♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet. ♪
- Hi folks I'm on Bob Schrupp, physical therapist.
- I'm Brad Heineck, physical therapist.
- 'Cause we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Should you use heat or cold on your hip pain?
- It's a good question Bob.
- It's a good question and we're going to give you
some answers today.
Now, first off, it really depends on the injury.
If you have a brand new
what we call it an acute injury,
especially after trauma or a fall,
or an athletic injury,
or if you've been in a motor vehicle accident,
or if you've had surgery.
Like if you've had hip surgery,
they're having you put an ice pack on it first.
- Right. You're not gonna go to heat
when things are tender and they're swelling up
and they're very sore.
The heat will just exacerbate the problem.
- Make it worse. - Yes.
- So yeah, after trauma like that,
you've probably damaged some blood vessels
and the swelling occurs.
The cold pack can actually cause
the blood vessels to constrict.
- Right.
- And it'll also reduce the swelling.
- It helps with the pain reduction typically.
- Right, very much.
- There are some people who do not tolerate cold at all.
Not a lot, but there are some,
and it just doesn't work
and you may be one of them, I'd say, 5%.
It's just a guess from my experience.
- Have you had people after surgery
that they couldn't tolerate though?
I thought most people after surgery could tolerate.
- Yeah.
- No, I don't know.
Sometimes we don't see them right after surgery.
- Right.
- We see them after they've been out of surgery.
- I'm trying to think of total knees though
I have such a big number of over the years,
but yeah, typically not.
- There's definitely people that,
if they've not had trauma, that day do not like ice.
- Yes. - That's for sure.
I see a lot of people.
I'm kinda one of them, I'm not a big ice person.
- Or they put it on in improperly, too direct.
You need to have some insulation between positioning.
Sometimes those are-
- Yeah, you wanna put...
You don't wanna get ice burn. - Right.
- So what you're gonna do is you're gonna put
a damp towel between the ice pack and the skin.
- Yep.
- That's even true right on the hip
where you have the point of the hip
is right near the surface.
- Sure.
- There's not that much skin there between.
- I'll use a dry towel often times.
- Sure. - I think a damp
is going to be even a little more...
If you don't like the cold,
maybe a dry one first or a couple of them.
- Sure.
- And also a cold pack that's flexible when it's cold.
I've had people get their cold packs
that's made for their little cooler and it's hard as a rock
and they're not comfortable and they just don't work.
- You can also use frozen peas.
- Yeah.
- And if you've got the BO range,
you can eat them afterwards.
But Brad's gonna tell you how to make your own.
- Yeah, we've got a couple videos on how to do it
and show how to make your own cold pack.
But you simply take a gallon freezer bag
or you can use a smaller one.
Freezer bag, not storage bag.
They're tougher.
Put in one cup of alcohol. - [Bob] Rubbing alcohol.
- [Brad] Rubbing alcohol, four cups of water.
Try and get all the air out, zip it shut
put it in a second freezer bag there, so it's stronger.
Get the air out again, zip that one shut.
Lay it down in the freezer so it's flat
not all folded up. - Sure.
- And within a few hours it'll be...
The alcohol keeps the water from turning into ice
and you have a slush pack.
And they work very well.
They're a lot cheaper than buying one,
I've used one, I had my mother, she had one in her freezer.
I wouldn't let my mother use it
if I didn't think it was a good option.
- Sure.
Can she use salt too?
- Yeah, you can use salt.
- Like, a cup of salt?
I'm trying to remember what it is.
- I think we have it in the video.
I always use alcohol because it's a little more convenient.
You don't have to get it into a solution.
- Sure.
- But yeah, I think if you look at our video
it does give the exact ratio.
- So now, when you're going to ice it
especially after an acute injury or surgery,
you could put it on for 15 to 20 minutes.
I wouldn't put it on for any longer than that.
And a lot of times it's starting to warm up by then anyway.
- Right. Exactly.
- And you can do as much as every three hours.
- Right. Exactly.
- All right, let's move on to heat.
Now, heat tends to be more
for chronic types of hip pain, arthritis, stiff hip,
muscle pains, soreness, recurring injuries.
That's the type where you might wanna use heat.
Heat's gonna cause the blood vessels to expand,
the muscles, to relax.
You probably get a little more increased healing with heat.
- Because of the blood flow.
- Because of the blood flow, yes.
- So again,
it's gotta be not tender, don't-
- Right.
You don't wanna have something that's inflamed
and put heat on it.
- You all know after you put a hot pack on,
it'll feel good.
Typically no matter what, hot pack feels good
while it's on there.
But after you take it off and then afterwards
say half hour later or an hour later,
if it feels worse, it may have been
you put the heat on too early
and you may have to go back to the cold.
But typically if you put it on well,
it feels good a lot of time.
You take it off, it feels good
and continues to feel good for the next couple hours,
you're good with the ice pack.
- Let's give some of the cautions, Brad, here though.
- Sure.
- We always tell people do not lie on a hot pack.
That compresses the blood a little bit more,
you can't get blood flow and you can burn a lot easier.
I've definitely had people
that have burned from hot packs, unfortunately.
- Typically it's the one you buy
at, I get this wrong...
- I think bulk?
- No, the electric ones that you shrug in
and there are three levels
and they shrug in highest level, put it down,
and then if they fall asleep-
- Right, do not fall asleep with it on.
- And then literally you can get blisters, it's not good
especially if you have fragile skin.
- I have had this happen many times.
Unfortunately, the patients we asked every five minutes,
'How does it feel?', He was fine.
And one guy
his skin actually blistered up and he goes, 'I'm sorry
this is my fault, you kept asking
and I kept saying it was fine'.
But that's why we try it check too.
- It shouldn't feel hot, it should feel comfortable warmth.
- And always, that we tell people
it should feel comfortable.
- And if it's set and you can't turn it down anymore
then you put some dry towels to insulate it.
So it gives you that comfortable warmth, not a hot.
- We're gonna talk about other heat options here, though,
if you want to get deep heat.
Normal heat, what we were just talking about there
is actually very surface oriented.
It only goes maybe a millimeter,
it just touches the surface of the...
- It's skin deep.
It doesn't get into the joints,
it doesn't get into the muscles,
but it still feels good and relaxing.
So it's not that it's bad. - Not at all.
- But if you wanna get deep into the joints
or into the muscles to increase the circulation
at that depth,
then you're gonna have to go to-
- To a Far Infrared.
Far Infrared, I, N, F, R, A, R, E, D, heat pad.
- There you go, Bob.
- Now what they have found through the studies
is that, that can penetrate as much as-
- 2.36 inches.
- There we go, which is quite significant.
If you think about it,
a lot of the joints and even your back,
when you put it on there,
it's gonna start getting into the joints
with that depth. - Sure.
- And if you wrap it around a joint, you might hit it
from both sides, even.
Now you come down to here.
- Do you have one to show how it can work?
- Yeah, I have one right here.
So, well, if you're obviously
if you're making it into a muff,
- Right.
- You did the hands, it would go
all the way through the hands.
- Oh sure.
- Now Brad and I both have one of these
and we both use it in our respective homes
and we both have it in our respective chairs, right?
I honestly, even during the summer now
I use it every day because it just seems like
it keeps my back in good shape.
- Sure.
- It takes a little bit to warm up.
It takes, I'd say 5 minutes to 10 minutes to warm up.
- Right.
A little longer for you to feel the heat,
but it goes much deeper.
So, there's a give and take.
- Right.
- But they do not get so hot. - No, they don't.
- Like a typical electric one.
- That's what's strange about it is that
it doesn't feel as intense as a regular hot pan heating pad.
So you're going to say, well, is this even working?
But you feel the skin and it's warm
and as far as pain-wise
it just seems like it helps better on that.
So we'll put a link below.
We like the Thermatex One. - Right.
- And,
they've got different sizes too
but we like the platinum one
'cause you can use it for a lot of different things.
- Right, you can use it on your knee, your hip,
your arms or hands.
It's just very versatile
and the quality of those is excellent.
They're not cheap, but they're going to last
and they worked very well. - They're not cheap at all.
All right, I think the final thing we want to say
heat and cold, quite often they're really not
as specific really right or wrong.
Expect right after an N G. - Right.
- Brad,
he's got his spindolos thesis, I never say it right.
But he- - It's a back pain issue.
- Yeah. Back pain issue.
And you'll often, if it flares up,
you'll use an ice pack, right? - Oh yeah.
If I'm doing something
and I know I'm going to irritate it, say some yard work
'cause I liked doing that,
I'm gonna have to go in and lay my cold pack.
But on the other side
particularly in the winter time if it's stiff,
not flared up at all...
- That you use the Thermotex. - Right.
And just like that, I have it in my recliner
and I'll use it regularly.
- So don't feel bad if for some reason
you're going 'Well, they're saying to use heat
on chronic problems'.
No, we're not.
We're saying whatever works best for you.
'Cause it's all about managing your pain quite often
especially when you've got chronic pain.
So if it works for you, go ahead and use a cold pack.
Just to always use the precautions in bed.
- I actually had a woman had very severe knee arthritis
so she could hardly move her knee.
And she just loved the cold on it.
- Isn't that crazy? - Which is really rare.
- It is rare.
- I didn't even want to put it on her the first time
it was like, this isn't gonna work.
And we did.
And she used it for a couple of years
and that was her pain medicine for her knees.
So there's always unique situations.
- Just a reminder here.
This video was part of a series of videos
on treating hip pain.
If you wanna see the rest of the series
go to our website, bobandbrad.com, go to programs
and then under programs you'll find
the series on hip pain.
- Yep, and there'll be a number of hip videos.
Go through the one that pertains to your needs.
You don't have to watch them all,
you know, you can if you want.
- And, there's a PDF with each video that you can print out
which this one, this video,
we have a printout of everything that was said in here.
- Right.
And you don't have to listen to us again.
- Yeah, 'cause we babble on and take forever
some people say.
But one way or another, it's free.
- Yeah. All right.
And no, we don't even ask for email.
So thanks everybody for watching.