♪ Bob and Brad ♪
♪ the two most famous physical therapists on the internet ♪
- Hi folks. I'm Bob Schrupp, Physical Therapist,
- Brad Heineck, Physical Therapist.
- Together, we're the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today, we're gonna talk about,
three, common ways your hip can cause your knee pain.
This has been a little bit of a surprise to me, Brad.
I actually, a couple of years ago,
I had a friend who was having so much trouble with the knee.
And especially when it's golfing.
- Ooooh.
- Big problem.
- Yeah. Gotta, take care of that.
- He actually had, some shots into his knee,
cortisone shots.
- Mmm-hmm.
- Finally, he goes in and that's enough.
I'm going to have a knee replaced.
- Sure.
- Goes in and they go, your hip is the problem.
You're having all the problem with your hip.
They replaced his hip, and his knee pain went away.
- There you go.
So you really got to be thorough on your assessment.
- Yes you do.
- You know, the doctors, you know, they do,
the therapists do. We all do.
- So, I'm going to mention a couple of research studies.
- Okay.
- Khan Et Al,
K H A N.
- What's his first name, and what's his last name?
- I don't know.
That's how they tell us in studies.
Khan Et Al.
- I know. I was just making fun.
- Looked at 60, patients,
And these patients were scheduled,
to undergo hip arthroplasty.
- Hip replacement.
- Yes.
- Mmm-hmm
- And now these patients, 69% had pain on the front of the,
on the same leg.
- Okay.
- So, he had arthritis here,
but the pain was felt here.
- Okay.
- And here too, I think.
- Sure.
So, so then, which is, which is the problem, I suppose,
is the question?
- Right. And of those 60 patients,
47% also reported pain below the knee.
- Below the knee?
- Yeah. Crazy.
It, can refer down that far.
- Yeah.
Well, I don't want to get it.
I had another story,
but we've got to get on with the program.
- Another study, Wang Et Al.
They had 255 patients with hip pain,
and knee pain on the same leg.
So they had hip and knee pain.
- Yep.
- They did the hip arthroplasty or replacement
- Yep.
- And the knee pain, commonly improved.
Almost in all, most cases.
- Most cases.
- Yep. So, you know, one test,
you could do a real simple.
- Okay.
- To find out, you know,
if you maybe have arthritis in your hip,
is to sit on a higher surface like this.
- So your feet are dangling?
- Yeah.
You're going to check internal rotation of the hip.
And what you do is you just move your ankle out like this,
- Swing it out? Yep.
- So you compare it to the other side.
So like, if you're like way up here on one side,
and this side only goes this far,
you've got some restriction there
which may be due to arthritis.
- Maybe pain associated with that?
- Maybe pain, right.
- Okay.
So again, these are one of those tests that it's not
- No, no.
A hundred percent, but it indicates that
- Right.
- There's a problem, you know, and it's always good to,
its nice when you have a hip or a knee, you can compare one
side to the other.
Hopefully, ones good.
- All right, well let's continue.
- Oh, yeah.
- And, the hip is still a problem here.
What happens with your muscles of the hip,
some are weak.
- Mm-hmm.
- So if your glute medius, gluteus medius,
or your gluteus maximus, are weak,
they can actually cause the bone of your thigh,
to internally rotate like this.
- Yeah. So, that knee will go in towards the other leg.
- Yeah. So, those muscles help pull it out like this.
- Mmm-hmm.
- So, if you're habitually turning your leg in like this,
this can affect the IT band,
- Mm-hmm.
- And give you a pain there.
It can affect how the patella or kneecap lines up,
- Sure.
- your pain.
It affects how your infrapatellar tendon lines up.
- So, essentially it kind of throws off the whole knee
joint mechanics.
- It does.
It throws off even the ligaments,
the main ligaments are off.
- Sure.
- So if you, you know,
you're gonna want to specifically strengthen that muscle.
I'll show you at the end.
- Okay.
- How, one exercise you can do for that.
- Okay.
- So we'll keep'em around.
Just to see that.
- (laughs) they can fast forward.
They, everyone knows that nowadays.
- All right. One final thing that can cause a knee pain.
And again, is at your hip,
like we talked about is when you walk,
when I take a step like this
and I'm looking at this hip right here, look right.
When I take a step forward like this,
this bone is in effect internally rotating.
- So when this leg is behind you, this leg rotates, in-wards
- Right.
Right.
- without you being aware of it really.
- Right.
The problem is if you lack that motion,
- Mmm-hmm.
- which you often do with arthritis,
that motion has to come from somewhere.
So quite often, it comes from the knee then.
So there's more torque on the knee.
I don't know if that makes any sense to you,
but you're going to have to take our word for it on this.
- Well, basically, what we're saying is
the hip and the knee joints work together.
And if one of the joints, is tight or has pain.
- The other joint is going to make up for it.
- Listen to this, it causes a compensatory movement,
- Wow.
- To the adjacent, joint.
- Bravo, bravo.
- Talkin' as if maybe we're talkin'to a whole classroom,
of physical therapist students,
and that's what we may have out here.
These people are incredibly bright,
and they want to be talked to intelligently.
- Right.
So, let's go back to the weakness of the hip.
- Okay.
- A good strengthening exercise. Brad is just a,
I'm gonna, you might have to,
- Oh. I'm sorry.
- Is just to do clam shells.
Yeah.
Cause you bend your knees like this,
and you bring it up and
it's working the muscles of the hip into external rotation.
- Right.
So, in other words, that knee, that's going this way.
Like Bob demonstrated, it's going to help correct that,
and take pressure off the knee.
- Right.
The other thing is, tightness of the leg.
We have a whole bunch of different stretches,
you can do for the hip.
I wasn't going to show them on this one because
- Sure.
it's, an entire program that you can do yourself.
- Are we going to bring that out in this?
- Yeah. Well, won't you mention that.
This by the way,
is a series of part of a series of videos on knee pain.
And so if you go to BobandBrad.com,
and go to the program section,
you'll find that series on knee pain.
- Right.
- And if you look through the titles,
you'll see some stretches that you can do.
- All right.
there's going to be 30 or 40 videos, on knee pain.
The titles will be specific to the problem that you're
looking for.
Look at that video, be 10 minutes long or so,
there's a PDF printout click on that.
It'll print out a review of the whole video,
as well as exercises,
so that you don't have to go back and look at us.
- Yeah.
Make sure you take your credit card and pull out,
And then at the end of this throw away,
because you don't need it.
This is going to be a free program.
- Yeah really, we don't even ask for your email.
It's completely, there's no strings attached.
- Yep.
Well, check it out.
- Is that it, Bob?
We're all done?
- That's it.
Yeah, we're already done.
- We've. we've hopefully got benefited
another 14,000 million people,
or bazillion.
- All right. How is your math.
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