♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
(clapping)
- Hi folks, I'm Bob Schrupp physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous
physical therapists on the internet.
- In our opinion, of course.
- Got my serious face on.
Today, we're talking about understanding shoulder pain
and how to fix it fast.
- Right.
- We're all busy, Brad.
- Right, and if you understand things
and you can work with it yourself
and you can relieve the pain under your own control,
it changes your whole life.
- That's right.
- You know, so we got--
- By the way, if you're new to our channel
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We provide videos on how to stay healthy, fit, pain-free
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Also go to bobandbrad.com and to the giveaway section.
We're always giving something away.
This week we're giving away the Booyah Stik.
- Yes.
- Which we will show you how to use in just a little bit.
- You can't go wrong with it.
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And we have--
- Podcasts.
- Podcasts every week with terrific people
that are really smart.
- Absolutely.
- All right, Brad, let's get it rolling.
- Okay so, shoulder pain, we're looking at shoulder pain
here that, probably not if you fell down
and you had trauma.
It's at shoulder pain that comes--
- We're not looking at fracture or anything like that.
- Right, from overuse, from working with it,
maybe some age, some arthritic problems.
It's just there.
And it's like, how can I control it or get rid of it?
So we're gonna show you some answers.
- So basically we're gonna talk about
two probably the most common causes.
- Correct, right.
- We're not gonna cover everything
but that'll cover the two.
- Vast majority.
- Yeah.
- What is arthritis?
- Right.
- In the joint, and we'll bring Sam over here to show this.
And then along with arthritis, there's that,
whoa, Sam, what happened?
- Sam's fainting.
- Oh my gosh.
Shall we dance?
No, let's carry on here.
He's all right.
So let's look at the joint here.
If it's arthritis.
Let me get the pen over here.
Wow, he's in tough shape.
- He's in tough shape.
There we go.
- The ball is often times, of the humerus,
you got a ball, a shallow socket, but--
- It could be slid forward a bit.
- Sure, it's either not in place.
We've got the shiny cartilage can turn into,
I always kind of compare it to a rusty surface.
- Yeah, it could flake.
- Yep, sandpaper and it rubs and it's painful.
The labrum I was talking about
is actually right on this surface.
- You can actually see it over there, if we pull.
- If we pull away here, we have got some ligaments,
and right there, that black part.
Can you see that Tanner?
That is where the labrum is.
If we put this in there, that labrum helps the ball stay
where it should be.
That labrum can get torn.
- [Bob] Right.
And it can wear down with age.
- Yep, it's one of those--
- [Bob] Aging things.
- Yep, exactly.
- [Bob] Like wrinkles.
- Yep, gray hair, wrinkles, labrum issues.
- Right.
- Now, the other thing, is we got a real common problem,
is a supraspinatus tendon.
- Sure, that's the other common thing that
we're gonna mention.
- Right, it's a rotator cuff tendon.
There's four rotator cuff muscles.
But the one in pink here is by far
the biggest problem child.
- Right.
- An estimated 70% of rotator cuff problems
is right on there.
And what happens is, when you go raise your arm up,
it's pinching right there because what's suppose to happen
is it's supposed to drop down
so that you have space in there,
but there's mechanical problems, it pinches.
Problems that can tear and actually separate.
- Over time, as again, it's aging.
Well it's wear and tear type of injury.
- Right, it depends on your work
and even at a computer workstation.
- Yeah, doing a lot of overhead, or if you're doing,
if you have poor posture.
- Yeah, just, if you have your mouse too far away from you,
that can actually stress that tendon.
- Yep.
- Anyways, we're gonna back up.
We're gonna start with some range of motion.
Particularly if you have arthritis,
that shoulder needs to get moving.
We're gonna show you some gentle arthritic
or a painful shoulder.
What's going on with Sam over there?
- Yeah, he's having problems.
- Always looking for attention.
- Some of the pain you're having from arthritis
might actually be not to all the wear and tear,
but the fact that you lost motion.
And when you gain the motion back,
a lot of times the tissue gets stretched
out and you feel better.
- Right. - So.
- So we're gonna start pretty simple here.
- Sure.
- Let's just start with some
swinging the arms back and forth.
What?
- I don't want to hit you.
- Oh, he's got those six foot wingspan there,
six and a half.
So this is just very simple, if--
- The Michael Phelps crosses.
- Yep, this might be all you need,
and this is gonna feel good.
But if you feel that just is easy,
you want to get more range of motion, you have to circles.
You can do one arm at a time or both.
And we come up like this and you can turn that thumb
or the palm away from your face.
- Palm forward, palm side, palm back.
- Yeah, kind of like you're washing a window,
but we're not gonna spend that much time.
We do it about 10 times on each arm.
- And you can reverse it too.
- Sure.
- Go the other way.
- Now, if every time you go up and it feels like
it's pinching in there, don't do this one.
- Right.
- Then we're gonna show you some exercises.
- You can do Codman's.
- Yep.
- You can just swing it and let it relax
by just using your body to kind of swing it here.
Don't use the muscles of the arm to swing it.
- This would be for if this isn't tolerated.
Maybe this one is, but it's a pretty sore shoulder.
You may even start with that one.
So we're talking about five to 10 repetitions
of each of those.
If they're too easy and you want to do a little
more aggressive range of motion,
we're gonna show you that in just a second.
- We're gonna show you that later on.
So right now we're showing some things
to manage the arthritis.
- Yeah.
If those are tough and you need some,
sometimes people just get some warmth in that joint.
Loosens up the muscles, loosens up those tendons.
A good way to do that.
You can use a hot pack.
You can take a shower.
After a shower, warm it up.
If you really want to get deep in there,
a real effective way to do it,
the most effective way is, deep heat is through--
- Far infrared.
- Far infrared hot pack.
- We recommend the Thermotex.
It's expensive, I'm gonna warn you.
So it's not for some budgets, it doesn't fit in.
But it does penetrate 2.36 inches,
which is quite deep into the joint.
Whereas regular heat only penetrates a millimeter.
- Yeah, it's basically skin deep.
- It's surface.
- Even if you take a shower
and you put that hot water on there,
it's pretty superficial, but it's still,
you'll find that it will help.
The next thing is avoid sleeping on that shoulder,
no matter, regardless of what.
If you sleep on it, the muscles relax.
It can push that humeral head
out of position and create some notable pain.
So if you're, oh, you want to?
- I was gonna show real quickly.
If you are just in such a habit that you end up
sleeping on it, I'm gonna show you what to do.
- Oh, yeah, the canal.
- Yeah.
- We haven't showed this for a long time, Bob.
- So here's, just take a throw pillow.
I do this every night and then I created a canal here.
Here's the painful shoulder.
- Yep.
- I lie on the pillow.
I usually have two pillows when I sleep on my side.
And you can see how the pressure now is here and here.
Not on the shoulder.
- You're right.
- But ideally, you want to sleep on the non-painful shoulder
and then you want to keep this arm supported.
- Keep some pillows around.
Yep, exactly.
- Support that painful arm.
- You can fold the pillow there, but yeah.
And then in a seated position, if it is painful,
even if it doesn't feel real painful,
you might be amazed how much better if you watch TV
and you just put a pillow under that sore shoulder.
- This alone is one hint that has helped more people than,
when I see people at the first treatment,
I usually give them one exercise and I give them this.
And this, they come back and it's calmed down.
- Right, yeah.
I mean, I've got a pain-free shoulder.
It just feels good like that.
- Well, it puts the shoulder blade up too.
Like if the shoulder blade is hanging.
- Yep, gives you a little better posture, which is crucial.
- Right, right.
- All right, so now we're gonna bump up.
If you do have that tendon problem,
reaching out overhead is consistently painful.
We may want to address that.
And we're gonna show you that,
working some postural exercises and some range of motion.
- Sure.
- And actually the giveaway has something to do with this.
We're gonna use a Booyah Stik.
You don't need to have a Booyah Stik.
You can use a stick, anything that's about five feet long.
You can take a broomstick, cut the broom head off.
- PVC pipe.
The thing that you want to do is make sure
it doesn't slip on the surface,
whether it's on the floor, up on the chair.
Bob's gonna grab one.
- Yep.
- So you move your hand up on the stick
and then you grab the stick and lean forward,
and that's gonna stretch that shoulder out.
And you just keep it relaxed.
So Bob's doing it in his chair.
- I'll sit here because I'm taller.
So what's nice about this is yeah,
you can start off, just walk your hand up as high
as it'll go and then lean forward.
And then come back and walk it up again
and then lean forward.
And the Booyah Stik has really good grip.
- Oh yeah.
This is no doubt a really nice device for this exercise.
- And you can even hold it for a bit.
Don't do this mistake.
Don't go forward and let it slide, hands slide down.
You gotta put some traction on there.
- And you'll do this five to 10 times and hold it.
It should feel good while you're doing it.
- Yeah, no pain.
- No sharp pain, especially.
That means it's not ready for it.
- You can do it throughout the day.
- Yep, exactly.
- It's not something you do once a day,
it's something you do throughout the day.
- Yeah.
- And people that I used this with
that had arthritis, really liked it.
And even supraspinatus.
- Oh, right, right.
We're gonna show you the next thing is particularly good
for supraspinatus impingement.
There was a surgeon, not was, he's still here,
that wrote this book.
And if you have a pull-up bar or something
you can hang on at home, it's called hanging.
This has saved this surgeon a lot of surgeries,
his patients actually.
- Yes.
- And he wrote a nice, how many editions?
He's got about four editions of that book.
- Yeah, I'll find it.
- Yeah, what you do is you grab a pull up bar, okay.
We use our handles here.
This is our pull-up handles.
This is nice 'cause it allows freedom with your wrists.
And if your back is up against the wall,
it kind of helps your posture.
And you gently go down and you stretch,
and you're gonna hang there.
And this will increase that gap
so the supraspinatus tendon no longer impinges.
And typically this won't take care of it in one treatment.
This takes a week or two or maybe more.
- Yeah, this is a commitment to time
and putting in the effort.
- But it's not a big deal.
- No, no, no, it's not.
- You hang for 20, 30 seconds.
- And again, throughout the day I think, if you can do it.
- And, 'cause I was having this problem,
is I was only hanging maybe a couple of times a day
because of my schedule where my--
- Yeah, you're a busy guy.
- Yeah.
But anyways, it worked.
It worked very well.
- Sure.
- It took a couple weeks.
And I'm just hanging, and actually now I just do it
for maintenance and it just feels good.
It feels good in the ribs and my back.
- Even decompresses the back a little bit.
- Exactly.
- And so his book is
Shoulder Pain? The Solution & Prevention
by Dr. John M. Kirsch.
- Kirsch, yep.
- So really good testimonials in there.
- Oh yeah.
- People that were going in for surgery.
- And he's got a great research in there.
So anyways, well-written book for the therapist
or the lay person.
Bob, do you wanna continue on?
- I was gonna go one more to chicken wing.
- Chicken wing, sure.
- Okay, now if you don't have rheumatoid arthritis,
because I don't want you to try this if you do.
If you have loose shoulders, I don't want you to try this.
But this is basically a little more complicated but--
- Little more advanced.
- But both Brad and I really had good luck with this.
- I just did it this morning.
- So palm on the top.
The stick is facing..
- Forward.
- Yep, palm on the, is facing back.
So now what we're gonna do is
I'm gonna actually pull up the arm like this.
Now you can first work on just internal rotation.
You can just slide the pole all the way down like this.
- That gets you that motion to reach behind your back
so you can tuck in your shirt.
- Yeah, 'cause you'll find with most people,
the involved shoulder will not go up as high
as the uninvolved shoulder.
- Yeah, it would be like this compared to this.
- Right.
- I want to get this one up.
- So we want to start stretching it this way.
And then the advanced stretch is to actually
tilt this forward.
Don't hit your head.
Tilt it forward.
Don't bend forward, stay straight up
and you're turning it into a chicken wing.
You said that's like a wrestling term or what?
- Yeah, it's like when you do the chicken wing
when you wrestle.
- Sure.
- Well, I don't know.
That's what we called it.
Anyways, so there should be no pain with this.
- Right, no pain whatsoever.
- Just a stretch.
- Stretch it out.
- Stretch feeling.
Do both sides. - Yep.
- I do it about five to 10 repetitions.
- If you have shoulders that want to dislocate,
I wouldn't do this one.
- No, no, no.
Hypermobile, double jointed, whatever you wanna call it.
- Hypermobile, yeah, exactly.
But for, Brad and I both had good luck with this.
It took mine away.
- Yeah.
It was the only thing that took it away.
- I just do it for maintenance now.
- Sure.
- Because I realized that my, this one got tight
or loosened up and I had my good shoulder
is tighter than my sore shoulder.
So I want to even 'em out.
Good maintenance.
Posture, you want to take a band.
Stretch bands like this, anchor it up.
We'll use a wall anchor, you get it to a doorknob.
They give you a strap with these.
And we're gonna work scapular retraction.
We do this one a lot.
So I'm gonna squeeze the shoulder blades together.
It's gonna work your posture.
It's gonna help the rotator cuff muscles
and get that ball in where it goes.
You're gonna do 10 to 15 of these.
Okay, and then also on this, we're gonna work.
Where did that towel go Bob?
- External rotation.
- Yep, this one.
90 degree bend in the elbow and go out.
There it is.
Now the trick to this one is,
is you're gonna put a towel roll right here,
or you can use anything.
But I usually do a towel with my patients.
And that form, and if the towel falls out,
that means your elbow got too far away from your body.
Pinch the towel in and work 10 of these.
And you'll feel, you're working a specific rotator cuff
muscle in there to help that joint go where it needs to be.
- So get that, make sure you get that posture one in there.
'Cause the day without posture is a sad day indeed.
- Well Bob, absolutely.
I think maybe we should.
- I just made that up.
- Yeah, we'll put it on T-shirts.
- Right.
- So, very good.
Once again, Bob, we can help just anything except for..
- A broken heart.
- And we're working on that too.
- Yeah, we're working on that.
- Yeah, we're a little slow on that.
- It's a little slow on the uptake.
- Whatever, we'll give it a shot.
- Thanks.
(upbeat music)