you to have good mechanics
And if that falls down that means your elbow came too far away from your ribs
You don't have to have it as long as you keep your elbow there, and these outies are one of the key
exercises and then we do want to add
Posture, scapular retraction bring in the shoulder blades together, we can show how we're squeezing them together
By the way the thing under the elbow here or the arm, they do that in golf too
Golfers glove. Yep to try and keep your arm
So you don't go flying out like this when you're swinging, sure it's amazing how things all fit together
It's kinda like physics yeah there we go
Now we're gonna go on to the next thing is we need a big ball Bob
So once you get things
We got some the isometrics innies and outies with motion and it starts to feel better that way
Then we want to start getting some strength and movement
If this is my sore shoulder both hands, the good one is going to help
The weak one and if you can do this
And actually come up to here too, it's starting to feel pretty good
Then the next step is to take the strong or the
uninvolved hand away and use the injured arm and see if you can do that and
push by itself
And I have my patients I say roll right up
Don't let your hand, sometimes people think they have to have their hand glued down to the ball
Cuz you can get a lot more motion if he goes way down, now look how high up
He really is, want to stand up, look at that so and the ball's supporting the weight so it takes a lot off and
Once this becomes good, and you're feeling stronger at this point you can start to lift your shoulder up, and it's feeling pretty good
Then you're gonna take the ball and go to the wall so I call it the ball up the wall exercise
He's using both arms to start off with, you're kind of getting active assistive device
Wait Brad, this is a very good suggestion. I have not done this. I am gonna incorporate this
Ball up the wall, there's nothing better, then once both arms work well
Then you take the weak arm the injured one
And then you start to incorporate that and then you can also put a little pressure on the ball and lean onto it
Which causes more co-contraction on the
Joints and really have good posture while you're doing these
Yep, good posture and because you want that shoulder to be supported by its base
And also I don't know what else I was gonna say yeah, that's good
That goes with age Bob, it happens to me all the time so when you get to this point and you can do this one arm
You got to be feeling really good
And we've got some advanced strengthening exercises if you want to be a thrower or something like that
Well if you're up to one arm you're doing pretty good
You're starting to get back to normal, but there are more exercises that are a little more advanced yeah
And we have those, just look it up on Bob and Brad and rotator cuff for throwers is a good one for example
So I want you to be careful Bob about anything that you do and you know if you're not careful have fun
Alright sounds good. Thanks for the advice Brad