♪ Bob and Brad, ♪ ♪ the two most famous ♪ ♪ physical therapists ♪ ♪ on the Internet. ♪ - Hi folks, I'm Bob Schrupp, physical therapist. - Brad Heineck, physical therapist. - Because we are the most famous physical therapists on the Internet. - In our opinion of course, Bob. - We get pumped up here, Brad. Today we're gonna talk about absolute best exercises for shoulder impingement and pain. I think, I don't know about you Brad, but when I see a shoulder patient, about 80% of the time, there's some impingement going on. - Sure. - It leads to a lot of
problems when it impinges it actually starts causing tendonitis. It can cause a rotator cuff tear. So this is not a minor thing. If you're having shoulder pain, this is probably, these exercises are normally going to be good for you. - Right. - And almost most shoulder instances. I mean, so, right. - Right, right. - So very, - Go ahead. - Very quickly, what is it, Brad? - Impingement? What? It's kind of, - You got your pen? - No, I don't. - It's right over there
in the corner there. - All right. If this, what the, the name, you know, says impinged things are getting it's pinched and right between this bone and this bone when you lift your arm. - So as a tendon comes through here - Your finger's just too big Bob. - Yeah. Ow ow. - Yep, that's gonna hurt your finger and it's gonna pinch the tendon. There's a tendon there that helps, is part of your rotator cuff muscle group. And when those tendons get impinged, you know, pinched, - It can get frayed after a while. - Right. - And eventually can tear. - Yeah. It's one of those
repetitive things where, you know maybe a few
times it's gonna hurt, but if you have a job working overhead or you're reaching up into the cupboard many times a day, it continues to wear and tear on that tendon and start to fray it. And that's where you can
have some real problems. - Quite often, when I'm looking at somebody with an impingement, Brad, you can almost see that that shoulder is a
little bit further forward. - Yeah. - It's set forward farther in the socket and it's quite often their dominant arm and - Right. - if you look at somebody and if you stand normally and if you want to see what
their thumbs are doing. If they have good posture and they're in standing
correctly with the chest, you know in the proper position and the shoulder in the proper position, the thumb should be pointing forward. - Sure. - When you're doing it naturally. Now, if I roll my shoulders a little bit look what happens immediately. - The thumbs point in. - Yeah. So my shoulder's
internally rotating now which makes it more
susceptible to impinging. - Right. - So it's one of those things where if you stand with poor posture and you lift your arm
up, you can go this high. But if you're a good posture, - Right. - it goes that much higher because there's more the mechanics of it. - Yeah. That's a good test Brad, actually that, to show
you the differences. Okay, let's get into the exercises, Brad. - Okay. - First thing, we're gonna show you what we want you to do daily. And this is something you
can do throughout the day. You can do it every hour if you want. - Sure. And one is just trying
to get the posture back and things set in the right position. So we're gonna do some shoulder squeezes. - Right. - So, yep. You can do it one of two ways. You can just squeeze back, Brad, I'm squeezing back and you wanna - Squeeze those shoulder blades in and together and a little bit down if you can. - Down, and you can just picture
it that they're going down. - Well, it's a nice shirt, Bob. I'm impressed. - Oh, thanks. My wife bought it as you can imagine. And if you want to, you can also do, you know a shrug and go back, if you want to, you know,
add a little bit to it. - Yep, sure. - So the other one you're gonna do is you're gonna need a countertop or the back of a chair. And I don't know how sold you are on this one, Brad but I've had, Brad, I've had probably at least 50% of the people that this really works for. - I find it, it works really good or it doesn't seem work at all - Work at all - in my experience. - Okay. And what we're
trying to do here is, we're trying to set that bone again, back down in the socket. - To get those two bones from pinching - Yeah. - and you get that space in there. - So what you're gonna do is you're gonna find like I said, the back of the chair you're gonna push down the whole time. You know, the whole time
I'm doing this exercise I'm pushing down through the chair. I'd be pushing right down to the floor. So I'm pushing down and I'm walking away. I'm pushing down, I'm walking away. I'm still pushing down. I'm pushing down, I'm pushing
down, I'm pushing down. - Now, do you direct
the force straight down or you kind of have them pull it towards their thigh? - I think either way is fine. - Okay. - I mean, you know,
I'm trying to push down - Okay. - is what I'm trying to do. - Yep. - But it, you know, if
you get further away, it gets a little more
difficult to do that, but and you can do a good, you know set of five of those, the squeezes you can do a good set of five. And again, you can do those every hour if you'd like. - Right. So I'd like to point it out, when you do this, you should feel like, oh boy, that feels a lot better. And the response I get for the patients that I have do it is they say I really like that exercise. If you do it, and you come up and your shoulder's sore, it's not feeling right or hurts while it's doing it, maybe that's probably not the thing to do. - Yeah. And I've used it myself, Brad, when I'd start feeling
shoulder pain coming on and it's helped me immediately. - Okay. Good. - All right. Next one that we're going to start talking about. Now, these are the more
stretch stuff you can do also could probably be done at least once a day. - Yep. - And you wanna start stretching out the chest muscles a little bit, because the more those are tight, the more you're gonna get rounded out here and pulled forward like this. - Sure. - That's why a lot of people, they work just on, if they do just bench press or pushups. - Yeah. - They get over dominant this way and they don't have anything pulling back. Exactly. So there's a lot of different ways you can do these stretches, Brad, you can go into a doorway. So picture it. You got me, Lonnie? I stand up and she just cringes, I think. Here's a doorway. I'm gonna put my arms on both sides of the doorway, Brad, like this. - Yeah. And I'm just gonna lean in and that's gonna stretch it out. - And you'll find if you've got a commercial door, it's gonna be too wide, probably. - Right. - Maybe not for Bob because he's tall. - Then you can go like this. - Yeah. You can do that. I like a smaller one because it feels better when I go on my forearms. - Sure. And you can do
different levels too. - Sure, right. That's
what I was gonna bring up. - Oh, lower, medium, high. - And usually the higher it's a little more stressful on the shoulder. You're probably feeling pretty good if you're going up high. - The one I do every day is I mean, I got fairly good mobility. I just go ahead and do this, Brad. - Yeah - I do this right as I'm warming up to, before I do a run. - Sure, okay. - I do this every time when I stretch out. - Yep. - But you wanna show
the foam roller, Brad? - Yeah. - This is the easy, the lazy man's way. - Which, you know, I don't know if I'm lazy, but I like to do things- if I could find an easier way to do it, and especially if it's comfortable, I'm doing it and it works. You get a foam roller you need a three foot long one at least. - This one's from OPTP, OPTP, very nice soft roller. - Good quality you can depend on from that particular company. But you're gonna lay on here and this is what's so nice about it. I'm just relaxed. - Yep. And he's getting
a good stretch right now. - Yeah. - You can even make it
a little more enhanced by putting your arms down, right Brad? - Yeah. And if you really concentrate on relaxing and breathing, it's good for your, just your overall health. But you just think about letting these muscles relax like they're butter on a hot summer day on a picnic table. And they're just, let
those shoulders go down. I'm gonna take a nap, Bob. - It's a good time to
be like a Zen moment. So all right, Brad, we gotta go out, We gotta do some strengthening now. So now let's say you, want to grab a couple pillows, Brad? - Now, if you don't have
any exercise equipment, this is an easy way to do some of the strengthening exercises. You wanna lay down, Brad? Do you mind laying down? - Two pillows? - Yeah. One or two, whatever you think. On your stomach. - Yep. As a matter of fact, - Oh, you probably don't
even want the pillows. - Yeah. I prefer a tall roll. Eh, that one's too thick, Bob. - We're gonna get it here. - There we go. - All right. So you can do some of the different exercises here where you're gonna go ahead. The first one you can do is you can put the hands out like a Y and he is gonna go, you can go thumbs up or
palms down, either way. And you're gonna go
ahead and just lift up. Hold for what, Brad? - I'm just go hold for
two to three seconds. This is much harder. - These are harder than you think. But he's strengthening
all the muscles that are gonna put the shoulder
in the right position. So you can go from that position to making more of, like a field goal. Now bringing those up. - Now I think with these,
if your shoulder's sore this might, it might be
more comfortable here. - To start there. - Yep. As opposed to up here. - And then you can do a T, you're not gonna be able
to get it on the other side but he's going just straight up like this. - Oh, I kind of get there. There we go. - And then he can do
a reverse Y and again, so there's just some different ways you can do it. I, what I prefer and I
think Brad prefers too, is using like a stretch tube. Do you wanna sit up Brad for that? - Yes. Low resistance band. - Yeah. - I'm gonna take it off. - That's okay, Bob. We got a little inside joke going here. - Yeah. - All right. - So, I'll hold. - All right. - A good overall posture one, and plus you get a little external rotation is just doing, - Doing like this. - Yep. Like that. - Yeah. So now he's
getting external rotation which is what you need to get. - Yeah. - What we call outies. - But you can do it like this for a pure, if you're working just on one shoulder. Not, not like this. Don't let this happen to your elbow cuz that's gonna hurt. - Yeah. Sometimes people
will even put a towel underneath their shoulder to... - Yeah, - I happen to have one, Bob. - Yeah, there we go. - And that forces - Yeah, that keeps you honest. - If that towel falls out, your elbow came too far away. - Yep, you're chicken winging it. - Yep. - So, the other one you can do is go ahead and do internal rotation, which if I come over here. - Yep. - So on the same one is going across and going internal rotation. - This one's almost always easier. It's a stronger muscle group. - Right. - You'll need, you may need a different size tubing for it, possibly. - Right. - And you don't like to do flexion, but we do. Again, the postural one Brad, going. - Yeah. And this is nothing. This is just another option from what we were doing. - Yeah, exactly. - Look at my shoulders. Right here is what's going on. Back. - He's getting it back and he's getting some strengthening. - Yeah. - So I, you know, I do these every day and I do, you know, up, middle, down. - Sure. - Do you wanna just show
that real quick, Brad? So you're going. - Okay. So we're going - Going up like that. - Yeah. And this is blue. It's too strong for me. - Yeah. It's too strong for that. Yeah. - And then. - And then more just in the middle, - The middle. - And then palms down, going down. Yep. Exactly. - If your shoulder's sore you're probably going to start down and work up because it may be painful when you're up at the top. - Yep. Thanks for watching this. - That's it already, Bob? - Yep. That's it.
