♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet. - In our own opinion,
of course, Bob. - And today, we wanna show
you how to use a TENS unit with elbow pain.
Basically, we we're gonna show you correct pad placement.
Brad and I have looked at dozens and dozens of TENS units
and most of them are really actually pretty good.
- Yep. - So--
- They all work fairly decent. - Yeah, they all
work fairly decent.
What we did find though, a lot of them don't
have very good instructions.
- Sure.
- Some of them don't have virtually any instructions.
(laughing)
- So we decided we're gonna endorse one brand.
We're endorsing iReliev.
And with the iReliev brand we did do videos,
describing how to use some of their specific products.
- Right.
- Their product number, were like was one was the
1313, 8080, and 5050.
If you go to Bob and Brad, our website, BobandBrad.com,
all spelled out, go to the program section,
and then you'll find the TENS series.
And we got a whole bunch of videos all about TENS,
depending on where your pain is and how to use the TENS,
and we'll demonstrate those three units.
If you got a different unit from a different--
- Manufacturer.
- Manufacturer, that's fine.
Uh, but we can't help you, right?.
- Well, the pad placement is the same.
- Right. - The concepts,
- No matter what, which pads you have,
our pads actually aren't colored like this.
We'd colored them just so that you know,
when we're using channel one and channel two.
- Right.
- But our pads are normally just black.
- Right, and almost all TENS units have two channels.
That's pretty common.
- Right, so with the elbow pain, we're talking about,
maybe tennis elbow, which is where Brad?
- Right where this red spot
is a most common complaint, pretty specific.
It can get spread out if it's a severe case.
Golfer's elbow. - Golfer's elbow?
- Is typically right here by the medial epicondyle.
That's why it's technically medial epicondylitis.
- [Bob] Sure.
- And lateral epicondylitis.
- And then we're all going to do one just for kind
of general pain, maybe for arthritis or something,
and we'll show you one with four pads.
Let's start off with one pad.
What's the first thing Brad though?
We do talk about shaving hair and maybe.
- Yeah, if you have a lot of hair, 'cause it makes the,
the pads will last a lot longer, they stick,
stickiness to the skin as much better if their hair is gone.
- And it also, the skin is clean.
- Yeah right soap and water, let it dry off thoroughly.
- So, again,
there's really no specific right or wrong to pad placement.
We gonna show you some general guidelines,
and you got to figure out which one works best for you.
So let's start off with the tennis elbow.
The first thing you do is try one pad right
on top of the pain
- Mhm.
- [Brad] And this is where we're going to first issue one
channel and two pads.
- So the second pad could either be below the pain,
and how much far, how far apart do you keep Brad?.
- [Brad] Well, the, the width of a pad or you know,
between three or four fingers.
So you might go, a lot of times I have a patient say,
put four fingers on there.
And go right about there.
A little closer, you know, plus or minus a half inches.
is not a big deal,
but you definitely don't want go this close.
- [Bob] Sure.
- Or touching for sure, you never want to have them touch.
There we go.
We could go there or we could experiment with going up here.
- [Bob] Sure.
- Should I just continue on Bob?
- [Bob] Yeah, keep going.
- Okay, then we could go one above and one below.
And get that TENS stimulation going right across--
- [Bob] Have to stay above you you have to be like that.
(laughs) That's fine Brad, that's fine, you understand--
- Gettin' technical on ya. - Yeah, yeah.
- If you do have more global pain around this part,
of the elbow, then you can go four,
two channels four electrodes.
And I'm going to put one there and one there.
Channel one.
- [Bob] And, and that's by the yellow pads,
and channel two is a green pad.
- There, and.
- [Bob] Now Brad's been using these pads a lot.
Also on hairy area so they're not sticking as well
as they should right now.
- Right, yeah, cause I started with these on my leg.
You can see the marks and they hair,
when you got this much hair,
it pulls off and it sticks on there, which really, really
decreases the stickiness.
- [Bob] What this does now, it actually creates a cross.
- Yeap.
- [Bob] You to see how it makes a cross and that'll work
on the whole elbow to some extent.
Now you can also do more of a,
- Well yeah, I'm going to show this and there
is one thing that you have to with certain joints,
elbow is one of them.
I could go there, but now I can't put it on the crux.
- [Bob] Right.
- Because when you bend your elbow,
unless you're gonna keep your arms straight,
which most people don't.
When you bend it, it doesn't hold so well.
- [Bob] It's not gonna help on either end.
on this side it's going to bend,
and on this side it's going to bend, so.
- So yeah, so that option that if you're doing a cross,
that first option was really the only one.
- Yeah, why don't you do a T now Brad?
Where you put one right above it and one below it.
- There.
- Yeah, and this is very similar,
and then a one on each side of it, of the pain.
- Well.
- And again,
you can't do that one again. - Yeah, yeah.
So again, we're getting into that, the crux of the elbow,
what should it just, you don't have.
- We're kind of, we're discovering this as we're showing it.
So you really can't do that, you really are limited
to the cross.
- Which you're gonna,
find a way to make it work.
- Yeah, make it work.
- There are plenty of options.
I've never had not having people not have success.
- Now we always promise with each one of our videos too,
that maybe when the pain has gone down a little bit,
that you can go ahead and we're going to show you one thing
to try, one physical therapy treatment.
So what I'm going to recommend is,
what works especially well with a tennis elbow
or golfer's elbow, is cross fiber friction massage.
So what are you going to do, is you know,
the tender point is usually right around in here.
You're going to go into the muscle belly here,
a little bit into the tendon,
and you're going to take one finger,
maybe on one on top of each other, or maybe side by side.
And you're going to go deep down to the tissue.
The arms should be relaxed on a pillow.
- [Brad] Right.
- And you're gonna go deep down in there,
you're going to, and you do cross fiber,
across the fibers of the muscle.
And you're going to deep down and you're doing the massage,
on that area.
Now, if you start doing the massage, and it just,
the pain starts getting worse and worse and worse.
It's too soon for that.
Continue with the TENS for a while, maybe some ice.
- [Brad] Yeah.
- If it starts to after let's say 30 seconds to a minute,
it starts to actually level out the pain,
- [Brad] Yeah.
- Or even feel better, you're doing the right thing.
That's exactly what you want to do.
You're breaking up scar tissue,
you're helping it get blood flow to the area,
helping it heal stronger.
So, you can do this for a couple of minutes,
a couple of times a day.
You can do it every other day,
and and see if that gives you some pain relief.
A lot of people do get pain relief.
- That's been a very, very common,
a good results on that particular technique.
- I think the TENS comes in handy here,
like if you have arthritis in the shoulder or in the elbow,
and it's really tough to make that go away.
- Yeah, yeah, you're not going to do cross friction massage,
if the joint has arthritis.
- Right.
- I mean, you could,
you could give it a try and see what happens.
- That's right.
- All right, check out the rest of our TENS videos,
on Bob and Brad.
- There you go.
- Thanks for watching.
- Thank you.