♪ Bob and Brad ♪
♪ The two most famous ♪
♪ physical therapists ♪
♪ on the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
(Brad coughs)
- In our opinion, of course, Bob.
- Boom! Cracked ribs.
We're gonna talk about the best treatment for success.
And yeah, I know people were looking at Brad here
and they're thinking that he was trying
to slim up a little bit.
Wearing a girdle, but that's not what he has in mind here.
- Right. Exactly.
Although, I did think about that last week.
Anyways, cracked wibs--
We have not done a video on this yet, Bob.
And it's time that we do it
because there's some information that is a little misleading
and things have changed
in the last few years. - Also, you just had a friend
that cracked his ribs.
So, we're trying to put together a video for him.
- Yeah, exactly.
Fell off of a ladder as a matter of fact.
He's...
Early sixties, good healthy early sixties.
But you just don't bounce back
like he used to. - Right.
- Even if you're a healthy sixties.
Sorry guys. - Well, I think
you first started off by saying cracked wibs.
- Well, that's it's-- - Like bugs bunny.
- We gotta get that speech therapist.
- By the way, we got a couple new subscribers, Brad.
If you wanna go ahead and take a second to subscribe to us.
We have a subscription button on the other side
of Brad or down here.
We provide videos on how to stay healthy, fit, pain free.
And we upload every day.
- Excellent, Bob.
- Alright, Brad, what are we gonna first talk about?
- Well, cracked ribs--
Let's look at Leopold, whatever--
- Napoleon. - Napoleon. Sorry.
But we're looking at the ribs
and you can see on here,
the ribs, if you look at the color of the ribs here--
Is that coming in Lonnie?
They're clear and then they look like bone here
and that's because between the sternum and the ribs,
there's a cartilage area right in here.
- Yeah, this isn't really bone.
- Right.
- It's really tough fibrous material.
- And that's there because when you breathe,
your ribs have to expand and contract,
or get smaller as you breathe in and out.
- Don't they kinda come up like this?
- Sure, yep.
And that's the thing with ribs.
There's not only ribs to be cracked
or there's cartilage that could be ripped or torn,
but there's muscles - Yeah.
- in-between. - The intercostal muscles.
- And it's quite a network.
There's muscles going different directions
and they're in there so that when you exhale,
they all contract and they push that rib cage together
so you can talk, breath, laugh, et cetera.
All the things that-- - Very complex movement.
- Exactly.
To understand that makes it so clear why,
when you crack those ribs,
you want to avoid laughing (laughs).
You know, that kind of thing. - So you shouldn't watch us.
(both laugh)
- So anyways, that's the function of the ribs.
Plus, they protect your heart,
your lungs. - Organs.
- Yep, exactly.
- He's got a little rib problem right there.
- Oh yeah.
We'll take care of that later.
- So, this device?
Is this good or bad, Brad?
- And this is what I referred to before as...
Years ago, it was wrap the ribs,
compress 'em, protect 'em with some ACE bandage
or you know, some (indistinct).
And now they're finding out
that this is what you do not want to do.
- So, this is a no no. - Right.
So, let's take this off right now.
There we go.
Get it away. - Just trynna get
your attention but...
We found that in our old
supply shelf. - Right. Exactly.
That is very good for other things
but not for cracked ribs.
Now, the next big question, Bob.
Do you need to see the doctor?
Because as people say--
Well they don't do anything with them anyways.
You just go home and-- - There's no repair done.
- Exactly. - Let 'em heal.
- But there's one exception, Bob.
And that's if you have a crack where the bone
of the rib actually punctures the lining between the lung
and the rib.
And with that-- - It goes right into the lung.
- Right.
You can get a collapsed lung.
And it could be a minor one where it takes a while
for that fluid to get into the lung and cause problems.
It's called a pneumothorax. - Right.
- But that-- - Nothing to mess with.
That can kill you. - Right.
That can be serious.
So because of that, it's probably a good thing
to go to the doctor,
make sure that's clear. - I think you have
to go to the doctor.
You just have to.
No way around that.
- Other things that you're gonna find when
you crack your ribs outside of the pain
with coughing, laughing, deep breaths,
is you may find yourself short of breath
for obvious reasons and dizzy.
And the reason for that is you cannot breathe deep,
so you may get less oxygen to the brain, causing dizziness.
- You may throw your breathing off too
And there might be more shallow breathing
and that can just throw you off.
- And the anxiety of it. - Right.
- You may get some anxiety involved.
You know, when you cannot breathe,
your body reacts-- - It's a panicky situation.
- Exactly.
And then general fatigue
because you're not able to breathe when you're working hard
because of the pain that the ribs kind of--
- The pain is fatiguing too. - Yeah, exactly.
So it all works together.
- So, treatment, Brad?
- Yeah, after you see the doctor,
make sure you don't have a pneumothorax,
they're gonna say, "Put a cold pack on it."
Not heat.
Heat might feel good but it's gonna draw fluid to the area
and actually make things worse.
So get a cold pack on it.
You can do that for 15 to 20 minutes.
Get a comfortable position.
And this is something else I wasn't aware of,
so I did some research recently is you can lay on the side
as long as it's not too painful.
In your bed, you're gonna lay on that side
and the reason for that is it reduces your chance
for pneumonia or getting fluid into the lungs.
I'm quite certain that's because the gravity flow
of the fluids. - Sure, makes sense.
So that's interesting.
Well, can you lay on your back too?
- Yeah, you can lay on your back.
What's comfortable. - Sure.
- But you shouldn't lay on the opposite side.
Right. Mhm. - Okay.
- Okay. - NSAIDs.
- NSAIDs. Ibuprofen.
Across the counters.
You know, if you go to the doctor,
they may give you something a little more--
- Stronger.
- Stronger or for the pain.
- But yeah, generally Ibuprofen will do it alone.
And remember, you always need to eat something when
you take Ibuprofen. - Right.
You need a piece of toast
or something like that. - Milk is a good thing.
With a meal is even better.
The next thing, and this is something I think a lot
of people are not gonna be aware of is you actually want
to start breathing some deeper breaths as you're improving.
Not the first couple of days but within the first week
as the ribs start to heal.
You want to start breathing
and expand those ribs into a little bit of pain,
not that sharp pain but a little bit.
Because what's gonna happen,
if this is where that injury is,
there is gonna be scar tissue forming all over
to heal those ribs and those muscles
and when that scar tissue forms,
it's gonna tighten things up.
And if you did shallow breathing
for the six weeks of healing,
you're gonna find a tight spot here,
it's gonna be painful when you move,
and you're not gonna be able to breathe deep again.
It's gonna affect
how you function. - He's talking about
those little muscles in-between the ribs.
Those are the one's that are gonna scar up.
- Right. - You know, the scar tissue.
And a lot of times,
what could happen too later on,
it could re-break open the scar tissue
and you could have more pain again.
- Right. Exactly.
- You need to have it heal strong as we always say.
So in a lengthened position. - Right.
So work that breathing as it's healing.
And they typically say six weeks
and you're gonna be healed up,
with the exception if you did tear
some of those intercostal muscles away from the ribs,
that can take even longer.
You know, that could take a few more weeks longer.
And that's where we're gonna show you some exercises
in a little bit that are gonna help you
with the healing of that
so that scar tissue doesn't bind things up
and you get back to a normal breathing.
- Good range of motion and yeah,
you don't find yourself in a tightened position afterwards.
- Exactly. Exactly. - So, where we at, Brad?
We gonna start with the exercises?
- Sure. - Okay.
- Now...
Oh, we need a chair.
Bob, we're without a chair.
- Why don't you show on here
for the spread of rotations
and then I'll grab a chair.
- You need a chair with back on it.
For some reason, we didn't have one here.
Rotation.
When you rotate the trunk,
the thoracic vertebra,
which connects to the ribs,
are doing a lot of movement with rotations.
So when you're driving, you gotta look behind you.
Or in a tractor,
look behind you 'cause Vince who broke his ribs,
he'll be out in his tractor soon.
There's a lot of movement going on in those ribs
which is gonna hurt when those are healed.
You wanna get that to stretch.
The proper way to do this or the best way,
is to sit down so that it locks your pelvis in.
You're gonna find a cane or a pipe.
This is a piece of PVC pipe.
Nice and light and plastic.
Put that over your shoulders like this with your hands here.
That locks the shoulders in.
Your pelvis is locked in.
And now, when you rotate like this,
this forces all the rotation to come from,
well not all of it but a good part of it,
from your thoracic spine.
- [Bob] What's nice about this, Brad,
is that it does force it to occur
in the thoracic area. - If you stand--
- [Bob] Yep, now see, he's getting it from the--
- The pelvis. Right.
So we wanna do it properly
and get the most bang for your buck.
- [Bob] And if it hurts in one direction,
move the other direction.
- Exactly.
If it hurts a lot that way and not so much this way,
go to the right. - Work on the right.
- Bend this way a little bit.
- [Bob] Yeah, (indistinct) to the left should come.
- And you're gonna do these about 10 to 20 repetitions.
Three times a day.
Depending on how it feels.
Go ahead, Bob.
(indistinct)
- Yeah, what's nice about this is if you actually...
Actually, can you give me a ball too, Brad?
- Oh sure, Bob.
Oh, I don't know if I wanna give you the Packer ball
but here you go.
- That's what's nice about this.
- That's success, Bob.
Packers is a success.
- If you have a chair that hits you about right,
a little bit below the shoulder blades.
What's nice about this is you can just go ahead
and bend over and gently stretch.
Again, we're expanding everything.
We're getting the rib cage opened up here.
You can put your hand's behind the head
and go like this. - Yep.
That actually works better
sometimes. - An office chair
that doesn't go very high
that's padded can be comfortable for this.
- Let's say you have a really high chair
that doesn't go up really high.
Take a ball like this.
I really love the Packers. - Yeah, Bob.
- And you put it in there-- - You gotta get over that.
- It's a double bonus here that I get to squish them.
And you can lean back over the ball.
This works really nice. - It does.
- And you can move it in different spots.
- You're not gonna use a basketball or a soccer ball.
It has to be a ball that squishes.
- Squishy balls. - Exactly.
- Works out really well.
You can do this in a standing position too, Brad.
You wanna show 'em? - Sure!
- So, in standing we're just gonna go back like this.
In this one it would be nice
to put a belt, possibly.
- Sure. - Where's our belt, Bob?
- We're not really prepared here today, are we, Brad?
- Well, I didn't think we were gonna get this far.
You take a belt...
You can use a band like this or a belt right across here
and you stretch backwards and you pull.
And this next one after you get done doing this...
- [Bob] That belt actually, would really work out well.
- Yep, it would.
It's the apple picking stretch.
You can do it seated - What is that, Brad?
- or standing.
You just pretend there's an apple up there
and you reach up high. - Oh sure.
- It stretches those ribs so you that get range of motion.
And typically, going forward comes on its own
because we bent so much forward so often during our life.
Oh, yes. Thank you, Bob.
- I imagine too, Brad.
You might even do this.
Like, grab down here
and come back up here for like PNF where you kinda...
You know, get the different motions
with the rib. - Sure.
- Well that should give
you a good start. - Right.
And this is, again, very close to the subject
that we're really--
We're gonna get our PhD I'm thinking on--
We're gonna build to fix anything except for the--
- Broken heart. - Yeah.
But we're working on it.
Matter of fact, I got someone lined up for another video
that's coming up soon. - Wonderful.
PhD, by the way, is piled high and deep in order.
- I learned that in college.
- Alright.
Thanks for watching. - Thanks.