♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the Internet ♪
- Energy up in the room. Hi folks,
I'm Bob Shrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the Internet.
- In our opinion, of course, Bob.
- Today, Brad, we're gonna talk about three messes,
three methods, what's three messes? (chuckles)
Three methods to prevent knee surgery
and natural pain management for knee pain.
This has really come home to be very personal for me, Brad
because my wife is going through this right now.
- Very severe knee pain to the point where
she had to use a crutch. And we'll talk about that.
But now we're on the upside. Things are getting better.
She's a...the crutch is gone.
But I could tell you in some circumstances
there've been people that would've been heading
down the road to surgery, I guess.
- Sure. Well, I mean, Bob, you and I over the last
30 years have worked with literally thousands
and thousands of knee patients.
And I think we got some really good-
- Good tips.
- Good tips that are gonna be effective for-
- Oh, before we do that, Brad-
- There are.
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- Oh wow! (laughs)
- Or a devil gets their horns.
We're not sure which one it is. (laughs)
But let's start off, Brad, what are we gonna do here?
- The first thing with knees, pretty much any joint,
but with knees, because that's what
we're talking about, is you want to
maintain range of motion.
You want to be able to make sure you can
bend it all the way and straighten it all the way.
Cause oftentimes with knee pain,
there's associated loss of range of motion.
So we're gonna show you a few tips on that-
- So it's not even maintaining
just maintaining, it's increasing.
- There you go.
- Cause, it's very subtle sometimes.
Brad, if you put both legs up on the stool,
it's very subtle sometimes but you'll see one,
it might just be, just slightly higher.
- Right.
- And if you have a loss of motion,
if you regain that motion, it is gonna help
decrease your pain.
- Right.
- And my wife can give a testimony to this right now
because she had just the slightest loss of motion.
But by doing these stretches, she's gotten better.
- Sure. And like, Bob had a good point there,
put both legs up. If you're sitting in a chair
and another chair next to it and see if they're even
usually the painful one, often time,
will not be able to fully extend.
If that is the case, what you're gonna do is...
it's nice to have a rolling stool, like an office chair.
- Yeah, it is.
- But you don't have to. Put it up there,
and you can just push down and stretch.
And you're gonna go pressure on pressure off,
you know usually 10 times. And you're only gonna do this
after the 10th one, or as you do more, it improves.
Sometimes you have to go to one side, in other words-
- Yeah. Sometimes you have to turn it out.
That's how my wife had to do it.
She's pushing on, kind of the inside
of the knee there and pushing down.
- Yep. Or you can go this way,
and you could try all three, you know,
straight up to the left or to the right.
And you're going to use the one
that more efficiently increases the range of motion.
And it'll be clear.
I just worked with someone last week
and it was very obvious, which way was the way to go.
- The one that feels best afterwards too.
- Right.
- It might hurt while you're doing it a little bit,
that's fine. Or it might feel better when you're doing it,
that's fine. But it should feel better after.
- Right.
- If it's worse after, then this may not be for you.
- Right.
- So, and you can do these by the way, even just
you know, you can go up to a step
and put your foot up on the step,
and do it this way too.
- Sure.
- This is a little high for me, but-
- The next one is the knee should be able
to bend all the way like a normal knee.
If, if you do one leg and it goes normal
and the other one, uh, it sticks there,
well, this is one stretch you can do.
Just simply sit, and I like to bring your hands
like this and see if you can...
- Pressure on - Pressure on
- Pressure off, pressure on.
Now this one too, you can take your toe
and point your toe out and see if it goes
a little easier that way.
You know if these create sharp pain
and it continues after two or three repetitions,
it's not the right thing to do.
Or you may have to wait till it settles down a little bit
or you can try to point the toe in. Okay.
- And these can be done every hour, by the way.
- Sure.
- So you can do 10 every hour.
Obviously you can't maybe always do it every hour
but that that's to indicate how often you can do it.
- Right.
- And that you're only gonna do it that often.
if there's, if it feels better-
- Again, there's improvement, right-
- It's getting better.
Bob, do you wanna show him?
- Sure. I'm gonna show on this, I think.
What we're trying to do here is...
this is a Mulligan technique.
So what you're doing, I'm gonna show eventually on here
you're gonna grab the lower leg here and I'm turning it.
- Sure.
- Oops, wrong way. I'm turning it in.
I'm turning it towards the other foot.
Okay. Let's put it that way.
Okay. So I'm grabbing, turning it towards the other foot,
and while I'm doing that, I'm bending.
- Right.
- Okay. So if I show you on here,
I'm turning it toward the other foot, and then I'm bending.
Now you wouldn't wanna do it on a stool like this,
cause you're gonna probably lose your balance.
- Right. You wanna have a...
now, even if you had a steady chair
but you don't feel comfortable doing this for balance,
don't do it.
- Yeah. Don't do it. Right.
- You don't want to fall.
- Same with this one. I'm turning it toward the other foot
and then I'm bending it.
- Right.
- So really an effective technique for some people.
- Sure.
- It really works well.
- And this last one is a little one,
but it can be important.
And I'm gonna expose myself here to the, in the leg area.
- Brad! It's a family show. (laughs)
- Well, Bob. (scoffs) You know we're gonna
have to break the rules a little bit here.
But the kneecap, when you put your leg up straight,
and you completely relax those quadriceps
in that leg muscle, your kneecap should
actually move up and down, right and left,
diagonal this way and diagonal that way.
And you know, I've had people where
they just don't feel or want you to
start moving their kneecap.
They tighten up...
- Right.
- Cause they feel it's awkward.
So that can be challenging.
But once you learn to relax,
then you wanna work that kneecap mobility.
And this again, you know,
might be a little uncomfortable at first
but it should improve and become very pain free.
If for some reason it continues to be painful
and it hurts afterwards, that means
the kneecap is not gonna tolerate it.
And then don't do that particular exercise.
- And that one is a good one to again
compare side to side.
- Right.
- You know, see if the painful knee is a little bit
tighter and that really is an indicator,
then maybe it really needs to be stretched.
All right, Brad, what are we up to next?
- Method number two is non-weight bearing exercises.
- Yeah. Very crucial.
- So you're not gonna go jogging with knee pain.
And even if walking starts to irritate it
you're not gonna do that either.
Things like stationary bike, if you have one.
Water exercise. Bob, we wanna talk about
the cane and the crutch?
- Yeah. My wife, by the way, did the stationary bike.
And we actually set the seat way up so
that there wasn't much bend of the knee.
- Sure.
- But she'd do it for like 10, 20 minutes.
And so the other thing very crucial, and this is a tough one
for almost every patient we have.
We'll tell 'em you gotta take weight off the leg for a while
because knee pain tends to flare up
and it calms down and we want it to calm down.
So, you know, either use a cane or a Walker,
and I can hear you all screaming out there already,
"I'm too young to be using a cane or a Walker."
- Right.
- And that's what my wife screamed to me.
So we got her a crutch because young people used crutches.
So she just used one crutch.
Now this didn't stop people from asking her,
"What'd you do to your knee?"
And she had to put up with that all day,
but she was to the point where she could hardly walk.
- Right.
- I think her pride went away.
- This crutch is obviously way too short for Bob.
- Yeah. It's probably about close for you, isn't it?
- Yeah, actually. Yep.
And we have videos on how to use a crutch or a cane.
We don't, we're not gonna get into it here
but don't be shy if it takes weight off
it makes it feel clearly better, use it.
It's a temporary
- It's a temporary thing. Right. It won't last long.
You'll get through it.
- The next thing is...some other things that were-
- Possible equipments.
- Particularly, you know, if you got that,
you know you have arthritis,
you know, you're probably a candidate
for knee replacement sometime down the road
but you wanna extend it as long as possible,
this is a really nice product that we found
it's relatively inexpensive, safe to use.
And it really works that knee without really irritating it.
And the nice thing about it, the closer you put your chair
the more it bends knee, which is kind of nice.
So you can vary that range of motion.
This is called the In-Motion Elliptical.
- Yeah. We've got it down
listed down in our favorite products in Amazon.
- Right. It's actually designed, that's advertised for used
as a standing device, but we found that if you put,
well, we've got 2 one-by-ones here, but if you put
2 two-by-fours elevated approximately three inches,
and you turn it around so this end is elevated,
and you come from this side
it becomes very nice and easy on the knees.
And it actually works the ankles
and the hips as well as the knee.
So it's a really nice product.
And we've had, I've had a number of patients...
We use them in the clinic
and they want to get one for at home and they do.
- Yep. I've had the same thing, Brad.
- The other nice product is this Knee Glide,
which, obviously. we're very fond of.
- Probably because we invented it. (laughs)
We gotta warn you right now, it's been so popular,
we actually sold out.
And so if you're watching this video,
we're gonna have more in stock
by April 15th or mid April, 2018.
I don't know, maybe you're watching this thing in 2019.
Don't worry about it, we'll have plenty by then.
But if you're watching it out mid April, 2018,
we'll have plenty in stock.
And this is, what's nice about this,
this thing actually, again, real easy.
My wife used this.
- Yeah.
- She put the, yeah, put it up on its angle.
The other thing about this is it weighs, what Brad?
- Little, just like 3.1 pounds.
- I can do curls with my fingers with this on.
- Yeah. And it's tough. You can drop it from a roof,
and it's not gonna break.
So you get different angles, which is really-
- You can do hamstrings or more quads.
- Yep.
- We're proud of it. Aren't we Brad?
- Yes, we are.
We, we love this device.
- Well designed.
- We use it all the time in the clinic.
Now the last thing is how to deal
with some pain and without exercise, which is always nice.
Cause people are, don't always want to exercise.
They just wanna make it feel better.
- Right.
- So usually with arthritic knee
if it's just painful has been chronic,
oftentimes heat is better but I have to admit,
I have one patient, she has severe knee arthritis,
and she loves the cold pack.
- Well, my wife, she started off with the cold pack, Brad.
- Sure. So we're gonna use heat or cold,
whatever makes your knee feel better.
Not only while the heat or the cold is on it
but afterwards for the next half a day
or whatever it may be.
So if you got a cold pack,
get a nice squishy cold pack that you can wrap
around your knee and get it
in a comfortable position. A recliner is really nice.
You wanna be relaxed when you're using
either heat or cold on it
- And even elevated.
- Sure. Yep. Especially if you got some swelling,
if it is swollen up
then you're gonna emphasize the cold pack.
If it's not swollen of just painful, then it's your choice.
Bob, you wanna talk, let's talk about the,
a hot pack that we really like because-
- This is really infrared heat, FAR infrared heat.
This is Thermotex. My wife used this too,
we used everything,
we pulled everything out, Brad.(laughs)
And what the thing about this is it penetrates a lot
deeper than normal heat.
Normal heat is only a couple millimeters.
This goes up to 60 millimeters or
- 2.36 inches. It's really gonna get into the joint,
and it's very safe to use. It's been...
- You do have to watch this, Brad.
You still can get burned
on a place like the knee with Thermotex.
If you don't, you know-
- Well, if you have a piece, a cloth,
if you have your pants on, you're gonna be fine.
You just don't wanna put it directly on there.
- Well, I'm saying fall asleep in it,
for two or three hours,
you don't wanna do that. But this works out.
What's nice about this, is it can be used all
throughout the entire body.
So if, you know, once you're done
using it with your knee.
I use this every night for my upper mid back here.
- Sure. Yep. I use it for my low back.
But as far as the knee, it's got three infrared panels.
You're gonna put it down like this,
and you can see how this is called
the Platinum Model, goes right around the knee.
It has nice Velcro straps so that, you know,
you can put it around the knee
and it's gonna stay there, and then you can watch TV.
- Yeah. The nice thing about this, by the way
if you are interested, it's probably black on black.
You probably can't even see it, Brad,
all you gotta do...oh, you've got your white striped...
The nice thing about this is Thermotex
is offering a discount code.
We'll put that down below and also
free shipping if you use that discount code.
- Right. Yeah. We've had a lot of nice compliments
on it and, you know, both Bob and I,
when we first looked at these,
we thought, "This is just another fad."
But we looked on the research in it
and then started using it ourselves and on our patients-
- We became big fans, big fans.
So, all right, I think we're long enough, Brad.
We already, it's 13 minutes-
- Yeah, I know, we gotta get out. We got things to do.
All right.
Thanks for watching. - Thanks for watching.