♪ 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.
- Today, were gonna talk about, we did a kind of a series
of videos on this, what is causing your hip pain.
We did one on arthritis.
We did one on tendonitis.
Today, we're talking about muscle strain or tear,
how to tell if you have torn a muscle
or if you strain a muscle.
So, what is a muscle strain?
It's a muscle stretched beyond its limit,
often happens with athletic events.
It can cause, different terminology I've heard is,
strain, tear, or pull.
I don't know if you've heard anything else, Brad.
- Well, you could say rupture.
- Rupture. - That's an extreme.
- That's the third degree, which we'll talk about here.
There's three degrees of tears.
It's not the worst thing to know this.
The first degree is (laughs)
if there's just mild over stretching.
The muscle might be sore, but it's not bad.
- Typically if you have it on your hip flexor or something,
you can still walk, but you feel it
every time you move that leg forward.
It kind of hurts, particularly if you've been sitting
for a while and you get up and walk those first 10 steps,
then it kind of loosens up, and it's not too bad.
- I think even if you work out too hard
on the hip.
Second degree, there's actually mild swelling and bruising.
You can visualize it.
You'll see that.
Possibly severe pain and tenderness,
even with a second degree.
So there's been a moderate amount of overstretching,
and you actually tore some fibers of the muscle.
- Right, but it's not like you...
- No, 'cause that's third degree.
Third degree is there's severe pain and swelling.
The muscle or tendon is actually torn all the way through.
The muscle could be put into two pieces,
or the tendon could have been pulled from the bone.
- Right off the bone.
And then you're gonna notice,
if you could lift your good knee up like this,
you're not even gonna be able to do a partial.
Maybe if we got some other muscles compensating,
but it's significant.
- It's probably gonna hurt so much
that you won't be able to lift it even.
- Swelling, a number of symptoms.
- So again, it often happens suddenly with sports,
or it can happen just even gradually with time
like a repetitive motion.
If you're doing something you haven't done in a long time,
or you increased it too quickly,
you can actually tear muscle.
- I think a real common one is the weekend athlete.
- You go out there and play a game of softball
with the kids and all of a sudden
you think you can go from first to second base
really, really fast, and then you find out
that things don't work so good. (laughs)
- I haven't run in two months. (laughs)
So yeah, if you attempt too much too soon.
And you wanna make sure that you warm up.
You're at more risk if you had a previous strain.
You're at more risk if you have muscle tightness, obviously.
If you don't warm up and if you attempt too much too soon.
Those are the things you wanna (murmurs).
The signs and symptoms.
Well, we talked about you could have swelling and bruising
over or the muscle.
You might have muscle spasms.
That's usually a sign that there's been some problems.
- Tightness, yep.
- Yep, a previous hip strain or tear, like we said.
That would be a sign.
Point tenderness.
So you can actually find the spot on the hip
that bothers you.
- The hip is a kind of a...
This is a tough one for the lay person,
because the hip has muscles all the way around it.
It could be a groin as related to the hip,
hip flexor in the front,
hip abductor on the side, or even in the back.
So this is pretty broad, so we're kind of touching this-
- The hamstring goes up into the hip.
- Exactly.
- These are all ones that could be constantly
giving you a problem.
Often, if you're in a sporting event,
you hear a pop, that's probably not good sign.
(both laugh)
- I do wanna mention like a groin,
that crosses that hip joint,
and that's right in here.
And I've had a number of strains, mild strains
where when I run, it hurts, it pulls.
When I walk, it does a little bit,
and it's usually within a week or less,
and I'll do some stretching,
I'll do some self massage, and it'll calm down.
If it's a second degree, you get in to do some massage,
it hurts when you hit that sore spot.
- You're gonna have to let it calm down.
- Yep, and you gotta get a cold pack on it.
And, again, third degree that that's pretty severe.
- Probably surgery. - You need to go in
and see a doctor and have it assessed properly.
- All right, so we're gonna show you five tests you can do.
We're gonna just try to test each muscle of the hip.
So, first one we're gonna do is hip flexion.
Now, normally you wanna test the non-painful side first.
So let's say my painful side is on my right.
So I'm first gonna lift the hip up like this.
Brad's gonna show in the seated position from the side.
And I'm just gonna try to hold it up.
I'm gonna resist and push it down.
Now, if it's weak or painful,
- Ow.
- that might be that you (indistinct)
the hip flexor muscles.
And check the other side.
That one's fine.
Compare the two.
- Notice, good posture when you're sitting there.
Don't be all slumped over.
- Hip abduction, that moving the hips out,
gluteus medius, minimus.
And so we're gonna push it out like that.
And, again, you can push out both at one time,
and if one doesn't hold,
one actually pushes back in or brings on the pain,
could be a strain.
All right, number three, hip adduction.
That's bringing the hips together.
So you can actually put your fists like this.
That's one way to do it,
and just squeeze your legs together.
This is where we probably feel that groin pull,
the muscles that go up into the groin.
That's the hip abductors.
All right, hip extension.
So that's the one that brings the leg down.
So bring your leg up, grab onto it.
I'm sorry, this one first.
Pushed down.
And compare it to the other side.
- Now, I just wanna say that these tests
also could be performed lying down.
It's hard to do that by yourself,
so these are not conclusive tests by any means.
It gives you an indication,
particularly a test of one side to the other.
And so you kind of understand
if you do go into a doctor or therapist,
you know what's going on,
it's not completely foreign to you.
- And it could be something else.
I mean, sometimes those things will bring on pain.
But the other thing you're gonna look for
is point tenderness over the muscle.
And probably the groin is a good example of that, Brad.
If you find like it doesn't hurt, doesn't hurt,
but right in the middle it hurts,
you probably tore the muscle there or strained it.
We'll show you some things you can do for that.
- On this video or we have that
on some other ones. - Yeah, on some other videos.
But that, again, is a sign
that you probably tore the muscle.
- Yeah, there's some massage techniques, but it's specific.
You can see some of our videos to get into that clearly.
- Yep, check it out.
Did I say it already on this one?
- Check what?
No, you didn't, I don't think so.
Mike, did he say it? - No, I didn't.
- Say it, Bob.
Okay, so this video is a part of series videos on hip pain.
It's a free series go to bobandbrad.com.
Go to the Programs section and look for the hip pain videos.
- So programs, meaning we got a program for backs.
We got a program for hip.
We got a program for shoulders.
So go to that. - Tens.
So, check it out.
We don't have them all done yet,
but we're working on it. - Work in progress.
So go to that hip program. - And each video
has what, Brad? - PDF, a printout on paper
of the highlights and exercises, so you can look at it
and to come right back and say, "Oh, I remember that now."
But if you want, you can go back to the video
and take a look at us again
and see what comes up with that.
- (laughs) See what's wrong with you.
(Brad laughs)
All right, check it out.
Thanks for watching.
- Take care.
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