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Ask the PT: Common Questions Answered!
- chelsie462
- 5 hours ago
- 11 min read
This article is a transcribed, edited summary of a video Bob and Brad recorded in October 2024. For the original video, go to https://www.youtube.com/watch?v=DfCZGRKH49o
Mike: Today, we're going to answer your physical therapy questions that you had for us.
Brad: That's right, we have four different viewers asking us real questions about their problems, and we're going to give them detailed answers. Stay tuned, and you'll be entertained and educated.
Mike: So our first question comes from username @rachellehmann. I probably butchered that, but I apologize. Anyway, the question is, "Do you have a sitting exercise video I can do? I am in a wheelchair."
Brad: The answer is, yes, we do. We have more than one. If you go to Bob and Brad on YouTube and wheelchair exercises, we have one excellent one we'll share with you in just a little bit. We're going to show you four good exercises, quickly, and then we have a real patient.
Mike: Technically, five, six exercises, but let's go to it.
Brad: Okay, the first one, wheelchair pushups for arm strength. Here on your armrest, we simply push up as high as you can and down.
Brad: Now, if you cannot do this at all, what you'll want to do is put a pillow or a cushion on the chair so it raises you up one to two inches, and it makes a tremendous difference. Do 10 of them like that? After a week or so, you'll be able to take that out and then proceed from there. Let's go to number two.
Brad: So number two is a "W" stretch, so this is more for your posture if you're stuck forward, if you're sitting in a wheelchair all day, so try to get in good posture again, and do what Brad is doing. Bring your arms back and make a W like this. You can do five to 10 repetitions. Hold each for a few seconds. If you happen to have shoulder problems, you can certainly leave your arms at your side.
Mike: There you go, and the next one is a trunk stretch. Your right arm, you're going to reach up, like you're reaching for an apple just above your head, and lean over, stretching the right side of your right hand is up, and then go and stretch the left side. Do five on each side. Make sure you breathe and relax, actually, with all of these. Good. Number three, Mike.
Brad: That was number three. Number four.
Mike: Okay, number four.
Brad: So we're going to do a combination for your legs. First, we're going to start with some ankle pumps. We're going to do 10 of those. Go on your toes and your heels, and we're going to follow them up with some kicks. So we're going to kick up, hold for a few seconds, back down, make sure to alternate, and we're going to do 10 on both sides as well.
Mike: Good, and finish up with a really simple one, marching in place. Get those knees up as high as you can. If you do have weak hips, simply assist with your hands. Get them up, get some range of motion, and strengthen at the same time.
Brad: Mike, let's talk about that real patient video.
Mike: So if you want to check out another video, watch "Chest, Arm, Back and Core Strengthening in a Chair (Or Wheelchair) (Upper Body with Exercise Bands)." That's a funny video title.
Brad: Well, yeah, it is, but again, we have a real patient. She's in a wheelchair and demonstrates the exercises very well.
Mike: Our next question comes from @jdaniell. They have watched our channel for a long time, have been doing some of the shoulder exercises we talk about, but are having some bursitis pain in the shoulder, wondering what they can do.
Brad: Well, this is a good question, and because of limited information, we're going to start. If that shoulder is so sore, it's hard to get range of motion at all. You back off and do the Codman's exercise if you can't lift it at all. You simply use gravity, where you just put your good hand on a tabletop, lean forward, and let gravity just work that. We call it the pendulum or Codman's exercise. For 30 seconds, just allow it to relax and flex and retract back and forth. You can go right to left and even make circles, all in that 30 seconds, just to get the joint moving.
Brad: Then go back, put a cold pack on it, do that for a day or two till the pain settles down, then go to the next exercise.
Mike: Next, we're going to do the W stretch. Now, you can do the seated, standing, in the doorway, whatever works. If you have good mobility, you can try to lift your arms up and actually make a "W," so relax, bring them back. This is going to help stretch and work on your posture. Because most people's shoulder pain is rounded forward. Again, do 10 repetitions. If you have trouble going up like this, you could certainly go kind of just at the side and keep your arms down here.
Brad: Right. This is one of those little things that make a big difference. If the posture is proper, the shoulder joint works much better with less pain, and then the next one, to get that shoulder to start going up. If you're unable to, a little painful, but it's kind of going, take the other hand to assist it. Put your hands together like this, and the right one will be my sore one. Lift and do assistance with this strong hand.
Mike: I'm using the Booyah Stik in case you don't want to hold your own hands.
Brad: So go up as far as tolerated. Using a stick or a cane is really an option that has been going on for decades in the therapy department because it works well.
Mike: So do 10 repetitions of that, and our last one comes from our friend, physical therapist Rick Olderman. We're going to show a couple of options here. Brad, you want to start with it?
Brad: Right, so the shoulder's improving by now. You're able to reach up without much pain. We want to stretch it and strengthen it. On all fours, do this on the bed or carpeted floor. Hands out here on all fours, just like I'm going, and we're going to put our hips or our buttocks back towards our heels, and my hands stay planted down, pushing into the floor, and I'm getting a stretch, and we're actually stretching those shoulder muscles so the scapula moves properly. Very critical part.
Mike: If you have some knee pain and don't like kneeling, you can do this in a rolling stool or a normal chair, same concept. Sit down, stretch your shoulder. Notice as I move my body backwards, my shoulder is slowly going up towards my head. Again, just do what's comfortable. If your chair doesn't move, go here. Maybe you have a towel. Just push forward and slide. Same concept, just if you have bad knees, it's an easier option.
Brad: Right, so do five to 10 of those. That will stretch the shoulder. Now, this exercise complements it, so do it afterwards, and it's called the pinky wall side is what I personally call it.
Mike: So you're going to put your elbow through your pinky, touching the wall the whole time. Do not let your elbows pop up. Go up as high as you comfortably can. If you just have pain on one side, you only have to do it on one side. You don't have to do both, like I'm showing. Go up as far as you can, lean into it. Sit here for 10 to 30 seconds, breathe, and come back down. keeping contact with the wall the whole time. When I'm doing this, if you're struggling to lift your shoulder up, try shrugging a little bit, and that may help. This teaches your scapula or your shoulder blade to work with your shoulder joint, which could help some impingement or bursitis issues you may be having.
Brad: Right, so take your time with this. If you cannot hold it up for 15 to 30 seconds initially, do what you can, wait for the next day or two, and progress to that length of time. Good. That is wonderful. Nice job, Mike. So again, take this in order. You may have to re-watch again to find out what level your shoulder is at. Is there anything else we want to add to this, Mike?
Mike: I don't think for this one. Let's go to the next question.
Brad: Number three.
Mike: Our next question comes from Michael Graham. "Is there anything you can do for Dupuytren's other than surgery? I have it on both hands. Thank you for all your help." And I probably pronounced that condition wrong, because it's a mouthful.
Brad: That's right. Actually, you're in luck. We have excellent information from this. We did do a video because Bob actually had Dupuytren's, and it's when the ring finger goes in like this, and the tendon gets contracted, and there's a lump in there. It really makes a difference in how you can use your hand. Now, in the video that Bob talks about, we're going to put it there; he goes through it in detail with a wonderful description of how it develops and how you can treat it or live with it, and then we found out he actually cured himself since then. That was a 10-year-old video. Watch the video. It has excellent reviews, and people are very satisfied. I watched the whole thing because I couldn't remember what he said, and it was educational. Now, the next thing is, there is a treatment for this since then that we didn't have then, and I believe it's an injection. It's called Xiaflex. You need to speak to your doctor about it. It's an injection, and it does have, what are the, 44 to 64% of the people resolve their problem with the injection, but before you do that, now, Bob had just informed us, he took care of his while doing pull-ups, and what it was, can we scoot over here? These are Pull-Up Handles, but you can use a regular pull-up bar. I think that's what he was, I don't know. Either way, it doesn't matter. I'll face this way, and Bob, were you just hanging there, and the weight of your body pulled and actually pulled the contracture?
Mike: He was just hanging.
Brad: Right, so he wasn't actually doing pull-ups; he was hanging, and that was enough to stretch and actually reduce or correct the problem. No guarantees that it's going to work for you. He had it for many years before that actually occurred, so that is no guarantee. It's just something that worked for Bob for sure.
Mike: The video is called "Dupuytren's Contracture (Starts as Lump on Hand) How to Treat." You can find out more details there.
Brad: Yeah, and it's like I don't have any gray hair in that video.
Mike: I'm not even in it. Our last question comes from MS, and then a bunch of random numbers and letters, so we'll just call you MS for now so "Hello, please make a video on shoulder pain during pushups." Now, to answer this, we're gonna relate to a famous physical therapist called Kelly Starrett, and he talks about having an optimal pushup position that can help minimize the amount of stress on your shoulders, which we'll get into in a second here.
Brad: That's right, this is an excellent question, because so many people do not do pushups properly, or they don't know how to modify them so they can do them without shoulder pain. So Kelly Starrett is the man; he's written books on this and gives classes on this to therapists. Mike, go ahead and talk about what he recommends.
Mike: So the first thing you want to do is kind of visually see how you're doing a pushup. Where your hands go is going to depend on how much stress is going on your shoulder versus your tricep, so if I'm way wide out here doing wide pushups, this is a lot more on my pecs and my shoulder. What you want to do is bring your elbows in closer to the side of your body like this. Now, if I keep them close and go down, I'm engaging my tricep more, my pecs, and I don't have as much strain on my shoulder.
Mike: You can kind of mess around with what feels best. Some people might feel good with their elbows tight, some people flare out just slightly feels better. Most of the time, if you're way like this, this is gonna be problematic on your shoulders, so try to go either right next to your body or maybe a 45-degree angle.
Brad: Now, we do have a video that goes through pushups in detail in regards to form, what he had talked about, and we're going to link that, too. It's about 10 minutes long, and I guarantee you, every aspect of the pushup is gone through in there. Bob and I made it a few years ago, but it is spot-on, and we do want to add, this is what I use are called...
Mike: Perfect Pushups.
Brad: My wrists hurt because of whatever joint issues I have. When I use these, everything feels better between my wrists and my shoulders.
Mike: Now, the nice thing about these, compared to just normal pushup handles, is they actually move, so if you're going down into a pushup, you can actually kind of rotate them around and see how your shoulder feels. Maybe it feels better out here, maybe in here. Do what's best, what feels optimal for you. But yes, it takes a lot of pressure off your wrist as well, because some people are uncomfortable going like that.
Brad: That's me. All right, the video, "Perfect Push-ups Guaranteed, Do them Right & get Stronger."
Mike: We would like to mention, you can try doing pushups in different positions and see if that bothers your shoulder, so countertop, table, or wall pushups could be an option to start.
Brad: Right, this is a wonderful way, and implement the rules that Mike talked about. Not too wide, not out like this, but in where we talked about, and a countertop can be a great way to start out. Once they get too easy there, go down to the traditional floor pushups.
Mike: So those are your questions answered.
Brad: That's right, and keep pushing up.
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