- You look like an English gentleman or something.
Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together, we are the most famous physical therapist
on the internet, Brad.
- In our opinion, of course.
- Our opinion.
Brad, today, what are we gonna talk about?
- Well, Bob, I thought we'd talked about the Packers.
I'm just kidding.
We're gonna talk about hip bursitis
- Top three steps for treating hip bursitis.
You know why we're doing this topic Brad?
You don't know why.
- No, I really don't.
- My cousin,
- Oh, sure.
- Contacted me through Facebook
and she has hip bursitis.
And I won't say her name, but it rhymes with Honda.
- Oh.
- There's a lot of choices there.
You think there's only maybe one or two,
but there's actually a lot.
- She's named after a country, Rwanda?
- See. That would be a possibility, wouldn't it?
- Anyway-
- One of my favorite cousins.
Anyway, she fell and got pressured directly
right on the bursa and she had pain.
In the end now we're not sure that it really was a bursitis
to be honest.
- Right.
- Because it didn't get better
and she got a shot and all that.
But anyways, so I've still promised her, we'd do this video.
- Sure.
- So top three steps.
Number one.
Well, first let's talk about what it is.
- Yeah.
- Hand me the spine, Brad.
- You better believe you can, Bob.
Here, catch this.
- Oh, thank you.
All right.
Basically what we're often talking
about is trochanteric bursitis.
And now here's your hip.
- You're throwing around a lot of big words
now, let's clear this up.
- This is the greater trochanter, isn't it Brad?
- Yeah. Now if you look, a lot of people think the hip
is right on the belt line
but it's really below the belt line.
Right where my finger is.
- This would be right here.
This is the hip
- Right there, right there.
- Right. Now on top of this bone, basically,
is a fluid-filled sack.
Are you picking up this Nancy?
This is amazing stuff here.
Now I wanted to have like a rubber ball,
that air filled you know?
'Cause that's kind of how you would look at it
and that's how a a fluid-filled sack would look.
If you squish it down.
But we didn't bring our rubber ball today. So anyway-
- It keeps falling.
- It almost, it probably, this is probably a little large.
- Yeah.
- But this is how it would be, a fluid-filled sack.
And then structures go over the top of that.
And that helps stop it from rubbing over bone, basically.
- Right? Like a lubricator so the tendons
and the ligaments don't get wore out
when they go over the bone edges.
- Right.
One in particular would be the IT band, the IT band.
Maybe if you've heard of iliotibial band
goes right over the top of that.
So base, I think most often, more than not,
bursitis injury is a repetitive injury. Overuse.
- Right.
- You're doing something that causes it to
rub rub, rub, rub, and it gets inflamed.
- Right. - Fired up.
So we gotta get that inflammation down.
- Right.
- Right Brad? That's step number one.
So how do we get inflammation down?
- Well we need to decrease whatever irritated it.
So if you were doing a lot of walking, you're maybe running,
you may have to-
- That's step number two.
- Oh!
- Step number one. We can do what? Ice?
- Ice. Yes.
- Ice packs, ibuprofen.
As physical therapists, well a treatment
that we often use is Iontophoresis or Phonophoresis.
- Sure.
- You don't know what those are
but they will decrease inflammation.
- We do have videos on those as well.
- Yeah. And then, if you get the doctor involved
and it gets to that point, you could have a cortisone shot.
- Sure.
- And they'll, from what I read,
those are very highly effective.
They tend to work pretty well.
- Right.
- So, alright. But let's say you're not to that point.
Let's say step number two is to decrease the stress
on the hip, Brad.
And one of the ways at which,
and this is what I recommended to my cousin
whose name rhymes with Honda.
She's my favorite cousin. Is that she use a cane
and she was reluctant.
I could tell.
And she finally went to a physical therapist
who also said to use a cane and she did.
And she started having less pain.
I don't know if it was because of the cane
or she had mentioned some other things.
Brad show, let's say you have bursitis
on the, what side do you want?
- Right here. Right here.
Right. A lot of people would think use the cane
in the right hand, but not true.
Always the opposite.
My cane is too tall, but we'd have
to adjust it down to here.
I'm not gonna do that right now.
But you use the opposite hand.
- Yeah.
- And you would, as the right foot goes forward
the cane will follow.
And you'll unload that hip every time you take a step.
A lot of the force on that trochanteric bursitis
is gonna actually go through here.
- Exactly.
- Taking inflammation.
- Can make a huge difference.
If I were to do one thing, this is what I would do.
- Sure.
- And we're not telling you to use a cane
for the rest of your life.
All we're telling you is use the cane
till your inflammation calms.
- Right.
So you're gonna ice it, maybe some ibuprofen, get a cane.
Those are three things you don't have to see a doctor
or a therapist for.
- That's right. You can just start off.
Avoid stairs.
I wouldn't lay on it at night either.
- Right.
- If your bursitis is out here
don't lay on it all night long.
So what you'd rather do is lay on the other side.
And even then, Brad, do you wanna grab that pillow?
- Sure.
Put it between-
- Because if this is the hip that's bothering you
if you're going like this,
even this is putting stress on.
- Right. Now a lot of them end up going up like this-
- And that's stretching on it all night long
irritating all night.
So this is just a way to calm it down.
Obviously you can sleep on your back too.
- Sure.
- So probably stomach also.
But this would-
- If you're a side sleeper, you're gonna do that.
And then sometimes go back down, Bob,
I'm gonna show you this.
Sometimes what I do or I have my patients do
if they like to roll from one side to the other,
we'll put pillows on this side.
- So then prevent them-
- Right, when you're sleeping you rollover
without thinking about it.
You end up on that side and your hip is sore.
So you put a couple pillows there
and that'll be a physical reminder.
Either that or you have your spouse
go right up next to you and tell her to stay there
all night long then you can't roll over on top.
- Well radical idea I heard, which I've had suggested
is that you sew a ball into your shirt,
a little tennis ball or something.
- Yeah.
- And if you roll over onto that side
don't you roll over onto it.
- Another use for the tennis ball.
- Yep. Yep. Those tennis balls come in handy.
- What else have we got with these?
- I think that's it for decreasing the stress?
Like I said, you wanna avoid any repetitive activities.
Probably bicycling, stair climbing.
What other activity would be bad for-?
- Well jogging, but jogging, you'll know
because when you do the activity, it irritates it.
- Right. If the activity irritates it,
you don't wanna do anything that's gonna make it worse.
Oh, don't carry a heavy purse.
Brad, I know you're prone to that.
You gotta lighten up that purse.
All right.
Finally, number three.
That was number one, decrease inflammation.
Number two was decrease stress.
And number three, we're gonna give you two stretches
and a strengthening exercise.
- Sure.
- I'll show you the first stretch.
I'm stretching this side.
Okay, Brad?
- Yep.
- I'll lay down.
What you're gonna do is gonna cross your leg over like this
like a figure four, and then gonna bring this leg up,
like this.
And you can even bring it up further by grabbing like this.
This is stretching that hip.
- The one on the back side, not this hip but the other.
- I'm stretching this hip.
So again, kind of just cross the ankle
over the leg, over the top of the kneecap.
- Yep.
- A little bit above the kneecap
making the what is called a figure four.
- Go on, do the stretch.
- Bring this up.
I'm just giving them the detail, Brad,
and then we stretch it like this.
- What's the second one?
- The second stretch.
You wanna show that one, against the door?
- Oh no. You show it. I don't like that one.
- Oh, Brad doesn't like this one.
- I think it's a good stretch.
But so many people have a difficult time doing it properly.
- Okay. Legs are quite far away from the door.
Okay? And what you're gonna do is I'm stretching this one,
I'm just gonna crossover like this and go down like this.
- [Brad] Yeah. It's a good standing one
when you can't lay on the ground, right.
You gotta be fairly nimble for this,
- As I am.
- Right.
- Even though I'm 50 and over.
- How long are you gonna hold these stretches Bob?
- I'd say 15 to 30 seconds.
- Sure.
- All right. And then the clam shell,
do you wanna do that one Brad?
Is there anything you want to do right now
besides just make comments?
- You're doing really good. Continue.
- This is the clam shell.
Again, I'm gonna strengthen the hip on this side.
You start off the bent over fetal position,
I guess is what you would be.
And very simple.
All you're gonna do is you're making like a clam here
opening up the clam shell.
Believe it or not this one, Brad,
if you don't do this one much...
If you do 15 reps of this, you'll feel it.
- Oh yeah.
- A lot of people don't strengthen their hips.
So it really...
I'm feeling this now!
And I do this exercise.
- Well, Bob, I'm not telling you.
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- Right? And if you're 40 or 50,
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