♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet.
- In our opinion, of course. - We're sharp,
we're gonna pump you up here today.
Okay, we're gonna talk about shoulder tendonitis,
absolute best self-treatment you can do and exercises.
You can do these on your own.
Do it yourself.
And it's a three-pronged approach.
- Okay.
- First thing is you want to try to give yourself
some immediate relief,
but, you know Brad, I think we should discuss
what often happens, why you get tendonitis.
- Sure. - Quite often,
there's what is called an impingement.
- Okay. - And let's bring
- Let's get Bonaparte out here.
- [Bob] Napoleon Bonaparte out here.
Do you got your pen Brad?
- Oh.
(Brad patting shirt)
- There's a pen over there, otherwise.
Where's your red pen?
- [Brad] Right here, Bob.
- Okay. - In good shape.
- Good.
So, I don't know if you're gonna catch this Lonnie,
but there's muscles that are on the shoulder blade here
and they go through,
especially one of 'em goes right through the-
- Move your hand.
Go like this, right through here.
And they connect up there.
- So, you see the pen,
that's actually the tendon
that attaches to the greater trochanter of the,
not greater trochanter.
(Brad laughs)
- Wrong part of the-
- Yeah, it's greater tuberosity.
Greater tuberosity of the humerus.
- We're gonna have therapists that'll catch ya.
- Yeah, they're gonna catch that real quick.
All right, well what can happen is
it can actually get pinched in there.
- Ugh, ugh.
You're gonna break my pen Bob.
- Yeah.
And that wears out that tendon and it creates scar tissue.
And that's why we're gonna do this next treatment.
- Right. - To break
up that scar tissue. - It's kind of
like a rope going through, then the rope gets frayed.
Very similar, good analogy.
I always liked that one anyways.
- Yep.
So, we're gonna show you how, one, to treat the frayed rope.
- Mm-hm. - And then
two, to stop it from fraying more.
- Right. - So, that's basically
the treatment that you're gonna do.
So, the first thing you wanna do,
and this really works well,
I just had an episode of this Brad.
- Sure.
- I was laying on the bed like this, reading,
- Mm-hm. - And so I'm jamming
the shoulder and kind of impinging it.
And I got very, very sharp pain.
I'm a little shocked how sharp it was.
And so I actually did this
- And he's a therapist. - and I'm a therapist.
So, there's usually two tendons that are mostly involved,
supraspinatus or infraspinatus.
You don't have to know which one is which,
but the supraspinatus, you can get at it the best
if you put your arm like this.
Yep. - [Brad] There.
- So, what you're gonna do is you're gonna follow along
your collarbone here, and you're gonna go to the acromion
and then you're gonna, right down in here,
you're gonna find a tender spot.
- The little bony area up there,
is usually right off this,
like a little cliff you drop down into there.
- So, if you come down here,
you're gonna find it, like you said.
And that's right where you're gonna rub.
Now you can put one finger on top of the other.
- Sure. - And you're gonna
really get in there.
I mean, you're not just pushing the skin around here.
You're getting in there and rubbing that tendon.
- Right, you're moving some soft tissue and-
- You gonna answer that phone by the way?
- No, I'm not answering that phone, Bob.
Anyways,
- What should you feel? - It's gonna hurt at first.
- Right. - But after
the first 15, 20 to 30 seconds at the most,
it should start the feel better
or a numbish feeling.
If it continues to get worse and worse after 30 seconds.
- No, then you're not doing that.
Then you're putting some ice on it.
- Right, put the brakes on and cool down.
- So, in my case, I did this a couple times and it was gone.
I mean, mine wasn't a real serious case obviously,
but you know.
So, you're gonna get in there again, rub.
Ciriax actually said
you can do this for 15 minutes, twice a week.
Nobody's gonna do this for 15 minutes.
I'd say do it for five minutes every day, you know.
- Right. - Is what I would do.
- Your hand gets too tired and your fingers get too sore.
- Yeah.
And people just don't have that much time to do this,
I don't think.
And what's nice about this,
you could do this at your desk
and do this anywhere
and just find that spot and rub.
Now, if it's the infraspinatus, that one's gonna be better
if you just go ahead
and put your your arm up on a pillow like this
- Mm-hm. - and keep that arm forward.
Not like this, or like this.
- Right, neutral.
- Neutral.
And then you you're gonna find it
and that tendon's gonna be more available in this position.
- Right.
And if you're not sure if it's the infra or the supra,
you could try either position
and just see how the results are
because this is the kind of thing there's no harm done,
as long as you follow the rule,
after 30 seconds it should feel better.
- Right, there's not gonna be any harm
in you rubbing the shoulder.
That's for sure.
No and you're certainly not gonna make things worse.
Generally, the supraspinatus is gonna hurt more
if you go the hand out, just straight out like this
and you push.
It just gives way.
where the infraspinatus,
if you push here, go out this way,
- Mm-hm.
- it gives this way or hurts that way.
So, someone's gotta answer that phone, Brad,
it's starting to bother me.
- I know, I'm gonna take that thing
and throw it out the door.
- All right, next thing.
So, now you've kind of treated the problem,
you know, the scar tissue,
you're gonna do this.
Like I said, you can do this every day for five minutes.
But now you wanna stop the impingement from happening.
You don't want to, you know,
keep rubbing it 'cause it'll just come right back again.
- Right, like a repeat patient.
- So one thing, this causes impingement, bad posture.
- Mm-hm. - You know,
this just pinches a lot easier.
Watch this once Brad.
Watch how high I can raise my shoulder,
when I'm like this.
That's all the height= - Oh, come on.
You're not trying. - I'm trying,
this is high as I can raise it.
But if I sit up, you know.
- Full range. - What does this mean?
It's getting blocked.
It's getting pinched.
So, poor posture.
So, you're gonna want to improve your posture.
- Right. - One thing
that we have everybody do is shoulder squeezes.
- Right.
- We've said this again and again,
I'm starting to sound like a parent, Brad.
- [Brad] Yes, over and over.
Why Bob?
- What's nice about this,
is you can do this throughout the day.
Again, these are all things you can do at your desk.
Instead of being at work and productive,
you can actually treat your problems.
- [Brad] You're taking that little break to stretch out
and you do these stretches.
- Yep.
And what that's gonna do, it's gonna strengthen the muscles
that pull the shoulder back
and keep plenty of room for that tendon to go through.
- Right. - But it's also gonna
improve your posture.
- Right. - People are gonna comment.
- And if you walk around like this,
then maybe you overdid it.
- Yeah. (both laughing)
- People are gonna comment-
(both talking over each other)
Right, okay,
The next one that you're gonna do
is actually called the Mulligan technique.
And this is gonna help set the bone down in the socket,
so there's more room.
I've had good luck with this one, Brad.
- Right.
- So, you need a countertop or you need,
do you wanna do it there, Brad?
- I thought I'd do it right off the end, like right here.
- Okay.
- Or we could do it here.
- Yeah, I think a countertop is probably a better height.
- Yeah, now one thing I like to say on this one, Bob,
with the patients I've worked with it,
they just love it or it doesn't work.
- Okay. - You know.
So, I think that you'll find out.
So, I'm gonna push down in this direction, right?
- Right, you're pushing down the whole time.
- We're supposed to look at the film.
(Brad laughs)
- He's pushing down.
- Right and as I keep that pressure down,
right now I'm pushing, I'm going back.
And this is something that a therapist clearly knows,
is that- - It's putting that ball
down in the socket.
- Put down your shoulder at the same flexion that mine is.
But now without being bent over.
So, right now my shoulder is like this with no pain,
'cause I'm doing the technique.
But if I were to stand up, it'd be overhead.
Then I continue to push and then I walk it back up.
- But he's strengthening the muscles
that help push it down in the socket.
- Right.
There and back up.
And if you're doing this and it goes,
"ow, ow, ow",
you just stop, stop, stop.
It's not for you.
- All right, so again,
that's something you could start right away.
Then later on, now you know, things are getting better.
The pain's gone.
It's not the worst thing to do,
is to do some strengthening of the shoulder.
- Sure. - And on an ongoing basis.
And we like to do innies and outies.
Now, this works better with stretch band, I think,
but this is something you can do with a soup can
or a weight at home.
And so if I'm strengthening this one here,
I'm gonna stay off the shoulder a little bit.
I'm a little bit, kind of more,
on the back of the shoulder blade itself.
And I'm putting the arm, the elbow, at a right angle
and I'm just gonna go up like this.
And this is the innies.
- [Brad] This one is probably not as important as the outies
that Bob's gonna show you.
- And this one's gonna be easier,
'cause it's a stronger muscle.
- [Brad] Right.
You're gonna take much more weight that way.
The outies, which works on that rotator cuff muscle
in the back.
- So, same thing,
I'm gonna start in this position.
Now again, right angle.
And now I'm going up like this.
- There you go. - And you can go all the way
up like this even.
- As long as it's pain free-
- Yep, some people put a towel here,
just to help keep them honest.
But this is probably the one that's more important,
yeah, like Brad said, if you're gonna specify just one,
How nice of you, Brad.
- Well, of course.
I care Bob.
- So- - Not much,
but I care.
- All right, put your head up here.
Give me something to slap.
(Brad laughs)
All right, actually, again, that's always shocking
to me, how that starts to get fatigued already.
- Oh right, yeah.
- 'Cause this is only what, three pounds?
- Right. - You know?
- And that's why, for a lot of people,
especially coming from an injury,
a soup can, a 12 or 16 ounce soup can,
is enough to start with.
- So, this is the full program.
You know, start with the cross-fiber,
then go to the good posture and the Mulligan technique.
And then go ahead and start, do some strengthening.
- Now, I know people are gonna ask on the comments,
how many repetitions?
How many times a day? - Oh yeah, bring that up.
- There you go.
Okay, so as far as the Mulligan technique?
- You can do that every hour.
- Right and you know what, how many repetitions?
- Five to 10.
You don't have to do that many, to be honest with you.
- Right.
I think 10, you know,
if you're gonna do 'em more often,
you can do less of 'em every hour.
- Right. - Even three to five
every hour. - Exactly.
Just do 'em really quick.
Shoulder squeezes, you can do 30 of them if you want.
- Right. - I mean,
that's just a good thing to do,
as a reminder throughout the day.
- Right, exactly.
- If you're looking at the computer right now, at us,
I'd like to see you doing a few of those right now.
- Exactly.
And if your coworkers give you a little hard time
about doing that, you just tell 'em Bob and Brad.
- Yeah, Bob and Brad. - You better believe it.
- We'll come out and-
- Okay, what about the innies and outies?
- Innies and outies,
I would go 20 to 30 on that.
- Right, I usually go a little less than that
and little heavier weights, but that's up to you.
- Well, to start, I would go higher reps
and less weight.
- Sure, the mechanics of it is important.
- Right, right. - Really important.
- Don't shrug your shoulders and work on.
Later on, again, if you go to stretch band
and you're doing these,
I mean, you can rip off 30 to 50 of those.
- Sure. - They're good
postural strengthening muscles so.
And you know, we've got the other videos on those Bob,
on some of the stretch bands that you're referring to.
'Cause we didn't go through 'em here.
So yeah- - I'll see if I find them,
I'll link them at the end.
- Yeah, the end of the video
is really becoming an informative place, Bob.
- Yeah, you really want to stay 'til the end each time.
- Right. - Thanks.
- Now watch this, I just wanna show people this,
this has got nothing to do with anything,
but I just wanna see what happens.
- Yeah. (Brad laughs)