♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ on the internet. ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous
physical therapists on the internet.
- In our opinion of course, Bob.
- Today we're gonna talk about dislocated
or unstable shoulders.
How to avoid surgery and pain.
We're gonna show you the seven top exercises.
- That's right, Bob.
So Bob, this is where a lot of people have had this,
but specifically Adrian I know,
someone who is- - Hey Adrian!
- dealing with this, and I said,
"I can show you some things."
We've had these videos before,
- Right.
- but I think this is going to be more comprehensive
and even better.
So this is gonna beat out our best.
- All right. - But, before we go that far.
- If you are new to our channel,
please take a second to second to subscribe to us.
We provide videos how to stay healthy, pain-free
and up we upload every day.
- Every day.
- Also go to bobandbrad.com,
go to the giveaway section, always giving away something.
- Yes.
- And this week we're giving away a FitGLIDE.
We'll show it to you in just a minute.
It'll also be pindistam page and Facebook.
You go to Twitter, Instagram, or TikTok
if you want a 60 second version of our program.
- And we have podcasts out there right now,
so you can listen to a number of outstanding authors.
- This is the FitGLIDE by the way,
it can be used in the chair or in bed.
Most people probably can use it in a chair,
under their desk, maybe.
- Right, it goes on the floor. You sit on it and you-
- It's a great way to get exercise.
Brad, do you wanna just show real quickly
how it can be used in bed?
- Yeah. Now, you know on the floor it's primarily for knee,
quadricep and hamstring,
but when you do it in bed, it also gets the hips moving.
- Yep.
So we can do that if you have painful or arthritic knees
and hips, walking and that is very uncomfortable.
This is a really good way to exercise them,
before you get out of bed or when you're taking a nap.
- Yeah, and the big advantage of it,
it's extremely lightweight.
So even the elderly can pick it up with one finger.
- Yep, and easy to clean.
There you go.
- Look at that.
- Wow. One finger Bob.
You are right. - Yep. Well 5 pounds right?
- 5.2, I think.
- Okay, there we go.
- Very close to five.
But let's get down to this shoulder thing.
I do wanna start this out with a story, Bob.
- Sure.
- It's a short one.
So just hang in there. - All right.
- We'll fast-forward. - Don't ramble.
- But actually, my mother fell, was about 15 years ago
in the winter time, landed on her elbow,
somehow, I don't know.
But I saw the x-rays,
and her shoulder was dislocated into her rib cage like this.
- Oh my god.
- It really hurt just to look at the x-rays.
To the ER they reduced it or brought it back into place.
And when she was done,
she was lifting her arm about to here.
You know, I lived a couple hours from there
and she didn't even do therapy,
with the exception of range of motion just to get it moving.
So whether you have a dislocated shoulder
or unstable shoulder, in other words,
your shoulder has a tendency to pop out
and it's a little uncomfortable and painful,
but it goes back in, kind of by itself,
these exercises are going to work either way.
- Right, 'cause you wanna strengthen to a large extent,
but a partial dislocation, it could be just like,
you go partly out of the joint.
- Right.
- And it pops back in by itself.
- Exactly. Exactly.
You know Bob, I think before we start showing...
Oh be careful with that.
- The hand was grabbing my microphone.
- Well, we'll talk about that later, Bob.
Anyways, I do want to talk about
the anatomy of the shoulder a little bit.
We do have to move forward,
because there's one part...
Let's see.
Can you grab that? - Do you have a pen?
Yep. Right there. - Oh, there it is.
- Thanks Bob.
If you look at this part of the shoulder
and we look at the ligaments and tendons
that keep that ball in the sockets, a shallow socket.
That's why I have good range of motion,
but if they get weak or loose, that socket can move around.
Now this one doesn't move, 'cause everything is tight.
But if you strengthen the muscles, if they're all intact,
all the rotator cuff muscles
and the deltoids are all intact,
we can strengthen it to get it like this.
This is the way it's supposed to be.
There is one thing that can be problematic
with a shoulder dislocation.
And that's if we open it up in here,
and there something called the labrum,
which is like a cartilage,
which is part of the fossa or the capsule of the joint.
- [Bob] Right.
- [Brad] If that actually has a tear in it,
that is one thing where it can be hard for that to heal.
It takes a long time for it to heal.
If it's a real bad tear... - [Bob] It may never heal.
- [Brad] ...that may need surgery
if you wanna go back to a high level of activity.
- [Bob] Also, if you're a person that just genetically
has really loose ligaments, loose joint, loose capsule.
- [Brad] Yeah.
- [Bob] If I remember right Brad, if you're like under a 17
or something like that
and you're dislocating your shoulder,
they're more likely to do surgery than if you are
if you are older.
- Sure.
- Because if you're older
you generally have tighter ligaments.
- Sure.
In the case where you've had an injury,
then I think you're better off.
You need to work on strengthening,
and really give it a good effort to get that shoulder
so you do not have to have surgery,
'cause there's nothing guaranteeing
that surgery is going to fix it.
- Any in any direction, whatever decisions you make,
the strengthening is going to help the shoulder.
- Yeah.
- I mean it's not bad to do it.
- No. - It's very good to do.
- It's gonna prepare it for surgery,
if you have to do that.
Otherwise hopefully you will not need to,
so let's show them some exercises.
- Sure.
- Key points though, Bob.
Number one, we talked about it being good
for the unstable or the dislocated shoulder.
Number two, we talked about the labrum tear,
that's something to be concerned about.
And later you're going to have to have an MRI
to really confirm that.
X-rays are not gonna show a...
- A labrum tear. - ...labrum., nope.
- Yeah.
- And all these exercises that we're gonna show you,
they should be pain free.
- Right.
- If you're working through pain, something's not right.
Listen to your body.
Skip that exercise and go to another one.
And that's the thing.
These are in order,
but you don't have to do them in this order.
The first one is not one that you'll continue to do,
it's just get range of motion.
If you only go this far
and it doesn't go any higher or it pops out
and that's it,
then you need to work some exercise
that we're going show you.
- But be careful that you don't go back like this at all,
'cause most people, I think like 90%,
they dislocated the shoulder forward.
- Yep.
- This, when you bring the arm back,
it moves the head of the shoulder forward.
- Yep. - So you don't want to go,
I always tell people there's like a wall right here.
- Right.
- Don't go past the wall back here...
- Sure.
- ...especially like this.
You'll get that apprehensive sign.
- Yeah, ooh.
- You'll feel not good about it.
You feel like the shoulder is starting to go out
and you'll wanna go forward.
- Well, I did want to say if sleeping on it
it's uncomfortable.
You wake up, and it's a lot of pain.
You gotta do what you can do not to roll over on that.
Put pillows on one side, obviously you roll the pillows,
so you don't sleep on that and dislocate it.
- Right. - Inadvertently.
That's a big one.
- Not good for healing, not good for comfort.
- Bob, you wanna show them how to gain that flexion motion?
- All right.
You could use any type of stick.
You could use a broom stick, you could use a PVC pipe.
We got the Booyah stick here.
It's nice, 'cause it's got tips on the end.
- Right, nice rubber tips.
- I use it 'cause I'm taller.
Some people maybe 'cause the shorter,
could start like this.
- Yes.
- But it's just a good way to start sneaking up on flexion.
So improve the range of motion.
- Go on up this way.
- So you could start off
by working your hand up as high as it feels not painful
at the shoulder.
And then you can lean forward like this
and put a little traction on the shoulder.
And stretch it a little bit.
Then you can work your way up a little higher.
- Yep.
- And stretch forward.
And you know, eventually
you'll get all the way up to the top
and you have regained your motion.
- Right.
- So then we gotta work on strength.
- Yeah.
I'll show you one way without the...
What my mother actually,
she just did the old fashioned wall walk,
where you just use your fingers to go up,
and then back down and back up.
And she did that for a number of weeks,
and she regained it all by herself without going to therapy.
Then she had her range of motion
where she could be relatively pain-free
without many symptoms.
Then she started the exercises...
- Sure.
- ...that we're gonna show you.
The first one, scapular retraction.
And that means squeezing.
This is gonna help posture,
if you don't have good posture.
- Do you see how his shoulder blades
are coming together?
- [Brad] Yeah.
- It's positioning this shoulder in such a way
that it is a lot more effective and useful.
- [Brad] Yeah. Well the ball is going to stay
in the socket much better.
- Yes. Yes, exactly.
- So you can do that without resistance.
For this, I really think you need some resistance bands.
If you're really gonna attack this shoulder...
- [Bob] Yeah, be successful at strengthening.
- ...and get it to be successful.
You need to attach it, and resistance bands,
you can hook it into a doorway.
They give you an attachment.
You can use a door knob. I've had a lot of patients.
We use the wall anchor because it just works really well.
Whatever you need to attach it.
And we're going to do the same thing,
but look how I use the resistance.
- [Bob] Be a little careful
if you go all the way back like this, Brad.
- Yeah.
- [Bob] Just again,
I don't want you to dislocate your shoulder.
Go only to neutral
if it feels a little uncomfortable to you.
- You're not going to go out like this.
- Yeah.
- Keep it in here, in tight like that.
If you need more resistance, just simply take a step back.
And if that gets too far,
then you just change to a more...
- [Bob] Darker band.
- ...darker band.
- Very, very nice to work with.
The next one, rotator cuff exercise.
- This is probably the most important one.
- Yeah.
- Right here.
- So you take a towel and you fold it up like this
and you'll see why in a second.
This elbow is a 90 degree bend here,
and I know Adrian's gonna be really good at this.
- Yeah, right angle.
- Elbow stays in by the rib cage and we do this motion.
- Yeah.
So palm must be facing in or to the right.
- Yup. - And he just brings it out.
Now, if you're cheating, you put the towel in there
to make sure that you keep the arms against the side.
You don't want the... Yeah, you don't want that wingy.
- If that falls out,
you know you pulled your elbow too far from your rib cage.
So a lot of times I'll have patients use that
just for the first few times,
and then you get used to keeping that in there,
but you can use it all the time if you'd like.
- Very important exercise.
- The next one, is you're gonna do going in,
which I'm gonna show you with the other arm.
- Sure.
- But you're going to do the same thing and go in.
Typically moving in is a lot stronger.
Sometimes you can just double it up
and you'll be fine with the same band.
And all of these we're going to do 10 to 15 reps,
and you should not get any sharp pain,
it just should be fatigue in those muscles.
- Again, you're keeping the elbow at a right angle.
- Yep. - And your keeping the elbow
right shape into the side again.
- Yep.
So these muscles are tightening up
and pull that ball into that socket so that it stays stable
and stays where it's supposed to.
- Yeah, that is the rotator cuff, it does its job.
The four muscles help hold that ball into the socket.
- There you go.
This is one I like to do,
is we need to get some weight bearing through that joint
and stabilize it.
- Plus you get a little range with this.
- Right. Yep.
We're going to start out on a table,
and you're going to do a four motions.
Your forward and backwards, 20 times,
while you're pushing into the ball with a straight elbow.
And then right and left,
don't push too hard that it dislocates,
so you can use good judgment.
- Yeah, you're keeping a pretty small range here.
- Yeah, just a few inches.
That's a good point, Bob.
20 that time and then circles clockwise.
20 times.
Then go opposite, counter-clockwise.
You'll be amazed how those muscles fatigue.
So then simply go to the wall at about shoulder level,
straight elbow, body weight into it, up and down 20 times.
And you can go to 30 times if you'd like.
Then right and left, tight motions, leaning into the ball.
Clockwise, counter-clockwise.
And give it a break.
You can do the other shoulder if you'd like to.
- And the final one Brad, number seven?
- Push-ups.
More weight-bearing, we're getting more functional.
By now it feels pretty good to do these exercises,
'cause you may not be doing six and seven,
these last two,
until you're feeling like a stronger shoulder.
I start pushups...
- [Bob] Against the wall.
- ...against the wall and do this.
And just see how it feels.
If you can do 10 like this,
it feels perfectly fine compared to the other shoulder.
Then you're going to go to...
Well you might wanna start on your knees, Bob.
- Sure.
- [Brad] Yup.
There you go.
And you can do 10 of them like this.
If this is too easy, you can go right to the GI pushup,
and a work that...
Bob you've been working on your form.
- Have I?
- [Brad] Excellent.
- It's a little better?
- So progress to pushups.
If you get up to 10, 15, it all depends, you know,
if you're an athlete or if your job...
I believe Adrian is building houses.
- Sure.
- Does some real fine work.
He was gonna need a little more strength.
- A little more physical, yeah.
- But I know he's got an athletic background.
He will figure it out very well.
So I think by the time we get to ending all of these,
you're gonna have a solid shoulder.
You're gonna get back, hopefully no surgery for you,
back to a normal life.
And like I said, my mother has been doing fine for 15 years
and she's 85 now and I just checked it yesterday.
- Oh did you really?
- Yeah, and she's up reaching around
and she's happy with it, so.
- She's able to slap you?
- Yeah, well...
Oh, I'm just kidding.
All right, very good.
- All right, thanks for watching folks.
- Good luck with that shoulder.
(end tone)