Hi folks I’m Bob Schrupp physical therapist Brad Heineck physical therapist, together we are the most famous physical therapists on the internet, in our opinion of course Bob Vikings won! Do they play football? Haha. Today Brad we’re going to talk about shoulder impingement pain The 7 best tips for pain relief and movement Now I’d like to say that a lot of these are probably less common exercises and stretches and massages that you may not see anywhere else Well in a way but I think it’s really gonna be an effective technique, yeah they’re important, right exactly and the whole concept is to get the muscles loosened up that are tight and strengthen the ones that need to be strengthened But first of all I wanted to talk a little bit about shoulder impingement, that’s what it’s about How do you know you have shoulder impingement if you’re not a therapist or a doctor just by symptoms You know I can’t guarantee it but oftentimes some of the most common symptoms is the location is typically Right in here you’ll feel it not always where the impingement is there but it’ll travel down the shoulder a little bit Sometimes it makes it difficult to do isn’t it because the problem is happening here but the pain goes here and sometimes up The other thing is is once you elevate up to about 90 degrees that’s when the impingement typically starts, not down here but up here And one thing I found and the pain for Lark syndrome I’m sure you’ve seen this Where they’ll get up to about 90 degrees, ouch it hurts a little bit but once they get past a certain place Then it’s okay, yeah you see both versions Well at least I do I see where it goes up and there’s pain and then stops pain and i’ve also seen where it goes up and there’s pain pain pain all the way through depending which tendon it is And where on the tendon it’s hitting, either way you can think of it like the tendon is getting pinched Which is like an impingement, and I want to show that on Bone-aparte But first I saw a few people walking in If you are new to our channel please take a second to Subscribe to us we provide videos on how to stay healthy fit pain-free and we upload everyday also like us on Facebook, Brad and I would Sincerely appreciate you liking us, cuz I know he likes me but yeah I like some real people, he’s one of the few people that does Okay so we’re gonna look at this red Theraband here Stretch band, yep now that represents the tendon and that’s the one that gets pinched and you can see down in here the gap where my finger is So right here is where it can get pinched You can see when you get up to this range There’s less space here and that narrows up and that’s where the impingement happens and what happens over time Is this roughens up the tendon and Eventually it can get to the point where it actually tears And that’s where you get a rotator cuff tear, and that’s a problem So we want to get this to come down drop down and have plenty of room in there and that’s what these exercises Are gonna do so First of all a lot of times This can come on Particularly the people who have shoulder pain without any apparent reason, they didn’t fall down they’re not pitching a hard ball But they get symptoms Impingement symptoms and it’s because of this Bob Poor posture is very common Shoulder is internally rotated and what does that? That’s the pectoralis major and minor Yeah it’s because people aren’t paying attention, then these muscles tighten up and it gets worse and worse, it compounds So that’s what we’re gonna do we’re gonna focus on loosening these muscles up to allow this range of motion to occur and Right here you’re gonna take a tennis ball or a lacrosse ball And we’re gonna get into that Pectoralis major and pectoralis minor You can just do it with your thumb, I was just going to say your thumb or your fingers This is how I’ve done it, and I’ve been amazed at Brad when you do this and you’re working the fibers run this way, so I’m massaging this way I’m massaging pretty deep But I’m shocked as after I do this how much easier it is to keep my shoulders upright You know and externally rotated and in a good position and again when we get that posture it minimizes Greatly the impingement risk and if your fingers get sore or tired you can again take the ball and work in there and then you can Roll on it and again up and down the fibers, get in there deep You know if you have someone else to help you, more power to you that’s wonderful If you really want to get fancy go ahead and use the Pure Wave Massager, this is our favorite massager On the market right now and because it has percussion, it doesn’t just vibrate it percusses So that makes all the difference and what we have on here is the pointer head They have a whole bunch of them, they have a softer one, this is the air-filled stick This is the pointer stick I like this one, but this might be too much for people to start with, you may need this one If you’re a pretty muscular person, then you’ll want the Pointer stick, and you can get in there and work that, and this is a lot easier than working with your fingers But you can still use your fingers, it sounds like you’re talking into one of those fans What’s nice about this Brad, you can do this at your desk, and you can do a little bit of massaging Like this throughout the day Yeah while you’re looking at your computer or watching TV or whatever you’re doing And then the next thing is we need to why don’t you stand up and turn around Right here if these muscles get tight here they don’t allow the Scapular to rotate up and That’s part of the mechanics that’s gonna help free up and eliminate that impingement, I think we should show that just real quickly Brad Because I don’t think people understand this, When you bring your arm up, your shoulder up, this bone also moves, and if this Shoulder blade doesn’t move You can’t get your arm all the way up and you start getting things impinged a lot faster So like my hand is here that scapula Has to rotate up like this and there’s muscles connected from this part of the scapula To the bones and if they’re tight They won’t allow that stretch but if we can allow them to stretch out and we get that motion We’re gonna have a video demonstrating this very well coming up in another couple of days, keep an eye out for that So it’s really strange you gotta work all these muscles around the shoulder, you’re thinking why aren’t we working on the shoulder Well we are because we’re working these muscles coming into the shoulder and they affect the shoulder, they’re all connected And I like to use a roller to self treat, get the muscles in the back Plus it’s gonna help the spine for posture, it’s a win win situation I like this roll, it’s soft density And when you’re rolling on your back, it’s a little uncomfortable if you get the real hard density one This one’s from OPTP, I think they have some of the best rollers on the market We’ve got it down in our link below Brad in our favorite products, Oh I just cavitated Bob When he says cavitated, what he means is that his back cracked You’re not gonna get up on your neck, it’s gonna be from about Where the shoulder blades start to where the shoulder blades end you’re not going to go to your low back And you’re just gonna roll back here and relax You could do that longer too if you wanted but we gotta get on with the show Okay so easy way to stretch it And plus you’re getting a little bit of stretch on the mid-back too so you’re getting a double bonus there which by the way Brad if You are tight this way That’s also going to affect your shoulder and cause more impingement, we always like to show this little thing don’t we Brad Here I am with bad posture, look how high, That’s as far as I can go, now good posture and I go all the way up Even if you’re not really hunched over, if you’re standing tall but your shoulders are forward it’s the same thing And right now he’s pinching when he’s going forward if he’s like that And so that does two things it straightens you up Straightens out the back and it stretches the rhomboid, exactly okay the next thing is the latissimus dorsi That muscle also pulls the humerus in and forward It internally rotates, so we want to get that stretched out as well, you can go up to a wall If it doesn’t hurt your shoulder Get your hand glued to the wall and stretch here Or you could just do it on a table or a countertop I’m gonna kind of grab here let your hand Stick to the tabletop and pull and stretch here and the next thing that we found to be even better yet is this Actually one of our viewers a few years ago brought this book to our attention, we both read the book it’s by an orthopedic surgeon, we found that hanging Like on a pull-up bar can do wonderful things, it stretches the lats, this is a cool book And if you listen to his reasoning it’s very sound, It’s John Kirsch, MD He’s actually not too far here, from Stevens Point About 150 miles or so “Shoulder Pain: The Solution and Prevention”, we’ll put this down in our list too, I think we’ve used it enough Brad and I both do some hanging and it’s so simple, who can’t do it You know, you just hang, you have to have a pull-up bar, He actually also then has some exercises in there you can do along with that It’s not a really complicated book, it’s real simple, it’s a good read for the lay person, it gives a lot of case studies It’s all scientifically based Alright next one Brad is Bringing the foam roller back out right? You better believe it, now you need the long foam roller for this, if you have the 18-inch one it’s gonna be too short Get the 36 inch one And even if you don’t have shoulder pain, this is a great one for posture also like the previous one I’m gonna get my head to rest on there and I’m just gonna have it go right down the center of my spine and just Let gravity work, he’s opening things up there Take a few deep breaths and completely relax, and you can just hang out here for 3-5 minutes Just relax and let things stretch out, get those shoulders to go back and Well you can just feel it open up your breathing, everything works better It’s a simple one, did you want to show strengthening Brad or have we had enough? Well yeah so now the big picture is we’ve got the muscles here loosened up so they can go back We’ve got the muscles in back loose so that that Scapular can rotate forward so everything is set up, now we do need to add a little strength We’re just going to get into this but these are pretty much two gold standards for impingement First one is external rotation Okay you need to have some kind of resistance band like this We’ve got this hooked up to the wall here now this is really important that my elbow Stays here and I don’t do this and I don’t do this but it’s just like this And then the other one now this one you don’t have To have a band, Bob you can demonstrate it maybe Without the band but with a theraband we’re gonna go back and get those shoulder blades to come back and down, back and down Oh I see yeah, just doing these, just squeezing your shoulder blades together, same motion but no Resistance with a band but it’s still and think about coming down your shoulder blades don’t come down but you think about it Then the lower traps kick in which is helpful to get that proper scapula motion, sometimes we even do this one, we do this way, hit the road Jack And that helps emphasize that external rotation It’s a really nice way to get both of them Remember folks, we can fix just about anything, I’m glad you said that Bob, Except a broken heart, but we’re working on it, we haven’t said it in awhile, Good way to finish it up. Thanks for watching.