♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ on the internet. ♪
- Hi, I'm Bob Schrupp, physical therapist
- And I'm Brad Heineck physical therapist.
- Together, we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- You got a painful shoulder?
- Oh, Bob.
- All right. For those of you who may have been diagnosed
with a specific tendonitis, supraspinatus tendonitis,
which is the one of the probably more common
- Right.
- Tendonitis, you also can get bicep tendonitis
up here, bicipital,
but we're gonna show you the top three treatments
or exercises for this problem.
- Sure.
- All right. The first part,
which we think really helps a lot
is it's a technique by Cyriax, which you're actually
gonna do a cross fiber friction massage.
- Okay.
- It's a lot of a mouthful,
- Yep.
- But it's really just a really focal massage.
You're really massaging a really small area.
- Right.
- And the way to find the spot is you're
actually gonna put your hand
your elbow at a 90 degree angle.
- Right here.
- This is the painful shoulder, by the way.
- Right. So if you look at it from the back side
it looks like this
- And this exposes that tendon really well.
- Sure.
- So, and then you can lean back
against something which makes it a lot more comfortable.
And now you're gonna find,
you're gonna rub around here.
You try to hit kind of, if you find a tender spot
what I'd like to see is actually find the tender spot
and go a little bit lower than that.
And then you're generally gonna be right on it.
- Now the tendon comes
in this way and this is a cross friction.
So you're gonna go more horizontal.
- Right. You're going across this way. It helps to
put like one finger on top of the other.
- Yeah. I actually triple mine up sometimes like this
Bob does this, whatever.
You'll you'll know it works for you.
- Yeah. And you're, I'm pushing hard.
And what you're looking for is that
as you do this massage after maybe 30 seconds
or so it starts to get a little bit better.
- Right.
- If you do this and it just gets worse and worse and worse
it's too soon to do this. - Right
- You may wanna ice for a while.
- One thing I wanna bring up with the pain pattern
of this particular injury is often time it refers down
and people say it hurts here.
- Right.
- But the source is up here and that's very
- Deceiving
- it can make it confusing.
- And that's a good point Brad. 'Cuz sometimes it's actually
can go quite far down.
- Right, when it's severe.
- But the problem is up here generally.
- Right.
- Pain tends to refer down or distal.
And the other point about this, Brad is that this massage
what it's doing is breaking up scar tissue.
And as long as that scar tissue is there
every time you start using the arm, it's like, ah it hurts.
You know, it just doesn't go away.
And sometimes just by breaking
up that scar tissue and allowing it to heal stronger,
it's gonna be less painful.
So you can do this,
Cyriax used to say 15 minutes, twice a week.
- Right.
- Which I don't think anybody can do this
for 15 minutes, Brad.
- You gonna wear your fingers out.
- So, I generally, I would do it maybe every other
day for five minutes or something like that
break it up more and do it more often
- And that's assuming you get good results
- getting good results. - feeling better.
- I'll start off kind of soft usually.
And then I'll work harder and harder as, as it tolerates it.
And if it tolerates, I'm not just moving skin either.
I'm going deep down into the tissue.
- Right. Yeah. You can see if everything
is moving there. Again after 30 seconds
if it's not feeling better or kind of a numb-ish feeling
Stop.
- Right. - It's not ready for it.
- And then the other two treatments, Bob.
- Okay. These are two exercises
basically one you're gonna wanna do,
we're gonna start to make sure
this isn't gonna happen again.
- Right.
- So, we're gonna try to get the bone in place
so it's not pinching on that tendon.
So, one you wanna do is shoulder squeezes.
You wanna turn around Brad?
- You bet.
- It's very common exercise for shoulders.
Next, he's squeezing his shoulder blades together.
We even talked about together
and trying to put 'EM down in your pockets.
- [Brad] Yeah. Not this.
- [Bob] Not that.
- [Brad] Right. Okay.
And do about 10 of those?
- [Bob] 10 of those. The thing, what's nice
about those you can do 'EM throughout the day.
- [Brad] Right. Exactly.
- [Bob] And I'd like to see you doing 'EM
throughout the day.
- Yep every couple hours you could.
- [Bob] Yep. Every, if you're at a computer
you could do it every 20 minutes.
- Right, if that, for some reason makes,
gives that a sharp pain.
It's not ready for it.
But usually that's not the case.
- Yeah it's usually not the case. Right.
- And then the final one?
- The final one, Brad, is we were gonna use that table.
- Oh sure.
- This is another one to try to help set the shoulder
down in there so it doesn't pinch.
So, you're gonna find a counter or a tabletop.
And this would be the painful shoulder,
but this is the painful shoulder now.
So, what you're gonna do is push down
and if the table wasn't here
I'd be pushing down just like that.
So, I'm pushing down the whole time.
I'm pushing down, I'm walking away.
- Right.
- And that's really setting that shoulder down.
so it's giving a lot of room
for that tendon to move and not be pinched.
- Sure.
- So you can do a good, you know
five of these, 10 of these.
- As long as it gives you,
as long as it feels better to do this, if you do this
and it starts hurting, getting sharp pain stop.
- Right. I'm pushing down the whole time.
I'm still pushing down. I'm pushing down. I'm pushing down.
- Yeah. And you'll know because it's gonna feel like,
oh wow, I can do it with noticeably less pain.
- I'd probably go ahead and do 10 times,
and you can do that throughout the day too.
- Right.
- There's not really anything wrong
with doing it too many, you know, too many times.
- Right. As long as you get the positive response
of decreased pain, more motion.
- So remember we can fix just about anything.
We can fix your shoulder, but we can't fix?
- Well right down close to it,
that heart Bob. we're still working on it.
- Yeah, here it is right here.
And I can do it animation wise, but I just can't do it.
- Bob, you're getting better at this.
- All right. Thank you, Brad.