♪ Bob and Brad ♪
♪ The two most famous physical therapists on the internet ♪
- Hey, lucky folks out there.
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.
- Hey Brad, we got five proven exercises,
proven in the sense that we've used them and they've worked.
- Right.
- For our knee osteoarthritis or knee pain.
These are things that are easy to do
and five things that you can try,
and you want to implement them right now?
- Yes. Well, wait till you see the video.
- Oh, yeah, wait till you see the video first.
Okay.
- So osteoarthritis just means typical arthritis
that you get in your knees.
- Wearing down of the joint.
- Arthritis.
- And quite often, sometimes little pieces can break off
and get in the wrong spot.
- Mm hmm.
- And also, and that's why this first one
often comes in handy.
- Sure.
- All right. This is a Mulligan technique.
Brian Mulligan, again from New Zealand.
- Mm hmm.
- And what he does, you go ahead,
and this is the painful knee.
This one actually works sometimes, Brad, with people
who have even a little bit of cartilage problems.
- Sure.
- I've had a nurse do this and she had great luck with it.
- Okay.
- So what you're gonna do is you're gonna put the leg up,
and you're gonna actually grab onto the lower leg
and you're gonna turn it in, turn it this way. So.
- So the idea is we want to get that tibia bone to rotate,
- Right.
- but the problem is you have skin around it and flesh.
- So you gotta really grab deep.
- Yeah.
- The whole idea here is that when you bend your knee, Brad.
Believe it or not, when you bend your knee,
this bone right here, turns.
- Sure.
- People don't know that.
They think it just is like a hinge.
But no, this bone actually turns like this.
- The natural mechanics of it.
- Yeah. So if you help it turn,
it's gonna go a little bit further.
And if there's a problem within the joint
sometimes that helps it smooth out or-
- Right.
- It settles, it maybe moves a little piece out the way.
- Yep.
- So.
- So, and again this is for someone
that's pretty high level, you have good balance,
your mobility's good, but you have knee pain.
- That's a good point, Brad, cuz yeah.
I don't want you putting your foot up here
then falling over and then, you know,
- Yeah, broken hip.
- Right. So you wanna make sure, yeah.
If you have the balance to do this
you're gonna put your leg up.
Again, I'm grabbing with both hands
and I'm turning this leg right here.
I'm grabbing pretty deep.
- Mm hmm.
- I'm turning and while I'm turning
I'm gonna go ahead and bend.
- And you're only gonna do this, you'll know.
- Look at that. Cracked.
- Wow. Yes.
When you do this it's gonna move farther and with less pain.
- Right.
- If the opposite happens and it starts to hurt more,
- Exactly.
- Stop.
- This is a pain-free technique. You should be pain free.
- Right. It does not work for everyone.
- No.
- As a matter of fact, there's only a certain percentage
of people it will work for.
- Right.
- But when it works,
- [Bob And Brad] It works well.
- Absolutely.
- You'll know right away.
- And you're trying to get more knee bend if you can.
- Yep.
- You know, especially if you have limited knee bend.
If you look at one knee, if you lay down,
Brad, can you mind if I lay down?
- Go ahead.
And if I bend one knee
and it goes all the way back like this
and I bend the other knee and it only goes this far.
- Right.
- And that's the arthritic knee,
this might be a good technique for it.
- Sure. Yep.
- All right. The opposite is also true.
If your knees, if you put your legs up on a stool or a chair
and one knee goes all the way down,
the other knee stays bent.
- Mm hmm.
- And that's the arthritic knee,
you're gonna wanna regain that motion.
- Right. If possible.
- They have found that even a slight gain in motion
will decrease the knee pain in that leg.
And I have found this to be completely true, Brad.
We've had great success with this.
- Right. And this is a whole concept that Mackenzie,
- Yeah, this is a Mackenzie concept.
So you're gonna want to get this knee straighter again.
So what you're gonna do is gonna go ahead
and put it up on a stool.
Let's put it up on maybe that.
- Yep, that's a better stool.
- So we can see it.
- There we go.
- So you're gonna put your foot up on the stool,
the one that's giving you trouble.
And it is very simple. All you're gonna do is push down.
You can push down here and here.
- Mm hmm. Not on the kneecap.
- Not on the kneecap.
And you're gonna do what we call
"Pressure on, pressure off."
Pressure on, pressure off.
And by actually saying the words,
that tells you how long to do it.
- Right. You don't have to time it.
- So yeah. Pressure on, pressure off.
And I don't know if I mentioned on the other one,
you should do it 10 times.
- Sure. Mm hmm.
- And you can do it twice in a row if you want,
but I'd only do it once a day.
This one you can do throughout the day.
- Sure. And one point I wanna bring up, Bob,
is when you do this, you see the first one, it hurts.
Doesn't hurt, feel good, but by the second or third one
the pain should start to decrease.
- Right.
- And the range of motion should increase a little bit.
- Over time. Right.
- If you push and it hurts and by the fourth or fifth one,
it just hurts more and more, then just stop.
- Then back off a little bit too.
- Yeah.
- Maybe don't push as hard.
- Yep.
- Or back off to the next day.
I had one guy do this, I gotta tell you though.
And he went a little crazy on it and he got really sore.
- Yeah.
- The first day. And it ended up working for him.
But he was kind of upset with me the first day.
- Yeah.
- That it had gotten so sore, cuz,
but I didn't expect him for him to go home
and do it every 10 minutes, you know?
- Right. Sure.
- So the first day I would only do one set of 10.
- Mm hmm.
- And then the next day, see how it, you know, fared.
- Yeah.
- And then maybe do two sets of 10.
So got all that, Brad?
- Yeah. So these, you only do
if it responds well, day to day.
I know it should mean some people say
if 10 is good, 100 is better.
- Right.
- But don't do that.
- You're spreading the forces out over the joint.
If you don't have the joint, if it's not moving
as much as it should be, it's just rubbing
on one little spot instead of spreading the forces out.
- Right.
- All right. In addition to that,
you're gonna wanna do some strengthening to the knee.
So those two are for the motion.
- Right.
- And so now we wanna start some strengthening.
So a good one to do is just a straight leg raise, Brad.
- And in theory, you wanna get the motion as much as you can
and then go to the strength.
- Right. To me, the best gain you're gonna get
is from the motion.
- Sure.
- That's what's gonna help you decrease the pain the most.
But over, time the strength will help you.
- Sure. So a straight leg raise, Brad.
You can do it a lot of different ways.
- Mm hmm.
- You can just go ahead and sit up like this,
and I'm gonna strengthen this one.
And you're just gonna go ahead and lift up like this.
1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
- Do it again.
I want to point out a small thing.
- 2, 3, 4, 5, 6, 7,8, 9, 10
- When you do this see if you can extend the knee
all the way to get those quadriceps kicking in.
- See, I didn't even know I was doing that.
- And it, yeah. Little things like that makes a difference.
- 2, 3, 4, 5 6, 7, 8, 9, 10. It is harder.
- Lot harder.
- Yeah.
- Now, one more little thing, Bob.
Do that and pull your toes up.
- 1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
- Yeah.
- It's harder.
- These are the little things that therapists-
- You can lay down and do it this way.
A little easier to start off with.
- Yeah.
- You can turn it a little bit.
Maybe get a little more of the VMO, right?
- Sure. You bet.
- This is one of the classic things
that a surgeon will say.
The person cannot walk, take their brace off,
until they can do a straight leg raise.
- Right.
- And keep it locked out.
- Good set of 10, and hold for 10, a count of 10.
- Right.
- And you can do the three ways,
but I don't know, let's not even do that.
Huh, Brad?
- No, let's keep it.
- Let's keep this just a quad.
Yep. Okay.
- There's a lot of options here.
- Yeah.
- But we're gonna stick with some basic ones that work.
- All right. How about the next one, Brad?
Why don't we show a hamstring strengthening one?
- Sure.
- That you can do.
- Yeah.
- Do you wanna do that one?
I'll just put you up on a chair here?
- Yeah. Now this is for people that if you know,
your mobility is good where you can go down
to a carpeted floor and you can go up
to a piece of furniture.
You know, some people can get down on the floor
but they can't get back up with knee pain.
- Right.
- So if you got that problem, this is not for you.
This is for the people who are mobile enough.
- Right. This is just a great hamstring one.
I mean,
- Right.
- you know.
- The hamstrings are in the back of the leg.
They connect from the knee down to the
- [Bob And Brad] pelvis,
- They show tuberosity, you don't need to know that.
But what we're gonna do is I'm gonna think
about pushing my heels straight down into the chair.
- Yeah.
- I'm gonna push down and lift my butt up a little bit.
You could start out with isometrics and just push,
hold it for eight to 10 seconds, and relax.
And you will feel it right in here.
And you'll do 10 reps of that.
- And again, with arthritis you wanna make sure
you're not having pain.
- Right.
- You shouldn't with this.
- And then you can start to pick up a little higher
and you can get some hip involvement.
If you scoot yourself away a little bit and work here,
you're gonna get both hamstrings
and you're gonna get little hip motion in there.
- And that's all good for you, too.
- Yep. That's all part of the walking phase,
That are all these joints and muscles work together
when you're walking.
- Good.
- There is an option.
One thing I do, Bob, probably more than you do,
is I'll do kind of like on and off,
as opposed to the hold for 10 seconds.
- Sure.
- But that's an individual preference, I think.
- Yeah. Depending on the person.
- All right. The last one that you're gonna do
is just very simple shallow squats.
- Yeah.
- These, you know, these are good for you.
A great one for the knee,
but most often people can't go down very far
before they start running into pain.
- Yep.
- But you, most people can do a version of these.
- Sure.
- So you can do it from hanging on the chair,
or you can do it in front of the chair if you want,
like this.
And you're just gonna squat down slight
and come back up again.
- Yeah.
- I know that doesn't seem like much,
but it actually is a great knee strengthener,
and you're trying to stop the knee from going past the foot.
Right, Brad?
- Right.
- You wanna show that with a-
- Again, if balance is a problem,
make sure you have something to hold on in front.
- So when I'm going down, I don't wanna see this,
the knee going way past the foot.
- Right. Puts a lot more pressure on
- I'll go right about to there.
You can even do little bit lunges like this too, Brad.
You can do shallow lunges
where you just kind of go like this.
- Yep. And that's where-
- Yep. That's where a chair helps out really a lot.
Is that you just-
- Right.
- Like this.
- Yep. You can put a chair there.
If you have a cane, you can put a chair in one hand,
cane in the other, anything to keep your stability.
- All those are nice functional strengthening activities
and they'll work well.
All right, Brad, what say you?
I stole your line.
- Aw, doggone it, Bob.
I say that we can fix just about anything, except for
- This broken heart.
- Right there.
- Darn it. It's just, it's been evading us.
- Yeah, but I got some big ideas for 2017 on this.
It's gonna break the-
- All right.
- Break the boat.
- You guys can't wait, can you?
(Brad laughs)
Thanks for watching.