♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the internet ♪
- Hi folks, I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Phyiscal Therapist.
- We are the most famous
physical therapists on the internet.
- In our opinion of course, Bob.
- Booyah.
- And strong like bull.
- Today we're gonna talk about how to fix
shoulder pain, impingement specifically.
Five easy steps, clinically proven,
and when we say clinically proven,
we've been seeing it in our clinics
that it's been proven to work,
and we've really had some good results with this.
At least I have, I don't know about you, Brad.
But seriously, from my family members to,
- I'm the one who made the video.
- I know.
- Of course I know.
- Well, I hope you do.
- Let's carry on, Bob, people are getting anxious.
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- You have a little thing to click on there.
- Right now we're giving away the RENPHO Foot Massager.
We're giving away two of these, I believe, Brad.
These are fantastic.
You want to dip it forward there, Brad?
So you stick your feet in there,
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well you can clean the inside of these,
but we have had good reviews on these.
People really love this thing.
- And it's on the Facebook too,
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- There you go, pinned, okay.
Shoulder, shoulder, shoulder.
So you know, Bob, with the shoulder,
the big thing is you want to regain motion,
but you need to do it pain-free.
If your shoulder is really sore and you just injured it,
you don't want to start stretching it right away.
You want to use a cold pack.
Get it to settle down, and it may take a couple days,
whatever, keep it comfortable, a cold pack 15 to 20 minutes.
You may do that three times a day or so,
but once this gets to the point
where you can start to move it,
then it's time to get it moving so it doesn't tighten up,
and you get a frozen shoulder or something of that nature.
- Yeah, you know, people are often shocked
how much their shoulder can hurt, I think.
Do you think that a lot of people are taken surprised?
They're like, it must be something really serious,
but just an impingement where you're pinching on the tendon
can actually send pain all the way down your arm
into the forearm, even.
- And so, again, this does address
a lot of impingement issues,
simply because it's probably one of the biggest reasons
for shoulder pain.
- It is, I mean, if I were to venture
a guess in my practice,
it's probably about 75% to 80% of the people.
- As a matter of fact, in one of the books I was reading,
they came up with 70%, unless you fall out of your car
or down the steps and you have trauma.
- Right, exactly.
- Anyway, the first thing to do
is we just want to get some motion with it.
So what you can do is just simply take a cane or a stick,
we got the Booyah Stik here.
- You can also use a broom handle.
- Yep, broom handle, anything that gives you,
let's say this is my injured shoulder.
I can start to move it, but up into here it starts to hurt,
so you're gonna give it some help with the stick
and my strong hand,
and I'm just going to give it assistance.
Now, often times, particularly with impingement,
you'll find right around 90 degrees it's a little painful,
but once you get up past that, it relieves.
And if that's the case, more than likely
it's impingement, almost certainly.
- Yeah, and you're trying with this,
wouldn't you agree, Brad,
you're not really wanting to recreate the pain.
- Right, right.
- You want to do this pain-free or all virtually pain-free,
because that'll just flare it up.
- You don't want to force it.
- Right, so hopefully by having the other arm help,
take it up to the point where you feel the pain
and then back down again.
- Good point, Bob, and you can do about 10 reps.
If it starts to get better each rep,
that's a really good sign.
- So the first one we're doing
is straight forward like this,
but then we're gonna go out to the side also.
- There you go, and when you do that one,
grab a hold of the stick with your thumb
pointing up toward the ceiling.
- Yeah, this one can be down, palms down,
the one that's doing the lifting.
- I gotta admit, I've had patients
where it was hurting that way,
but then I had them turn over,
and if that goes easier with less pain,
I will do it that way,
but it has to be less pain or no pain,
and you follow the symptoms.
- Yeah, and it's gonna depend on
where the tendon is pinching,
is basically that's why sometimes it feels better
with the palm down.
- So again, 10 repetitions, three times a day,
don't push into the pain, don't irritate it.
We're gonna take it gently.
Now we got five options here,
but I want you to go through and try all of them,
and you're gonna find probably that one or two of them
are gonna work much better than the others.
Those are the ones you're gonna stick with
until it improves.
- I would say these are often quite beginning ones,
wouldn't you say?
These aren't the ones that I don't think
are gonna solve the problem.
- Just getting you moving.
- Right, these next ones that we're doing,
they could actually help.
- Right, they get that joint into place
where it needs to be.
So the next one is just the,
- Mulligan flexion?
- Yep, the Mulligan technique.
You can do it on a cupboard.
- So what you can do here is go to a cupboard
or to the back of a chair or a table,
and what I'm gonna do is I'm gonna push down.
This is my involved arm, this is the arm I'm having pain on.
I'm pushing down into the table or the counter,
and while I'm pushing down, I'm walking away.
I'm walking away, I'm going as far it'll let me,
and then I'll walk back again,
and the entire time I'm pushing down.
And this is help taking that humeral head
and pushing it down into the socket
so there's more room for the tendon,
and hopefully it won't be as pinched as bad.
I mean, you can go ahead and do a good five to 10 sets
of these, five sets, I mean five reps of these,
and repeat them.
What's nice about this, you can do it throughout the day.
You can do it five, six times throughout the day,
and 10 times each time.
- You can do it on the back of a chair.
This chair is a little bit low, but you could do it.
Usually a little higher.
See, the idea is I'm pushing down this way,
my lats are contracted,
getting that humeral head into place,
and right now if I keep that thing, I actually,
- Yeah, it's a sneaky way of getting motion.
- Right, and I just bumped my mic.
- Yeah, you did.
All right, the next one that's similar to this
in some regard, what you're trying to do
is kind of similar to what you were doing with this one,
and this is Brad's invention here, is the Statue of Liberty.
So you can take a Booyah Stik,
you could take a broomstick if you took the handle
and maybe unscrewed it,
'cause you need a pretty good length.
You need probably a good five feet.
You're gonna put it on the chair like this,
and you're gonna grab it,
and then I lean forward and stretch.
This one's been real good for me, Brad,
as far as even people with arthritis have liked this.
I have an older gentleman right now, bless you,
that actually he's been starting this,
and he really likes the results he's been getting.
His shoulder has more range and there's not as much pain.
Little bit of a kind of a variation of the hanging book.
- Right, which I have right here.
- Oh, there you go.
- This book was written by an orthopedic surgeon
who worked on many, many shoulders,
and he came up with hanging, which we have videos on too,
but this does a very similar stretch to the shoulder
as hanging without having a pull up bar.
- Yeah, and you can do it one of two ways.
I'm just sitting here stretching, letting it hang right now,
or I can do pressure on, pressure off.
- So about 10 of these or hold it for 15 to 30 seconds.
Actually, the first person I ever did this with
was a high school baseball player, and you know,
he needed that range of motion,
and it worked well for him, and I thought
he looks like the Statue of Liberty sitting there.
So there you go.
What about the chicken wing, Bob?
- Yeah, this is the one I came up with.
So let's say this is the involved shoulder now,
this is the shoulder that's giving me pain.
I'm gonna put it up behind my back like this,
and I'm gonna grab it so my palm is out on this one.
My palm is forward on the other one.
- I'll show it from this angle.
- And you don't want to hit your head like this,
so I usually go out a little bit off to the side,
and you bring the arm up,
and then you're gonna actually push it out like this.
So up, and then push it out like this.
- Now, if your shoulder's not ready for this,
it's gonna be painful and it's gonna hurt,
and that you do not do.
- I've had some people, Brad,
that can't even get their hand back here.
- Right, and it's too early.
- Or they could get their hand back
and we can just start with this,
and then eventually we went to this.
But the reason I'm very affectionate about this one
is because this is the one that took mine away.
I shouldn't say it was just this.
I did the Statue of Liberty with it,
so one of them did it, and I was having troubles.
It was hurting, and it was like,
everything I moved with that shoulder, it hurt.
- Yeah, and it's not good for the therapist
to go to work with a bad shoulder.
- I'm a big believer on those two.
I mean, a big fan.
- Well, you know, when they work, they work.
And then the last one, this is pretty universal.
This particular exercise has been going on
with therapists for decades.
It's simply get some resistance bands.
We got two with the handles on.
You can use anything that has resistance like this.
- [Bob] You can put it on a bed post.
We're using the wall anchor right here,
but they often come with even door attachments
that you can put it in the door.
- Exactly, or you could have someone hold it
and hope they don't let go.
- My wife actually has one in the window.
She's used it for years.
She just closed the window on it, and she has an attachment.
- I know we get accused of babbling too much,
but just think, if you got this in the window
and you let go of this accidentally
and this flies into the window, there goes your window, Bob.
- I hadn't even thought about that, why would you let go?
- The exercise is like this.
Squeeze the shoulder blades back.
- So here, I'll show from this angle here.
I'm squeezing my shoulder blades together.
What you want to do is you want to give your shoulder
a good foundation, and the shoulder blades are what do that.
If they're winging out or coming forward,
that shoulder's gonna be more likely to impinge.
And this is great for posture too.
There's not anybody that wouldn't benefit from this.
- And then tell them about the shoulder blades
into the pocket idea.
- Oh yeah, it's nice as a visual to actually think about
not only bringing the shoulder blades together,
but down into the opposite pockets.
So you're really trying to visualize
that the shoulder blades are going down,
and it just helps you strengthen the right muscles
to do the job for the shoulder.
So those are the five steps, Brad,
and again, with the exception of the first one
where you use as a warmup basically,
yeah, these, try the other ones and see which ones help you,
and those are the ones you want to repeat.
- Be patient with it.
Shoulders typically don't get better overnight,
over a week or two.
- Yeah, it took a couple weeks
before mine started showing improvement,
but they did get better significantly when they did.
- Once you found that, whatever,
we're done.
- Remember, Brad and I can fix just about anything.
- Except for, - A broken heart.
- There you go.
- But we're working on it,
just like we worked on shoulder impingement, we fix that.
All right, thanks for watching.