- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck physical therapist.
- And together we are the most
famous physical therapists on the internet.
- In our opinion, of course Bob.
- Brad that skeleton looks a lot better than you do.
- Well, I'll tell you what.
This skeleton has very good vision
and you know why?
- Why? Why does he have good vision, Brad?
- Take a look close at this, Nate.
We gotta show these people. He's got prescription glasses.
- All right.
- Oh, ha.
- All right, let's get rid of this.
- All right, Brad, we're gonna talk about people
that have had, if you're having pain up in this region here.
- Sure.
- And maybe you could even have pain going up to the neck
and down in the arm.
- Right.
- Maybe some numbness and tingling.
It might be your first rib.
Now we're gonna show you, after we show the treatment,
why it might be the first rib.
I'll give you more explanation.
But right now we're gonna show you how to do
the treatment first. So you jump in.
What you're gonna need is a belt, or you're gonna need
like a rolled sheet, Brad.
- Sure.
- Okay? And this is,
we're gonna say, this is the side of pain.
You take the belt and you're gonna, you're gonna have to
have enough arm mobility that you can reach back behind you.
- Right.
- I'm sorry. That's a necessary evil.
So you're gonna pull down with this one, the back one.
And you're gonna pull down with the forward one.
I'm kind of pulling towards my right knee.
- Yep.
- The opposite knee. Yeah, diagonally here.
- Why don't you stand up so they see
what it looks like on the back?
- Oh, sure.
- So they can see your hand.
And that's why Bob would say you gotta build a
reach behind you and get the force properly on there.
- All right.
And I'm gonna have you do it two ways.
One is you're gonna actually bend your neck this way
and even turn your chin a little bit.
And that puts the sternocleidomastoid on relax.
And you don't need to know all that.
- The muscles on this side are relaxed a little bit.
- So I'm pulling down. I'm gonna pull down for 30 seconds.
I'm gonna take some deep breaths.
- Helps the muscles relax.
- Yep. And while I'm taking deep breaths
I'm pulling even a little harder.
- Pulling down this way.
- Yep.
- You can see his hands and knuckles are getting right.
He got some nice force on there.
- Yeah. Now,
- And this should not hurt, but it should actually
- No
Yeah, should feel good.
You can do that three times, 30 seconds.
The next time you do it,
you can get a little more aggressive.
- Mm hmm.
- So next time you're gonna get the belt in place.
And now this time you're actually gonna pull
down and you're gonna actually bend your neck away.
- It's gonna put those muscles on stretch.
- And same thing.
You can even hold a stretch for 30 seconds if you want.
Or you can just do a a repetition here over the 30 seconds.
But 30 seconds, take a rest.
- Yeah.
- Then do another 30 seconds.
Take a rest and then do a final 30 seconds.
- So Bob, what I wanna know is we're talking
about the first rib.
- Right.
- First of all, what does that have to do?
- I'll show over there.
- Here. We're gonna have to have Nate come over here now.
All right, Nate. Come on over here.
One thing I wanna show is right up here.
Can you come up here? Do you see that?
You got the collarbone, which goes
like this and you got the first rib that goes like this.
So it forms an X like this.
Here's the first rib, collarbone. Coming through that area,
right underneath that collarbone are all these nerves,
arteries, and veins that are coming from the neck.
So they're coming right through there.
If this rib is elevated, and that's usually why
we're trying to push it back down again,
that narrows the space underneath the collarbone
and it's gonna cause you symptoms.
It's gonna cause you pain here
but it's also gonna cause you symptoms down the arm.
- Right.
- All those, the nerves, artery
the vein go down the arm at that location.
So if you irritate it here,
- Yeah, and if you're pressing on an artery what's
gonna happen is you might be feeling like the hand
feels cold and numb.
- Right.
- And just doesn't have the sensation that
- Sure.
- That might be the nerves too.
- Mm hmm.
- That's just gonna,
even changes in color and appearance.
- Right.
- So this is when you wanna try this.
I was just having a little pain up in here.
I tried this and it really helped.
It really feels good.
- And if you can see.
Can you get right in here, Nate?
This first rib is only about as big
as your fingers right here.
And this is in an adult
and we're just getting in and pushing that gap down.
- Yeah.
- And you can see that movement of that rib there.
So that's why we call it first rib mobilization.
- You can actually, you know, someone who's good
at this, can actually feel both ribs and can feel one
that's elevated.
- Sure.
- If you're an expert like me.
All right.
You're gonna need to subscribe to us
if you haven't already done so.
- Right. Have a good day.
- Yeah.