- (laughing) Oh, hi.
Hi! - What about that one?
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous
physical therapists on the internet.
- Well, in our opinion, of course.
- Right.
Brad, today we talk about patellar tendonitis.
And what I think is the best treatment for it.
This is really a cool trick.
I think if you can try,
you're gonna be really pleased with it.
Patellar tendonitis is when you're getting that pain,
I guess I can roll mine up too,
right below the kneecap,
right on that band there.
- Right.
- I think this works really well to show it.
This would be the knee, right here, like that.
Like that. - Except for,
this model, the tendon popped off.
- Popped off, yeah.
- So it looks like this.
- So you got the kneecap and then you got the band,
the tough fibers band that helps hold that kneecap
down to the tibia.
- It's actually a part of the tendon for the quadriceps.
- Yep.
- We're not gonna get into that.
We're just gonna talk about
that particular tissue right there.
- Now this is not, we're not talking
Osgood-Schlatter disease, which is a whole different thing.
And after inflammation of this bone here
and maybe even a little bit of separation on that bone.
- Sure.
This is the actual tendon itself is giving trouble.
And what we're gonna be doing.
Nancy, can you see this?
We're gonna be rubbing across this tendon.
Right across it, because how often a pop happens
is this tendon has thickened
or it's maybe got some tears in it
or it's just a little bit inflamed.
Now, when you're doing this rubbing,
you're gonna be rubbing across here.
If it just gets worse and worse, as you rub,
you're gonna probably wanna ice first.
- Right.
- You're gonna put an ice pack on it
or maybe do an ice massage to it.
Which we've had videos on that before.
So, alright, let's go right through this, Brad.
Let's do first,
I'm gonna have you lay down
or sit up with the leg out straight.
- Yeah.
- There you go, perfect.
Okay.
What we're trying to do here is,
we would tip the kneecap up a little bit.
So I'm on the top part of the patella
or the top part of the kneecap.
Now you can do that one or two ways.
I've seen people go kind of just like this
and hold it up like this.
And then usually, I like to use the long finger,
some people use the ring finger.
Either way you're supporting one finger
with the other finger.
So you're gonna go like this, and this holds up.
The other way to do it is just to take
your whole finger eminence here, I guess.
- The web between the pointer finger and the thumb.
- The web, yep.
And you can push the kneecap this way a little bit
and it's also help holding it up.
And you're gonna take your finger,
you're gonna rub across it like this.
You got that Nancy?
Good.
Now I'm not just rubbing the skin.
I'm getting in there deep, aren't I, Brad?
- Yeah, getting in there.
- Now the patellar tendon even actually attaches
up to the sides here.
You can even work on the sides a little bit here.
I'm going across the fibers.
Again, I would start right here.
And now you can expect some tenderness,
but after a while,
20, 30, 40, 50 seconds. - Right.
- It should start to maybe get numb or actually feel better.
If it doesn't, then it may be too tender.
Then you may wanna ice.
- Ice and then do it?
Or just ice and leave it go for a day?
I would say ice and then leave it go.
And then maybe try it the next day, again.
- Um Hmm.
What kind of symptoms are gonna be present
that are indicative-
- You're gonna have pain.
You're gonna have a lot of,
a lot of times, people call this jumper's knee.
A lot of times they'll get pain
after they've been doing a jumping activity,
high jump or basketball.
It's just really,
pain is the biggest indicator.
- Specific to that area.
Exactly. - Right, right.
- So you can do this,
you can go up to five minutes.
You can even do 10 minutes,
if they power it.
Most people, it's gonna be about five minutes here,
you can do this and you can do it every day,
from day one. - Sure.
If the response is positive.
And I could do this to myself then, right?
- I think you could.
I think you could push like that.
- Yeah.
- And then,
- Get in there.
- and put one finger over the top of the other.
- Yeah, I got, I like using that middle finger
and then support here.
- [Bob Schrupp] I bet you do like using that middle finger,
don't you be Brad?
- [Brad Heineck] Oh Bob!
Why, Bob?!
- (Bob laughing)
- [Brad Heineck] Alright.
So I'm gonna work in there like that.
There we go.
Actually doing it to yourself,
you can, cause you know where you're-
- [Bob Schrupp] Yeah, you can work it
where you need to work it.
- [Brad Heineck] Right.
- [Bob Schrupp] I think it's a fantastic thing
to try to do yourself. - [Brad Heineck] Sure.
- [Bob Schrupp] Absolutely. Why not?
- [Brad Heineck] Um hmm.
- Really no harm that can be done with this.
- Right.
Again, did we mention this is that cross fiber?
- Cross fiber friction massage.
- Fibers go this way. - Yep.
And we're going opposite 90 degrees.
- Alright, let's go into
another bonus treatment here that you can do.
- Oh! - Brad, why don't you just go,
right on over the edge, here.
Sit up on the edge.
It'll probably be more difficult to do on your own,
but you could.
What you're gonna do now,
is you're gonna actually pull your arm
right underneath the kneecap, again.
The kneecap is right here.
I'm gonna pull down the skin a little bit this way
towards the foot.
- So he's actually pushing.
- Oh Brad, I'm sorry, I'm gonna go this way.
I'm sorry, I'm gonna push up.
- Can you do it with the other hand
so they can see it better?
- This right here?
- [Brad Heineck] Yeah. Yeah.
- [Bob Schrupp] Okay. I'm sorry.
I was going the wrong direction.
I'm gonna attack and push up,
and now I'm holding that.
And then while I'm doing that,
I'm gonna bend the knee. - [Brad Heineck] Oh yeah.
- [Bob Schrupp] And bend it.
- [Brad Heineck] Essentially stretching it.
- [Bob Schrupp] I'm stretching that tendon.
Cause what often happens is you got a thickening
of that tendon or the tendon is tight.
And because it's tight, it's pulling
and that's what's irritating it,
when you do use it in activities.
So again, place the thumb below the patella,
below the kneecap,
push in and then push up,
and then hold it,
and then bend the knee.
- And he's pushing fairly good.
- Yeah. I'm pushing hard.
- And it doesn't bother me at all.
- Yeah. I would do a good 10 of these.
- Um hmm.
- On someone that is having trouble or tightness,
they're probably gonna feel this.
- Yeah.
- I did this to myself, last night.
Wanna try it yourself, Brad?
- Yep. - Cause you could do it.
You could attack it like this
and then bend it back yourself by-
- I could use my other leg?
- You could use your other leg, yep.
- For a passive? - Yep.
- Would that be better
or actively doing it?
- Either way is fine, actually.
Because sometimes when you activate the hamstrings,
the quad relaxes automatically.
- Sure. Yep, yep.
- So that would be a good way of doing it.
- Then I could really get a good lock on there,
if it wasn't too tender.
And I'm bumping up against the-
- Yeah. - table here, but...
- As a final thing, just as a final bonus, bonus.
You can go ahead and actually stretch
that leg, then too.
You can finish by grabbing onto a chair and grabbing.
I can do it this way.
- Sure.
- You may have to work up to that.
- You could lay down. - Yep.
- You grab here.
It's a little aggressive, but- - Yeah.
- it feels kinda good, right now.
- And that's gonna stretch that tendon
and the quadricep out too.
- Oh yeah.
That was the double bonus.
Alright.
- By the way, Brad,
we can fix just about anything,
but we can't fix a broken heart.
This was made by my daughter.
This is folded book art.
If you're interested, go to happylittlegifts.com,
happylittlegifts.com and you can buy.
- Be cool, this is good therapy in itself.
You can make that.
And I want her to make one and give it to my wife,
next Valentine's Day.
- I was gonna say,
my son made one for his girlfriend.
- Oh really?!
- Yep. - Wow.
He's a very sensitive man.
- (laughing) Oh yeah.
He's sensitive, alright?
See you later. - Take care.
- (both laughing) - He actually isn't.
(playful music)