- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Okay, and together, we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- All right, Brad, if you haven't watched our video yet
on the simple test for chondromalacia,
or patella femoral syndrome, pain syndrome, it's right here.
Watch it because it's really important
that you're gonna do the first treatment
of this problem with taping.
- Right. - And then after that,
we want you to do some exercises and here they are.
- Right. - All right. Let's start off.
You're gonna wanna keep the leg stretched out,
especially the quadricep here, rectus femoris,
'cause that really pulls on the kneecap,
which can help hold it down and make it grind.
- Right. - So a good way to do this
is I usually take a chair. - I thought you were
running away, Bob.
- I was running away.
All right, now I'm gonna stretch this side here.
I'm gonna try to keep my arms out of the way.
You're gonna pull it back like this.
Now, if you don't have much flexibility,
maybe you can grab a pant leg like this.
Do you want me to turn this way more?
Like that, grab a pant leg.
I can actually grab the ankle,
and now here I can see I'm putting a good stretch on it.
- Yeah, now you can actually
tilt your pelvis down like this,
if that makes sense, and then you're gonna put
even more stress on it, but that's a little difficult
for a lot of people to understand.
- You'll feel the stretch.
If it irritates your knee,
if it irritates the symptoms that you're trying to treat,
you should not do this.
It should just stretch the muscles.
- Right, and now I'm pulling the knee
over toward my other leg.
Don't have it this way.
Oh yeah, there we go.
Brad's directing me here today.
So I want it not this way,
but over toward the other buttock here.
- Right, so it's kind of across
that body there. - Now, if you do have trouble,
you could take a belt and wrap it around the foot.
I got this all messed up already.
- That's all right, Bob.
They understand. - We've got time, don't we?
We got plenty of time,
but you can take a belt and start it off that way
if you had trouble.
You could even put it up
over your shoulder like this,
and put it and that would make it easier
for you to hold that stretch.
Good. Well, 30 seconds, times three.
- Great. Yep. - A long, nice stretch there,
assuming it's just stretching the muscle.
All right, second exercise, Brad.
- We wanna strengthen the quadriceps, and particularly,
the muscle's called the VMO, vastus medialis obliques,
and that muscle's on the inside of the knee,
and that's gonna help pull the kneecap
back into the groove where it belongs,
reducing the force on it, therefore reducing the pain.
- We're gonna show you, actually, Brad,
I'm just gonna change it midstream here.
We're gonna show you two open chain exercises.
- Oh, okay. - And one closed chain.
- Okay, so it's nice to have one of these kids balls
that you can bounce.
You can use a soccer ball or another ball,
but these work a little nicer, I think.
They're just softer, more comfortable.
You're gonna put your foot across like this,
and then you're gonna take your toe
and go out that way away from your body
so there's an angle out that way,
and then you're gonna go up and just do what we call
longer a shorter quad works, straighten the knee,
and that's gonna make this inside VMO,
that inside quad muscle work.
- And one thing you can actually do
to give yourself a little feedback
is you can actually tap this muscle
a little bit. - Sure.
- And it'll to let you know,
that's the muscle you're trying to kick in.
- You bet. - And you can do this
with weight, right, Brad?
- Yeah, you could put ankle weights on,
and it's important though that when you do it,
you go up and hold it just for a second.
Don't don't do these type of things.
But one, two, you get a little tap in there.
Sometimes I like just to feel that muscle
to make sure it's kicking in.
And by the time you do 10 or 15 of those,
you should be fatigued.
- Right. - Okay?
You said you had another open chain one?
- Weren't you gonna do the one where you?
- Well, yes. - You want this chair?
- I just got confused there,
Bob, - Okay.
- Once in a while that happens.
Now I'm gonna show a closed chain.
Here we go.
I like this one.
This is a little more difficult than that one.
Take a squishy ball, put it between your knees,
just above the kneecaps, and then point your toes in.
It's a really awkward kind of a feeling position,
but what you wanna do is get the pressure of the ball
on that inside VMO, that muscle right there
that we're trying to get to strengthen.
That contact will make the muscle wanna strengthen more.
Then you squeeze the ball,
and if this is the involved knee,
the one we wanna strengthen, you go like this,
as you point your toes in and get pigeon toed,
and this is pretty aggressive.
I can feel all these muscles right now working real hard.
And you're gonna do 10 to 15 of those.
Three sets of these, three sets of those,
and then Bob has one more,
- Okay. - With weight
through your leg. - Now this is more
of a closed chain.
You can tell Brad's never played basketball.
So I'm strengthening this one here,
and you're gonna start here,
and you're gonna try to again,
stop the knee from going past the foot.
You got that rod, Brad? - Yes I do.
- Brad's gonna show you what that means by that.
- You put a pole line from the toe up.
- So I don't wanna go past that.
I wanna stay behind it as I do this.
So I'm starting here,
and all I'm doing is sliding this leg back,
and you can see I'm not even getting
close to it, am I Brad? - Right.
- Now, what I don't wanna see though,
is if we're like this, is I don't wanna see the leg
going this way or this way.
You're keeping it right in the center,
and then you're sliding back like this.
- And how far back are you gonna drop, Bob?
As far as that foot in dropping your body down.
We're gonna stick within pain free range.
- Right. There we go.
I wasn't sure where you were headed with that, Brad.
(Brad chuckling)
I don't know what.
So I'd like to see a good 10, 15 with this,
and this is really working, Brad.
It doesn't seem like I'm working.
I'm holding onto something, 'cause I'm old.
Maybe if you're younger, you can be able to do this
without holding onto something.
- So let's say you go back, go a little deeper,
and it starts to hurt right there.
- Yeah. - You're gonna-
- Back off. - Yeah, don't go that far.
Eventually. - You can start
dipping down further and further as you get better at this,
and as it gets stronger.
Boy, that really
fatigues that knee. - You better believe it.
- So those are the three exercises you can do.
And if you haven't already, Brad, put your hand up.
- I really think they should subscribe to us.
- Yeah. Put your hand up. - Put my hand up.
- Slap that subscribe button.
All right. Thanks a lot.
- It worked pretty good.