- Bob and Brad the two most famous physical
therapists on the internet - Howdy folks I'm Bob Shrupp, physical therapist. - Brad Heineck physical therapist. - We are the most famous
physical therapist on the internet. - In our opinion, of course, Bob. - Today were going to talk about 12 rules for massaging away knots muscle strains or tendonitis. Basically anytime you need to
massage these are the rules. - Even dozen and we're talking
about some manual and even. - Yes, we'll talk about that. We'll mention that. So let's first talk about knots, Brad. Cause those are kind of
a world of their own. We're talking about trigger points. - Right not a pull and knot. Not a knot with a rope. - Not a tie knot, no. So the trigger point therapy
workbook called the Knots. They define it as a grumpy
little spot in a taut band a tight band, a muscle tissue
that hurts when you press on it and may reproduce
your pain symptoms. - So same as a trigger point. - Yeah, same as a trigger point. The thing about knots, and Brad I think you'll agree with this, they really don't know what causes them and they really don't understand them to a large extent. - They got theories. - But these are the rules
according to the workbook. Well, how you want to manage these knots. - I think the good news
is, is you can manage. - Yes, exactly. So number one, never massage a pulse. If there's some arteries near the surface like you want to go along
the carotid artery here you wouldn't want to massage it especially when you're using a tool. - Right. - Cause you can really leverage it then. - Yeah. - So, and number two is use the
tool whenever possible. Cause you're going to save your hands. I don't know how massage
therapist do it, Brad. I really don't. - I think a lot of them must use tools. - I think they do and their
elbows and stuff like that. Some of the tools are like the theracane or a
cane like this massage cane. You can use the lacrosse ball . Brad and I kind of like
this little spiky ball. - Yeah, plus it lights up. - Yeah, how fun is that? - See, they're cheap too. - The massage guns, you know we got a whole variety of them. They work really quite
well because they percuss at the same time you can pressure on and you know, become tighter. - And they have different
heads, five different heads. - Right.
- So there's very versatile. They're wonderful. - All right. So yeah, I just talked about the tools. Now, whenever possible you're
supposed to use deep stroking. So get deep down in. If you're going to try
to get rid of that knot. - And that's why you don't
want to go over a pulse. - Right. - You wanna go over
muscle belly, you know. Bob mentioned the pulse. Maybe, you know, obviously
in the wrist, there's a pulse there's a pulse, that's in
the crux of your elbow here. So if you think there's a
pulse there , you can feel it. Be real quiet and stay
away from that area. - So you're supposed to deep strokes but you're supposed to do
repeated short strokes. So you're kind of staying
in the area of the knots. So if there's a knot right
here and I'm massaging it I'm not going across like this. I'm staying right on the knot deep and I'm doing short strokes. Also, the next one is actually in the same direction. You want to, you want to go you don't want to go this way, this way. They just say ergonomically. I'm not sure the reason for that, Brad but you're supposed to
stay in the same direction. - So that's a little
different than the cross fiber the Cyriax cross fiber. - Right. Okay. I don't know, is it? - We wanna go across the fiber. - Yeah, what you can do here too. - Oh I See. - Just one direction. You're supposed to pick one
direction, stick with it. So... The pain should be a good pain. You don't want to have, if on a scale of one to 10,
you're getting over a five. That's probably too much. But you know how it is when it feels something feels like it hurts so good. - Right. - That that's what it should feel like. You're doing something good. - And that rule of thumb,
you know, you'll find that knot that it would be like ahead of my teaching if i said
like a Tootsie roll. That's kind of like the size of them, there's that
knot and it's tender. But when you start a massaging
and after 20 or 30 seconds it should start to feel better. - Exactly. You want to see the pain levels
go down a couple of notches. - And some people are, you know, report. And I've had this
experience myself where it it kind of feels like a numbish feeling. - Yes. - That's another positive sign. If it feels like it's tender, it's making you squint
and it's, it's no good. We don't want sharp pain. - The stroke should be done slowly. They want you to go back
slowly, back and forth. They are recommending 10
to 12 strokes per knot. And so that's not that many but then you're supposed to do it throughout the day three to six times. - Okay. - So you're going to have
to have your tools ready you know, carry them with you. Let's see if there's no relief, that's the final rule, you're probably on the wrong spot. - Sure. - It's what they're saying. But otherwise, you know,
if you do it three to six times a day and it's
feeling like, you know if you're following the rules, like we say hopefully that knot is
going to get better. So now what if you are having trouble with like a muscle strain
or tendonitis in that case we're going to do more like cross fiber friction massage. Developed by Cyriax and Dr. Cyriax, who is the father of orthopedic medicine. So James Syriac, right? - James. - Yeah. So if you're a, let's say on a a muscle belly or on a tendon it's really kind of the same
thing I want you to take. You can put your fingers
side by side or one finger right on top of each other,
and you're gonna cross you're gonna find a tender spot and you go go across the fibers,
the fibers run this way but you're going to go across the fibers whether it's a tendon or
whether it's a muscle. - Yeah if it was in your
calf, the fibers go this way. And so we're just going to work that. - Yeah. Using your
thumb there, aren't you? - Well, yeah, actually ,
on my calf it's hard to get my fingers as good. - And that's what we talk about sometimes. And it's where a gun comes in handy. So I'm actually going have Brad, show the gun here
in just a little bit. - You bet. - Because how you use it for cross fiber. So you try it for 30, 60 seconds. And if the pain just keeps getting worse it's too tender to begin this. So if it does plateau
gets numb or gets better you can keep going. - And you know, maybe we
could just say, you know the difference between a knot is where muscle just tightens up. But had, Bob had mentioned,
if it's actually a tear a micro tear, a small
tear, then it's different because the tissues
actually has micro tears and it may knot up as a
result of that or get tight or it's just painful as a result. But then you're trying to break up scar tissue versus
just release the knot and - Get more blood flow to the area. - And those too can be confusing if you're not really familiar with it. - Kind of as a general rule of thumb if the pain is spreading
out, it's getting worse. If it's concentrating and
getting more in one spot. Yeah. Centralization McKenzie calls it. It's getting better. So if you, what you're
doing is spreading out more. It's probably getting worse. - Sure - You're going to try something else for awhile and then come back to it. Or you might massage
the muscles around it. - Right. - And then focus on that. So, Brad, do you want to
just show the massage gun? How you use it across fiber on a tendon? - Sure, so again, like
with this gun, this is one of our smaller ones, but really
has a great one for size. We got two of them, but
you can see now this is reciprocating this way. Okay. So let's say I was doing,
let's see, I had tendonitis in my patella. So I'm not going to take it
and go right in like that. You can see that that would painful. - It's not going to help. - You're just going to make things worse. I'm going to go sideways
because the fibers of the tendon go vertical in this point. And we're just going to work it this way. And you know, you can vary
the angle a little bit. - I was thinking about this. Why a massage gun is for the
good for this because James Cyriax, if you follow his
recommendations for many of these things, he recommends
15 to 20 minutes of massage. Now we tell people to
break it up, you know throughout the day, but even five minutes of massage with your hands. - Yeah, if I'm doing this,
you get a sore thumb. - Yeah, you're going to be
having your thumb treated. - Especially, if you're,
you know, a little older and you got some arthritic
joints in your hands or fingers and it's even worse. - Or especially younger
and you text a lot. - Yeah. But you can see, I put
my leg down so I can let the muscle relax. And I'm going to have a better result. There's five different
levels of intensity on this, so you can work with that, as well. - And different heads
like we mentioned already, if you wanted to get one. There was more of a, there's
a pointer one, but I have to give Brad credit. Maybe it's somebody else
has also come up with this. But he's the first guy I know that came up with that cross fiber. That way of going across
that way, instead of going like this. I mean, maybe somebody else has done it. - No, I'm sure not. If I thought of it I'm sure
many other people have. - He's a genius. - So, all right. This video is a part of
series of videos on massage. If you want to see the entire series, go to bobandbrad.com go to the program section. We have a whole bunch of programs there. If you have some
problems, go check it out. And under the program
section, you'll find the one on massage and watch the videos
that just pertain to you. - You can scroll through the videos. They're all in one spot. Look at the title of the video. It'll be self-explanatory
if it's what you want. And the beauty of these
are there's a PDF printout that you print out a review and how to do the whatever
information is on the video. And the next beauty is it's all free. - It's free, baby. - Not even an email. - Just a couple, we'll
ask for your oldest child. - Why Bob? That deserves a why Bob, why. - Thanks for watching. (upbeat music)
