♪ 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're the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Today Brad, we're gonna talk about hip pain,
the top critical things you need to do now.
All right. These are the things that
when we get a patient with hip pain
we start going over
these are the things we want you to do at home.
And to help it, you know
go through basically these three steps.
- Right.
Some things that you can control the pain with
as opposed to thinking, oh, I need a hip replacement
when in fact maybe it's just how you treat it
and you can manage the pain
for quite a bit longer without having that replacement.
- Maybe never have it.
- Exactly.
- And if you are new to our channel
which I see a couple people wandering.
- There they are, Bob.
- Please take a second to subscribe to us.
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I like how I pretend like I'm seeing somebody, Brad.
(chuckles)
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We're giving away lots of stuff.
In fact, we're doing a video, a live video today, Brad.
- And we're going to give away.
- Yeah. We're gonna give away stuff.
- Okay then.
- All right.
First thing, Brad, we tell every patient
is that you need to get that pain calmed down.
- Right.
- Especially, really no matter what it is,
because you know as the inflammation goes, a lot of things
flare up and they calm down again.
Especially like arthritis.
- Right.
You have your good days and bad days.
- Yep.
So you want get that, you know.
Some people start getting pain they go,
this is my arthritis
and it's gonna just keep getting worse and worse.
Not necessarily, arthritis can get better.
- Right.
- And so,
and so the things you wanna do to calm it down
one very simple obviously, is you could use ice.
Here's an ice pack.
You could just
go ahead and slip it on the hip here.
- Sure.
(Bob exclaims)
This works nice in a recliner.
Or a soft chair
so you got a soft to help support it here.
You don't have to hold it with your hand
and get a cold hand like Bob is doing right now.
- Especially with bursitis, a good one.
Arthritis maybe it won't feel as good.
- Yeah. You may need to go with some heat on that.
But one way or another
use some temperature change
one way or another
and you may find some wonderful results that way.
- Ibuprofen.
Remember if you take ibuprofen,
make sure you eat something with it,
some toast or something with it.
Turmeric is the natural, I'm not saying it right.
Turmeric?
- You know.
- Turmeric.
- But someone will comment to help us out on that.
- All right.
The second thing,
the second thing of calming it down,
this is the one, a lot of people don't like to hear
but it really helps to use a walking aid
for a short period of time just to calm things down.
Brad, are you gonna show us how to use it?
- Yeah. So oftentimes,
if your balance is good,
you can just use a cane.
- Right.
You know, if you're a little wobbly, elderly
perhaps you might go to a walker because you can unload.
- We got a four wheel walker right here.
And now you can really unload then.
- Yeah, exactly.
And it's gonna,
if you're a little stable because of the pain,
you're gonna be stable with this.
Plus take the weight as you walk off of it.
which more than likely,
if walking is a constant irritant
it's more than likely
from the weight bearing through the joint.
So you can use either our, again, if you're pretty mobile
the red band here represents my sore hip side.
So I'm gonna use the cane on the opposite side.
Okay.
And you're just gonna walk normal,
and normal your right hand goes forward
and your left leg goes forward.
And then you're gonna put some weight through the cane
and it's gonna unload the left hip
and you're just gonna walk normal.
This is one of those things that as a therapist
I usually just tell which hand my patient to use it on
and I say, just walk.
And usually without any verbal cues
the sequencing is right
because it's just the natural way to do it.
If I say,
make sure you put your left leg out and your right hand.
- Yeah. I've seen this many times.
- Then it makes you think
and, and it becomes very difficult then, then
and then that's like the heck with the cane.
- I've seen that hundreds of times to be honest.
So I've gotten to the same point as Brad.
We came to the same conclusion.
Just tell them to start walking.
- And it falls into place.
- Now a lot of people are really opposed
to using a cane, Brad.
- Or, and a walker's even kind of worse.
- So you might say a walking stick.
You wanna grab that white one, Brad?
- Well of course Bob.
But Brad, Brad just
he forgot to bring it
but he had, he had carved one at home.
- Well I didn't, it's a natural one.
It was on my parents' land before they sold their house
and it was, I didn't have to carve it.
Just varnish it, put five coats of varnish on it.
And it's got a natural handle
where the knot was in the wood.
It's really a nice little deal.
I'll bring it in next time.
You'll see it sooner or later.
- So what's nice about a walking stick is then
people just think you're trying to be cool or something.
- Exactly. Yeah.
- Or you can use a cane, like a English gentleman.
- There you go.
But you know, these, you know
you got some self defenses.
- But I, you know
one thing I want to say Brad
is that quite often that alone calms things down.
- Right.
Unload the, unload the joint.
- Couple more things on to calm it down
or you know, one more thing, Brad
when you're sleeping at night
you don't wanna sleep on that hip.
- You're usually, your body's gonna tell you.
- Right.
- It's gonna say, ow, that hurts.
And that your body's saying get off the hip.
- But it's funny.
Some people still sleep on it Brad, even when it hurts.
- Well, because they've been sleeping on that side
for the last 30 years.
- Right.
- And it's a habit.
So they sleep on it,
maybe go to sleep on their back.
But during the night when they're not,
you know when they're sleeping,
inadvertently they
go onto that sore side and you know, it starts to hurt.
- Yeah. You're right Brad.
Things that might help, you know, obviously is if
if the painful hip, you try to get it
up on top is what you want to do.
Sleep on the other side
and then put a pillow between the leg.
It's just gonna put the hip in a better position.
- Exactly. And it typically, most people,
it feels good for some reason
to have a pillow between your knees anyways.
- It does.
- Plus it makes your hip feel better, you can relax.
- And you can lay on your back too.
And it, sometimes it feels better to have a couple pillows
underneath the knees.
- Sure.
- Just bringing the hip up a little bit.
It seems to take some of the stress off of it.
- Should we show them the leg wedge?
- Yeah. Do we have it?
- Yes. As a matter of fact, Bob
I just had a patient about a month ago
with hip pain and I said, why don't you lay down?
And I was doing some things.
And I said, let's just try this.
And I did this and a person's
went from this to a smile
and they went out that very day and bought one downtown.
- Yeah. What's nice about these leg wedges,
I mean you just go on Amazon
and type in leg wedge, about 25 bucks or so.
- Right.
- And if you gives you a peaceful, nice rest,
I mean it's well worth it.
- These people as matter of fact,
they went downtown.
I say, you can get them 25 bucks on Amazon.
They wanted one that night.
They paid $50.
They didn't care.
They felt that good.
I'm not kidding you, Bob.
- All right.
So once we got things calmed down a little bit
we're gonna go step number two.
Now we're gonna trying to get
two things we're trying to accomplish here.
One, to get some motion
and maybe to calm it down
with a
take the pain levels down with a massage.
- Sure.
- So the first thing, a lot of times with a painful hip
you start to lose motion in that hip
because over time it hurts
so you don't move it and then it gets tight
then it gets tighter and it hurts more.
And then you don't move it,
it's just it's a vicious cycle.
And what we have found or they have found
we didn't discover this.
If you can regain even a few degrees
of motion back in your hip,
it tends to decrease your pain.
- Right.
- So we're gonna show you all the different
motions that you can try to gain back.
- And plus it's hard to get your shoes on
when your hips are tight
because you can't get down there.
A lot of functional things make it easier too.
- Yeah. So one of the ones that we do first, Brad,
I do with most people is, you know, laying on their back.
I just start having them do rotations.
- Sure.
- Now this may look like you're rotating the back
but you're actually rotating the hips too.
- Right. And you are doing the back.
You're getting, you know
a multiple joints involved here.
- If it really hurts in one direction with your hip
just work the other direction until,
and then every once in a while
try that other direction again.
So,
but you can actually
then start working your way, you know, way over like this
eventually if it starts to feel okay.
- Yep, yep.
Listen to your body.
- All right.
Then the other one you can start going in
is the hip flexion.
So you can do this
and we do pressure on, pressure off.
Pressure on, pressure off.
You wanna do it within a pain level.
You don't wanna push into the pain
to the point where that you're getting all fired up.
- Now one thing, a lot of people are
may have a sore knee or a replaced knee.
- So grab under here.
- Grab under there.
You can take a towel roll and put it under here.
- Well you could even take that strap.
Is that readily available, Brad?
- Well of course, Bob, we put it away in it's home.
There you go.
Grab that.
- So you can take a strap like this.
If you're, if you have trouble reaching and pull like this
this is the stretch out strap.
It, it comes with handles like this and you can
you can pull like this and easily get into that position.
- So many times people have problems getting that knee up.
If you're older, if you're, you know
a little overweight and things get in the way.
- A standing way to do it Brad is to,
you know actually go up to a chair and go like this.
And then you can kind of lean forward like this
pressure on, pressure off.
So you can do this throughout the day.
- Right.
- Brad would probably fit better on the chair, right?
- Yeah. And it gives you something safe to hold onto,
you know.
Make sure you take your shoes off, of course,
and work that.
Work it gently, don't, if it starts to hurt
don't think no pain, no gain and really wrench on it.
Be gentle with it and it'll work its way through there.
- Yeah.
Again, we're not, we're not aiming for pain here.
- Hey, we're aiming to just loosen up in a cordial way.
- Next one is external rotation.
This is a nice one.
Can you do, do it while you're sitting very easy to do.
And, and I always tell people, you can check out your hips.
You know, you can put one up,
like the painful one, and see where, how far down it goes.
This is external rotation.
And then compare it to the other one.
And if that one goes down a lot further
you now you can kind of see how far you have to stretch it.
- As a matter of fact, we can see on Bob
his right hip is tighter than his left.
- It actually is a little tighter.
- Yeah. Yeah.
- So again, you can just put your hands on here.
Pressure on, pressure off.
I had a lady, Brad, that she's about our age, fifties.
She was in her fifties.
- Still young.
Yep. And she literally could not walk more than
50 yards because of pain in her hip.
This is the only thing we had her do.
- Yep.
- Went away.
- There you go.
- I mean, it was like a miracle.
- That's when it's really fun to be a physical therapist.
- Yeah. That's one, it's one of the good times.
All right. Another one is hip extension, Brad.
Now hip extension, you can do,
I'll do this up here but you can do this on the floor.
And you put a pillow down and I'm stretching this one.
- Right.
- And I'm leaning forward like this
and I'm stretching this hip.
- Right. So this back leg
he's getting a stretch right up in here.
If you were gonna do this, I'll do it on the floor.
- Sure.
- Like this and, and this is the.
- And he's keeping good posture.
Look at him, sitting up nice and straight.
- We're not doing this
although we did discover that actually.
- That's a different way of doing it.
- We're learning something new all the time.
There's different ways for different people and whatever.
So you'll know the whole idea is
if it feels better when you're done
and things are improving.
- You can do it on the bed like this.
You can put the hip like this and then lift up like this.
- Sure.
- This is a great way to do it also.
- Right.
- Actually I feel pretty good actually.
- These are obviously for more mobile people.
If, if you're weak or you're older,
some of these are gonna be too aggressive,
so be safe with them.
- All right.
That's all the movement ones.
And you wanna see,
especially if one's lacking in one direction
you wanna make sure you hit that direction.
If there's soreness around the hip,
you know that you can actually palpate or feel,
you may wanna try some massage.
And we got, you know, we got the pure wave massagers.
This is a cordless massager, this is a real nice one.
We've done a lot of videos on there.
And you can just work that area
maybe work it all the way down here even.
It actually feels better.
- There's the IT band here that
that you're connected directly to the, to the hip abductor.
And so that whole chain there.
You might wanna work in the
gluteus maximus or in the piriformis
which might be pulling the hip back in an abnormal position.
- I was gonna say, that's probably a little loud
while we're talking Brad,
but that's also the tensor fasciae latae.
- Yeah.
- All those muscles there.
- You wouldn't be doing this standing,
you'll lay down, but Bob's in my way.
- Here's a cheaper one, less expensive one.
The nursal massager, same thing kind
of work the area.
- And it works nice too.
You know, it has a cord on it.
- Yeah, this one has a cord.
- But other than that, you know, for the price
it's a good deal.
- Okay.
You can also not spend any money and just use
like a tennis ball and work the muscle like that.
Now this is a lot more aggressive, isn't it, Brad?
- Right. This is if you've got a tight muscle or.
- And you wanna massage it like that.
- Yeah. You want to get that tightness out to relax it
to let the joint relax.
That's something you're gonna have to work with
and you know, be careful with it.
- Boy, Brad, I see.
We're really running along here.
Let's jump right into the last one.
Last one is you really wanna try to do some strengthening
of the hip.
Cause especially if you see someone walking along Brad
and they're doing this
it's because that hip isn't strong enough
and that's putting stress on the hip every step they take.
- That's a pretty common, you you'll see the people walking
like this that's called a trendelenburg gait.
And the, the exercise that most therapists are gonna give
for that is gonna be the hip abductors.
- Yeah. Why don't you show that Brad?
- So if you're holding onto a Walker or a cupboard base
and this is the weak hip
we're gonna do an exercise like this out to this side.
My toes are not pointed out this way,
but pointed straight in front of me
and you do them good control,
not this
but this. It's harder to do it.
Doesn't go as high, but it that's the way you want to do it.
- Yeah. I would definitely start with those.
That's the, the main one to do.
Just do lots of those.
And you might do some shallow squats.
- Sure.
- Ball on the wall is always good for that.
- Someone's gonna ask repetitions.
I would say 10 to 15 repetitions is a good place to start.
- I'll do it right over here, Brad.
- Okay.
- So a ball or you could do squats without them too.
I mean, you could just do squats behind a chair to be safe.
- Yep.
- But what's nice about this
it really gives you a lot of support
and you can do shallow squats and then eventually work down.
So some deeper ones.
- Right.
- But just, just a great one
for strengthening the hip extensors.
- Right.
Exactly. Good weight bearing exercise.
Again, we're just, we're getting too loquacious, Brad.
- Yeah. Wow Bob, you've been studying your thesaurus.
- So thanks for watching everybody.
(chuckles)