♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Well hi there folks,
I'm Bob Schrupp, physical therapist.
- Hi Brad Heineck, physical therapist.
- And together we're the most famous
physical therapists on the internet.
- In our opinion of course Bob.
- Brad, what are we gonna talk about today?
- Well Bob, today we're gonna talk about shoulder pain.
And is the shoulder pain from cartilage?
And there's two types of -
- Cartilage.
- Shoulder pain, cartilage that it
- Right. - Can be from.
But before we get into the details,
we're gonna cover this, we better get rid
of this thing so we can walk around.
- That's right, so we are giving away
a full mattress again of your size.
You get to pick. - Yes.
- It's a SleepOvation mattress,
it's got 700 tiny mattresses.
- 700?
- [Bob] Yes, this is a sample one.
- [Brad] Oh yes.
- And it's very comfortable.
And it's got air channels, so it's nice and cool.
- I like that.
- Both of us like our individual mattresses
so much we can't do it without it.
- I really do appreciate mine,
and these giveaways are great, we do quite a few of 'em.
- Yeah go to bobandbrand.com
and go to the giveaway section and that's how you sign up.
- There you are.
Okay, hyaline cartilage is one type of cartilage
that can cause shoulder pain.
Now, - So, if I pull your arm off.
- There we go, we got Sam volunteered.
- Right here, this smooth surface
is covered with a thin, like a Teflon.
- Yeah, it's white and it's smooth and slippery.
- And it helps glide the shoulder along
like this and that way.
- And, when you get arthritis in there
that hyaline cartilage, I like to refer to
as like, it gets kind of rusty, it gets rough.
- And flaky. - Flaky, yes.
And then it makes pain, associated pain, with movement.
Now there's another type of cartilage
in there called the labrum,
which we're gonna get to in a little bit.
Typically, if you have arthritis or DJD
the degenerative joint disease,
common symptoms are more general pain,
it's usually with people 50 or older,
associated getting worse as you get older.
Oftentimes. - Your shoulder's wearing out.
- Yeah, I would say, there's no scientific proof
to this, but I think you'll agree.
Any therapist will say, people come in
before a storm or with weather changes
and their arthritic joints,
they say, I could tell it was going to rain today.
- And it's funny, the research does support them.
- Right.
- But, the labrum by the way is a circular piece
of cartilage and we highlighted where it would be
with a black. - Marker, mhmm.
So this black ring, and what that does,
that helps support the ball or the humeral head
where it needs to stay for proper mechanics.
- Yeah, it keeps it stable.
- Right, now that cartilage can actually tear.
And that's called the labrum and that'd be a labral tear.
A real common labral tear is called
a slap lesion or a slap tear.
And that stands for superior labrum, anterior, posterior.
- Right. - In other words,
it thoroughly tears. - In other words,
you don't need to know that.
- No, but it oftentimes tears in the top part,
it can tear in other locations.
- So, a athlete, a pitcher.
- Yes. - You know, someone
that uses the shoulder in a violent manner.
- Right, yeah, or you got aggressive.
Now in my case, and right now I think I may have this.
And I'm a swimmer, I've been swimming
for 20 years regularly.
And there's - - You're probably
wearing it out. - Yeah.
Wearing it out and there's a few tests you can do for this.
Now, oftentimes if you have the hyaline,
or the arthritic cartilage, if you do exercises
for range of motion, in an appropriate manner,
it usually loosens up and starts to feel better.
Now, if it's a labral tear or labral problem,
if you exercise it and it continually gets worse,
then that's an indication that it may be there.
- Right, right. - For like,
in my case, I can swim now, but the longer I swim,
the more it hurts. - Right.
- If I had arthritis and I -
- Generally, you wouldn't feel it,
start to feel maybe probably a little bit better, right?
- Right, as long as you didn't overdo it.
- Right. - Everything is within
range of using common sense of course.
So - - We have us
some tests, right? - I do want to talk about
one other thing. - Oh, sure.
- If you have cartilage problems, arthritis,
in an x-ray, it will typically show up,
particularly if it's been around for a bit.
- The hyaline.
- Yep. - So this surface
will look roughened.
- Yep, and that can be seen in an x-ray.
As it gets, the older it is, the longer
it's been around, the easier it is to see.
Now the labral tear will not show on an x-ray.
You need an MRI for that.
- Exactly.
- So, there are some manual tests
and typically they're done by the professional.
We're gonna show you two of them.
And these you could do at home and assist of one person,
but don't, you know, don't bet a whole paycheck.
If they're both positive that you have a labral tear.
This is something that really, you need the final diagnosis
- Have someone that knows what they're doing
take a look at it. - Exactly.
So, shall we carry on Bob?
- Sure. - All right.
So, the first one is you'll need a partner.
I'm going to stand like this, put my arms out.
This is actually my sore shoulder right now,
so we're doing a real test, real time.
- So you've got the thumbs up or which one?
- We start with the thumbs down, like this.
- And I'm gonna put my hand across both arms.
And I'm gonna push down.
- And I'm gonna hold.
- Now we're looking for a difference
between the two shoulders.
- Right, right.
Now I'm gonna do one, just rotate both palms up.
And then we're gonna compare
and see what the difference is.
Now, if you feel distinct pain in the shoulder joint -
- While I'm pushing down.
- Yep, it's positive, particularly if the thumbs are down
for an injury as more anterior
and posterior if I remember correctly.
Either way, you're gonna feel it.
Now, I personally, it's semi positive.
- Sure. - It's not waking me up.
- More on this side than that side.
- Yes, exactly. - Sure.
- Now, so if that's positive, you just say
well it doesn't mean you have labral tear.
It means that's an indication that you may have one there.
Now the next test, I stand with my feet squared up
on the floor, about shoulder width apart.
Now this arm, the involved arm,
and you should probably do this
on the uninvolved arm first,
just to see how it feels, and then compare.
So I'm gonna go back like I'm gonna throw a baseball.
And I'm going to go back comfortably, so it's not painful.
- And I'd be giving some resistance,
so I'll stop him from moving forward.
- It's gonna be like Bob's hand is a wall.
It is not gonna allow it to move.
With my opposite leg, my right leg,
I'm gonna step forward like I'm going to throw the ball.
Come forward and then I'm gonna push.
And you can feel if you have pain
in the backside of the shoulder,
a sharp pain in the joint area.
- Right.
- Now that too was a kind of a semi-positive.
- Sure. - So, do I have
a labral tear, Bob?
- I don't know.
- But, indications are, there are some other tests
that I've looked into, but I think
you have to have palpatory skills.
You need to be a therapist or a doctor
to get in to feel the biceps, tendon.
- I definitely think you have some labrum involvement.
- Right. - I think
it's not totally fine.
- Right, so we should mention the bicep,
the long head, the bicep, the long head tendon
actually connects to the top side of the labrum.
So if you do have problems with curls,
when we're working below the level of overhead
and you feel some pain,
- Which you do.
- which I do, feel a pain in there.
That's another indication it's labral.
And you know that wouldn't make sense
with arthritis. - One thing
you need to understand about Brad, though,
is that when he does something, he goes all out.
So like, when you swim, - Who?
- I betcha when you swim,
- I'm starting to settle down.
- how long do you swim?
- Well, if I have a healthy shoulder, 45 minutes.
- That's a long time.
I mean, you may have to start -
- Well, what are you gonna do, Bob?
- wrapping down a little bit.
- I know Bob, you know, I'm not gonna do that
until I have a problem, it's a personality issue.
It's common with people like me.
They're out there.
- Head problems, yeah.
- Yeah, so if you do these,
and you want to learn more
about strengthening shoulder exercises,
you're gonna do any exercise that doesn't create pain.
You have to avoid any sharp pain.
We do have a whole list of exercises
if you go to bobandbrad.com, the program section,
click on there, go down, and you'll see
a whole section on shoulders, - Right,
there's one on shoulders, yes.
- Click on there and there's about 30 videos,
plus or minus, on shoulder.
And just look at the titles, pick out the ones
that pertain to you for strengthening.
And you're gonna find a 10 minute video
with a PDF printouts.
- Right, so you can print it out
and you can take it with you
and make sure you're doing the exercises right.
- Right.
- And plus, this is free.
- Absolutely, we don't even ask for an email.
It is completely -
- Right, it's our gift to you.
- Exactly right.
So, good luck with your shoulder.
And I hope you can get back to swimming
if that's your problem.
- Your problem.
- Like mine.
(music fades)