- We're rolling at the edge. - Hi.
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- Oh, in our opinion, of course, Bob.
- We have creative differences there in filming.
Okay, today we're gonna talk about hip pain,
three most common causes.
- Right.
- And I think this is a good video, Brad.
'cause a lot of times people come to us,
and they say they're having hip pain,
and a lot of times I don't think it is.
They're pointing to the wrong spot.
- You know, on the same thing,
I get referrals from physicians
and they say the patient has hip pain,
and I find out it's something different,
and we'll talk about that as well.
- Right, exactly.
- Okay, so first of all, the hip,
one of the biggest things that I find is people really
don't know where their hip is.
- Right.
- I'll have people say my hip hurts,
or they're talking up here where the belt line is.
And actually the belt line is way up here by the pelvis.
- Right?
- Okay, and back here, we've got other tissues,
and the hip is actually lower than most people think.
And what I tell people, I just explained it to someone
in the clinic the other day,
I said, put your foot down and act like you're squishing
out a cigarette, 'bout like grandma and grandpa used to do
if they were smokers.
Put your finger right there,
and you're gonna feel this bone bounce back and forth.
- Back and forth.
- So over your finger and that's the greater trochanter,
which is directly connected to the ball of the hip.
- Yep.
- And that's where the hip is.
- Right.
- And that's very important for one of the diagnoses.
That's a common cause.
- Sure.
- So the, but the first we're gonna talk about
is now that we know where the hip is, is arthritis.
That is a common cause,
and that's why we have hip replacements.
- Right.
- So what are some common symptoms Bob?
- Well, one of 'em is I think where the pain itself is
at with arthritis and generally to me, most, quite often
with people, it tends to be right on the side here.
- MM-hmm.
- Okay. It less often does it go into the groin.
I usually think that's something else.
And less often, does it go
down from the back or into the butt.
It's right on the side.
Maybe going down, if it's really bad,
it'll go down all the way down to the knee.
- Sure.
- So.
- And, and with that, one thing that you can kind of,
a quick treatment is use a cane in the opposite hand,
and use it, watch your video on how to use a cane properly,
and it's gonna take pressure off the disc
and give you pain relief while you walk.
- Right. So if you're getting relief
with the use of the cane,
that's one sign that it, it is a good sign,
the possibility that there might be some arthritis
in your hip.
- Right.
- The other thing I see, Brad, quite often is just a lack
of motion in that hip.
- Yeah.
- You know, it doesn't, especially the one
that I look for, the first one I look at to see
if I think someone has arthritis or not,
I wanna see how the leg turns this way,
and how it turns this way.
- While on a chair like that?
- Right, on a chair. You're really supposed to try
to keep your butt down, but I'm so tall,
It doesn't work for me.
- Sure.
- Come on. How well does the work on you?
- All right.
So we're gonna do this motion.
- Yeah.
And with arthritis, the one that really tends
to be limited is this one going out here.
A lot of times the people have no movement that way.
- Yeah.
- None whatsoever.
- Okay.
- And that's a good sign that there might be arthritis.
- Sure.
- They might be limited this way too.
- Mm-hmm.
- They might even be limited going into extension.
But the arthritis generally, you know, it's starting to wear
down the joint and it's just not gonna move like it should.
And, and the capsule, which is a covering
around the hip tends to start getting tight.
- Sure.
- And that's why these won't move.
- let's go on to number two, one of the second
most common cause of hip pain is bursitis.
- Right.
- Bursitis is typically
over the greater trochanter that I referred to before.
And it's right there.
Typically with bursitis, walking irritates it.
So it's similar to, you can get it mixed up
with arthritis as well.
But with bursitis, if you find that bone right there
by doing this, and you rub over that,
it's gonna be tender.
- Yeah, that's one of the signs that it, it may be a bursa.
A bursa is a fluid filled sac.
- Right here.
- So it's right over the top of the bone.
It helps the muscles glide over the bone.
- Right.
Muscles and tendons glide over the bone.
- Right.
And if it's tender and inflamed, while you touch it,
it's gonna be high.
- And it's again, it's gonna be right
on that side, again right here,
like Brad said, you turning, it's not gonna be back here.
It's not gonna be in front here.
It's right there.
- Right.
So again, walking irritates it.
You can use a cane with this one also,
just not for arthritis.
- Right.
- It'll help, cold packs on that one for sure.
- Yep, exactly.
- Okay. And the third reason is you don't have
a hip problem at all.
It might be a referral pain from a back problem.
- Right.
- And the pain,
- Very common.
- Yeah. I've had people come in to, orders from the doctor,
to treat the hip.
I find out the problem is from their back.
I treat the back, hip pain disappears.
- I've even seen it go further, Brad,
where they've received a cortisone shot
in the hip and it didn't get better.
And the reason was it was coming from their back.
- Right.
- I mean
- Now that gets a little more complicated to try
and diagnose yourself.
- Right.
- I think a therapist usually can.
The only simple thing I can think of
for you to do is if you have hip pain,
and this is very simple, it doesn't conclude anything.
But if you have hip pain and you lay on your stomach,
and you do this and it changes the pain in your hip,
it's probably from your back.
Because when I do this,
my hip is not moving at all, just my back.
And if I do that,
and the pain in my hip moves to my back,
- Right.
- That's saying it may be or likely from your back,
even that's not conclusive, but it's a little quick test.
- I think just the fact
that if you're having back pain, you know,
throughout the day and hip pain, I would definitely think
of the back
as a possibility then. - Sure.
- I mean, - You bet
- they certainly both could be going
on at the same time,
but you know, - Yep.
- it's gonna make me think you know,
that's a possibility.
- Right.
- So, and if you're older, and you've had a fall,
there could be, you know, a fracture of the pelvis,
which could be giving pain over there.
- Right.
- There's a lot of other possibilities obviously.
- So, I hope we made it clear as mud. (laughs)
- Oh yeah. All right.
- So keep subscribing to us,
'cause we're gonna give you more helpful hints
on why your body hurts and how you can make it feel better.
And what do you, just subscribe?
Or are we supposed to slap or something?
- Yeah. Slap that subscribe button, man.
- Just slap it.
- All right, thanks a lot.
- Don't wreck your computer doing that.