♪ 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. - Ah, my shoulder's popping. Oh, in our opinion, of course, Bob. - All right, you're popping off, that's for sure, Brad. Today we're gonna talk
about danger if my shoulder clicks and pops. Learn why and how to fix,
we're gonna cover it all. - That's right, Bob, we're gonna carry on. - We don't want a noisy
shoulder, not a nosy shoulder. Okay, by the way, if
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some excellent interviews, but what about the clips or the chirps? - Oh yeah, the shorts. - The shorts, yeah. - Bob and Brad clips,
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- It is. - It comes in a big normal size. - This changed my life, literally. Okay, Bob, let's go on with
these shoulder problems because it's not uncommon
for people to have clicks and cracky shoulders. And people get concerned, is
this something I need to see the doctor about?
- Exactly - Very good concern,
and it's possible, yes. But we're gonna explain
to you why you may have those clicking and
popping in your shoulders. Sometimes it's just
like grinding, you know, I'll say to my patients
is it like Rice Krispies? If you ever had those, and they say, yeah, that's kind of like it.
- Sure. - Or it could be something
like a clunk, clunk, or a pop, whatever, there's
a number of different reasons that we're gonna show
you why this can happen. It can make you feel better just knowing that your shoulder is not
literally falling apart. - Well, we'll show you some things that might help take it away too. - Absolutely, Bob, that's
gonna be a little bit later. - A lot of times, you
don't actually hear it, you feel it, Brad, you're grinding. Okay, Brad, let's show what
some of the causes could be. - Sam is gonna be grateful
and happy to help us out. So we're gonna look at
the shoulder right here. If you're gonna have
these noises and whatnot, they're gonna come from this part of the shoulder joint typically. Here's the ball or the socket which is a very shallow socket. And then the nice rounded
ball on the humerus. And keep in mind, it
doesn't look like this, it looks more like this with a lot of connective tissue around it. And that can start to cause
some of these problems. We'll get back to that. - One of the problems, do you mind if I say this now, Brad, is that quite often the shoulder bone here moves forward in the socket. It's not back in the
socket where it should be. And that causes things to grind, it can put pressure on the labrum and it can put pressure on
the tendons coming through. And you're gonna show that, right, Brad? - Exactly, so this
represents a tendon coming through from the supraspinatus, and that comes over, connects to here. Now sometimes that tendon can slide back and forth like this. - Sure, and that can make sound. - Right, also there's a
tendon right here that goes for the bicep tendon, and
that can pop back and forth. - Yep, or it can also get squished right there on the chromium. And that can cause noise after a while after it gets scar tissue. - Exactly, so along with
it is arthritic changes. Let's say the ball of the
socket is getting arthritic. - It's getting flaked. - Yeah, it's not smooth
anymore, it becomes rough. And that can also be
that Rice Krispy sign. - And then there's the labrum. - The labrum which we did mention already, but we're gonna show you.
- I think we can kind of see that. - We're gonna, this brown rubbery stuff represents a capsule
and some other tendons. But right in here- - Can you see any of than tendon? - There, yep, right there's a labrum, and that's kind of like
a cartilage material. And sometimes that can actually rip, Chris has one of these,
it's been confirmed. And that'll make a clunk sound. - It's not holding the ball in the socket the way it should be. And again, if your ball
is not in the socket like it should be, it
could actually put pressure on that labrum. It's just not working the way it should. - So obviously, number of reasons. Now, sometimes these can be bad enough where you may need surgery, but the big rule of thumb, if your clunks or snaps and Rice Krispies and there's no pain with
it, you just feel it, that's a pretty good sign, you don't have to get
too concerned about it. - Yeah, if there's no pain or not. I mean, to me, sometimes
it's a precursor to pain. - Right. - I mean, I would like to
take it away if you can. - Yes, and we're gonna
show you some good rules on how to do some exercises
and how to correct it before it turns into a problem. - One other thing, Brad,
we forgot to mention is the shoulder's not gonna
work the way it should either if the rotator cuff, the four
muscles around the shoulder, they're not working like they should. So that's why Brad's gonna show a strengthening exercise too. - And that goes back from, Bob mentioned, that ball can come forward
oftentimes out of that socket, if you will, and then you get those- - Yeah, and if the rotator
cuffs' working like it should, it should rotate the ball correctly and not cause problems. - Exactly. - Exactly. (both laughing) - I think it's a funny joke. I'm gonna bring an egg in here. Come on, Sam, get out of the way. All right, so, here we go. Let's just the first thing
we can look at is posture. It all boils down to the fundamentals. If the posture is not
right, then we can't- - Look at this, if I'm
rounded out like this, look, and I bring my shoulder up,
that's as far as I can go. But now if I straighten up. - Shoulders back. - Look how high my shoulder goes now. - You get about an extra
20 degrees of free mobility just changing your posture. - Right, and this is also
causing it to impinge, can lead to some of the problems
we were just talking about. - Right, so you look at your posture, and sometimes you have to take a picture of you when you're not aware of yourself or have someone tell you, and you might find that
your shoulders are here and you're not aware of it. And we need to bring them back like this. So just squeezing back,
I would call them Ws, if you bring your arms back, squeeze your shoulder
blades behind your back, and do 10 of those.
- Just today. - Yep, help promote that. - That's the first exercise I
give patients, is I tell them, go home and start doing some of these. - You can use a wall, try and
touch your elbows to the wall and hands to the wall. If that way you kinda
know where you're at, you might start out not even
be able to touch to the wall. And the goal is to get back there. My left side is always tighter. So I work on that myself. - I can tell. - Yeah, exactly. So posture, look at that. Number two is we're gonna
look at two specific range of motion that you'll see. And one is flexion, we talked
about that, going up this way, or extension, going back this way. - So you compare one shoulder
to the other shoulder if you have one that's
better than the other. - Let's say, this is my good shoulder, this one has it clicking and popping. And this one goes up like this, and this one goes up to here and it might start the click or pop or maybe that's all it
goes or a combination, we wanna see if we can
get this range of motion back to normal. And we've got a couple
of tricks to show you. - Yeah, we've got whole videos on this, but we'll show a couple
of them right here. - Right, probably the
two, our favorite ones. - Sure. - Let's see, Bob. One of the thing, it depends on the level. If your hand only getting up to here, you can just take the
other hand like this. - Absolutely. - Start with posture, and
then the good arm goes up and stretches the bad one, and just you don't push
it into a real sharp pain, just a little stretch pain is all and then go back down. Up and down, and do that 10 times. And then do that three
or four times a day. To get more aggressive,
we like to use a stick. - Oh, you can do it this way. I mean, you can actually just work on, moving it up like this, but you can, I think you should show
the Statue of Liberty. - Absolutely. So let's talk about this one a little bit. This would be the shoulder
that we need stretch, then this arm is doing
the work, just relax this. But the Statue of Liberty
stretch is much easier. - Well, it's easier and
it's more effective. - Yep, I agree.
- Because first, you're gonna start off, let's say you don't go up that high. You're gonna work your
way up a little bit. And then you can lean forward and put traction on the
shoulder, so much more effective. Don't let the arms slide
down, but you come back and work your way up a little higher. To progress the Statue of Liberty, Statue of Liberty is
obviously high, right? - Right. - So eventually you hope you
get all the way to the top and you can just give it a
little good, long stretch, and you're gonna find out
it improves your range rather rapidly. - And again, this shouldn't
create any sharp pain, if it does-
- We're not looking for pain. - You do not do it, it's
just not the right stretch. Also use a stick about
four or five feet long, and tips on the bottom so
it doesn't slip or slide or poke a hole in your
furniture if you're- - Right, these tend to have a
really nice grip by the way, and you can say Boo yah. - Boo yah!
- Boo yah! - All right, and the other one
is extension going backwards. And you can just take
a cane even for that, you don't need such a
long stick for this one. And it's like you're paddling a canoe and you just stretch back. And again, you'll check one side compared to the other, the good side goes back to here. This side goes back to there. - This is one again where
you could clasp your hands, bring them back. Now, Brad has trouble with this one. So he actually uses a towel. His shoulders are tight going back. - Oh yeah, I'm a tight
shouldered person, Bob. I'm not sure what's
wrong with my shoulders, but they're getting better. - Probably doesn't want
to reach for that wallet in your back pocket. - Well, hey, yeah, we
wanna keep it in there. - Speaking of tight. - Yeah. (laughing) Yeah, some people say
it's frugal, not tight. - Brad's no tight, I don't
wanna give any impressions here. - I've been called that
before though, Bob, it doesn't bother me.
- Okay. - Let's go to the next one, where were we? - Well, we just did range of motion. I'm gonna throw one more in there, Brad. How about hanging? - Oh yeah, once you get to
the point where you're up here and you're almost there and
it doesn't hurt that much, there's no sharp pain,
but you're in the more to get more aggressive to stretch it, just hang on a pull-up bar
or something very sturdy that'll hold your weight. - Yeah, we have our wall anchors here, and we have a whole bunch of devices here. So I don't want you to
get too big stop here, but this is one itself, this is the pull-up system of ours. And you get three of
these anchors with it, and you just put it in there and you can actually go like this, and then you can go ahead and just hang. - Yeah, I mean, obviously I
wouldn't buy them just to hang, I would buy to do pull-ups. - If you're gonna do pull-ups too, this is the system you're gonna wanna get. So this one actually, you can actually throw
some pull-ups in here, and you can twist the
arms so that you can do actual pull-ups, chin-ups,
and neutral grip. Now these are the hanging handles. These are what you'd get
if you just wanna hang. - Yep, specifically for hanging. - Yep, and what's nice about
it is you can start off by putting some weight on your feet. - Right down here. - And then eventually go to
the point where you actually lift your legs up. It's good for your back too, by the way. - Yeah, it's good for
decompression of the back. Good for posture, good for
your shoulders, hand strength, there's a lot of benefits to it. - Do you wanna do
strengthening it all, Brad? - Yes, I do, I wanna show you- - I wanna finish up my advanced one. - Oh yeah, okay. Now the strengthening part
we mentioned before about a weak rotator cuff, probably 90% if not 100% of the therapists are going to show you this exercise for the course strengthening exercise. You're gonna need something
stretchy like this, a band, put it on, anchor it, we're
using the wall anchors here 'cause it works very well. And then we do this, the
mechanics, the elbow stays in by the ribs, 90 degree bend in the elbow and it looks like this. Not like this, not like this
where the elbow comes away. - Yeah, a lot of times
we would put a towel underneath there, Brad's gonna grab it. - If the towel drops out, it means your elbow got too
far away from your ribs. And this is a great way
to get that posterior rotator cuff strength which
is usually the problem, that's why we do it so much. 10 of these, and then do
that three times a day. Well, as it gets better,
you can go two sets of 10, but the repetitions per day
is probably more helpful, Bob? - All right, the final thing is I'm gonna show you this
one, this is more advanced. Well, actually what I
put up here is one of our looped bands here, and these
are for pull-up assists, and you can actually do
a lot of moves with it. But this again, you're
gonna wanna make sure you don't have loose
shoulders or arthritic, like rheumatoid arthritis. - This is probably for
more the active person. - Yeah, this is the active person, maybe a little bit younger. What I'm gonna do is I'm gonna actually, you know, when he was showing
the ball in the socket, I'm trying to put the band
right on the ball itself. So I don't wanna be too far
over, I don't wanna be on, yeah, if you wanna show, I don't want to be over onto
the scapula or the clavicle. - Right about where that black band is. - Yeah, there you go. See, that's gonna pull the
ball back into the socket. - How does that feel, Sam? He loves it. - He's having pain because
Gumby is on his shoulder. - Oh, our little Gumby. - So anyway, this is
pulling the shoulder back. And while it's in this
position, I can work on flexion, I can work on external rotation, I can work on internal rotation. It's just a great way of
teaching that shoulder to stay back in the socket. And this alone, after
you do this a few times, the clicking stops. - Yeah, actually this is one, if you're a therapist and
you're not aware of this, you may wanna do this with your patients. - Yeah, and I actually, a lot
of times I'll put my thumb or hand on the band to
keep it from sliding, I'm trying to keep it
on the shoulder itself. It's better to error and have
it down a little bit further than have it too far up like this 'cause then it's not working. So beautiful exercise. - It is, I did want to, now that you mentioned
you got the big loop ends, if you have those, I like the smaller one, this works really good for
doing that external rotation. So you go like this, stand
on it either one or both depending on how much resistance you want, bring it up to here and do this. It's a little bit, you know,
use the right size band. You might use the smaller
and the yellow one. But I like this because you get both sides and it
puts some pressure down, so it does a little more
strengthening than the other way. It's just another option. - It's very mobile too - Oh, it is, you can-
- Yeah, you can. - Yeah, you can take this with you. - Yeah, and you can snap people. - Well, they are fun,
you got to be careful. But Bob, we don't wanna recommend any of those childish things. - No harmfulness. - That's right, we are a family show. - Be kind, (laughing) take care.
