♪ Bob and Brad ♪ ♪ The two most famous ♪ ♪ Physical therapists on the Internet ♪ - Hi folks, I'm Bob
Schrupp, physical therapist. - Brad Heineck, physical therapist. - We're the real most
famous physical therapist on the internet. - In our opinion, of course, Bob. - Can I Heal My Torn Rotator Cuff? By I we mean you. - Oh, I thought you were asking me. - So, we're going to go
into the answers for this. But by the way, if you're
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version of Bob and Brad a day. - Right. Rotator cuff, shoulder pain, a lot of people-- - Very common.
- Very common. And this question, do I need surgery? - Right.
- Right. Or can it heal with
exercises and some treatment? So we went and did a little research, Bob. - Right. - And we found out the answer. First of all, we do want
to clear this up though. If your rotator cuff is injured, the vast majority time, it is one tendon, the supraspinatus tendon, vast majority of surgeries happen on that. And we're going to show you that first, before we get to the answer. And at the end, like Bob said, we're going to show you some exercises. - I didn't even say that. But yeah, at the end, we're gonna show you some exercises. You do wanna hang around until the end, because in case you do
have a torn rotator cuff, we're gonna show you
ways that might help it. - Right. Things that we actually
we use with our patients. So here we look at the shoulder, they got the humerus and the scapula
- Yeah. - Or the shoulder blade and the tendon for that supraspinatus, it's suppose to like gets impinged. That causes a whole problem. We have it pink right here. We got a little piece of
pink Kinesio tape over it. And the muscle for belly actually
back up here, right there. So, the job of it is to help position the ball of the humerus in the right spot so it functions properly. If it's not functioning properly, all kinds of problems, it can go wrong. And that's where it all boils down to. - And certainly can result
in impingement where-- - Oh yeah.
- The tendon gets pinged. I'll go ahead and sacrifice,
Brad, go ahead and bring it up. - Oh yeah, here we go. - Awh, awh, awh, awh.
- Yeah. - So eventually it wears it down, and eventually it causes a tear. - Right. - So that's why impingement
is not to be ignored. - Exactly. - You may have... like you fall down and you couldn't, you could injure it that way as well. But oftentimes they come-- - Overuse.
- Overuse, exactly. Sam, out of the way, we've got
better things to do with you. All right.
- All right. So you've got some studies Brad? - Yeah. Let's have a seat, Bob. Let's talk about this. I'll get serious. So these are the studies that I've found. We're look the-- - Mike, do you want us to
tilt this or it's okay? - We got, it's not blurry. Okay. Journal of Orthopedic Science, in 2013, now this was a review of the literature. So they went through numerous studies-- - Which I always think that it
was a great studies. I mean-- - Right. it's nice to do that cause you're not looking at just one. I did pick one that they cited, but there were a number of other ones that were I found in there. And they had similar results, but this is an exact thing, where they had 105 shoulders,
patients with shoulders, full thickness tears. They were diagnosed full thickness tears. - So it went all the
way through with tendon. - You're right. The ages 44 to 80-year old.
- Sure. - So these weren't young athletic people, but these were people
that had shoulder problems from overuse typically. Six months of physical therapy exercises. - Okay. - And then they came back
12 years to 48 months or 12 months, one year to-- - To four months, oh four years. (laughs) - We sharp here. - Right. So one year to four years. - So we're looking over
a span of how this, recovered from the exercises. If we look at pain level, just pain, how do they result in pain? 50% of them reported pain free shoulder. - Wow, wow. - Which is good. - Yeah. So 40%? - And another 40% reported, only mild pain that did
not need pain medication. - Wow. So 90%. - Right. With pretty darn good results. - Right. - It's better than surgery. Now function. Could they use it? And this was subjectively taken. 75% of them stated no daily limitations. In other words, they could... Now I'm assuming these
people probably weren't, like drywall hangers,
- Right. - Where they looked overhead all the time, but they could reach into the cupboard. They could function a daily
basis without problems. - Sure.
- That's pretty strong. Right. - That's very good. That's very good. - Let's go on to the next
study by Kuhn Et Al in 2010, this is just one study. It wasn't the review. We've had 396, so it was pretty good--
- A lot of study. - Full thickness tears once again. And they had physical therapy treatment, and six weeks of it. - Sure. - Six weeks later, 90% of
them reported improvements. 10% did choose to have surgery. - Got it. - Okay. Then they went
back two years later, 80% of them continued-- - To have improvement.
- Right. They did not have surgery. Another 10% did elect to have surgery. So it's still-- - Fairly close between the two studies. - Right, right. So a very good sign to say, you might get some healing going on. - Right. You know, and the thing is, if you decide to take the
conservative therapy treatment and it doesn't work out, surgery is always an option.
- Right. - And stronger you get the
shoulder before surgery, the better the results are
probably going to be afterwards. - You can talk to your
doctor about that too, to confirm that every case is different. - Yap, absolutely. - So now you may be saying,
what are the exercises? We're going to show you a few of them. There are--
- A lot of them. - A lot of different exercises and the therapist varies
on the individual patient. We're going to show you some of the ones that we really like and
have good succession. - Sure. - Wow. - So we're going to start off with one involving the Booyah
Stik, or did you wanna... - Oh, you wanna start with
The Statue of Liberty? Why, what did you wanna start with that? - I'm fine with it, but we've got to get this
out of the way quickly. - All right. - Quickly, Bob quickly,
these people are waiting. Go, run, Bob. Man, he works like an old man. Let's get this out of the away. - I wanted get out of the way. - There we go. All right. So, here we go. Now this one I actually started, I don't know if I invented it, but I haven't... - You invented it? - But it came from another, an orthopedic surgeon, has a book written on
rotator cuff treatment. - And hanging. - Right. Hanging. - Dr. Kirsch.
- Dr. Kirsch. - Yeah. - Yap. He's actually from Wisconsin. - Yap. - 30 miles from my hometown
is where he lives right now, but hanging, he has a
whole book written on it. We're going to talk
about it a little later. So this is based off of that treatment. If you take a pole or a stick... - Or a broomstick, even would work, - A broomstick would work. I've had people use that, This is the Booyah Stik. They work really well because they're easy to grab onto and you get your arm up about, the arm can't be really sore. This has to be where you
can actually reach up. Might be a little painful, but not too bad. - Well, you can reach up to start off just as far as you can and
then start moving forward. - Right. So you can start doing this. This is not, the true hanging. - Yeah, you can do it on the floor. - Range your motion. And then, you know if he
creates sharp pain with this, it's too early, it's not ready for you. You need to heal a little more, but as you get up taller or as you can get where you can reach higher with less pain, but it's still not functional. This is gonna create
that gap, so that tendon, does not gonna impinged anymore And you just lean forward, but don't let your hands slide down, keep your hand gripped. And the Booyah Stik really
works well for that. I've got it stuck on the chair. So it does not slide. So you have to have a little rubber cap on there or something on the surface, lean forward and stretch and what I'm doing to distracting that. And if it, again, it should be pain free and you're going to hold it for five to
10 seconds and go off. - And the thing is, you want
to do this throughout the day. I'd like to see you doing
this six to eight times a day. - Sure. - And it only takes a few minutes. - Right. So, it's something you can
certainly throw in there and you can work your way up. You start off lower cause
your arm only goes that far. - Right. - And I mean, we've had people with
arthritis that have done this and they started way down low. And by the time they come back, the next time, they're really proud.
- Cause they're up further. - They're moving up. - So good judgment.
Don't go too fast again. It should not create sharp pain and get it a little sore. That means you overdid it and you have to take a
break for a few days. - Sure. - Next one.
- Next thing I'm gonna show you is based on the same
principle, Dr. Kirsch on hanging. Now you can hang on a pole of bar, Brad and I wanted to come up with a way that you could hang at home with a way that's not that intrusive.
- Right. - So we have the wall anchors. So we sell a kit that
actually has two wall anchors and two handles. And the handles, you got to get the anchors
secured into a stud. - Right. - You have to put them in right, - And then we have instructions on that. - Right. - I love these because not
only do they work my shoulders, they actually decompress my back too. - And they help them with your posture. - Yeah. So what I do is I actually, take a break like every 20 minutes or so when I'm working on the computer and I just hang. Now I'm tall, but I'm still
putting a lot of pressure on my shoulder and I'm actually can lift up
my feet all day completely. - Yeah. When I do that, I just put my legs out in front of me. Yep. Relax them on the floor. - Oh, like that. - Yeah.
- Yeah - You can do it that way. I prefer this way. - Sure. - Whatever works good for you. I actually do some of these two Brad. I actually retract my
shoulders a little bit when I'm doing this. - Oh, sure. Yap. Just to work on my shoulder retract, which is good for that rotator cuff. Yep. Yep. Now again, if you've got
to pull a bar at home, you can use that and that works. - You can hang on a branch. I don't hang on anything that works. If you've got some beams, you can hang. - Yeah, we do have the book. It's not a very expensive
book by Dr. Kirsch. - Kirsch. - I'm sorry. - So again, what's nice about this. I have this just right by my office and I could just walk out and do it. If it's that convenient, you're going to do it a lot more. - Right. - And it's going to give you more chance for your shoulder heal. - You wanted to show these - Yeah. Now some other more
traditional exercises that, at least for Bob and I, before
we learned these newer ones is you need a resistance
band of some sort. Again, I'm going to use the wall anchor. A lot of times you'll see
people on videos or therapists, they'll say wrap it around a door knob, which is fine. - Or a bad poster. - Yap, yap. This works so nicely cause you
can put them on off easily. And we're going to start out
with scapular retraction. Bob you wanna show the main emphasis. - Yeah. So what we're doing here is, strengthening the muscles that hold the shoulder blade in place, which is really key. Cause the shoulder blade has to be in place for the shoulder
to work correctly. If it's not in place, you're
gonna get that impingement. - Exactly. - So this'll make sure
that you're not gonna make things worse. Cause you might have a partial tear. You might have a full tear, but you could keep tearing it to the point where it actually retracts,
the muscle retracts and let's go over the bone. - Yeah. That's an issue. - Then surgery is
probably gonna be around-- - Next surgery is probably gonna
be around the bend for you. You can also show external rotation. - Yap. This is a very, very... This is kind of like the go to exercise or rotator cuff impingement issues where you keep the elbow by your side, move their arm. - Now this is something
that you would not do, probably right away. - No. - This is something you have to be able to do it pain-free and you
gotta be able to do it. If you have two week to do it, you can came too early. And that depends on the band. And I got a red-band. You might start with a yellow-band. Repetitions of these, you're going to tend to 15 of these and then go ahead and
do 10 to 15 of these. And that might be enough
for the first time after a week or two, you
may go two sets of 10. And I have my patients
go up to three sets of 10 as they get stronger, maybe a few weeks. - Yeah, these are small muscles. So we start off with small resistance, - Right. - And you don't normally end up hitting that much resistance on these, obvious. Cause again, they're small muscles. Right. And we do have videos on more exercises for
rotator cuff strengthening, just Google Bob and Brad. - But gosh, we have videos on everything only a couple thousand. - Yeah, only a couple of thousand. All right. - Take care. - Thanks for watching.
