♪ 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 are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- All right, let's hope he concurs, Sam.
- Say no more, say no more.
- So today we're gonna talk about how to use
the massage gun on patellar tendonitis.
So what is patellar tendonitis?
It's an injury to the tendon.
- Whoa! Look at yours! - I've got it marked
off right there, yep. - That baby is in rough shape.
- So it's a tendon,
it's a thick tendon, - Yeah.
- that attaches the patella
to the "tubercurl", tubercle (laughs)
- (laughs)
- I can say it.
- So the shinbone - The bone.
- to the kneecap.
- Yeah, and you got all your quadricep muscles,
the four muscles that attach,
blend together and attach to the kneecap
and then it attaches there,
so it provides, like, a lever-
- Yep.
- So that you can straighten your leg.
- It's a sesamoid bone, is that right?
- Right. Yeah. Very good - I remember that from school.
- So you can straighten the leg.
It is involved with jumping
and running and kicking
- Pretty much any weight-bearing activity.
- Yeah.
And in fact,
patellar tendonitis is known as jumper's knee
and it's very common in people
like basketball players or volleyball players
or well,
if you do the high jump, obviously.
- Sure. Oh yeah.
Yeah. So should we show what it looks like on Sam?
- Sure.
- So obviously Sam has got all the quadricep muscles
here removed,
but we do have the patella,
the knee cap is actually part of the tendon.
- Yeah. You can see it underneath.
- Yep, there it is.
So we're talking about the infrapatellar.
So we're talking about,
infra means "below,"
the tendon from here to here,
this attaches to the shin or the tibia.
And right there-
- We actually it a little bit
didn't we. - Yep, it's a little bit black
there is that clear on the-
Yeah. So that is the area that we can get tendonitis.
In other words, that tendon becomes inflamed
from overuse or excessive force on it.
When it gets inflamed, it becomes painful
and we need to get that settled down
and you can get scar tissue that can build
up around there and cause problems.
And that's exactly what we're going to get rid of.
- You actually get microtears in there
and then it starts to heal
and forms the scar tissue Brad was referring to.
And so we want to break that up
and we'll show how to do that.
In this case, also,
just like we mentioned in the past
through some of our other videos
we're going to massage also the quadriceps.
- Sure.
- Just to make sure, you know
if they're a little bit supple,
they're not going to pull on the patella
- Right. - and the tendon as much.
And so you can maybe avoid this
from happening in the first place
or prevent it from happening again in the future. So-
- If those quads get tight,
they have some trigger points in them
and they wad up and tighten up
it's not going to do anything good
for your tendon - Right.
- down below the kneecap.
- So we want to go ahead and massage the quadriceps.
Now with the quadriceps
and you're using the gun
large muscle,
so you can certainly use like the ball
cause that could cover a little bit larger area.
I liked the,
that flat head, Brad. - Oh yeah. Yep
- It's a nice aggressive one.
It actually covers the decent amount of area, too.
This one, if you have the smaller gun,
here, all of the guns
come with at least five attachments
at least the Bob and Brad ones, guns.
- When you first start,
you might use the airfield one cause it's a little softer.
And if that's not enough, you'll go
to the more aggressive ball or even what we're showing here.
- Yeah. And I actually like,
I prefer going over the clothes.
- Yep.
- It's just more comfortable for me.
These guns, by the way, some of them
you may have to hold the button for three seconds.
Some people think they're broke because-
- (laughs)
- They're not kicking and running right away.
But you can work along the fibers
and you can also go across fibers.
Especially if you find a trigger point.
- Yeah. That's a tender spot.
- Yeah.
- It knots up and it's painful.
I'm going to just go on my skin directly
just cause it's easier to see
there's black on black.
That's just hard to see.
So I'm going to work it.
You got the VMO muscle here.
We got all four of the lateral,
and you're going to work wherever you feel a tight spot.
You can go straight in,
but that can be painful.
particularly if you're going over your femur
and you get in deep,
like right there, ow!
I'm not going to do that.
I'm going to go sideways.
- Our recommendation is
you keep working an area until that pain gets knocked down.
I mean that's,
if you have a tender spot in the quad
it means it requires some work.
Now you can also do some flossing while you're doing this.
Brad's on a stool actually that'll work kind of well.
You can, uh,
work the quadricep back and forth.
I also have one of our knee glides here
and I don't know-
Can you pan that far down?
So what's nice about this is
I would actually,
I'm gonna flip it this way,
so the stand is up toward the back.
So now my quad doesn't have to work that hard.
In fact, it doesn't have to work at all.
I just let it go downhill like this.
- Yep.
- So I pull up with the hamstrings.
I let the quad go down like that
and I can do flossing really easily
without tightening up the muscle.
So it just works quite well.
You're going to be able to get a little more
mobility in the muscles.
All right, let's go to the tendon itself.
Now the tendon,
first off let's talk about what you want to feel with this.
If you start doing massage on it and
it keeps getting tender and more tender and more painful,
you stop.
It's just,
give yourself about 30 seconds to try.
- Yep.
- The massage.
And see if it plateaus or
it starts to feel numb.
Then you're good.
Then it's a good sign.
But if it just keeps getting painful,
you're going to have to wait a while to let it rest.
- So if we're looking on this,
you know, you can massage this.
We're going to go across the fibers this way.
You can do it with your fingers
and get similar results.
The same thing that Bob just mentioned,
but your fingers get pretty darn sore.
Especially if you're, you know,
50 or older.
- Yeah.
- Those little joints just don't hold up.
And you know, you really want to
if you get the good results that feels better,
numb-ish,
you want to go over that, you know,
10 to 15 minutes and I guess Syriac says 20 but,
- Yeah.
- That's, that's a long time.
- Yeah, we usually break it up throughout the day.
- Yeah.
- Brad came up with the idea
to you do the massage with the gun
kind of from a sideways,
in a sideways fashion.
- You need the round head for that one.
Typically it works the best.
So I'm going to go sideways
right over that tendon,
of course, on your leg.
- It looks like this. - Yeah, go directly on it
once Brad. Just so that-
yeah that doesn't work well. - That is not
what you want to do. - No.
You're gonna have pain
and you're gonna irritate it and have problems.
So you're gonna go this way and go across.
It really does a nice job.
So you, you know, for my leg,
you want your quads loose.
You've already worked those to loosen them up
and we're going to go,
we're not going to go on top of the knee cap.
- No.
- It's below the knee cap.
You know where we mentioned here that-
- You don't really want to go down far,
too far either you'll hit the,
the tuberosity there.
- You're just working bone. - Right.
- Which is not needed at all.
- Now, if that gets to the point where that's no
longer painful and feeling pretty good,
you can even get a little more aggressive with this head.
I mean,
I'm gonna turn it off just for a minute so you can see.
This head here is,
is more rounded and flat on the top,
but on the edges here,
it's fairly, a little bit
sharp.
I mean, it's, it's still rounded
- Right. - But it's a little bit more
focused.
- Yep, the radius is tighter.
- So what we can do with that then is-
We're going to go ahead and start it here.
Why aren't you starting on me?
- There you go. - There you go.
- You gotta be patient-
- You got to hold it for a little,
at least three seconds.
Now I'm going to go across like Brad was doing
and I can really get aggressive on this now.
And this is the one that'll take you home.
(snickers)
- And you know, you can do this with your knee bent
like this.
And it puts a little more,
as it improves. - Yep.
- And work it this way as well.
This is one area where you're probably,
I don't know if you're ever going to go straight in.
- Right.
- And it's going sideways.
And that way, if you get one of those massagers
that just vibrate,
it's not going to be near as effective as
one that reciprocates and has travel-
- Exactly. Those are day and night.
In fact when these first came out Brad,
I didn't know that they had the transverse-
I thought they just
- Vibrated. - Vibrated.
I was like, "Wow that's worthless,"-
But these, these
all make all the difference.
I mean- - These are therapeutic.
The vibrating ones just kinda,
well I shouldn't say that but,
for our purposes,
they're just kinda feel-good things.
- Brad and I have found that,
I had patients,
about 50%, would actually prefer the gun over our hands.
- (laughs)
- I mean, they just,
well, your hands,
off course. (scoffs) - Well my hands, yeah.
- "Get them away from me."
- Yeah. - I'm just kidding.
You know, there's a little story I gotta tell you
that I thought was pretty funny.
- Okay. - I think the reason they have
a three second hold on this
is to help kids, young children,
two, three years old.
So they don't push it - So they don't mess with it.
- Get it going.
You know, my grandchild came out.
He was four years old - Oh, sure.
- And he's down there playing with my stuff.
I'm not worried about it.
He comes over the, and he's got this gun
and he's got it working! - Oh!
- It's like, how do you know to hold it for three seconds?
But you know, those kids there's-
- He's got the mechanical mind already.
- Yeah. - Got it from Brad.
- I don't know, so I got to hide the gun from him.
The massage gun, of course.
- All right.
- (laughs)
- This video, by the way
is a part of a series of videos
on massage guns.
And if you want to see the entire series,
go to bobandbrad.com,
go to the programs section,
and you'll find out we have all bunch of programs there.
- Yep.
- Like on sciatica and tendons and shoulder and hip and-
- Neck. - Neck. Yep
- You bet.
So anyways, you go there, look at the
there's going to be a host of videos under each subject.
Look at the title.
It'll be about 10 minutes long.
Pick out the title that fits your needs.
Watch it.
And to boot,
you'll get a PDF printout of the video
with a complete review of everything we've gone through.
So you can look at that very conveniently.
So you don't have to keep going back and forth
to your computer.
And looking at our sad faces. (laughs)
- And the cost is only zero dollars.
- Yeah, and we don't even ask for an email.
- Yep.
- You know, that just doesn't happen.
- We're trying to take away the friction.
- Oh, friction. Is that kind of a pun on words
with the friction of the massage gun
on that patella there. - There you go.
Why did you use that phrase "to boot"?
- To boot?
- So that's like from the thirties-
- Well it's coming back, Bob.
- All right. (laughs) - Don't worry.
In another couple of years,
everyone's going to be "to boot"-ing.
- To boot you.
- (laughs)
- All right. Thanks.
(upbeat stringed theme)
(music fades)