♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ on the internet. ♪
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet.
- Well, in our opinion, of course.
- Lonnie agrees.
Wait a minute. - Leave him alone, Bob.
Leave him alone.
- Today we're gonna talk about shoulder pain.
And this is actually based upon a book,
and it's called
"Shoulder Pain? The Solution & Prevention"
And it's by Dr. John Kirsch.
And he came up with an interesting concept, Brad,
that he talks about.
You're gonna treat shoulder pain
by hanging from a pull-up bar.
- Which is completely opposite
- Of what we think.
- Of what we were taught in school.
- Right. - And throughout.
So when I heard it said,
I said, wow, this is...
And look it, he is actually a board-certified
- (in unison) Orthopedic surgeon.
- So he knows his anatomy and he knows the mechanic.
- Yeah. I'll put a link down below for this
so you know where to get the book.
(overhead buzzing)
Little overhead noise there.
Anyway, he calls it radiating
- Okay. Hanging.
- But he says, it's based upon, you know, monkeys and apes
and maybe our ancestors hanging, if you believe that.
- Sure.
- That, you know,
that they had healthy shoulders and...
- Right. So why don't, why can't we do some overhead things.
- So he spends a good part
of the book trying to explain why it works.
And he also has a lot of case studies in here.
- Sure.
- And the actual treatment is very short, so...
But I wanna show very quickly
what you're trying to do, Brad.
- The mechanics of it? - Yeah.
So what this is good for, by the way,
is shoulder impingement.
Subacromial impingement syndrome,
rotator cuff injuries,
and also frozen shoulder, is what he said.
- So typically you have a hard time going overhead
either because of pain or tightness.
- Right. You're getting that pinching
when you're going up.
So let's bring him forward a little bit.
What about there, Lonnie? Or...
There we go.
So here we got the ball and the socket,
but here, this is the,
represents the supraspinatus tendon.
- [Brad] Right. The orange pipe cleaners.
- Right. That's a tendon coming off the muscle
and it goes in through here.
And what happens is,
when you bring it up,
Brad, where's your pen?
- [Brad] I got it. Hold on, Bob.
- How are we doing Lonnie?
Okay, yeah, we can see.
When you get up into this point here,
you can actually start pinching.
- [Brad] That's an impingement syndrome right there.
- It can get pinched beneath the acromion here.
It can get pinched,
there's a ligament that goes across here.
It can get pinched in there. - [Brad] Mhm.
- And it attaches to the coracoid process here.
So what he demonstrates though,
is if you get the shoulder all the way up like this,
like when you're hanging and there's weight...
- [Brad] Right there.
- [Bob] Through the shoulder,
there's actually no longer any pinching on that tendon.
- [Brad] Right.
The mechanics of it allow it to open up at that point.
Once you get to a certain
overhead flexion of that stretch.
- [Bob] And believe me, in the book,
he gives plenty of examples of this.
He shows
CT scans or MRIs. - [Brad] Sure.
- And how that is no longer...
So what we're trying to do...
Rip this off.
- [Brad] Oh, I know Bob. - [Bob] Yeah.
- What we're trying to do is we're trying to reshape
there's a ligament that goes across here.
And we're trying to reshape this bone
and the ligament when we're stretching
by hanging up from the bar. - [Brad] Sure.
- And you say, how can you reshape bone?
Well, there's this thing called Wolff's Law.
- [Brad] Mhm.
And he gave the example of how you can shift teeth
with an orthodontist, you know, with the bracing.
- [Brad] Right. - [Bob] And over time,
you can actually reshape bone
if there's pressure on it. - [Brad] Sure.
- So that's basically the explanation behind this.
So now we're gonna go to what the treatment would be
and this is gonna represent our pull-up arm.
And Brad's thinking, he's gonna try this, right, Brad?
- Yeah. Because I don't do pulls
because my shoulders hurt when I do it.
So I just never pushed it. - And Brad has limited motion
now, kind of in the shoulder. - Right. Right.
- By the way, in order to be
to qualify for this,
he says you should be able to lift your arm
to horizontal with fairly good strength.
- Okay.
- So if Brad can go,
come this way, yeah.
To horizontal and he still has pretty decent strength there,
you're a good candidate for trying this.
But if he goes up to here or can't even lift it up to here,
or if he gets to here and just goes right down,
you're probably not a good candidate for this.
So, and it's not for an unstable shoulder either.
I mean, if you have a shoulder that's dislocating.
- Oh, sure. - And I don't want you
doing this here, or if you have severe osteoporosis.
- Weak bones. - Yeah.
So, 95% of rotator cuffs tears are caused
by subacromial impingement syndrome.
So this is a lot,
it will help a lot on the shoulders.
So you're gonna start by
your palms are always gonna be forward, Brad.
- Okay, not like this. - Not like that.
And the thing is
you're gonna wanna probably wear gloves.
I tried this myself and
it's really hard on the hands.
- It's just on the skin.
- It's just on the skin
and the skin...
And I do pull-ups and it still bothered my hands.
And what you also you gonna probably wanna start is
probably with a partial hang.
So, you you're gonna have your bar set
to the point where your feet are touching the ground.
- Right. - And you're maybe just
bending your knees a little bit.
- So I'm gonna adjust the pressure by bending my knees.
- Right. - And how long am I gonna
hang here with that pressure?
- Okay. He's gonna start by trying to hang
for 10 to 30 seconds. - Mhm.
Then you rest a minute.
You can do this for up to 10 to 15 minutes.
- But if it starts to hurt, do you continue?
- No, pain is gonna hurt.
- So how bad do you let it hurt?
- I mean, we might know.
- We might have people hanging so bad...
- He said it's gonna hurt when you're doing it
but it should stop
when you're not doing it anymore.
- So he says, start out with the low..
- You are not damaging anything.
He kept saying,
I'm going, again,
by what the book is saying.
You are not damaging any structures
even though you're feeling pain.
- Sure.
- So you're stretching structures
so it's gonna hurt. - Right.
- So yeah, you might start with less time.
- Start to 10 to 30 seconds and build up slowly
to that longer duration instead of going from 30 seconds
to 15 minutes and think you'll get better overnight.
- Right. But this is a, you know,
this is an involvement of a fair amount of time here.
If you want put in 10 to 15 minutes, I mean, you know...
- It might take weeks before you get to that point.
- I'm guessing. - Right.
- And again, not having done it myself
except I do pull-ups
and I used to have...
We were talking about this before, when, on camera,
I used to have trouble with pull-ups
but now I do 'em all the time.
And now I,
my shoulders feel great.
- Matter of fact, lift your both arms up higher
over your head, but face the camera, Bob.
- Like this? - No, no, face...
I know they don't like looking at your face, but...
(Bob laughs)
but look it, he can almost touch his ears.
Now watch me.
Yeah. Look at this chomping face.
- That... - That's not bad.
You're a little more tighter this way too, I think so.
- But I'm not getting my,
I can't give close to my ear.
- Yeah. - That kind of hurts.
- Your head's smaller.
- No, I got a big head, Bob. It's fat.
(Bob and Brad laughing)
- All right.
So in addition to the hanging, you're also gonna do weights.
Some lightweights.
Where did our weights go?
- Yeah, use those.
So those are the ones I usually use.
- So anywhere from...
Again, you should be able to
lift your arm above horizontal without weight
before you start weights
- You can't read the prompter breaker.
(Bob and Brad laughing)
- So you have to lift above. - Yup.
- You'd be able to lift all the way up
and take a little bit of resistance
before you can start with weight.
- Sure. Yep.
- So you can start with like a pound
and you can start with a soup can.
- Mhm.
- And basically you're gonna do...
You wanna face them
and I'll do it this way? - Yeah.
- So flexion all the way up.
And he talks about a lot of reps, 30 to 45 reps.
- Oh, yeah.
- So one to eight pounds is what he says.
So that's flexion.
And then abduction.
Out to the side.
- Back off.
- All the way up.
- I'm thinking you might wanna build up to that 30, 40 reps.
- Yeah.
- He's not a therapist, he's a surgeon.
They don't mind if... (Brad laughing)
- Yeah. And then extension,
you can lean over or, you know, like...
- Oh yeah.
- Keep it in line,
not out here. - Yep.
- So, you know, to me, this all makes sense.
We have not really tried it.
I had a little bit of it myself, and, you know,
hanging from the pull-up bar. - Right.
- But you know, over time, we'll give you a report on it
or if you guys try it, let us know, but try.
- Right, get the book.
And we've been on for so long, Bob.
(Brad laughing) - I know.
- There's probably nobody watching anymore.
- All right. Thanks for watching.