♪Bob and Brad ♪
♪the two most famous Physical Therapists ♪
♪on the internet. ♪
- (Bob Schrupp) Hi folks,i'm Bob Schrupp,Physical Therapist
- (Brad Heineck) Physical Therapist
- Because we are the most famous Physiotherapist on
the internet.
- Well, in our opinion, of course, Bob
- Brad, today, we wanna talk about hip flexor strain
or tendonitis.
- Sure.
- On how do you treat it?
How do you stretch it?
How do you strengthen it?
The big Three.
- Yes.
It's kinda interesting, Bob.
Cuz just last night I got my haircut.
Did you notice?
- Yeah.
- Anyways, her daughter, the woman who come in
her daughter has a hip flexor strain playing basketball.
And she was asking me advice on this last night.
I told her, go to our channel.
We have some good information.
- Wow. And I must have telepathically knew that
because I started putting together this topic
- On it is amazing how things work out in life, Isn't it.
- By the way, if you are new to our channel, you've never
seen us before.
I hope we didn't scare you off already, but make sure you
take a minute to subscribe to us.
It's over here on the screen somewhere, somewhere
- Up there.
- Yeah. We provide lots of videos.
We upload every day
on how to stay healthy, fit and pain free
- Even for hip flexor problems.
- Yeah. And this is a fairly common problem, Brad
and that's why I think you're gonna run into it
in your lifetime
whether it be you or a family friend or
something like that,right.
- A lot of times it's, it's people that are active,
you know, running kind of events.
- Yeah. Quite often athletics.
- Yep,mhmm.
- All right.
The pain is up here, Brad generally.
- So yeah, just blow the belt line usually, right?
- Right.
- And it it's quite often the rectal of the lowest muscle
which is part of the quads.
- Right.
- But the thing that makes it different
than the other quads Brad, is that it
it also crosses the hip.
So
- Let me get my therapy stool out
Bob.
- All right.
So this blue piece
of tape represents the muscle
- Right? And, and this is bone lippoy
- Napoleon bone apart.
- We Haven't had him with a video for a long time.
I kind of forgot about him.
Yeah. Anyway, so the, the muscle we're talking
about is gotta the longest muscle,
It goes from below the knee all the way up.
And it's deep inside the pelvis.
It looks like it's not too close to
the, out to your Skin.
- Now, if you feel, you know, a bump on your pelvis
that's probably this big bump here and that's the
anterior superior that spine I'm gonna impress,Brad.
But it actually doesn't attach to that when attaches
to the bump low, which is the anterior inferior SU IC spine.
I got
- It. A S PS.
I, so it's, it's down in here and it's not superficial.
You have to get in past some muscle to get to it.
- There's a reason we're taking all this time,
to show you this, Brad
because we wanna make sure they know where to
start doing the rubbing when we're gonna show 'em how
to do the massage.
- It makes sense.
You'll have a better treatment, better success.
- Yeah. It actually has a little piece that comes
off from right over the acetabular too, Brad
- Right? So it's, it's a broad
broad attachment to the bone.
Unlike other muscles
- It comes down, then it comes together with
all the other muscles
and then it goes into the kneecap.
So it, it actually bends the hip this way,
and it also straightens the knee.
so does both.
- Biarticular muscle that we call that, not that you do
- This way and this way does both of those.
- So two different things.
And that, that may be one of the reasons why
it gets strained off and kinda hamstrings.
- Sure. So when you're gonna
the first thing we're gonna recommend, and this is the
the gold standard, this is the one that's gonna
help you the most,
of everything we're gonna recommend today.
- Yep.
- That's why we're showing it first,
In case you're getting bored.
- What you're gonna do is find on your pelvis.
You're gonna find that bump.
I'm gonna come a little bit closer to you Yani.
So this is the anterior superior iliac spine
- Right there.
- The muscle doesn't attach to that, attach it
to this bump right below.
But as a landmark, because most people can find this one
that bigger bump, you go eight centimeters below that,
which is what about three, two and a half inches maybe
- right?
- Yeah.
- About two and a half inches.
Yeah. They always say centimeters, this was an English book.
- So yeah
- Sure. You can measure about eight centimeters
and that's where you're gonna put your
and you're gonna rub.
Right. And that's where quite often you should find
at tenderness
- You know
it's not gonna be exactly eight centimeters cuz everyone's
body's a little different, but that's pretty close.
- Right.
- You'll find it when you hit the spot.
- So if I'm gonna get myself in this position, Brad
you're gonna kind of, you can be kind of relaxed.
You can even
you know, put a couple pillows into a chair here
- On a couch.
Might
- Be a good place to do it.
Yeah. So I'm kind of in a 90, 90, you know
90 degree angle here.
- So the hip slack, the little bend and knee could
put a pillow under here to get more relaxed if
- You'd like to.
- Yeah. Well, can we do that Brad
- Sure,Bob.
- So now we're in a good position here,
and things are relaxed
and now I'm gonna go eight centimeters
below that bump right here, which I can feel
- Keep trousers outta the way,
so I can see what's going on there.
And now I'm gonna, I'm gonna be rubbing right
in this area here.
I'm putting one finger on top of the other
or two fingers side by side.
And there we can apply the pressure
- And he is getting deep.
Cuz we said, it's a deep muscle.
- You gotta Go very deep,Brad,right on this one.
- Right.
- And you should be able to find it should be
it probably is gonna be tender.
- Right.
- And you're gonna go ahead and start.
And if after a, you know of doing this for
let's say 30 seconds to a minute, it gets worse.
Then you're gonna probably back off and ice it right now.
- Right? It's it's not ready for it,
Get a, get your cold pack out
and lay down and put a cold pack on there 20 minutes.
But after 30 seconds to a minute
if it starts feeling better and it feels like, oh
the pain is going away.
- Then that's a really good sign.
- How long are you gonna go then, Bob?
- Well, the thing, that's the thing about this, Brad,
the serious thing to recommend,
you can do this for 20 minutes.
Nobody can do this for 20 minutes.
- You're, gonna get such sore fingers
that it's not gonna merge.
- So what we recommend quite often is maybe just, you know
do it five minutes here, five minutes there.
- Right.
- And you, and you could even do it every day if
you want, if you can tolerate it.
- Sure.
- He recommended just three or four treatments a week.
And a lot of times that often would do it.
It didn't take very long.
- Usually if you get this
at the right time and you get it deep, usually, you know
we have people say, boy, they notice big difference
over the first couple, three days.
- Yeah. It responds well to this.
If it is the right thing to do, right.
It's possible that it could be down further
in the muscle too.
And that might be a different problem.
You maybe are into the general quad, but generally
the hip fractures are more up closer to the groin.
- Right. And that's where the injury often time occurs.
- Yeah. I can't emphasize more.
You know that you really have to rub this hard
cuz you're breaking up scar tissue quite often.
Sure. And, and you're getting more blood flow to the area.
You know, again, we're getting aggressive when we do this.
So
- And again, you're probably not gonna do it
twice a day cuz that's gonna be too much
- For some people might be able to tolerate.
If you're only doing five minutes, Brad
you might be able to tolerate five minutes.
- But if You do every time, it should feel better by the
- Time you're done.
Right. Right.
We're looking for the same symptoms every time.
- Yep. Symptom.
- Let's say you're doing this.
It actually now feels better.
You're doing much better.
Let's go ahead.
And now you're gonna start doing some gentle stretching
on it cuz that'll help realign those fibers too.
Right? That throw me a pillow, Brad.
- Sure. Bob
- This is probably the most.
Holy holy Batman.
- Sometimes, I'm a kid.
- Okay. So I'm gonna stretch this one.
You're gonna put a pillow down and as you can see
I'm leaning forward here
and I'm putting a good stretch on that muscle right
- Now. If you notice Bob's good posture, he's up tall.
- I'm not like this, right?
That's not stretching it.
If I'm, if I'm doing that
you're actually taking stretch off the muscle right now.
I'm really leaning forward and putting the stretch on there.
Good, Prolonged stretch,
You can even make it worse Brad.
- Better, better
- Bob
- Better
- Stretch by pulling up like this.
Now you're really getting a good stretch on it.
- Now keep in mind you have an injured muscle.
The, the goal don't go use a Flossy, no pain, no gain.
Cuz if you stretch it too hard, you're gonna
- Re-injure it.
- Yeah. Just give it a gentle stretch.
Sometimes people later on are able to get
to this point where they grab their ankle
and they're bending like this and stretching it.
- Right.
- And even at that, you're gonna be as tall as you can.
- Yeah. Yeah.
Trying to keep in, in good position here.
- Brad, do you wanna show a dynamic stretch?
- Sure.
This is a good one to do before a sporting event.
A lot of times they recommend, especially if you're in more
of a power event,
- you know where you need sprinting.
- Yeah. Sprinting.
- You, you wanna do a dynamic stretch as opposed
to a static stretch, which static stretch.
The one why I just showed you.
You can do after the event.
- Sure.
- But this one is a good one to do prior.
- So, Keep in mind the, the injury is healed up.
You're done with your cross friction, the icings all done.
You're back to running, but you're not know
if you can do the, the full event yet.
So you're, you're the end stage of the rehab.
So the, I like to have something to hold
onto for balance and I'm gonna bring the leg back
and just swing it back like this.
And I feel a stretch here
and if I wanna make it more aggressive
watch what I do with my knee.
At the end, I bend it up.
Now I'm not gonna hold it like that.
I'm just gonna leave it swing relaxed.
But when I bend my knee
I can definitely feel the extra stretch
the whole length of that muscle.
Again, that muscle crosses a joint here in here.
So that means when I bring that up
it puts a little extra stress on it.
And it's the dynamic kind of like when you're running
everything is moving and happening quickly.
So you're just preparing for that dynamic event.
- All right, Brad
then we're gonna show some eccentric strengthening here.
- Oh yes.
- You know, that's really the, the key phrase.
A lot of times people are now with
with tendons when they're trying to help them, you know
get the injury to heal.
- Right.
- You wanted to
the eccentric strengthening seems to help then.
- Right? It it's, they've done studies
on this where eccentric Strength
Strengthening is faster.
It can develop the muscle faster
weightlifters do it all the time.
They call it negatives sometimes.
- Right. And then yeah.
You know, so basically you're strengthening the muscle
while it's lengthening.
So the, the one that I came up with Brad here is
so this is the one that's involved.
So I'm, I'm going up this way.
So I'm really not, it's not really working that hard.
Right. But now I put it this way
and now it's working on the way down.
- It's Helped.
Yeah. It's limiting that movement of the
Leg. So I come up this way and I go work it on the way down.
Okay. Not very difficult for the first few Brad
but when you start getting maybe 11, 12
it's gonna start working a little more.
Yeah. And then eventually you can do some weights if
- Yeah.
- If you say, geez, Bob, you know
I did it 15 and it feels like it can be.
Or if you're just one of those guys that think
that they may have to make it hurt more
but you really shouldn't.
You could put a couple pound weight
out on the ankle can make a big difference.
- Yeah. So again, the first one, not that difficult.
- Sure.
- But now with this one
I'm already feeling it on the second one here.
So, and
- Even if you're really a high level
and you really wanna push it
we can start the, the dynamic oscillation.
- Right. We can start going like these.
- Yeah.
- And now that's a little bit concentric too, but, or
- Right. That's mixing it up a little bit.
- Right. And we'll go into those Brad, let's say, okay
now it's, everything's kind of healed.
Everything's good.
Now we can go in just into regular strengthening, Brad.
Sure. Yep.
And, and one of them is just straight leg raises like this.
Yep. You know, you're coming up like this.
You're gonna do, and I gotta weight on already.
So that's making it more difficult.
And then you do with the power kind of the power move at
- The end here.
Yeah. Power oscillations.
You know, another nice thing
about this is when you're doing the straight lake one, Bob
you might as well go up high and get a little hamster
in touch with it and get two birds with one
- Get the double double benefit.
This one, this one will work.
You I'll tell you that one.
I definitely
- Much, but you'll, you'll get a workout.
- All right.
The next progression then Brad would be to standing
- In simple.
- Yeah. Simple.
And you can do both.
Yep. And then of course, some
of the more dynamic one where you kind of get
into a lunch position here and you're going like this.
- Sure, Yeah.
I mean, you can see that key, you know
geared for that athlete where they're trying to get
out of the hole, you know
- So
- Wow. That was a good job, Bob.
- Thanks.
- Thanks for watching folks.
- Hip flexor (indistinct)