♪ 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.
- I'm pumped up today, Brad. (Brad grunts)
Today we're gonna talk about how to treat knee bursitis.
And we're talking about suprapatellar, prepatellar,
infrapatellar, pes anserine bursitis.
What is that?
- You're spitting out a lot of big words, Bob.
- I know, I know but we did a- - We're talking knee pain.
- We did a video on this already and you can look it up.
What is causing your knee pain?
Is it knee bursitis?
And if you look that up, it'll kinda
give you a description of what those were
and what those big words were.
- And it happens to be in the program, so.
- Yeah, we'll talk about that, yeah.
- Oh okay, yeah well, just hold on.
- So we can provide some suggestions
on how to treat knee bursitis at home,
but the first question that need to be answered,
that needs to be answered is,
when do you need to see the doctor?
- Yeah.
- Cause you, if you have bursitis,
you could have an infection,
you could have a fracture,
you could have auto-immune disease.
I mean, you know,
if you were kneeling on your knee a long time
and you got bursitis,
it's pretty obvious that it's from that.
But if it just pops up,
you know, suddenly you get inflammation in your knee.
- For no apparent reason.
- Right.
Especially if you had a knee replacement.
- Yeah, if you've got a knee replacement
and you've got some redness, soreness in your knee,
that's, I would say better see the doctor
to confirm what's going on.
- Right.
So once you've seen the doctor
and you determine it's not an infection,
then we can go ahead
and you can try some things here.
So the first thing,
for the first 24 to 48 hours, you might try some ice.
- Cold packs, yeah.
- Yeah.
And we have actually a video on how to make a cold pack.
- Yeah, you got rubbing alcohol and a bag.
- Yeah.
- Actually, you can use salt too.
I believe we have both options in there.
Works very well.
I've used them at home.
I've had my mother use-
- Vodka?
- Well, I had one patient use Jack Daniels.
(Bob laughs)
It's pretty expensive.
- Yeah, that's an expensive ice bag.
- Yeah, especially when his actually broke open
and got in his recliner.
(Brad laughs)
- Oh geez.
- Yeah. He was an interesting patient.
- Yeah. That I should say.
So you wanna ice it.
And a lot of times you want it
between the ice pack and the knee,
you wanna put a washcloth. - Yup.
- So you don't burn. - Yup.
- You know, you can get the ice burn or...
- You could get a frostbite.
- A frostbite type burn, yeah.
- Just like clothing, you know,
a pair of pants typically works well.
- Yeah, that'll work too, yes.
And do it like 15, 20 minutes. - Yup.
- You don't need to do it any longer.
- Exactly.
- You might also take, if your physician approves this,
you might take an anti-inflammatory,
like Ibuprofen. - Yup.
So, you can also use, by the way,
a bag of frozen vegetables would also work.
- I always like peas.
- Peas, would work. - Yeah, they seem,
as long as they're not frozen, a solid chunk,
you have break them up in there.
And I wouldn't, after using it a few times and thaw
and freeze and thaw, I'd probably not eat 'em.
(Bob laughs)
Yeah, put them in the garbage. - Good point.
Your work has been done.
- Good point.
Okay.
You also want to avoid activities that irritate
the bursa, - Right.
like
kneeling on it, you know? - Mhm.
- Cause a lot of those bursas,
then again, they're fluid-filled sacs.
They're all around the knee. - Mhm.
- And it's,
you'll know if you're irritating by kneeling because.
(Bob and Brad) It hurts.
- It's pretty a sensitive to tissue.
- Even repetitive activities
can irritate a bursa once it's
irritated already. - Right.
Like walking, biking, running.
- Up and down a lot of steps.
- Again, it shouldn't be
rocket science here.
It require rocket science,
if you're walking and it hurts,
you know, - Yeah.
you need to back off right now, so.
All right.
So we're gonna show you some suggested exercises.
One is I just want you to
bend and straighten the knee every hour.
Or every half hour,
and do it like 10 times.
This is good for the knee no matter what you have.
- Yeah.
Yeah, if you got just pain in the joint
from arthritis,
just ranging the knee out,
without putting force,
it's good to get that synovial fluid going,
get some circulation.
- Now, with a lot of this bursas,
they might be attached into tendons
or muscles. - Mhm.
- So we wanna make sure all the muscles
are stretched out. - Mhm.
- That affect the knee.
- Right. - So the first one is
you actually want to stretch the calf muscles.
Brad, do you want to show that maybe?
- Sure.
The easiest one, if you uh,
as long as you've got a wall
and a solid you know,
solid wall and a floor,
you're gonna bring
this is the foot I'm stretching.
This one is just here.
Point it towards the wall,
straighten the knee out.
I always tell my patients,
pretend your heel's glued to the floor
and lean forward.
Keep the heel down and get that stretch and hold it.
Make sure you breathe and relax.
That's so critical for a
good effective stretch.
And then come back, bend the knee,
keep the knee bent,
keep the heel on the floor and repeat.
And you'll feel it stretches a different muscle.
And it's important that you get both muscles.
You can hold it 15 to 30 seconds.
If you wanna go pressure on, pressure off,
10 times that works too.
- Now hamstring stretch,
that obviously crosses the knee.
- Mhm.
- You can do that lying down.
- Ah, yes.
- You can do it without,
really you just grab underneath your thigh.
Like this. - Sure.
Leave this vertical
and pull up like this
and just keep pulling to have a hamstring stretch.
- Sure.
- Or you can also use a sheet - Sheet.
- To hold on. - Belt.
- A belt or a stretch out strap.
Do we have one?
Probably not. - Not handy right now Bob.
- And Brad, you just go and put your foot up on it.
- Yeah, if you're up, able,
you have good balance and you feel steady doing this.
- And you have good back motion.
- Yeah you're not rounding over.
- Yeah, not rounding over. Good posture.
- Shoulders back and just lean.
You'll feel an isolated stretch on those hamstrings.
Make sure you relax and breath with all of these
and you're gonna have a much better success
on the stretch.
- Now quadriceps stretch.
That's a difficult one for us.
- Ah, yes.
- I mean you can do it lying down.
- Yup.
- You know, you can actually lie like this
and grab your ankle and pull it back like this.
- That would be sideline right?
- That'd be sideline, right.
- That's because you're on your side.
- Yeah.
(Bob and Brad laughs) You can also do a stand.
- That's how I remember it. - Yeah. Very good Brad.
- Yeah. Standing like this, you know, again, good balance.
I always
need to hold on to something. - Yeah, I had to hold
on to something right.
- And if you do go like this,
it won't work. - Right.
- You have to, a good tall straight posture
and then bring the knee back. - Pull it back.
- And you'll feel that.
Whoo.
- So you can also stretch the hip adductors.
That's the muscles
inside the thigh here.
So you can sit cross-legged.
Let's see if I can do this Brad.
- You'd be like the clam?
- Yep.
- Yeah.
- And they can use your elbows to push it down.
I can feel that.
- Oh, absolutely.
- I also just do it like this Brad.
- Lying on your back.
Yeah, that's what I do too.
Pull up.
Grab your feet like that.
- Oh, like this? - Yeah, that's it.
Push it out with your elbows.
- Yeah. I don't do that.
- Yeah. It's fun.
- I just lie like this and I go like this.
- Yeah, the both of them works. It depends on your
joint configuration.
- So keep all those muscles stretched out.
It's gonna be good for you knee
no matter what problem you have.
- Right.
- And also it's gonna be good for bursitis.
Now, how about some
strengthening exercises? - Aha, yes.
The stronger the muscles,
the less stress there is on the knee.
So I'm gonna do just some simple ones here.
Straight leg raise?
- Right.
Yeah, you're not gonna, you know,
go to the gym and get on the weight machines.
Although, maybe it'd be an option,
but these are,
if your knee hurts, you got bursitis,
you don't want to overdo it.
- Yeah.
What we're doing here is really isometric.
And we're also striking the hip at the same time.
- Sure, yep.
- Which is good for the knee.
- Yep.
- So, but we're gonna do straight leg.
I got this leg bent, to kind of stabilize the pelvis,
and then I bring this knee
up till about that knee.
- So this is the sore knee.
- And that's the knee that I am strengthening.
- Yep.
- And then you can, you know, count to 10
and repeat 10 times,
and you're gonna go right around the circle here.
You're gonna go around the horn as they'd say Brad, right?
- Oh, so you're going to do the side?
- Sideline.
- So he's getting that
hip abductor, which is connected to the IT band,
which goes down and crosses the knee joint right here.
So we are getting the hip and the knee
at the same time on this exercise.
- And then I'll go lie on my stomach.
- Ah, prone, huh?
Keeping the knee straight.
- Yeah.
- And notice how Bob does it.
And he holds for a second or two
and that's critical.
Good control.
That control motion is really critical for strengthening.
- This is the little more difficult one.
- Yeah, you know what I do with that one?
- What do you do?
- I usually take this leg,
- This go like that - Yeah and like that.
and I'm feeling a little more stable.
It does kind of
make your hip go back.
It's not as isolated.
But - Right.
- It seems like it's worth it. - I feel like I'm posing.
- Well, yeah. (Bob laughs)
You could be one of those. We flew on a beach
and you could have a little Speedo on and-
- Okay.
- That'd really make people wanna
- Yeah, leave. - Spew.
- All right, yeah.
Okay, next one
is a really important one.
This is the muscle they have found through research, Brad,
tends to get weak with any knee injury or problems.
- Sure.
- So this is probably the number one,
exercise you should do.
- What muscle are you talking about?
- The quadriceps.
- That's what I was thinking.
- The quad, four muscles.
- If you have an ankle sprain,
the hip abductor gets weak.
- Right.
- They have studies- - Weird thing isn't it?
- Yeah, it's just one of those
things that as therapists,
we just drool over.
(Bob laughs)
- So we should have probably showed this one first
cause this is the most important one.
- Yeah, well. - If you don't have time,
just do this one.
- Sure.
- But you could take two pillows
or just fold a pillow. - Yep.
- And I'm gonna strengthen then this one.
- Want the knee flexed a little bit.
- A little bit.
And I'm just going to push the pillow down into the bed.
- So you're trying to keep this heel on the table.
- Yeah. - Or the floor.
- I am.
And I'm doing an isometric quad.
- Oh, I love this, quads are working.
- Yup. And I would hold again.
You could hold for like 10 seconds
or repeat 10 times. - Yup.
- And this is one you could do
three sets if you'd like to.
You don't have to do it every day.
- This looks
easier than it is.
- Right.
- Even if you're a pretty strong person, you do this,
you're gonna feel those muscles fatigue.
And the idea is that you strengthen those muscles
without irritating those sore bursas.
- Again, what's nice about this is that you can,
everybody can do this one. - Right.
- I mean you can
set it up that,
I mean, you can't fail.
(Bob laughs)
- Right. You could do that one in your bed.
- So there's a hamstring one Brad, you can do too.
You could do this while you're sitting in your chair.
You guys should just put your,
here's the leg
that we're gonna strengthen. - Mhm.
I'm putting my heel into the floor
and I'm pushing.
Into the floor.
- You're pushing? You're pulling?
- I'm, well I'm pulling, your right.
(Bob laughs)
You're right. I'm pulling this way.
- You know,
what I used to do with patients,
but you got to have a good stool
and proper floor is-
- The walking?
- Yeah, the pulling like this.
And it gives you something to do.
And it really works the hamstrings.
- Makes you feel like your working.
- But most people do not have appropriate stool.
- What if an office chair?
- Office chair? That might work. Yeah.
- You can just go around visit people.
(Bob and Brad laughs)
- I'm doing my therapy.
But stay away from the stairs, you know.
- Now this one, I got this from Kelly Starrett.
He wrote "The Supple Leopard".
And he talked about that sometimes these bursas
kind of get stuck down with
adhesions. - Mhm.
- Like he was talking about the
prepatellar,
no, no, not a prepatellar,
the suprapatellar of bursa.
- Above the kneecap.
- Right above the kneecap. And I had trouble with this
and I did massage it. - Yeah. I remember that.
- And it did help.
So I don't know if it was the bursa
or if it was quadricep tendonitis,
but either way,
I took it and
you could do it with your hand.
- Mhm.
- But the massage gun worked really well on this.
I actually,
I'm gonna use the ball attachment here.
And Brad came up with this one.
- Yeah, if you use your fingers, it works,
but your fingers get pretty tired
and sore after a minute or two.
- You want it nice and relaxed.
So you want the-
- Yeah. - Actually supported.
Brad actually recommended that you go across this way
instead of going like this,
which is pretty aggressive.
- Yeah.
- This is, you can ease into it that way.
- Yeah. You get that cross friction aspect
that (inaudible).
- Yeah. And if you hit the bone, it's not
uncomfortable.
- Yeah, it's not banging into it.
It's just going across.
So yeah,
just a variation that...
It's one of those little simple jewels.
or is it a pearl?
- It's a pearl. - Yeah.
- Pearl of wisdom.
- I really never liked that,
it just sounded stupid to me.
No, my instructors at school.
Your pearls. I had no, what the hell?
I don't know what he's talking about?
What you talking about pearls?
It's an idea. It's a concept.
It's a, but not a pearl.
I'm thinking of jewelry, you know.
Anyways. - I had an instructor that
she was from Al or she's from England or what,
but she did a whole lecture
and she kept saying, chuma.
Chuma.
And finally someone at the end of the lecture,
one of my classmates,
I'm sorry, we don't use this term called chuma.
We don't know what you're talking about.
She was saying tumor.
(Bob laughs)
She was saying tumor.
- Really?
- And she was saying chuma.
- I'll be damned, that's interesting.
- Isn't that funny?
- Ha ha, it is to laugh.
(Brad laughs)
- Remember this, Brad, by the way,
this a part of a
series of videos - Oh that's right.
- On knee pain.
So if you want to see the entire series,
go to bobandbrad.com,
go to the program section,
and you can watch that video on bursitis.
How to tell whether or not you have bursitis.
- Right, which would be a good idea if you haven't.
- Yeah.
Otherwise you can watch the ones that pertain to you.
- Right,
and there'll be a whole list of them.
You just go through the titles,
pick out the title.
We'll, you know,
let you know if you should watch that or not
because of your symptoms.
And there's a PDF printout for every video.
Print it out,
push the button, click the button,
print it out.
Did I say that enough?
- Yeah.
(Brad laughs)
Anyways, it gives a preview of the full video.
It gives the exercise- - Review.
- Review!
Preview, preview.
What the hell is wrong with me?
- We're having trouble today.
- It's a family show.
Just cut it out.
You'll figure it out.
- Thanks.
(upbeat music)