♪ Bob and Brad, the two most famous ♪
♪ Physical Therapists on the internet ♪
- Booyah!
- Booyaah!
- Hi folks I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- And we are the most famous
Physical Therapists on the internet.
- In our opinion, of course Bob.
- Today we're gonna talk about the five most
common causes for shoulder pain.
Plus we're gonna give you at least one exercise
on each one of these to help you relieve it.
- Right, right.
- We always deliver Brad.
- That's right, we like to give a little more.
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(Brad laughs)
Alright Brad, take her away.
- Okay so, these are as far as shoulder pain
that is not from trauma or an injury,
these are the five most common causes of that shoulder pain
that comes on for sometimes no apparent reason.
Other times, sometimes you have a pretty good
idea what happened.
- Sure.
- So the first one is, a tight posterior rotator cuff.
So, what does that mean Bob?
- What does it mean?
- So, we're talking about the rotator cuff muscles
on the back side of the shoulder.
And when they over tighten they change the mechanics
of how the shoulder joint works.
And then therefore particularly when you work overhead,
you can start to get impingement--
- And other painful problems. - Sure.
- So it's kind of one of those things that
a number of these five kind of roll
into each other sometimes.
- Yeah there's four rotator cuff muscles.
- Right.
- A lot of them are all back here.
- Right, so--
- Ones on top but three of them are basically in back.
- Well, we don't wanna get into
the discussion too much on that.
- Sure.
- Because what we're gonna do about
this particular one is a simple stretch.
This is the one that is often times,
I see this one done at a lot of fitness classes
you simply go across here and stretch.
- A lot of baseball players and softball players
especially pitchers are doing this one
and there's a reason they're doing it.
- And you can hold this one or you could go
pressure on, pressure off, five to ten times.
And the nice thing about all of these problems
is you could do one side and then check the other arm
and see if there's a difference on how they feel
and often times the one that's more painful
is gonna to be tighter.
- A little tighter, yeah.
- A little tighter or more painful.
- I'm a little tighter in my left.
- Ah oh really?
- And that is my painful shoulder.
- See.
- [Both] There you go.
- Number two, Bursitis.
Now, bursitis is, just remember a bursa
and itis means inflammation of a bursa.
You have Bursa sacs all over your body, typically by joints
- Right.
- Your knees, your hips, your shoulders, so there's a--
- It's helping the tendons glide over that joint.
- Right, right.
- Over that bone I should say.
- Just hold on there...
Okay I'm back.
I don't know what happened to Sam
so we're gonna go with--
- You're doing a spontaneous--
- Napoleon Bonaparte is back!
- He's back, how ya doing big guy! (laughs)
Yes it's good to see you too, so if we look here
where the shoulder is, and this is gonna be
right below my white stripe on my shirt.
There's a bursa sac right under the acromion
in here and when that bursa sac inflames
and gets tendered, think of it as blowing up like a balloon
and it's getting all tight, really tendered
a lot of nerve endings in the bursa sac.
And so when this happens a real common symptom
not a common, but a number of symptoms
is kind of a global achiness in the front of the shoulder.
It kind of aches all the time where in some shoulder
problems typically they are irritated--
- Only with movement.
- Only and often times overhead this one is irritated
with overhead but it often times just aches while you're
sitting there without movement so--
- You gotta get that inflammation calmed down.
- Right so, one thing that works nice is a cold pack.
- Sure.
- There ya go, you're gonna put that on Bob?
- Yeah.
- Okay then, there ya go.
Now that's a bigger cold pack than what you would need
but it's still, you know, it works fine.
Put it on, I like to put 'em on in a recliner
you can recline it back and trap it in there.
- Lean back and it'll stay in place.
- Yup, read a book, watch TV, take a nap if you'd like.
- It actually feels good!
- Yeah it does its wonderful!
You can take NSAID's, you know,
Ibuprofen at the appropriate amount.
- But always take it with food.
- Right, yup.
At least some milk, you know.
- That surprised me when you told me that.
- Yeah my Pharmacist says, you know
milk is a pretty good thing with ibuprofen.
So I would say milk and crackers or whatever.
- And we're gonna show you one stretch to try.
- There ya go.
- This is with the Booyah Stik or any basically
I guess you can use a wooden dowel.
- Sure.
- Or maybe a broomstick even. - Yup.
- But you're gonna take it,
so I'm stretching this one, this side here.
- So your left arm is the sore one.
- So I'm grabbing here, where am I?
- [Both] There ya go.
- And I bring it up over to the side of my head
and I bring it back like this so it's like a chicken wing.
- Right.
So this helps open up that gap
and we've had some good success with this
that's why we're showing them.
But you're only gonna if this really irritates
it and makes it worse--
- Yeah, no.
- Then it's not the right thing, it's too aggressive
get the cold pack back on, leave it and settle down.
- What I'd like to see Brad actually
is you do a few sets of these, just a few repetitions
of this I should say maybe--
- Three to five?
- Yeah, three to five.
And then feel it, does it feel better?
- Right.
- If it feels worse, no this is not appropriate then.
- It's one of those things that gives some immediate--
- It usually feels better right away
and I mean there should be, at least certainly not worse.
- Sure.
- Okay next one Brad.
- Hypermobile shoulder.
That's those shoulders that they come out
of the socket actually quite easily.
- Yeah, you could dislocate easy.
- And you know people have dislocate easy
often times they come back in easy.
Often times pitchers or athletes
who have overhead repetitive motion
can over a number of years can actually--
- Stretch the ligaments out and stuff yeah.
- Yeah, exactly.
- It just doesn't become as tight.
- You know so the thing with this is you've gotta
do exercises that are gonna tighten up
those rotator cuff muscles.
I'm not gonna give the whole--
- The whole scenario.
- Yeah the whole exercise group with that
but I will go with this and--
- Lemme clean the area up here for you Brad.
- Oh yeah we've got a mess over here Bob, look at this
oh we got, why are you here?
Oh sorry about that we invited you.
So, we're gonna, if you use the band like this
we got the wall anchor here that really works well.
But this is probably the go to most important exercise.
- Yeah, the external rotation.
You're keeping the arm at a right angle.
- Yup.
- Sometimes we even put a towel underneath there.
- Well of course Bob, just reach back in your cupboard
with the crooked door and put that right there
and that really helps give you good mechanics.
So if that towel comes out your elbow
went too far away from your body.
So keep that in here and you're usually gonna do
three sets of 10 of these and you'll feel
this muscle get a little tired.
Again that should not be painful
it should just create fatigue on that muscle.
- Now this is one of those that you're not looking
for immediate relief.
- No.
- This takes time to build up the strength
and I mean this could take weeks
or even months before you start seeing some--
- And I would recommend go to one of our videos
on rotator cuff strengthening and then you'll see
the whole protocol of three or four
exercises to put together.
- Brad I'll bet you're gonna need
the pulley on the next one.
- Well yes Bob you are right.
You're very astute today Bob.
- It's the shape of the acromion--
Brad what are you looking for, your pen?
- I was looking for my pen, I usually have
that red pen back there by now.
I don't know what happened to it.
But that's alright I'll use my finger.
So we're looking at the acromion here
this bone right here, you can see between my fingers.
Now, this would be a real healthy bone here.
- [Bob] Why?
- Because it's smooth, but often times either with age
or maybe just congenital--
- Just born with it.
- The person's genetic--
There becomes like little,
they reminds me of icicles you know.
- Sure.
- Edges that could come down and they can cause--
Look at that!
- That'll work out good!
(Laughing)
- Impingement, okay, so with those--
- Or it could be the shape of it
it could be shaped like a hook.
- Right, there you go!
- [Bob] Exactly there's different shapes
that can cause a problem.
- My mind kind of got thrown off when the shoulder came off.
- [Bob] You pulled his shoulder right off.
Sorry 'bout that
- That's one reason why we retired him.
(Laughing)
So, we just come up with
the Statue of Liberty stretch while hanging
which we've had some really good success with.
- Yeah so...
Do we have the hanging book?
Is that over there?
- Yeah.
- I can show the Booyah Stik here first while you're--
So one thing you're gonna do is you can just
grab on to a pole again, or the Booyah Stik
and you could just lean into it like this.
- Yeah.
- And really puts a stretch on that shoulder--
- Right.
- And you could do...
Again pressure on, pressure off,
or you could just go ahead and hold it
which I do this every morning on my one shoulder.
- You do, yeah, great.
- I do a double stretch, I stretch my calf muscles
and I stretch this by putting it on the step.
- Oh sure.
- In front of me and well you know it works
it's double it's ya know I'm being efficient.
- Yeah two for the price of one.
So then the book we got, the concepts for this is from
Dr. John M. Kirsch, Orthopedic surgeon.
Worked on shoulders a good part of his life
the way I understand it.
But it's a really good book
and we've had some really good results.
- Yes.
- With this very simple exercise.
- You can also use a pull up bar to hang on.
- Right, yeah we don't have ours set up right now
but we do have this book in our favorite books.
- Yeah books below.
- Below and it's a wonderful--
- Take a look see!
- Yup, quick read, okay next one and not last
but probably this is one of the most common ones Bob.
- Sure.
- Tight pec muscles which produce...
Poor mechanics.
- Yeah rounded out shoulders.
- And when your shoulders are rounded out
the mechanics of the shoulder just do not work properly
and it really increases the chance for impingement.
If I'm rounded I can reach up this high.
If I'm in a good position, good posture
easily can get up higher.
- Yeah look how high that goes.
And this ya know day and age of us being on computers
you really need to do stretches
like Brad is showing right now.
- Right.
So you go to a door or a corner of a wall.
And just stretch here and depending on
where you put your forearms changes the stretch
so you're gonna do it and you're gonna hold it
you can even just go pressure on pressure off
or you can hold 15 to 30 seconds.
And you'll feel these muscles right in here
the major, pec major and minor getting a stretch
that's gonna help promote that posture
and eliminate some of these problems.
- It's one of those stretches you can actually
do throughout the day.
- Right.
- That's why every time you come to a doorway
go ahead and do a stretch.
- There you go.
Unless there's a lot of people behind you
you're gonna stop the flow of traffic.
- That's true, we don't wanna be
we don't wanna be responsible for that.
- Okay so there ya go those are the five most common
problems with shoulders and a few little ideas
on how to fix them.
- There we go, thanks for watching.
- Be careful.