♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists on the internet ♪
- Hi, folks
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today we're gonna talk about the top five self treatments
for tendonitis of the hip.
We just did a video.
It should have come out already, actually on how to tell
if you have tendonitis of the hip.
- Sure.
- So maybe give you some clues.
If you do, watch this one,
and we'll hopefully we can help you.
- That's right.
- So there's two common hip muscles that get tendonitis,
and they both can flex the hip.
- Right. - Basically.
- Bring the knee up.
- One's the iliopsoas, and one's the rectus femoris.
You really don't need to know that.
Except on the rectus, we are gonna do a little bit
of anatomy lesson later.
Just so you can see where you're gonna do the treatment.
- Exactly.
- All right.
So muscles attached to bone through the thick tendon,
and the tendon becomes overused and with repetitive activity
and it gets inflamed.
And the hence the--
- That's what itis.
Itis is Latin - That's right.
- for inflammation or. - Itis, right.
So that tendon can get inflamed.
And we, these are the five things
that can help calm it down.
- Right.
- So the first thing, sometimes the tendonitis occurs
because those muscles are tight.
- Sure.
- Especially if you sit a lot.
These muscles can shorten up over time.
And if you never stretch it, when you do stand up,
you're putting extra stress on that muscle and tendon.
- Right.
Especially if you're walking and taking long strides,
things of that nature.
- So you're gonna want to gently stretch it
because if you stretch it too much,
you might actually irritate it.
- Right, and go the wrong direction.
- And go the wrong direction, right?
So we're gonna show you the stretches,
and then you could actually use a foam roller
or a massage gun may help too.
- Right?
Nice to have a little assistance sometimes.
- If you want to do the first laying down, lying down.
- Lie down.
- And stretch the hip flexor
in a prone position. - Absolutely.
- In a supine position.
- So both the muscles are likely in the general same area
in the front of the hip.
And if you're lying down, and you can do this on your bed.
Don't get too close to the edge of the bed
so you might feel like you're falling off.
Keep your shoulders well on the bed
and then slide your right hip
if you're stretching your right hip so it can go off
and let that leg go down.
Keep this one here for right now.
And this will start the stretch.
- [Bob] That's probably gonna be enough for some people
to start off with.
- If you bend your knee, it's gonna help stretch
that rectus femoris a little bit.
So a gentle stretch pain is okay.
Anything that creates sharp pain, don't do that.
It's too aggressive.
And then, you can take this knee and pull it up like this.
And Bob, can you show them what's what's going on?
- Now, see all the hip is going up.
That shows there is tightness in there.
He stabilizing the pelvis, and that's why this is coming up.
But Brad doesn't have really tight hip flexors, but you can.
It shows you even on someone who's not tight,
we're putting a stretch on it and puts tensity on it.
- Someone who's tight, they may be way up here.
- [Bob] Yeah, I think maybe up there.
- You know it's not uncommon.
- [Bob] And you'd flip around and do the other side too.
- Right.
If you're on the same side, you'd have to do this
and do the opposite leg as well.
- There you go.
Now another version you can actually do is,
if you want to give me the pillow.
- Oh, I thought you wanted to shake hands.
- Yeah, that type of thing.
So we can actually stretch it.
Kneeling down is how I tend to do it in the morning.
I put it on a pillow, and I stretch forward like this,
and you can see how I'm stretching that.
- [Brad] Right.
- I do this stretch everyday.
- [Brad] You're religious
on this one, yeah. - Yeah, I'm religious
on this one because it really helps your hip.
It did.
It really.
And I see I'm keeping really good posture.
- Yeah, look at this nice vertical.
Show them the wrong way to do it, Bob, where you're, yeah.
Yeah, when you're reaching forward for the ground,
and that's--
- And also you might even take your hand
and push forward a little bit.
Give it a little more stretch if you'd like
to really like to push it along.
- That kind of actually forces good posture
in the correct motion.
- Yeah, sure, sure.
Absolutely.
Yep. - Yep.
All right.
Next one.
If it is the rectus femoris,
and this is where we're gonna do a little bit
of an anatomy lesson.
- Oh yes.
Sam I am.
Good to see you back.
- So the rectus femoris actually attaches right
to this bone right here.
So if you follow along on Brad's pelvis there
and the first big kind of a little bump you feel,
that's where the rectus femoris attaches.
- [Brad] Yep, right there.
- Then it comes down, and it blends in, goes to the femur,
but blends in with the quadricep muscles.
But about three inches below this, that bump.
So you find the bump, go three inches below,
that's where the tendonitis tends to occur.
Find it.
And if it's sore,
that's where you can do some cross fiber massage.
Cross fiber massage is what Brad's doing right now.
You probably want to do it in a seated position
where it's under less tension.
- Yeah.
And this is a little bit high.
I mean, I think you could do this lying down.
- Lying down, right.
- As well.
Sam's in the way, but you know you have to try
and get that muscle to relax.
- Yeah, you might have it up on a pillow,
but see he's really digging in there when you're doing this.
And what you're looking for is that you start rubbing it,
and if after like 20 to 30 seconds,
it starts to feel better.
Or neutralizes. - Right, yeah.
- It doesn't get any worse.
Doesn't get any better.
- But some people will say it feels kind numb ish.
- Right, right. - That's a good sign.
- Good sign.
If it just keeps getting tender.
Like he'd do it and ow, ow, ow, then you're gonna stop.
Probably ice it for a while and let it rest for a while.
- Yeah, so we're talking a day
yes before. - A day right.
When we say awhile. - Keep assessing it.
You have to follow the rules
as far as continue if it feels better.
- But I think if you, you know,
if you can do massage on it five minutes a day,
you're gonna probably be doing pretty well.
And that should calm it down fairly quickly.
- And, and if it does, if it's painful here,
you could go down on the muscle down here
and work that just to get that muscle to relax more
and even some more blood flow in that part of the muscle.
- Now understand this.
This is not taking care of the initial cause of it.
The initial cause is probably the muscle's tight,
and that's how we're stretching
or the hip is not in the socket like it should be.
- A little misalignment.
- Yeah so, that's where some of these other exercises
are gonna help with that.
Brad, we forgot to mention the massager.
- Oh yes.
Well, yeah.
And that position, you know, a lot of people--
- Well, the massager we talked about also
for stretching the muscle, remember?
With the first exercise we did,
we were gonna talk about using the massager
to stretch the muscles that we can always.
Okay. - Right.
So we're gonna,
should we show now? - Yeah, show them, yeah.
- This I think, I just got some green tape on here
because if you're going to have a massager,
you need to have one that percusses,
that moves in and out, not just vibrates.
This gets deeper.
It's gonna be much more effective.
And this one actually has our name on it.
We know this is a good one.
That's why we put our name on it, and you can get in here.
And this one has six different levels.
I usually go to level three, and I'm gonna get in here.
The thing about this is it's a lot easier on your hands.
My fingers get tired after about two minutes
as a max or so.
This your fingers don't get near so tired.
- It does come with different heads too.
Like if you get to the point where you really want to get
in there, it's got the light called the pointer.
- Yeah.
And that one's gonna get it, and I can try that.
And this one also, I probably use the round one more,
or the one I just had, which is the air filled one.
- [Bob] The air filled one is a cool one.
- But you know, you do have to be careful with this.
That you don't-- - Yeah, the pointer.
Yeah. - Yeah.
- [Bob] That gets aggressive.
- I'm gonna just start on number two.
That's a little lower.
There.
And I can get right over there.
- [Bob] I actually think that might be the one
for this, Brad, to be honest with you.
- It's gonna depend on the individual.
Some people that are really thin.
'Cause you don't want to go on your bone over the pelvis.
You'll know 'cause it just doesn't feel good
when you're over a bone.
- But again, I, you can actually use the massager
over the entire muscle to help make it more flexible
and pliable. - You bet.
- And that way it's gonna be less likely to injure
in the future. - Absolutely.
- So you can do this with a foam roller too.
I don't think we need to show that, Brad.
But you can roll over a foam roller.
- Sure. - So, all right.
Number three.
This is where you're actually trying
to solve the problem here.
You're gonna strengthen the glutes.
It's kind of hard to explain,
but they help stabilize the hip.
And if it's unstable or it's moving forward a little bit,
those tendons can rub over it and cause problems.
So especially the glute maximus and medius.
So I'm gonna show you just one easy exercise
to do is just clam shells.
Just going to lie on your right side or left side,
whichever one.
I'm working the upper one right now.
So left side.
So basically you're just doing, you're putting your ankles
and feet together, and you're making a clam.
- [Brad] Yep.
- Okay now, Brad.
- Or you know if you're like me
when you're back in the '80s you played Pac-Man,
that's what it reminds me of.
Sorry, I digress.
Let's go back to the exercises.
- So anyway, you could start off doing five to 15 reps
depending on do it until fatigue.
Eventually you might add some bands to it.
- [Brad] Look at Bob's feet.
He keeps his feet together.
That's a pivot point 'cause that really
then you know you're doing the mechanics properly.
And it's harder than you think.
- Yeah, especially if you have done these before.
I made the mistake of doing it with a black band right away.
- So the rubber, the loop that goes around.
- Yeah, exercise band, and I got so sore.
I honestly, I couldn't lay, lie on my hip for a long time.
I had to, I had to sleep on the other side and all right.
- So starting without a band is a good option.
- Yeah.
All right, the next one is gluteal pumps.
Another exercise for the, you mind if I do these too, Brad?
- [Brad] Sure.
- So you can lie down on your stomach doing these
like this lad and just lift up like this,
and you're gonna lift up like this.
- Let's keep in mind the glute muscle,
the glute max particularly, works directly
with the hip flexors that we're working with.
So if this muscle is working, it allows the other muscles
to relax.
It's just--
- Yeah, it's a weird concept.
Yeah, the muscles do opposite things on opposite side
of the body.
So if this muscle is working, the hip flexors have to relax.
- Yup.
And you don't even have to think about it.
That's just the nature
of the body. - Right, that's just does
what it's gonna do.
Now you can do this in the quadruped position too.
A little more tougher, probably.
- Sure.
Notice Bob has his knee bent.
- I don't know.
Is it bent to 90 degrees.
I can't even tell.
- It's pretty close, which puts emphasizes more work
on the glute muscles was which we want to do.
So do it in that manner.
Don't bring your knee way up by your butt.
We don't wanna get you to hamstring cramp.
Just about like this.
- I don't want
to go like that, right? - Right, yep.
- Okay.
All right.
The last one is a little bit difficult to understand too.
But you want to walk correctly.
If you're walking and sometimes people, they tend
to use their hip flexors too much when they're walking.
So they're actually when they walk,
they take a step and they're lifting the leg.
- [Brad] Sure.
- But should actually propel off the leg.
So if I'm moving forward here,
I'm gonna push off this one instead of lift this one.
Does that make sense, Brad?
I'm going to push off, push off, push off.
- [Brad] Yeah.
It is kind of a weird thing.
It's how you think.
- It's gonna help if you do these other things.
If you'd probably take shorter steps.
So if you take really long steps, you're gonna try
to lift the leg forward to do that.
And you also want to try to hit on your mid foot
or mid arch as opposed to hitting on your heel.
If you hit on your heel,
you're actually gonna not engage the glutes as much.
You're gonna fire up the hamstring a little bit there.
- [Brad] So it's more of a flat foot.
And you know, sometimes, you know, I always try.
If I'm walking fast,
I always think oh I gotta reach way out there.
But that puts a little more stress on the hip and the back.
So think about not reaching so far out
and landing more flat-footed.
- I know this is a difficult one.
If you can't do it, just work on the glutes, you know?
But it's a concept that Brad and I both kind of embraced
with our running.
- Right, right.
- And it made a big difference.
In fact, I was getting hip flexor problems
with my running until I did that
until I started shortening up my stride.
I'd go faster, but I go more forefoot running
than heel to toe running,
and it's all makes a big difference.
So you have to trust us on this one so.
This program, by the way, this actually video is a part
of a series of videos on hip pain.
Just go to BobandBrad.com.
Go to the program section.
And in the program section,
you'll see it listed for hip pain.
- Right.
- We also have one on sciatica, plantar fasciitis.
- There'll be a whole series that we don't
'cause like somewhere between 10 and 20 videos.
- Oh, I think we have more now on the hip.
- Well, there's a lot.
We're still working on them.
- We're still working on them.
There's gonna be 20 some.
- But you can go to them, look at them.
And the nice thing about it, you can print out a PDF
of a summary of the exercises
that comes along with it. - Each video,
it comes along with it. - Yep.
- Absolutely free.
We don't ask an email or anything of you.
This is something we're doing for all of you
'cause we love you.
- That's right.
- All right.
Thanks for watching.
- Be careful.
(light music)