♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- The most famous physical therapists on the internet.
- That's right Bob, in our opinion of course.
- That's right, and our opinion is always somewhat correct.
Today we're gonna talk about simple strengthening exercises
for painful knees, using a set of stairs, voila.
Arthritis or osteoarthritis,
these work out really good for this.
Because a lot of people have stairs, Brad.
- Right. - They don't have to buy
any equipment unless they want to add some weights
to this after a while. - Sure.
- But it's a great way to do it correct
so you don't injure the knee more than it is already
or make it hurt more than it is already.
We'll get into that. - Right.
And it's true, I can't tell you how many times
I asked "Do you have any stairs in your house?"
Going up to the upstairs and it's nice,
especially if they have to have two handrails
to work with these. - Right.
And you'll see why that really comes into play here.
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on YouTube here down below, we are doing a giveaway again.
We're gonna do a giveaway every week, but this week
we're giving away the SleepOvation mattress!
- They are really nice mattresses, very high-end.
As a matter of fact, I just got one in the mail yesterday
at my house. - Oh nice.
- Yep, we're having guests coming over
and we want to make sure they have good sleep.
- They got the good comfort.
There's some reason to visit Brad now.
- Yeah. - Before there wasn't any.
- Well, my wife. - Yeah, that's right.
- She's pleasant. - Yeah.
We got find somebody in the house.
Okay, let's talk about it, first thing,
Brad, I want you to follow three rules
when you're doing exercises with painful knees.
- Sure. - One,
you're not gonna want to bend your knee
more than 90 degrees. - So not deep squats?
- Yeah, it's a right angle, it's 90 degrees,
and ideally, to start, you probably
don't even want to go past 45 degrees.
And the reason that is, this is is 45.
- Right. - About halfway between
a right angle and straight up and down.
- Sure, look at the knee.
- When you go past that,
you're starting to grind the cartilage.
You've got the cartilage in your knee.
I don't know, can we see this on him or not?
We're doing this spontaneously,
but you got the, that's the cartilage right there.
And when you go past the 45, you really start
to put pressure on that cartilage.
- And typically you're gonna feel it.
It's gonna hurt, so let pain be your guide
with these as well, it's really important.
- Very good, Brad, because that,
no matter what we say, if it hurts
when you're doing this, you can't do these.
- Right. - You gotta back off
and do something else. - Right.
And it's not a no-pain-no-gain philosophy,
it should not be hurting. - So that's rule number one.
Rule number two, and do we want to show it
using the blue stick, Brad? - Sure.
- I don't want the knee to pass the toe
whenever you're bending the leg.
- So what he means is for that to have a vertical line
on the toe and as you go forward,
we don't want that knee going like that.
We want to get it to here
and then you're gonna drop down here.
And that's where you use a handrail
or use the stick, and it's nice to have for balance.
If you have a painful knee, I've had people
drop down and they hit that painful spot
'cause they went too far and I wasn't cautious enough
with them, and I had one lady, it was like
she went bowing, I mean she didn't get hurt,
but it's like I grabbed her, so be careful.
- Because the knee is weak, quite often.
- Right, you need to be cautious.
- Right. - Take your time with these.
- And the last thing is, the last rule is that
the bottom bone here, the tibia and the fibula,
we've got a piece of tape here on Brad's,
you don't want that to go in or out.
Because, what it is, you're putting stresses on the knee.
On this case, you're putting,
this way, you're putting stress
on the medial compartment here.
In this case, you're putting
stress on the lateral compartment.
You don't need to know that, all you need to know is
this needs to be straight up and down, straight vertical.
- Yep, and I always tell, just look at your kneecap.
It should be in line with your toe if you're lined up here.
Usually people have a tendency to do this direction
but not always. - Especially women.
A little wider hips, a lot of women.
- Right. - And that's how
they tend to get injured, too, in volleyball
and stuff like that. - Right.
It has to do with the Q angle, but we don't have to
get into that. - Yeah, right.
So let's talk about the first one, Brad.
You have a set of stairs, and it's nice again if you have
two railings, but you can just start off by doing
some squats, and you can do it a progression here.
What's nice is you can hang on to the railings
and I can do some shallow squats.
I'm keeping my knees back behind the toes.
I'm not going in, I'm not going out.
I'm just starting some squats.
And depending on how your stairs are shaped,
you might even be able to take your butt down
to the stair in case you lose your balance.
- Sure. - You could just drop onto the
stair and not worry about it. - Right.
- So you can start doing these squats.
You can keep in good position back-wise
and work it that way.
Now if that gets to be too easy,
you can go with one handrail. - Right.
- And maybe you only have one handrail.
- And sometimes if they only have one handrail
I'll have them take the stick or a cane
and they can use that in one hand
and the rail in the other. - Yeah, exactly.
Or they can progress to the one,
just going with the stick or the handrail.
And then finally, you can actually add some weights.
Brad, do you want to?
I brought purple to match my outfit today.
- Yeah, and he happens to be a Viking fan
but we don't hold that against him.
- And they had such a good year.
Okay, so again, you can do that
or you can keep them up here. - Sure.
- Wherever you feel most comfortable here,
but you can start doing some squats like that.
- By the time you get the weights,
your pain in your knees, you should be feeling
pretty confident and it should not be painful.
This is more towards the end of your rehab.
- Exactly, so the next one we're gonna do
is actually what we call lateral step-ups
and these work out really well on a step.
So I'm strengthening this one right here.
- Sure. - So I step up to the step,
and this railing here prevents my knee from going too far.
- Right. - So it keeps you,
it keeps you honest basically. - Sure.
- And you can use the railing if you need to,
and you can step up like this, just doing
little step-ups like this, and this may seem
really easy, but on a higher step
and if your knee is weak, this is probably
one of the better ones for you to start.
- And also you don't want to have--
If there's a wall there, that keeps you from
leaning forward and cheating that way.
- Right, exactly. - So the wall would be here.
Show them what sometimes people compensate by.
- Oh yeah, they want to go like this.
- Yep, and then that's not proper either.
- So in the next step up, the next step up would be.
- No pun intended. - With no railing at all
and trying to work it this way.
And you want to try to slowly go down.
- Right. - You want to
don't try to go too fast.
These are a little harder after awhile than you think, Brad.
- What I do with this when people get good,
I say pull your toe up and just let your heel touch.
- Oh sure, so you're going like this.
- Yep, and then go down, just the heel touches.
And then pretend there's an egg underneath your heel
so you just touch the floor. - These aren't that easy!
- Yeah, it gets much harder.
Use that for balance, but that's for advanced.
- I swear my legs are pretty strong, I thought they were.
Yeah that is more advanced, and then of course
you add weights to that-- - Right.
- And it's gonna really start gettin' tough.
- Right, it is amazing how little things,
if you do them properly, you can really
have some pretty tough exercises.
- Boy you're right Brad, it's a,
I'm actually starting to feel it here.
And again, this is a short step.
- Yeah, we're about six inches here.
- Alright, next one, let's just flip it around here Brad.
I like this one too because--
(laughs) What are you doing?
- Well it reminded me of those shows like--
- Yeah, I know what you're talking about.
(Brad laughing) Somebody at least does.
Alright, so we're gonna do a step up here on this one.
One thing about this, again, you can use the rail
or one rail, and you step up and it's really easy
to keep the knee past that, behind the toe.
And with this one now, now you're getting into
the hamstring a little bit. - Right.
- And the glute max, so you're getting some of the muscles
behind the knee, too. - Right.
- Not just in front of the knee.
- Very functional, obviously. - Yeah.
- When you get better, you're gonna be
going up and down steps, maybe doing some hiking
up and down some hillsides, etc.
And notice I got the stick here,
so it keeps Bob, you want to keep that posture
upright as opposed to leaning forward
and cheating or compensating as we would call it.
- And I'm doing the same thing you had recommended, Brad,
where I go up and now I'm just touching my toe
and coming back up again. - Sure.
- And now you start to feel it.
And if I go to one and if I go to zero,
it's actually very difficult. - Right.
- When you start getting that one leg.
And again, you don't want the leg in or out.
You want it straightforward like Brad said,
the knee going right up over the toe.
- Right, right in the middle.
So, obviously we're going through
a pretty progressive rate of exercise
from simple to when it's painful and weak.
And these last ones, it may take weeks to get to that point.
- Yeah, if you get to the point where you're
using double weights and you're doing step-ups,
I've got a feeling this is not gonna go well.
(laughs) Actually, that went okay.
Okay, so, yeah.
That makes a big difference. - Right.
So you'll know, your judgment.
If you're an athlete, you're 25 years old,
you might be using heavier weights
or even one of the next exercises.
- Yeah, why don't you show the next one Brad.
You do these on a, what, a couple weekly, times a week?
- Three times a week. - Three times a week.
- The Bulgarian Shuffle. - Split Bulgarian.
- The Split Bulgarian Shuffle?
- I don't know what the shuffle part is.
- Just kidding, just kidding.
So you can put one leg back here.
We didn't know it had a name, it's the Split Bulgarian.
- I usually use this stick because I like it for balance.
I see people doing it without a stick and with weights.
- So which one are you strengthening, Brad?
- The front one. - Yeah.
- And you're getting some of the back.
- Sure. - You're getting a nice
stretch on the hip flexor on the back leg,
which gives it, it's like a bonus.
And I'll do this, I'm looking to make sure
my knee is in line with my toe, not right or left,
and I'll go down to about 90 degrees and up
and I'll do three sets of 10 on each leg.
And again, if it's a problem, if it's problematic,
you could go down to 45 degrees, could be the angle.
- Sure. - You wouldn't have to
go all the way down. - Right.
If you want to use weights, a good posture here,
and do you use weights? - No, I don't.
Maybe I should, I don't have any weights.
I don't use any weights, I use all bands
and I use a stick and I use a ball
and I like the benefits from that,
but maybe I'll get into weights someday.
- Alright, well we'll be waiting with baited breath Brad.
Okay, by the way, if you're new to our channel,
we already said that, if you...
We can fix just about anything, that's what I
was trying to say. - Oh good.
But Bob, it's snowing outside. - Yeah it is.
- So this is a good sign.
Except for a-- - Broken heart.
We can fix just about anything except for a broken heart.
We really messed that up, Brad.
- Well, I know, but that happens with age.
- We do everything live, so, you know.
We don't edit anything. - Things happen.
- Yeah, alright, thanks for watching.