♪ Bob and Brad the two most famous ♪
♪ Physical therapists on the internet. ♪
- Hi folks. I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous
physical therapists on the internet.
- In our opinion of course, Bob.
- We want to talk about three critical exercises
for pronated flat feet, which by the way are the same thing,
causing foot, knee and back pain.
This is an updated video because we did it wrong last time.
- Well we had good information, but we had black socks on.
You could hardly see my foot.
- What we were doing.
- Right, this is much better and we've got another,
better, updated exercise as well.
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Let's go to work.
- There you go Bob. Okay, what is a flat foot?
Do you have a flat foot? You hear people talking about that.
Some people, I think, think they have flat foot
but they really don't and vice verse.
- You're gonna kinda show how to tell.
- Right, we're gonna clear this up.
- So we're gonna use this stool.
We have a little black pad here.
Now we're gonna use a black pad but not black socks.
- Right.
- Okay, and in the therapy world, the medical community,
it's called pronated
- Right.
- You're foot pronates.
- Not flat foot.
- Which, pronated doesn't have anything
to do with the foot, by the way.
Because your hands can pronate. Your feet can pronate.
It's just one of those terms
that means things go in a certain direction.
If you look at the red arch on my arch,
you can see, I've got a pretty much normal arch there.
But, if I put weight on there, watch what happens,
and I'm gonna exaggerate because
someone that has a true flat foot,
this will, they put wight on and it'll flatten right out.
I can put two to three finger in their now
and if you flatten out down to one finger
and I'm exaggerating. My feet don't flatten that well,
but some peoples will.
And also, what happens with that. If you look
and that's why we talked about, or the title says
foot pain, knee pain, back pain.
What happens here, can effect what happens at the
knee, the hip, as well as the back.
- [Bob] And reverse. So, what is happening
at the hip, knee, can effect the foot.
- [Brad] Right
- [Bob] So we don't always know which one is which.
- [Brad] Could go either way, but one way or another
the exercises will work both ways.
- [Bob] Right.
- [Brad] If you look at this red line, that's my tibia bone.
And watch what happens to
my tibia bone when my arch flattens.
- [Bob] It rotates.
- [Brad] Yep, it rotates in, so here, this is subtle.
It's really hard to see,
but you're gonna see a little motion.
It rotates this way.
Which can put a little stress on the knee joint, or if...
- [Bob] Or it can put some stress on the hip joint.
- [Brad] On the hip. Matter of fact, why don't we show.
We took the leg off of Sam, our skeleton.
So he's over there with one leg and wondering what's...
Yeah, but ya know, you've gotta sacrifice.
- [Bob] That's right.
- [Brad] So here we go, let's look at this.
Now in this even, you can see all the bones.
We've got the tarsals.
- [Bob] Right.
- [Brad] Yep, and there is a number of tarsals and they all
- [Bob] Tarsals and metatarsals.
- [Brad] And then there's some muscles, intrinsic muscles,
smaller muscles that help support that.
As well as the larger muscles which are up in the calf
which, support ankle motion.
But watch what happens as I go weight bearing.
And look right here. Can you put your finger in there Bob?
- [Bob] Sure.
- [Brad] Go ahead. So there he's got some room
- [Bob] Trying to get out of the way.
- [Brad] Yeah, can you see it?
So as you pronate.
(loud sigh)
Ah, see that hurt Bob, doesn't it.
- [Bob] Yep.
- [Brad] So, look and you can see
that actually flattens right out.
And I've seen many people
where they'll flatten right out
and their bone, is not literally on the floor,
but there's little skin and soft tissue,
but they really flatten out.
Which effects the ankle joint.
And again, let's look at this.
I've got a little red line here,
they've got a mark where the muscle attaches.
But look at the joint on the knee.
We're gonna focus up here and not on the ankle.
When that ankle pronates, that knee can change.
And we get gaping here. We get stresses on the ligaments.
That articular, the joint itself...
- [Bob] Could get jammed right there.
- [Brad] Yep, and that could cause arthritic problems.
So then all the sudden you got bone on bone here,
you got problems on the foot.
Up in the hip, we've got internal rotation,
which can stretch some of the muscles.
And we're gonna show them a strengthening exercise.
- Also on the opposite end,
let's say you tend to internally rotate your hip,
you turn it in.
- Yep.
- Which can cause the tibia to go like this,
which causes the foot to flatten out.
So, your flat feet could be caused by your hip or your knee.
- Right.
- Or vice versa.
- Yep, okay so,
- Three exercises.
- [Brad] There's one more question.
- Oh no you're gonna talk about...
- Yeah because you can't...
People say well can't I correct it with proper footwear.
And sometimes you can.
- Yes, absolutely.
- If you get what is known as motion control.
If you go into a good shoe store, motion control shoes.
The sales person should know
exactly what you're talking about.
- They are very heavy shoes though.
- Right, if you look at...
This is not a motion control shoe,
but if you look at this part.
They are very heavy in style here.
If you try to bend a motion control shoe,
you will not be able to do this.
I can do it relatively easy with this shoe.
If you put one finger on there,
you might get the tip of the shoe to bend.
But this is very rigid.
It makes up for the flexibility
of the pronated and flat foot.
So you can do that. You can also put in...
- Buy an insert.
- An insert, we do have a couple
really good videos on that too.
- Arch support, ya know, insert, that works.
- We're not gonna get into the details
because we want to get into the exercises first.
- I wouldn't spend much money on it.
I would try one off the rack first.
- For an insert.
- Yeah, for an insert and see how it works,
before I'd spend money on having a custom made one.
- And you could try the motion control shoes on.
Only buy a motion control shoe
if it feels good in the store.
- It should feel good immediately.
Don't think you need to work your way into it.
That's a fallacy. It's gotta either
fit good right away or it's not gonna be good.
- Cause they're expensive.
- They are expensive.
- They're probably the most expensive shoe
that you could buy. They're, ya know, $150 - $200.
- And heavier, like I said.
- Yeah, they are heavier. Use them for...
- All right three exercises.
- So, the first one. We're gonna have to go down.
Down to the floor. I'm gonna...
- Use the Booyah Stik?
- Yep, you can use... you may...
If you have good balance, you don't need it.
Or you can go up to a cupboard
and put your hands on a cupboard
or something to balance.
So I'm gonna do it with my blue socks on.
What we're gonna do is just simple toe ups.
Like this and back down.
And if you're strong enough to do it on one foot.
You're gonna go up,
but one thing you're gonna want to think about is
when you go up, try and get your foot to go this direction.
So, it's like you're putting your weight on your pinkie toe
in that direction. You're not literally doing that.
But you're gonna go up in that direction.
And up in that direction.
What that does is it works these muscles in the arch
and that, the muscle, what is that muscle Bob?
I've got a brain fart.
- Fart not a toot.
- Posterior tibialis. Yes.
It's a large muscle up in here that pulls on that arch.
And that's what we wanna engage and get that muscle.
And you're gonna do, you should be able to do ten of those.
And you should feel some fatigue.
You could do more than that if you want.
But if you go on one foot and really bear weight
it works it harder.
So that's exercise number one.
- I find it amazing too. You think that...
It'll be a while before it shows any change.
But it really actually, within a couple weeks
you might start seeing a little bit more.
- And you should do these everyday.
- Yeah, if you can tolerate these.
That's a big strong muscle. They are.
And they can often tolerate it everyday.
- Any of these that they create pain.
If you guys have bad arthritis
and it's creating some sharp pain.
You guys are gonna have to hold off on it
and just do the ones that aren't painful.
All right, next one.
This one, let's see.
- What do you need, Brad?
- Well, we're gonna. Can ya sh...
I'm gonna show. We're gonna have to move this quickly.
Quickly Bob. Quickly! Because I need a wall.
- Out of the way?
- Yep, just go over that way.
That's good, right there.
All right, so ya gotta go up to a wall.
I'm gonna show you on my left foot here.
And what we're gonna do is.
If I go out this direction,
my hand is gonna push into the wall.
Watch what happens. And I'm gonna go on one foot,
So I'm on my left foot, balancing.
And if I push into the wall, that direction into the wall.
My only option is, right now I'm pushing against it
and relax.
- [Bob] You can see that arch form there.
You can see that it's working the arch.
- [Brad] Yep so, you can actually lean into the wall.
With the arm, but the idea is
you keep your foot flat on the floor.
- [Bob] Yeah, I don't know if you can see it, Brad,
but it's showing really well.
- Oh, it is?
- [Bob] You can see the arch.
- This is a lot better than the black sock video.
- [Bob] Yeah, it looks like a frown.
It's like it's frowning each time you do it.
- I could feel these muscles in here,
in through here get fatigued already.
- [Bob] You can see it.
- So you can do ten to fifteen of those.
- [Bob] Yeah, that's an excellent exercise.
- Now let's show the one for the hips.
- [Bob] Let's bring us back in.
- We didn't have to do this in the last video.
That's why this one's updated and improved.
- So again, if you work the external rotators on your hip.
It's gonna put the hip in the right place,
which puts the knee in the right place,
which puts the foot in the right place.
- It's one big chain.
- So you just, it works out well with a band.
You could start these without anything
to be honest with you.
- Yeah, so in other words you don't need that band.
- You could do clamshells basically.
Yeah, if you're just starting out.
You probably wanna start out
without any weight at all, without any resistance.
But I, I started these and I...
I got a little rambunctious.
I used a black band and I was doing it everyday.
And my hips got so sore,
that I had to hold off for like two weeks
before I could get back to it.
Now I've built myself up to the point
where I can use the red band and of course I hit both sides.
But it really has made a difference, Brad,
as far as my hip strength.
- Now if you're not familiar with band color,
almost always, the darker the color
the more resistance it has.
So Bob started off with black
which is like the hardest color.
- The hardest one, and I was like,
I just pounded away at it and I was doing it everyday.
It's amazing. The hip muscles really aren't that big.
Ya know, like the hip abductors.
- Well yeah, the small.
- The small right.
- Cause the gluteus maximus is the big one.
- Right, the gluteus maximus, also the external rotator,
that could also play a role.
- Now if you're thinking about a band,
start off with the yellow.
Yellow's a light resistance.
It's plenty to start with.
- Yeah, works well on your balance too.
Helps your balance a little bit.
- Absolutely, so try to do a set of ten of those a day
and build up to three sets of ten.
That may take a few weeks.
- Now we did review. Did we talk about...
What was your name when you were...
- Did we mention that at the beginning?
- No we didn't mention it, did we?
- Oh my goodness.
We've thought about that for such a long time, Bob.
- What was your name growing up?
What did your sister call you?
- Well, it relates to the video.
In sixth grade Mr Wangarden used to call me big foot.
Not flat foot, big foot.
- That's a little bit cruel.
- It was, but he always did it in a way
that was supposed to be funny.
All the other kids laughed and you know, I can take it.
I got thick skin.
- You do have thick skin.
- I laughed too and ya know,
I was gonna throw something at him.
- All right Mr Wanburger,
- Wangarden
- Wangarden, You're out of here.
- Wineburger.