♪ Bob and Brad ♪
♪ the two most famous physical therapists on the internet ♪
- Hi folks am Bob Schrupp physical therapist.
- Brad Heineck physical therapist.
- We are the most famous physical therapists
on the internet.
- In our opinion of course Bob
- Surgery for your knee arthritis, not so fast.
We're gonna show you eight best exercises
of physical therapists and hopefully,
this'll maybe buy you some time.
- Right.
- Maybe it'll buy you years.
- It's really very possible.
- Sure.
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- There you go.
- Brad, this video is actually for a former patient of mine.
He's been having some trouble in his knee.
I know we showed you some exercises,
but we're gonna show you a few more
maybe here or at least condensed,
you know have them summarized.
- Sure.
- So that he knows what they are all are,
I know also I've talked to you
about using a walking stick or a cane,
and I don't know if you're still doing that,
but if your knee is still bothering you,
I'd still like you to go back
to that for a while.
- Reduce the weight-bearing.
- Yeah I'm gonna mention a couple of ones
that were sent to us by a company here.
We have no relationship with them,
but as I just mentioned,
I liked their Prime stick.
This is actually a walking stick that they use.
It adjusts, yeah you can make it any length
you want and it just easy.
You just twist it like this
and it's lightweight, it's got a good handle.
And yeah, you're uneven there Brad.
- Yeah that's alright I've always been that way.
- They also came out with a cane.
So that's called the Prime stick.
This is called a Cyclone Cane.
I didn't like the adjustment on it.
I gotta be honest Brad.
I thought the adjustment was a little onerous,
a little hard to do,
- Yeah
- But once you got it in place, it doesn't matter.
- Right, you only adjust once.
- A very comfortable cane as far as handle.
- I really like the handle.
- Best handle I've seen.
They recommend you actually have the handle out
like this instead of like this.
- Right.
- Interesting.
- Which, i like it.
- Ergonomically works better, but not set for me right now,
- No its a little short, let me try.
- Yeah, that's good for me.
- Yeah.
- Yeah it really has got a nice grip.
- Alright let's go into the exercises.
The first one and I think you're doing this one already.
I don't wanna use your name
because I don't know, People
- No you better be stealth.
- The first one you're actually going to do,
I know we talked about that.
I don't want you to sit
with the knee bent more than 90 degrees.
So if you are like this,
I don't want you to sit because
he works at a desk a lot.
- Oh sure.
- I don't want you to sit (mumbling)
he said yeah my doctor told me that too.
- Yeah
- Because this actually is putting pressure
on the knee all day long.
So you wanna have the knee out like this sometimes
Or maybe just like this,
but every so often,
you're gonna do active knee extension
- Yeah.
- Five times I'd like to see
you probably do both knees,
just five times every 30 minutes.
And this is just getting some movement in there,
getting some fluid in there.
It's just a great one to do.
It doesn't take very long,
You know, you can actually keep working
while you're doing it.
- Yeah it's good for circulation, strength in the legs.
- Now, if you're on the opposite end of the spectrum,
and you're doing a lot of standing for some reason,
Brad, if you're standing up for a long time,
Your job requires it,
then I want you to try to sit down every so 30 minutes
- Right.
- And you're gonna flex the knee.
One,
two,
three.
- The idea is to keep things moving
- Four,right.
- Don't be in a static position for long periods of time.
- All right So, that's the first two.
The next one.
If you're lacking some knee extension,
your knee doesn't completely straight out.
Especially if you compare like one knee,
that's worse than the other.
All right If I put this knee up and they can see,
you have a little bit of a bend,
this one goes completely straight.
You're gonna wanna work on that extension.
It can be very Subtle by the way.
- Sure
- It could be very minimal (mumbling) train die.
It would take a train die sometimes to pull it out.
- Right, perhaps exaggerating so you can see it.
- So what you're gonna do
is you're gonna work with that knee.
You're gonna do pressure on,
you're not gonna push right on the knee itself,
but I push right above it.
Pressure on pressure off.
pressure on pressure off six.
You know you can do that for 10 times,
but you can do it on a bed too,
six to eight times a day.
This is a really important one
because we have found,
if you regained the extension,
quite often what happens
is that the pain level goes down.
It just a seems to coincide.
- So I was just showing
you could put a towel roll underneath your ankle,
that gives you a space if you're doing it,
you know in bed.
You could put a towel,
not a towel roll but you know
( both mumbling)
Yeah just to make it more comfortable
- Now let's say you're doing this.
Ah, it's just not helping.
What I want you to try,
is either turning the foot out or turning the foot in
and then do pressure on pressure off.
See which one feels better.
For my wife It was turning it out a little bit,
and she did pressure on pressure off like this.
She really, it took time,
but she really had good results from the knee.
She's back running again
like we just mentioned a different video.
kind of really almost a semi miracle,
because I mean she was to the point
where she was using double crutches.
(both chuckling)
I mean she was
- Did you get credit for that Bob?
- Yeah, she does
She does give me credit,
- Good
- But it's funny,
I just remember her crying in the bathroom like
"I don't want a knee replacement"
and I'm like no, you're not having a knee replacement yet.
- I hope she doesn't see this video.
- I know I hope she doesn't either
she's not gonna be happy with me.
- So anyway, try one way
the same thing It's gonna be 10 times,
six to eight times a day.
I know you're going to say,
are you kidding me?
I can't be doing an exercise that often.
Well then you're gonna live with the pain.
You know am sorry.
- And they don't take that long 10 times
its gonna take you 30 seconds.
- Yeah its gonna make a big difference.
Now, let's say you're one of those people
that's lacking bending.
So I check one side,
check the other side and it doesn't bend as far.
All right In that case,
what are you gonna do is the same thing,
but pressure on pressure off
with the bending and again 10 times.
- And the nice thing about this one
you can do it laying down, you can do it in bed.
You know, you can go on the floor
if you'd like to.
You wanna show them?
- Yeah show the towel,
if you're not making gains on that,
what you might do is take a rolled up towel,
stick it on there into the
what do we call it?
Knee gap?
- Its a popliteal fossa.
- Popliteal fossa i was trying to think of that.
And then I was trying to think of the lay person term.
I couldn't come up with either.
So this actually kind of gaps the knee.
It actually feels good.
It's a great one to do.
You know, when you are checking
comparing one knee to another,
you may not even hardly see it.
Like there's a lack of a vignette
but you'll feel it.
- Sure
- Yeah that one just doesn't go as well.
- You Can I actually put your hand in there
like this and do it doesn't work quite as well,
but you get some benefits from that, just an option.
- I'm gonna Show you one more variation on that too.
So I'll show it in this direction here actually toward you.
What you could, this is an advanced one.
So what I'm gonna do actually,
while I'm bending the knee,
I'm actually gonna turn to the,
the lower tibia fibula out this way.
I'm gonna turn it and while I'm turning it,
I'm gonna bend the knee.
I'm holding it in the turn the whole entire time.
The only reason I bring this up,
is because some people have really had good luck with this.
So I'm twisting it the entire time
out this direction.
If it was this leg, I would twist it this direction.
All right.
- Yeah that one is a little advanced.
I've had patients that've had,
it's somewhat tough to teach some people.
- Yes
- Because you're not, you know you're grabbing the
tibia through the flesh.
- The only reason I'm doing it Brad is cause
some people have really had good luck with it.
I just hate not mention it.
- So You'll know if you do it
because it's gonna feel good
and It's gonna be very obvious that you can get more range.
- All right
then we're gonna start you with some strengthening.
So like in the McKenzie book,
which a lot of this is from by the way,
how to treat your own knee, Robin McKenzie.
What they actually do is
they have you take your chair up to a door.
Let's say the doors this way Brad
and you can actually grab the handle
and start doing sit to stands like this.
Now you certainly can do this by a sink too,
just grab onto the sink or our counter.
- So if you're strong enough to do it
without that you stooge.
- You can
well, what they want you to do is quite often
is pull yourself up and then lower yourself down
sure you're doing a little bit of eccentric strengthening.
But
very soon,
if that works pretty well,
you can then progress to just doing squats without it.
So you can just do them like this,
or you can even do pushups,
push out if you have arms on the chair.
You can do them prisoner squats.
- Ooh that's a little more aggressive.
That's quite a bit harder.
- Right and eventually
you can even go to the point where you start going down
and don't touch the chair.
- It's nice to have the chair behind you,
just in case you need gives out or you lose your balance,
You don't fall.
- Right and the whole thing here
is We're trying not to flare up the knee.
Don't do things that are gonna make it worse.
- Right
- So Brad, we're already at number eight.
We made it.
- Eight
- I know you like seven.
- I know I like seven but
- You know what i did?
I added one just to bug you.
- Oh really?
- Yeah.
- Okay Show me.
- Well, that was it.
Number eight.
- Oh (laughing)
- I could've done seven plus one
a bonus.
- We are really in tune today.
- All right, enjoy the eight.
Thanks for watching.
- We did it already.
- Yeah we did it.