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.
Today we're gonna show you how to stop pain, exercise your pain away science says. It's like Simon Says-Right, you know
yeah, what we have is some really good research here,
that is gonna show you that you can manage your pain through exercise if done appropriately.
And I think we've seen this from many sources and we're gonna mention some today,
but I've seen it beyond that even. It's a commonly
--a commonly accepted concept-Sure. Mhm.-Try to say that three times fast.-There you go. All right, Brad
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Pain. Now this is often times
it can be pain after an injury or a surgery and you're rehabbing to get back into motion,
or it could be chronic pain or like from arthritis or fibromyalgia, things like that that--
Things can happen and you get pain and then you're afraid actually to move
because you can relate that movement to the pain that you experienced before.
And I would say the other thing that can happen. Some people their nerves become hypersensitive
So what their injury is or they maybe don't even have an injury anymore,
but the nerves are overreacting and they're sending a pain signal to your brain,
even though you really are no longer injured-Right.
So that's why it's nice to get this movement going and get the confidence knowing that
hey, I can move it without increased pain.
So the whole thing is education and they've studied this
on numerous times where without using pain meds or exercise, but just
educating the patient or the individual that's trying to manage their pain,
educating them on how the body works and actually
what Bob had mentioned, they mentioned that doesn't work like
if you hurt your hand or you got elbow pain,
the elbow doesn't send a pain message to your body.
It sends information and then your mind translates-interprets it.
Right and with some people
they might interpret it as like that's really not painful and others are gonna say that really hurts!
So what we're trying to do is we're trying to get your mind, the nerve to send you the message like
yeah it's okay. I'm getting moving. I'm getting blood flow to it.
I'm you know, if there is an injury it's starting to heal-and to really get this understood
you know, if you really want to conquer, if you're one of these people with chronic pain,
it really is helpful to read a book on it or even you know
do something more in-depth from what we can do in a few minutes here.
So you want to mention the one book first Brad that we don't have here.
Right it's called "Explain Pain" and that's by Larimer Mosley and David Butler.
So Mosley and Butler are the authors, explain pain,
And Butler's I don't know if you recall Brad. I mean he's been in the therapy world for years
Really one of the experts on pain and it's management.
So I would highly recommend that book.
Right and these are some books that we've used in the past that we've read for reference.
"Paindemic", we recommend this one Melissa Katie.
She's a DO. It's got some excellent advice and she goes into some of the exercises
that you can actually do, with this book and
Adriaan Louw-Yep, he's got a whole series of books on on pain and the hypersensitive nerves and
he does a great job of explaining it-Right some good analogies and diagrams so you can relate to it.
This one's called "Your Fibromyalgia Workbook"
but he's got a whole series of books.- Right right, and they do a nice job of explaining it to the layperson,
so it's easy to understand. You don't have to know some of these long terms.
Probably better than we're doing right now.-Exactly.
Well you're gonna kind of show a series right Brad of things you can start, exercises.
Right so with movement, that's the next stuff they talk about,
exercising like the title says, we get the education then
how do we move and then like how many repetitions or when do we do it?
So that's what I want to get into now.
For example if you have shoulder pain, okay,
and you're unable to lift it up to here because it's painful painful painful,
you need to get over that shock that you know
if it because over the last three weeks before say you had a sling on it,
you knew that it was extremely painful to hear, so you take the sling off and you're just terrified.
You're anxious-Anxious, right, yep, just like oh it's gonna hurt to do that.
So we need to teach the mind that it's gonna be okay.
So one thing that therapy oftentimes uses to get you started is some pulleys.
So we need to start with graded resistance or no resistance in this case
we'll start with no resistance, and then the range of motion needs to be graded.
In other words, you know, I never have a patient with a shoulder problem like that
and say okay start working the pulleys, you know, and I'm not gonna do that because they're just gonna--
they're not gonna walk out the door, they're gonna run out the door-Yeah and they won't come back.
Exactly so if this is a sore shoulder I'll lower that down
I'll say just put your hand in there and just relax it.
Now take your other arm and just gently work it and you're just starting with a few inches of movement.
And that's what I do, I'll start with just small oscillations
and they've got to definitely be told that because most people right away start to try to go the full range.
It's like you might do this for a couple days. I mean, you know-not straight-not straight.
Yeah, so the repetitions we're gonna shoot for 30 of them
and then take a little break and then do another set of 30,
but try and go a little bit higher.
And what I might even do Brad sometimes I might do one set of thirty that the first day
and then say hey see how it responded.
Right-to make sure it doesn't get too sore.- That's a good point.
So you gently introduce movement and then once you started getting confidence and it's like oh, yeah,
that's a little sore but-I can move it. Yeah, it's not so bad-it's not gonna break.
Yeah, and that psychological aspect can really break through things.
That's exactly right. If people feel like, you know, my shoulder my back or whatever is injured, and I can't move it,
but if you don't move it it gets worse-sure, right.
So once you get to the point where oh wow, this isn't so bad.
And you're really then all of a sudden you think well, I need a little more resistance.
I got full range of motion. It doesn't hurt yet. I want to get this arm a little bit stronger, but at the same time,
doing this still hurts. So we do not want to get after it that quickly yet and start lifting weights.
We're gonna use either a cane or we can use like the Booyah Stik that we have.
A little longer stick works better in most cases.
Now I'm just going to start my strong arm. I'm gonna take my weak arm,
you can put it over the top of the stick or just grab on and then we're just gonna gently start working it here,
up and down and as the arm feels stronger, instead of just letting the sore arm go for the ride,
we're actually going to make it work a little, and the other one is just going to help as needed.
Now you can do it this way or when it gets stronger, then you can just go this way,
and that's a little more resistance.-Yeah now that the left arm is not helping the right arm as much.
So and you definitely have to do some lifting with the right arm
So getting this nice progression from getting help
to you know kind of just getting a little bit of help and then getting almost no help.
Right and little things like you can put your hands closer together and
then the strong arm is helping more and as you go wider apart, that weak arm is doing more work.
So little tricks like that, that as therapists will help you out with.
Again, we're still shooting for three sets of thirty, still low repetition or high repetition with low resistance.
And for chronic pain people, that's as far as you're gonna go.
You're not going to start lifting go up to five or six pounds and getting stronger because that's not the goal.
You know if it's after an injury and you want to get back to what you were doing before the injury,
that's where we kind of stop at this video.-And you can do this with pretty much
And you can do this with pretty much every body part, you know even your back,
you can start off with just getting some movement laying on your back.
And if I would start, I want to get some movement in my back, I might just start with the rotations here.
Right getting a little motion going.-Yep getting a little motion,
and if one direction hurts, I won't do that direction and maybe I'll go the other direction
But really small oscillations and then eventually you can work to larger oscillations
where the muscles actually have to work a little bit too by doing this action.
So and then you can move into some other back exercises with a little bit of oscillation and a little strengthening.
So the whole concept is do some movement that can be pain free
low resistance and that repetition, higher repetitions, so very good.
I think you're-Yeah you want to get things moving. That's universal.-Mhm movement education and there you go.
All right. Thanks for watching.