♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Howdy folks, I'm Bob Schrupp, Physical Therapist.
Brad, stick with me here.
- Brad Heineck, Physical Therapist.
- Together, we are the most famous
Physical Therapists on the internet.
- Well, Bob, in our own opinion, of course.
- Today, we're gonna explain the shoulder
and we're doing it by really bad drawings.
- Yeah, but Bob, it's your shoulder.
I was wondering why you're messing up your clothing.
- Yeah, so we're gonna explain to you
what we feel when we palpate along on a patient.
I suppose they don't know what palpate is.
- Yeah, so when the therapist or doctor
is pushing into your arm and your shoulder
with their fingers,
they're feeling for certain landmarks, tissues,
things that are either abnormal or normal
and where there's painful areas.
- And what is this here for?
- Well, Bob, once again,
we have a wonderful giveaway of these beautiful,
- [Both] Sleep Ovation mattresses.
- 700 tiny mattresses, I counted all of them.
And there's springs behind there, airflow.
They are extremely comfortable and,
- They're really made for if you have pain.
I think, I mean, they're always comfortable.
- Right.
- No matter what, but if you have pain,
this is really gonna to help you.
- They support my back like no other mattress,
and I can sincerely say that I'm grateful.
- And that's just a small sample by the way,
the one you get will be regular size.
- Yeah, they should make them like that for dogs.
- Yeah, you keep saying that.
Okay, all right.
So we drew on my shoulder.
Brad, do you wanna come on this side?
- Oh, yes, yes.
- And Brad's gonna help point out 'cause I can't see.
- Get underneath him.
Oops, I found your mic piece here.
There we go.
It's all right.
Yeah, this is a beautiful drawing here.
- Yes, it really is.
Okay, let's start off, Brad.
You know, usually the first thing that I look for
is the clavicle or the collar bone.
- Sure.
- Because it's easy to find
and it kind of leads you to the other ones.
- So this is outlined in blue right here.
And it's pretty easy.
Anyone can feel the clavicle bone.
It gets kind of tough when you get up in here
when it transfers back into the acromion.
- Right.
- And that's a joint, Ac joint.
- That's AC joint.
It's awfully painful in weightlifters.
So, I will push on the joint to see if I have any,
I think Brad's wife has trouble, right?
- Yeah, she has hers separated.
- Right.
- I separated mine. It's a common one to separate.
If you don't break your clavicle when you fall,
you're gonna separate that one.
- This bone actually pops up a bit.
- Yes.
- So you can also push along here.
I found it broken on some people.
- Yup.
Bites a little bit.
And usually I'll push a little bit harder in here,
and we get over in here and right there,
I can feel the AC acromioclavicular joint.
- Right around here.
I'm pointing right, the humeral head.
- Get your hand out of there, Bob.
- Show them.
- Bob drew this humeral head.
I think it's a little bigger than it actually is
but Bob says no, but yeah.
Anyways, the humeral head
is right underneath all this muscle.
There's large deltoids, Bob has.
- So it hooks up with the glenoid fossa.
- That's deep.
Yeah, that's deep underneath in there.
- But it's part of the upper arm, basically.
- Right, it's that ball and socket joint of the shoulder.
- The most important area, Brad, I think,
is the area underneath the acromion.
- Yeah, can you turn sideways a little bit?
- Sure.
- Now this blue area right here,
if you push on it, it's skin and then there's bone
and that's the acromion which is
the end of the scapula or the shoulder blade.
And that's important because that's part of the joint
and the supra, oh, let's pull this up.
- Yeah, if you could show the supraspinatus.
- The supraspinatus muscle is here.
There we go.
The supraspinatus in black, here, dark brown.
You can see it goes underneath the tendon.
Here's the tendon, here's the muscle belly.
The tendon goes underneath this acromion bone,
then it comes out again and connects to that humeral head.
But that is probably the most commonly
injured rotator cuff muscle.
- 'Cause it gets pinched under the acromion.
- The impingement Syndrome.
- So, if it doesn't pinch under the acromion,
there's other things that can get pinched under there.
The bursitis.
- Yup, the bursae.
- Can get pinched.
Can you show the coracoid acromion ligaments?
- Sure.
So there's a bone right here.
There's little blue on here and that's a little bit deeper
and that bone stops here, but there's this kind of a
colored purpleish color thing.
That's a ligament that connects the coracoid
to the acromion and that is.
- It can also pinch stuff.
- Yup, yup.
Actually, when they do a surgery on that,
they'll actually cut that and get it right out of there
because they say it's not even really necessary.
- I didn't know that.
- Yeah, I just learned that on my
continue Med surgery class.
- So when we're pushing, you're pushing around,
you wanna see if it's tender under the acromion
or under the ligament.
- Yup.
- And that means something's being pinched, very common.
It's like 60 to 80% of the shoulder problems
that are from that.
- And typically, when you go up like this
is when that impingement happens on that tendon
or the bursae.
- So we will show you two exercises to help you.
If your stuff is getting pinched in there.
If it's your bursae, your tendon.
- Yes.
- If it's getting pinched in there,
we're gonna show you what to try.
- Right.
- Just so the bone gets pushed back in place
and doesn't pinch.
- What about these other anatomical structures?
- These muscles often get stretched out
if you have poor posture.
- So, there's a bone right here,
right underneath that is the
infraspinatus.
- Right.
- This is the supra above the spine of the scapula,
the infraspinatus below.
That muscle also is part of the,
it's one of the rotator cuff muscles
that connects to the humeral head.
- All three of these muscles are.
- And then this orange one right here,
that's another part of the rotator cuff.
It is the teres minor.
It makes your arm externally rotate, smaller muscle.
And then, let's look at your bicep
before we carry onto to the exercises.
- Sure.
- Look at this massive bicep you have there.
The lines here represent muscle fibers.
That was my idea.
And then they go up to the tendon.
There's two tendons to the bicep,
that's why it's a bicep two,
two muscles, two tendons up here.
But we're only gonna show one
because that one is the most commonly injured.
- That's one that gets pitched.
- Yup. It goes up into here
and actually connects up to the.
- Labrum.
- The labrum which is part of the
glenoid fossa, the ball and socket.
And actually, I have a problem with that right now.
I might get mine injected next week.
- Right.
- I'm not sure yet.
So anyways.
- You're very familiar with it.
So I'm sure that was clear as mud.
- Yeah.
- But either way,
if you push,
under the acromion.
- Just right in here.
- You'll find that,
so if you follow the clavicle and right at the end
and then push down a little bit,
go down a little bit.
- I'm gonna go right over, right there.
- Sure.
- That's where I usually
and there's a tender spot if you have that tendonitis
because that's oftentimes where it gets pinched
and that's where it connects to that humerus.
- Then you're gonna try one of these exercises.
- Yeah.
- So, the first one, if you got a broom stick
or a booyah stick, what you're gonna do,
Brad and I kind of discovered this by accident
and we found out it seems to work.
- Oh, we're doing the,
- Amazing.
- Oh, not the statue Liberty.
- No.
- Okay, good.
Well, it started from McKenzie's,
- Right.
- Stretch for the shoulder.
- And we just added a little twist to it.
- Exactly.
Bob really discovered this.
- So Brad called it chicken wing
because that's a wrestling move, right?
- That's a reminded me of in high school,
about 10 years ago.
- So I'm trying to, we're actually,
now this you won't do if you have
a shoulder replacement,
- Right.
- And you won't do if you have osteoporosis
and you shouldn't do it if you have loose ligaments.
- Hyper mobile, you have double jointed.
- So first,
I'm gonna probably just go up,
move the stick up the shoulder like this.
- So this arm is just doing the work.
- Yeah.
- This one is getting the stretch.
And you're not gonna do this
if it creates sharp pain.
Should be a stretch.
- This should feel better, yeah.
- Yeah, just a stretch.
- And then, this palm is out, this palm is in
and then, I'm gonna go ahead and leverage it.
But I'm not hitting my head,
So you leverage it forward
and that's gonna stretch it out like this.
- Over here, yeah.
And again, you're not gonna do these
if they create pain.
If it does, you can just bump in to the pain a little bit
and then go back down and day after day,
you should stretch it a little bit more.
If it gets worse the next day,
it means it's not the right stretch or it's too early.
- I've had success with this.
I mean, it helped myself, it helped my wife.
It helped you for a while.
- Yeah, but mine's a complicated story, as usual.
- Yeah.
- But if you have problems reaching behind your back,
to like maybe get your wallet out or tuck your shirt in,
- If this side goes way up.
- Yup.
- And this side only goes up to mid back,
you could probably do the stretch
and you're gonna find out it helps the end.
- Yup.
And you probably have a little pain with the tight shoulder.
- Right, right.
- As a combination.
- Exactly.
It's usually a combination.
So you wanna show the strengthening
of the external rotators Brad?
- Oh yes, yes.
Let's get up a band here.
And we were considering, oh, here we go.
So you need a two band,
you can use any kind of stretch band that you want.
You need to anchor it.
We use the wall anchor, it works very well.
And then I'll show you, let's do this.
There we go.
- I was gonna say, yeah.
- So, I'm going to go this way.
This is a very common rotator cuff strengthening exercises
or exercise.
Elbow, stays close to the ribs.
If we go out like that,
you wanna get that towel?
- Yeah.
- We'll show you a little trick that
we use all the time with patients.
So we assure you get the mechanics proper.
So you do 10 of these.
If it creates pain, ouch, then you don't do it.
Oh, there we go.
You can just take any towel,
roll up, put it there.
I'm doing this, this is correct.
If I go down like this, it's no good.
If I go out like this.
- He's maintaining that right angle.
- Yup.
- The entire time.
- If the towel falls down like it did,
that means my elbow was too far away.
Typically, I'll have a patient do this
and when they come in the next visit,
they'd understand the mechanics
and you don't have to put the towel in there every time.
'Cause once you're good, you're good.
- If it keeps dropping, you put some soap in here
and you beat him like this.
- Why Bob?
Why?
He's digressing into childhood again.
That's what happens when you get over 60.
Do we go to the next one?
- No, that's it.
- Oh, I thought we were gonna show.
- I showed the,
- Actually, if you want more rotator cuff,
- That's what happens when you get over 60.
Brad's not over 60 yet, but.
- Yeah, but I'm a little early.
- Yeah.
- If you do wanna get exercises
and complete program for your shoulder pain,
we have a programs on it, don't it?
On our website?
- Yes, yes we do.
- Go to Bob and Brad website.
You'll see a programs tab, click on that,
and you're gonna see a program for,
- Shoulder pain.
- Shoulders.
It's gonna be about 15 to 20 separate videos
and they have a PDF printout.
So you click on that and it gives you,
- What's it cost Brad?
- Zero.
- You get a PDF print of all the exercises.
- Let me tell you.
- My mic?
- I'll tell you, you would pay a lot of money for these.
I mean, there are people out there charging
for these programs.
- Right.
- And they're charging several hundred dollars.
- I think, do they call them programs?
That's ours.
- I don't know.
- Yeah, we got to get that word out.
People need to know programs.
Is that still on?
Or am I popping in?
Maybe I got low batteries.
Yeah, goodbye.
We don't have to about this in.
(playful music)