♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- You know, we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today, we're gonna show you
how to fix Achilles tendon pain in 60
to 120 seconds.
We're gonna include tendonitis, strains, and tears,
in case you have trouble knowing
what's really going on, we'll give you some hints.
- Right, we're gonna give the whole spectrum.
- There we go.
By the way, if you're new to our channel,
please take a second to subscribe to us.
We provide videos on how to stay healthy, fit, pain-free,
and we upload every day.
Also, you hit us on the right week here, folks.
Go to bobandbrad.com, we're always giving something away.
We're giving away a mattress.
- Ooh. - A SleepOvation mattress.
Awesome.
We're also giving away a couple SleepOvation pillows.
- Pillows.
- We'll talk about just in a second.
Like I say, go to the giveaway section.
Also, you can find the contest,
it'll be pinned to the top of the page on our Facebook.
Go to Instagram, Twitter, or TikTok
if you want a 60-second version of our program.
So, this is just a sample of the mattress,
it's actually much larger,
you can get any size you want. - Nah. (laughs)
- But it has 700 individual mattresses,
really spread out the comfort for pain.
And it's also got individual air channels here,
that it can make you a little bit cooler.
All right, you done playing Brad?
- Yep, get that out of here. - Go to work, Brad.
- Before I fall asleep on it.
Okay, Achilles tendon pain.
This is a very common injury, and the reason it is,
in my opinion of course, and I think this is
well-accepted throughout the therapy community
and the medical community; every time you take a step,
if you look at my foot and my heel comes off the ground
and my left foot leaves the ground,
the weight of my whole body is going through
that Achilles tendon as a lever, so to speak.
- Yeah, you see a lot of weekend athletes
can injure it. - Right.
- A lot of tennis players. - Yep.
- Where you're really up on your toes a lot.
- Right.
- And putting a lot of stress on it.
- Yep, or if you're climbing up a hill.
- Sure. - Hill climbing, going up
just any kind of incline really increases the force.
There is one thing, before we go any farther,
if you have a full-thickness Achilles tear or rupture,
this video's not for you.
- Well, you're gonna know that,
because you're not gonna even be able to walk on it.
- Yeah, you're gonna have surgery.
- Right.
- I think that's the one Bill Clinton had, didn't he?
I think he--
- Bob, we don't cover politics in this.
- It's not political, (Brad laughs)
he just had a tear.
- Anyways, if he did he's probably better by now.
- Right, he is.
- So, it's a large tendon, and let's take a look at it.
- Sure.
- And where's my--
- A very thick tendon. - Very thick, yeah,
and it's because of the forces that it goes on.
It connects to the-- - Calcaneus.
- [Brad] Calcaneus, and that's a very large bone there,
very solid connection which is about right here.
And right here it's very thick,
I'm just gonna draw it in.
- [Bob] Yeah, it actually splays out here too, I think.
- [Brad] We'll get it all on there.
(Bob laughs)
We do have high technique and high everything.
- [Bob] High technology here.
- [Brad] Yeah, so here we go.
It's not back in here, though, there's a hollow spot there.
That's gonna be important for the first technique
in how to treat this.
And then, somewhere in here it goes from a tendon
into muscle. - It transitions into muscle.
- [Brad] And it's not a on-off transition.
- Right. - It kinda tapers and whatnot,
it goes out. - Right.
- And that's important to know, too,
as we talk about some treatment.
So, there we go.
Now, the first treatment, if you are having specific pain
in your Achilles tendon, and you can feel it in this tendon.
You'll feel it, it's very palpable.
What you're gonna do is
we're gonna do a cross-friction technique.
- Right, cross-fiber friction massage.
- And you're gonna take your fingers like this,
and if you get that pincher technique.
Now, I usually support my pointer finger
with my third digit, my middle finger, and this one
so I can really have a good, strong pincer grip.
And I'm gonna go right around, I'm gonna do it this way
so I can do this better, I'm gonna go around
to the back side of that tendon a little bit.
And I'm not gonna go vertically to massage it,
it's gonna actually go horizontal.
- [Bob] So you're really on the sides of the tendon, Brad.
- [Brad] Exactly, Bob.
- [Bob] The injury or the tear usually does not occur
on the back of the tendon. - Right.
- [Bob] It actually occurs, more often they find,
on the sides.
Sometimes on the inner side,
which you can't get to very easy.
- [Brad] Yeah, we would call that the anterior aspect,
but it's up in there.
- [Bob] So, you're gonna wanna work both sides
of the tendon, rubbing back and forth,
and Brad's being very aggressive here,
that's not just a light pushing of the skin.
- [Brad] I'm not doing this, I'm not moving skin,
I'm getting into the tissues of that tendon.
My leg is moving because I'm getting after it,
I need to actually hold it still.
And you wanna relax the leg, you're not pulling,
you're not stretching at the same time,
you're not pointing down or plantar flexing.
- Yeah, you want it in a relaxed position.
It's funny, the last person I saw with this, Brad,
he's a really good golfer,
and he had had it for quite a long time.
And this is all I did, I took a few minutes
and showed him this.
(fingers snap) It went away.
- The first time, or did he have to do a few techniques?
- No, he had to do it for a few times.
But I'm saying, he had had it for months.
- Yep, and it was clear that this was the game changer.
- Yeah, and what happens is, you know,
there's micro-tears in there, and it starts to heal,
maybe overnight it starts healing,
then you get up and you re-tear it.
This stops it from re-tearing it because you're--
- Breaks up that scar tissue.
- It breaks up the scar tissue,
and it gets more blood flow to that
so it heals lengthened and heals stronger.
So, this is the money treatment.
(Brad laughs)
- Game changer, the money maker.
- The game changer, yeah.
- So yeah, now I lost my train of thought, Bob.
- I'm sorry about that. - Why Bob, why?
So Bob, I know that the viewers are gonna give this question
and I haven't answered it, is how long do you do it,
five minutes, 10 minutes?
And that's in the title of the video.
- Right.
- 60 seconds to 120 seconds. - Sure.
- And you could do it longer than that,
particularly as you do it, it feels better,
kind of a numbish feeling, and that's gold,
you know it's gonna improve.
But what happens is your fingers get tired.
- They do.
- And you gotta give it a break.
- And that's why you may wanna do it multiple times
during the day. - Yep.
- The other thing, and you kind of alluded to this Brad,
is that if you're doing it and it just starts
getting worse and worse when you're doing it,
it's probably too early. - Yep.
- You're maybe gonna wanna ice it for a couple days.
- That's right, get a cold pack on it 15, 20 minutes,
give it a break and don't walk on it so much
if you can do that.
- Right, you may have to use a cane or a crutch
for a few days. - There you go.
- Or sometimes we have people put like a little heel cup
or cut out a piece of carpet and just put it in their shoe.
It raises their heel up a little bit,
and that takes stress off the tendon for a couple days.
- Right, yeah, but that's getting a little more technical.
- No, it is, but it's useful information.
- Sure.
- But again, if it's getting worse you gotta stop.
If it's getting better, or it's getting numb,
it's the right treatment. - Yep.
Now the next thing, what if you do this and say,
"Well, my tendon feels okay, it's not tender."
- Yeah, there's no tenderness there.
- But then you realize oh, the pain's up here.
And sometimes if you have a torn muscle here
or a strained muscle here,
it may refer pain into the tendon,
it may refer pain up here.
So then what you're gonna do is actually palpate
or dig around in your muscle and find a specific spot,
and a common place is right where the base of the gastro
connects-- - In the soleus?
- [Brad] Yeah, right in there is a common place
where you'll get that painful spot.
- [Bob] Well, it's often mid-muscle belly is what it is.
- [Brad] Yep, yep.
- [Bob] It's in the midpoint of the muscle belly.
- [Brad] So when you find it, and you'll find it,
it'll be like, "Whoa, that's a hot spot,"
and it may be all knotted up
kinda like a tootsie roll in there.
That's the spot you're gonna do your cross-friction massage,
similar to the Achilles tendon,
but the fibers of the muscle go this way, we're gonna go--
- Yeah, you don't have to do on the sides on this one,
you can go right across the back of it.
- Right.
So, let's say it is right there.
I'm gonna take my thumbs and I can use both
or you can use the fingers, whatever works good,
but get into that.
- [Bob] And again, he's going across it.
- Yeah, and it's gonna hurt at first,
that's very normal, but within by 20 to 30 seconds
that pain should resolve until like,
"Oh, that feels better," or it feels numbish.
Then you're gonna go until your thumbs get tired and sore.
Usually a couple minutes and you're already there.
- [Bob] Sure.
- And then you're gonna do that throughout the day,
maybe five to eight times, as long as it responds.
If you do it and it just hurts more and more,
you need to give it a break.
- Yeah.
- And you can maybe do a gentle massage--
- Same thing. - Cold pack,
give it a break for a day or two.
- And again, less weight bearing on it.
- Now, there is an option if you don't like
that kind of pain to start out with
for the first 20, 30 seconds,
and that's called positional release,
or strain-counterstrain.
And to be honest with you, I would do this one first
because it really doesn't hurt,
and we've had really good success with it.
- Yeah, it's been amazing to me.
It's certainly a good adjunct to do along with it,
and in some cases it's maybe--
- Adjunct, that's a good one.
- Yeah, and in some cases, it may actually take it away.
- Right, so should I show them that?
- Yeah, let's show them that.
- And it's in a comfortable position,
you don't have to stand up.
- [Bob] Yeah, that's what's nice about it, it's not--
did you want a pillow?
- Oh sure, Bob.
Now I know he does care. (Bob laughs)
So, this is what I'm going to do,
is you can do it laying on the floor or a bed.
I would do it in bed 'cause it's a little more comfortable,
but it's not important.
You lay on your back.
Now, with positional release or strain-counterstrain,
the whole goal is you already found that sore spot,
and you rub on it.
and give it a number, say it hurts,
10 would be you're screaming and yelling, zero is no pain.
And I get there, oh, that hurts,
I'd give it about an eight when I'm pushing on it.
So we know the level of pain it's at with that pressure.
Keep that in mind and forget about that for now.
Don't forget about it, but just temporarily.
We're gonna shorten that muscle as much as possible.
Now, because we're therapists and this is our job,
we know to shorten, so we need to flex the knee
as much as possible, and you can bring the knee up
and flex the hip, that's okay.
And then the ankle, we need to plantar flex.
So to do that, I'm gonna hold here, and I'm gonna--
- [Bob] The toe actually goes down.
- Yep, put some gentle pressure there.
And you may want to take the ankle and rotate it in or out,
and you're gonna find the position of maximal comfort.
I mean, if it feels more comfortable when I bring my knee
out here and I pull in this way, that's fine.
You're just gonna kinda play around with it,
and when that pain level goes down close to zero or one,
then you're gonna hold it.
And it's very critical, you don't start the clock,
and you need to use a clock on this,
go 90 seconds, no less than 90 seconds, to get that muscle.
So once again, once you find
that position of maximal comfort you're gonna relax
and you're gonna breathe, and you're gonna hit literally,
you have to be be looking at a timer
or have someone time it for 90 seconds, no less.
The studies have clearly shown
you have to hold that position of comfort for 90 seconds,
and you can go longer, up to 120 seconds.
One way or another, that's the time,
and then you're gonna slowly come off from that and relax.
You can gently move your ankle up and down,
nothing aggressive, and you're gonna get up, stand,
walk around gently and give yourself five or 10 minutes
where you're gonna do no aggressive activity.
And obviously it's still gonna be injured,
it's not gonna heal it like that
but it's gonna give you a big step in the right direction
because it increases the blood flow in that muscle
which is what you need, and to get the muscle relaxed
to achieve that enhanced healing time.
- [Bob] Yeah, and I think what happens quite often, Brad,
is that it breaks up the pain cycle.
- Sure.
- When you get a painful area,
like a lot of times you get knots,
the pain makes you tighten up even more--
- Yeah. - The muscle, in response.
- Right. - Gets more pain,
tighten up even more, and it just goes on and on and on.
- Yeah, yeah, yeah.
- This breaks up that cycle and sometimes that, alone,
again, you kinda did it for my hip, and like you said,
I was like, "Oh, I don't know if it really helped,"
and he goes, "Well, have you had any pain since?"
No. (laughs)
- You forgot it. - I forgot about it.
I kinda forgot that I even had it.
- I had the same experience with my tennis elbow.
Again, nothing new, this has been around for--
- Yeah, this has been around a long time.
- A long time, 20, 30 years.
So one way or another, between these three options
you're gonna find one of them
that's gonna give you some relief
and get you going on your feet better.
- Make your comments below, we always like to hear from you.
And remember, Brad and I can fix just about anything.
- Except for-- - A broken heart.
- But we're working on that.
- I wonder if you cross-fiber on that?
- No, no, Bob, that's too invasive for us.
- Okay, all right.
- Nope, we're not going there.
- Ciao. (Bob and Brad jingle)