- Oh!
(Brad and Bob chuckle)
Bob! We have-
- Why?
- Both Bob and I, together, we're thinking about this.
We have treated over, you know,
thousands of rotator cuff patients-
- Shoulder.
- ... shoulder patients over the years,
often with rotator cuff problems.
And we came down with three treatments that worked the best.
- We like these.
- And lot of these treatments actually prevented surgery.
- Right!
- So we're gonna get right at it after this message.
(Bob laughs)
(singing) Bob and Brad - (singing) The two most...
♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- We just wanted to show a little bit of the mechanics
of the shoulder.
You realize that the shoulder
has one of the most complicated joints
in the whole body.
It can move so many degrees of angles.
It has so many working parts.
- Plus the shoulder blade.
- Show the shoulder blade?
- Plus the shoulder blade.
- Right, and that is all part of it.
One big thing is impingement,
and impingement is probably up to 70% of shoulder problems.
And this...
Bob's finger, he's gonna sacrifice this finger.
- [Bob] Right.
- That represents that supraspinatus tendon.
And impingement means-
- [Bob] Ow!
- Yeah.
That's what happens when you go up like this.
Say it again, Bob.
- [Bob] Ow!
- There you go.
We gotta eliminate that impingement.
Okay.
So the first...
if you're having this shoulder problem,
we're gonna take a McKenzie-
- Robin Mackenzie.
- Right.
He was one of the first...
he's passed away now, but he is...
every therapist knows about him.
This technique has...
I can think of one patient right off the top of my head.
She was scheduled for surgery.
We did this extension exercise.
Surgery canceled after a week.
- Wow!
- So anyways,
and this extension where the shoulder goes back this way.
So if you can go back this way and it feels okay,
well we need to do that more often.
- Right.
- So we'll do it up to 10 times
and it's like,
"oh, it feels good.
It feels better.
I can lift up my arm higher."
- So maybe six to seven times a day?
- Right.
And if we wanna add a little overpressure,
you can take a stick like this
a broom handle,
Booyah Stik,
whatever.
Bring it back to here and then I'm gonna drop down
and a little more stretch.
None of this should create sharp pain.
It should just be a nice stretch.
And what you'll do
is see how far you can go up
before the stretch.
Do the stretch 10 times.
And if you can go up higher with less pain...
- That's test retest.
- Yep, test retest.
The other way to do this,
this may not make sense to the layperson-
- Right.
- ...but this is the same stretch
and it's a little more complicated too.
- You could use a broomstick.
- Yep.
And you just need a stick about four to five feet long
whatever it is.
Grab it like this: thumb down palm away from you.
Go over the top of your head.
Again, this is a little weird.
Now this would be the shoulder getting stretched.
Palm is away from you
so the back of my hand can touch my back.
Grab the stick there
and pull up like this.
This is actually the method that worked well
for that patient I was talking about-
- Sure.
- ...where it eliminated the knee for surgery.
- Again, you do this five or 10 times.
- As you can tolerate it.
I do the test and, after the stretch, do the retest.
- Retest.
- If it's better after the stretch,
you know you're in the right direction.
- You're healed!
- Be gentle.
Don't get too aggressive.
It may not come in one or two days,
but as long as it progresses.
Let's go to number two!
- Will do!
- Okay, the second stretch,
we're actually getting this from Rick Olderman,
who's a physical therapist.
He's written a number of books on self...
how people can self-treat.
This is one of his stretches
in order to get the scapula moving in the right direction.
- [Bob] Right.
- If the scapula doesn't move
with shoulder motion and properly,
it will create pain.
So this is a stretch to allow mobility where it should be.
And you do...
just like Bob is on here on all fours,
holds his hands in one spot and stretches.
And again,
this should not create any sharp pain,
a little stretch pain,
but not too much.
Don't overdo it.
Five to 10 repetitions.
But do not get into that painful area.
If this is starting to look good
and this is the shoulder that has a problem
and you can go all the way back without pain,
simply take this hand
and move it over this way.
And that'll give you a little bit stronger of a stretch.
So we get that scapular motion
so we know we have adequate scapular motion
that's gonna help that shoulder joint.
How you doing Bob?
- I got a runny nose.
(Brad and Bob laugh)
- Don't worry about it, Bob! It's Christmastime.
Okay, we've got the third option.
And this is actually from Dr. John Kirsch.
He's written a book
and he's got a number of editions to this
but he calls it... it's "hanging."
How to improve your shoulder health by hanging.
He should know because he's a surgeon of shoulders
and he has written this book
and, actually, he lost business
because he started having people doing this-
- That's right.
- ...less surgeries.
It's a good book.
Please buy it if you want to.
It's written for the layperson.
The primary stretch he talks about is hanging.
Look over here.
Don't look at Bob yet
(Bob chuckles)
'cause he's doing it,
but he's doing a modified Bob and Brad method.
If you have a pull-up bar at home, it works well.
If you have hanging handles
we think this works a little bit better,
but it's not necessary.
Pull-up bar is fine.
Make sure whatever you have is low enough
so that when you grab it,
you're not hanging.
So now,
the wall...
the reason the wall...
or the pull-up handles work better
'cause you're up against the wall
and I'm sliding down slowly.
And that's important that you don't get on this
and hang all your weight right away
'cause that can be too much too soon
and you can cause problems.
Just go down and when you get 50% of the weight
and see how it feels.
Let it back up and see how it goes.
And this is one of those things that's gonna be some pain.
- A little bit.
- Yeah. - Yeah.
- Don't get too aggressive.
Use good judgment.
That's why the first day you do it,
I wouldn't get too aggressive.
See how it feels after you're done.
You know, work it out.
Come back the next day.
If it feels pretty good,
then you can add a little resistance
and hang a little more.
It may be a few days or a week
before you can do full hanging.
The goal isn't that you necessarily full hang right away
but once you get there,
you're gonna hang.
And again, 10 to 30 seconds is all you're gonna hang.
- Right.
- And actually he does talk-
- Work your way up.
- Yeah, you work your way up.
I never...
I do this for maintenance on my shoulders.
- Yep.
- If you don't have hanging handles
or you don't have a pull-up bar,
but you do have a stick,
a broomstick,
a piece of doweling,
about four, five foot long.
This is an option.
- Yeah, reach really high, and lean forward a little bit.
- But make sure the hand is gripping tightly up here.
When you lean forward
and your hand doesn't move
what that does is it puts that pole
or that hanging traction just like what we did over here.
So it can work really well.
This is a nice option for it, Bob,
don't you think?
- I feel like a monkey.
- Yeah, well you look like one.
(Bob laughs)
- Okay.
Now after you get your shoulder so you can elevate it,
you got that impingement worked out with...
you may work more than one of these.
Maybe only one of these techniques is working fine.
So only use the technique that works good.
But once your shoulder's feeling better,
you need to do some specific strengthening.
This is bonus on the video we're gonna show you-
- Right.
- ...a couple techniques.
You need a resistance band and,
you know, if you just have a band,
you can do this motion
and that's going to work the external rotators
of that shoulder.
It works better if you can take that band
and anchor it around a bedpost,
a doorknob works really good.
We've always used doorknobs with patients over the years
but we found out,
you know,
if you use these for other exercises,
you may have a wall anchor.
You want to get one, that's up to you.
But anchor it somewhere where you can do this.
Every therapist does this exercise
for a rotator cuff strengthening.
- Keep a right angle.
- Yeah, right angle here.
Don't let this happen.
- No flying!
- Make sure that you have the elbows in tight
and you go out like this.
I have found if it's sore and it kind of hurts up in here-
I had a problem with this-
and I reached over in here,
put a little pressure right on the top of that joint,
and all of a sudden,
oh, I can...
it feels much better when I do it that way.
And then after about a couple weeks
I didn't need to do that anymore.
And it was a real...
- Helped you a lot.
- Yeah, I made that up myself, Bob,
but it really worked well.
- Good job.
- Yep.
The next one- I wanna show Bob this.
We don't talk about this a lot,
but if you have...
I think this is forgotten
in rotator cuff strengthening sometimes.
- Yeah?
- You take a ball that's squishy,
put it on the wall, elbows straight,
and then you lean into it.
And this works on the muscles that contract
to co-contract
to stabilize a joint with pressure on it.
Like if you're pushing a cart or a wheelchair,
something like that,
this exercise is really important.
Push on it
make circles in both directions
up and down,
right and left.
And you'll be amazed
how much fatigue you feel in that shoulder joint
after 30 seconds of doing that.
- We'll help the rotator cuff do its job!
- Absolutely.
You first get at the range of motion,
strengthen it,
and then go to work and be careful.
We don't wanna have shoulder problems your whole life.
Well Bob,
once again
we can fix just about anything except for...
- A broken heart.
- Yeah,
and I'm not gonna go crazy this time.
I'm just gonna be calm and collected.
- Calm and collected.
- No stress.
- Mm-hmm.
(Bob and Brad laugh)
(cheerful upbeat music plays)
(music continues)