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This article is a transcribed edited summary of a video Bob and Brad recorded in September of 2018. For the original video go to https://www.youtube.com/watch?v=D0Ll6aDOMkU
Bob: Today we're going to talk about how to fix shoulder pain in seconds and this does work. I know because I'm actually using it on my shoulder right now.
Brad: Right, and not only that we have used it on our patients over the years. We just don't pick these things out of the air.
Bob: All right. So these are five exercises and how you can do this in seconds is, I just want you to do one of these exercises every few hours. It only takes you seconds to do it. Everybody's busy, nobody has time for pain. I just had one of our aides, she hurt her knee and she goes, "I don't have time for this." And it's right. You don't have time for your shoulder pain. You don't have time to rehab it either. So I'm going to show you things you can do throughout the day, maybe even in the office or wherever you work.
Brad: Right, so you're going to try all of these and only do the ones that are successful, because more than likely, not all five will work on one person. Usually one or two are going to be successful. So work with them.
Bob: Exactly, find the ones that are working for you and stick with them. And the thing that we're trying to treat here mainly, is what we'd call impingement because impingement often leads to rotator cuff problems. And I'd say about 80% of the shoulders that we see are having this difficulty.
Brad: Right, as a matter of fact, our hanging book has studies saying this is the primary source of shoulder pain, not all of it, but a majority.
Bob: So very quickly we're going to show you what impingement is. It often occurs from kind of poor posture, leaning forward, or being hunched forward. And what that causes is you have the humeral head and it goes into the socket or the glenoid fossa and you have a tendon going over here. That's what this red thing is. And if there's not enough room in there what's going to happen when you lift the arm, it pinches.
Brad: I'm going to show you the healthy way. You have a gap in there. Plenty of room. The joint drops down where it's supposed to, and the rotator cuff is doing what it's supposed to. Unhealthy shoulder, it pinches, and that's about where you get it, is where your shoulders around 90 degrees, it starts to pinch, ouch, ouch, ouch.
Bob: And what happens, over time, is you start to saw away at that tendon and you can actually get a rotator cuff tear. You can tear the muscle. It throws everything off. These exercises are designed to get you a little more room in there.
Brad: Right, so we eliminate that impingement or that squeezing, pinching, nasty painful stuff.
Bob: All right, the first one is the one that I've been doing. Without going into too much detail, I have a little bit of winging on the left scapula because I actually lost a muscle when I was younger. I had nerve damage. So this one tends to come forward, more than the other one. So, this is something you do throughout the day. You want to do shoulder squeezes and they're very easy to do. You can do them no matter where you are. You can do them standing. You can do them sitting. And I'm just going to go ahead, bend my elbows. And I'm going to squeeze my shoulder blades together.
Brad: There you go. You can see the wrinkling of his clothes, showing the movement of those shoulder blades, from this side.
Bob: Are you saying I just got my clothes out of the hamper?
Brad: Yeah, they're wrinkled. You have to get them taken in, Bob. Once again to the press.
Bob: One, two, three, four, five. I usually hold for a 5 count.
Brad: You count it like that in your head?
Bob: One, two, three, four, five, yeah.
Brad: Everyone's got their own little ways. I just go “hold” and then relax, that's my mantra. “Hold”, relax.
Bob: By strengthening these muscles, you're strengthening the core of the shoulder. And that helps, if these are held back right here, it puts the shoulder in the right position. So instead of our shoulders being flexed forward, they're back and that's where you want them to be.
Brad: Right, they work much more efficiently and in less pain.
Bob: So that's one I definitely want all of you doing. That's one, I want you to slip in throughout the day. The next one is our Mulligan technique which we're a big fan of. And you can just do this off the back of a chair. And again, this helps set that humoral head down in the socket, to give you more room for the tendon to glide through. So I'm on the back of the chair. I'm pushing down into the chair. And while I push down into the chair I walk away and the left is my bad shoulder. So this is the one I should be doing it on. And I can feel this actually stretching really well.
Brad: So you're kind of pushing, not straight down, but down and kind of towards your toes. So it's kind of going that way.
Bob: Hear that crack?
Brad: Oh, I didn't hear it, but I believe ya. Yeah. It's always louder to the person that has it, but you can see his range of motion.
Bob: That's it again.
Brad: Yeah. I did hear that. Audible crepitus, that's what we call it in the field.
Bob: So we're trying again and it is a sneaky way of getting more motion. And it's a sneaky way of getting more gap.
Brad: Right, with this technique, if you're unable to raise your hand over your head but you do this without pain, it's the right thing. But I've had some patients do this, and they didn't like it. It's painful. It creates some sharp pain, if that's the case, that one goes off the list, we go to the next one.
Bob: Did you want to show it with the Booyah Stik?
Brad: Why don't you, Bob?
Bob: Okay, so if you did have one of our Booyah Stiks you could use the Booyah Stik and you can actually do it one of two ways. You can walk away from it or you can also push down and move it away. Either way, but, it works out really well to walk away and push down the entire time.
Brad: Sure, and if you don't have a Booyah Stik and you don't want to buy one, we've had people comment they're using the broom handle or something. You have to do it on the carpet or something, so it sticks. That's what we have these nice rubber ends for.
Bob: Or the back of a chair, like we just did. So the next one is shoulder extension. So now we're going to start working on bringing the shoulder back. Stretching this area out in front of the shoulder. Again, making more room for the shoulder to do its job, to work correctly.
Brad: And we talked about people who started these, Mulligan, he's a famous physical therapist. I think he's getting up there in age. I think he's still alive. He's got a whole system. There's a McKenzie technique. And he's developed his own system that's worldwide, popular in the therapy world.
Bob: So we're working on increasing the amount that the arm goes back. Brad, I thought you showed really well on the countertop there.
Brad: So, in the early phase, when your shoulder is tight, you may just go up to the counter here and then get your good posture. And then you just squat gently. And right now, as I do that, that extends my shoulder. And you just go until you feel some pain, not much, then you come off it. A little pain, then off. So we go to pressure on, but not into the pain, you never go into sharp pain. When the range of motion starts to get better and it's like, "Oh this is getting much better, much less pain." Along with that, you're going to find that going in front is easier.
Brad: To increase that extension you open up the cupboard. Now this would be for a high level. This is for someone whose shoulders are really doing well. They just want to maximize the range of motion, you know, maybe they're a baseball pitcher or something.
Brad: There you go. So you can use other things in the house for stretching.
Bob: Yeah things that just end up being the right level for you. Go ahead and use it. All right. Next one, again, you don't need to do all these. I have all of you doing the shoulder squeezes. With the other ones, I would kind of find out which one seems to be working the best for you for decreasing your pain. This one's a really easy one. You just use a belt and you're going to go ahead and hook it on your wrist.
Brad: This is a little challenging to get set up. Use a belt that is smooth and shiny and you're going to do it with clothing and you'll find out why in just a second here. Sometimes if you have a little help to reach the bent.
Bob: That's what I was trying to do.
Brad: So the painful arm is relaxed.
Bob: I'm going to show you this, quite often what you're going to find is the tight arm is down here, where the other arm I can put way up here.
Bob: And so I want to get this arm up to equal with that one. You're just going to go pressure on, pressure off. This belt really does work well, once you get it set up. Takes a little bit of doing, but it slides really well.
Brad: Matter of fact, we did a video a number of years ago on a patient who was set up for shoulder surgery. And then she said, "Can I do therapy?" And the surgeon said, well, go ahead, you can do it. Within four visits, she was doing this exercise, and no surgery was needed. Her arm started therapy going up to 90 degrees and finished with full flexion. She canceled the surgery and I still see her and she's still in good shape.
Bob: Wow. Nice. Yeah. There are some miracles every minute in the Bob in Brad clinic, right?
Brad: There you go.
Bob: Alright, the last one we're going to do is this one. You're going to need some equipment. I mean, you need a place to hang. Brad and I have become big fans of this.
Brad: Yeah, you just need a hanging bar. And you're just simply going to relax and hang. And you know, when I first heard of this I thought this is crazy. It's going to make the impingement worse. But once I read the book, I understood the mechanics and I started trying it and we started working with people doing it. It's like, yeah, this can be really effective.
Bob: Yeah. We've become big fans. It's such an easy thing to do if you have the equipment and you can wear gloves, which makes it easier. So the book is "Shoulder Pain, the Solution and Prevention." It's by John M. Kirsch, MD. We have it in our favorite books, don't we?
Brad: Yeah, we do. Yep, he's an orthopedic surgeon. Matter of fact, he does his practice 30 miles from where I grew up, in Wisconsin.
Bob: Does he really?
Brad: Yeah. Stevens Point.
Bob: Oh cool. Yeah. My daughter went to Stevens Point.
Brad: There you go. It's a nice town. Got a river running through it and everything.
Bob: Go to Stevens Point too.
Brad: There you go. So here you're going to hang for 10 to 30 seconds, depending on what you tolerate, up to three repetitions of that. And depending on how you respond to it, so the first time you do it might get sore but after you do it for a few days you'll be able to do this two to three times per day and we've really had good success with this.
Bob: And you still said seconds. Remember we promised seconds. Yeah. So it's 30 seconds out of your day and you can make a great improvement.
Brad: Oh, that's right. We have to stick with our title.
Bob: All right. Thanks, everybody for watching. Remember we can fix just about anything
Brad: Except for…
Bob: A broken heart.
Brad: There it is.
Bob: But we're working on it.
Brad: We'll never stop.
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