♪ 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 therapist
on the internet.
- Depending of course.
- Okay, Brad we're gonna talk about rotator cuff tears.
You know, how to get your strength back after this
and it's possible that you can even after a full tear.
- Sure.
- I've heard people that have done it.
- Because some of the other muscles took over.
Especially on a partial tear, but the thing is
it's a long program and it takes dedication.
Ours today, we're gonna go from easy to harder.
And you know, it's like a progression.
- Right. And I think, you know
if you wanna go to a high level
if you're gonna be throwing a ball or something like that
you probably not gonna get that.
- Yeah, we're gonna do that later Brad.
We got one that's called the throwers' ten.
We're gonna do that later.
But right now we're gonna do this one.
If you had surgery on your rotator cuff
this is not for you.
You might be doing some of these
but you need to follow their protocol on that.
So let's go ahead and get started Brad.
By the way, if you wait till the end, I'll tell a joke.
How's that? If they want.
- Oh that's gonna be good Bob!
- Oh, I'm sure it's gonna keep everybody.
Okay. You start off.
You're getting some, you know, you tore your rotator cuff.
You're having some pain.
You're gonna ice and elevate and all that.
But very quickly you can start to do shoulder squeezes.
Cause you need to strengthen
the muscles around the shoulder blade too.
- Right.
- So very simple.
You're just squeezing your shoulder blades together.
- Right, so I gotta show it like this.
- You wanna show on you Brad?
- You bet.
- So he's bringing the shoulder blades together.
We even talk about bringing them down
to your pockets a little bit.
So you can bring the arms out to the side with
a 90 degree angle.
Good set of 10.
You can do these throughout the day.
There's there's no limit on those.
- Exactly.
- I don't want you doing this though.
- Right.
- No shrugs.
Okay. So shoulder squeezes, number one.
Number two, you're gonna start doing pendulum
the famous pendulum.
So you're gonna lean over like this.
This is my affected arm and I'm gonna start
swinging like this.
Now I'm not going lifting it like this.
I'm letting gravity do the work
and you can go side to side like this.
Just don't hit things like this.
- Right. The idea is you're trying to
keep that arm relaxed as possible.
And you might just start if it's sore, you might just start
- Real little.
- Real small motions like this.
- And circles.
The thing that's cool about this is if you
start getting up into here, if I were to stop here
and stand up, it's a sneaky way of getting motion.
- Right, right.
- So again, that one can be started
almost right away too Brad, would you say?
- Sure.
- Don't do anything that increases the pain
but that certainly sometimes calms it down even.
- Exactly, a lot of times I have people say
Oh, that feels good, when they learn to
relax it and do it gently.
- All right.
The progression to the pendulum
the next one is actually this one, Brad.
I actually have people lay
on the edge of the mat or on the edge of the bed
just don't fall off please.
And you're gonna start swinging your arm this way.
It's a little bit different.
You got me Lonnie?
You're getting up a little bit even higher now
is what you're doing.
You're not working down this range.
You're working on this range.
Just a great way to do pendulum.
- Sure.
- PROM pendulums.
What's number three, Brad?
It looks like we're starting isometrics.
- Yep.
- You wanna get a wall?
- Yep.
- (laughter) I think we're gonna use this wall.
- Oh Bob, you gotta threw me off at the wall.
We're using a
- simulated wall.
- Right, a prop.
- So when you start isometrics and again
once you've started some of these, you can start
as you get further along
you don't have to do some of the earlier ones then.
- Right, Yep. They're progressive.
- Right. So you're gonna do innies, outies, and abduction.
So the first one here is , if this wall wasn't here
you put your arm at a right angle
Right elbow at an angle, 90 degree angle.
And you're gonna push in like this
and you're gonna push against the wall like that.
- Let's say this was a wall and this is a doorway.
You might stand in the doorway and face this way.
Then you can do both sides.
Why don't you do that?
- So I'm standing. Oh I see, okay.
So again, if the wall wasn't holding me
I'd be pushing it like that.
But I'm pushing, pushing 1, 2, 3
4, 5, 6, 7, 8, 9, 10.
1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
Now I'm gonna go to the other side and again
if the wall wasn't here now I'd push it out this way.
- This works good.
- So going like this.
So the same thing.
1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
Keeping the right angle at the elbow.
1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
What are we doing?
Ten on all these Brad? Or 8-10?
- You mean the length of time?
- No. The repetitions.
- If it's tolerated well
I like to go ten at the max.
Okay. Between five and ten
depending on the individual.
- Then the last one you're gonna do is
you're gonna actually push out like this.
So Brad, if I was pushing the wall, what would it do?
- Actually push that way.
- So I'm gonna push out here.
1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
And so on.
- Right.
- I think they got the gist, right Brad?
- You better believe it. They're very smart.
- You wanna show innies and outies Brad?
- Sure.
- We're not talking about belly buttons.
- Okay (laughter). All right.
So we're gonna start.
This is probably one of the
- Affected arm or this is the affected arm?
- This one right here is the affected arm.
This is probably
the classic, most common rotator cuff strengthening exercise
Would you say?
- It is, yep.
You really want to get those external rotators.
- Elbow at the rib cage cage, just lays there.
And then you just leave it bend down.
90 degree bend at the elbow
it shouldn't be down here past your belt line.
It should be above the belt line
right about at your belly button.
You can use a soup can.
You don't have to go out and buy a weight.
- [Bob] That's what we're trying to do here today
is give you stuff that you can do at home.
- Right, you don't have to go out
and purchase a whole mini rotator cuff kit or weight room.
And you simply go up like this.
Early on, you may not even need a weight, you know?
If it's sore, you might just do ten of these
and it'll be
- [Bob] You can't even handle a weight.
- Right And when you can do up to 15, it's too easy.
You can get a one pound weight
or a 12 or 16 ounce soup can, hold it in your hand.
- And even if initially you can only go up to level here
that's fine too.
Very important muscle part of the rotator cuff.
And you need to start strengthening that.
- I can feel that working already, Bob.
- [Bob] Yeah. It doesn't take much weight.
You'd be surprised.
These are not big, heavy muscles that you wanna bulk up.
- Right. And a good point, Bob is pain-free range of motion.
And if you only can go out halfway
and then it starts to hurt.
Just do it in the half.
- [Bob] Yeah, work in the range that it gives you.
- Now, we wanna also work the innies.
- [Bob] Yeah. And on this again
once you've done these, you no longer have to do
the isometric ones that we just taught you against the wall.
- Right. You progress out.
- [Bob] You're progressing, you can stop these.
And these are usually a stronger muscle.
- Yeah, exactly.
You're definitely gonna use a little more weight on this
and you go simply right up to your stomach.
- Brad's trying to lay off the shoulder a little bit.
Try to lay, you know, maybe a little more onto his back
because obviously you don't wanna lay on the shoulder.
It might hurt.
- And these quite honestly are probably
not as important as the other ones.
- [Bob] That's for sure.
I agree, Brad.
- You know, if you have some thera-band
that's another video.
- [Bob] Yeah, if you have a stretch band
it would work a lot better to do these
and you could do heavy duty.
You're right.
I actually never do those.
I do external all the time.
- I usually don't but yeah.
- Okay. Prone.
I'm gonna go ahead and do prone or supine now, Brad.
- Supine?
I'm sorry.
Laying on my back (laughter).
So now the arm's coming along
it's getting stronger.
Again, this is the involved arm right now.
Now we're gonna do active assistive range of motion.
The other arm's gonna help out.
Now you can do that one of two ways.
You can actually just grasp your hand
like this and start working, going up like this.
Try to let this one help.
I mean, you know, let it come into the picture too.
Let it do some of the work.
- The arm that's not injured is helping
but only as much as it needs to.
- Right. And that's why sometimes a cane or a broom
or something, some type of handle PVC would work better.
Because you could start with your hands together like this.
Where it's helping out a lot.
And then you can go to the point where it's helping less
by putting the arms apart.
Does that work, engineer Brad?
- Yeah, I like that.
And again, you're gonna go up to here.
If you can go farther without pain, you can.
- Yeah, give it a stretch.
Go ahead and give it all the way like that.
- Usually what happens is once you get up way up here
it starts to hurt early in the rehab.
- Right.
This is the next step
which I liked a lot.
This one, I don't think a lot of people do Brad.
But I want you to come up and now you're gonna let go.
And you're gonna see if you can lower it down on its own.
If it just goes like this
it's probably not ready for that yet.
And then you're gonna wanna
still work on doing up and down with it.
- Sure.
- But bring it up, let it go
and see if you can lower it down.
Slowly lower it down.
- Right. So that's technically eccentric strengthening.
Which is a good way to start a weak muscle.
- Very key to starting to... oh I got one more this way.
- Oh yeah.
- So when it finally
when you're able to lower it down
then you wanna start seeing
if you can bring it up on its own.
This is a big day when you start doing this Brad
because now the muscles are starting to work.
They're kicking in.
- And if you can do that without pain
the joint is where it needs to be for the motion
which is a really good sign.
- Right. It's rotating like it should too.
- Exactly.
- So once you're able to do that
then you can try doing it seated.
Cause now you're fighting gravity more.
- Exactly.
- Now you're gonna start
and if that's too much
you may wanna do seated active assistant first.
- Right, so the strong arm helps through the cane.
- Yeah. Again, this is harder than laying down
because we're fighting gravity more this way.
- Right, exactly.
- So start with this and if this works
then you might even do this and let go and do eccentric.
All just ideas on how to roll here.
- Yep.
- Okay? And then finally
you're gonna do active range of motion, seated.
- Now on this, you might find
that if your thumb is pointed up
It may go a little easier.
That's one of those little mechanical things
in the shoulder joint up.
- Yeah. You certainly don't wanna go this way.
It won't go any farther than that.
- Yeah. That's gonna limit it.
- So then the final exercise
would be taking the soup can
and start working, maybe go up to 90
and then eventually even up like that.
- Right, as long as it's pain free
and you're just feeling muscle fatigue.
There's a lot of nice tips in here about it.
- Yeah. There is, it's a long program.
- We're giving away a lot of secrets from therapists.
- Yeah, this is valuable (laughter).
- Therapists are gonna get mad at us
because you won't have to go see them anymore.
- So Brad, did you hear about my dog?
- No. Bob, I want to hear about your dog.
- He's been a real problem.
He's been chasing people on his bike.
- Oh good (laughter).
- I already screwed up.
He's been chasing people on a bike
and I was gonna say
it got so bad I had to take his bike away from him.
- (laughter)
- I'm not a joke teller as you can tell.
- Yeah Bob, that was funny (laughter).
- All right.
Thanks for watching.
- Take care. Now, they're never gonna...