- Hi, I'm Bob Schrupp, physical therapist,
- Brad Heineck, physical therapist.
- And together,
we are the most famous physical therapists on the internet.
- In our opinion, of course.
- Brad, we're gonna go back to the godfather
of orthopedic surgery and orthopedics,
and that's James Cyriax.
He's gonna show us today
how to treat hip flexor tendonitis.
- Which is?
- Well, that's a tendonitis,
an inflammation of the tendon of a certain muscle
that most people feel right here.
Especially when they're running.
I imagine you could probably feel it with walking, even.
It's like a pinching, I think.
Pinch, pinch.
You know, every time you bring the leg forward,
'cause the hip flexor does this.
- Right.
- It brings the leg up.
So it's actually a fairly easily treatable thing
if you can get to the right spot.
- Right.
- So the inflammation of the tendon.
The muscle is generally the rectus femoris,
you don't need to know that, but the rectus femoris,
Brad, do you wanna explain what this is?
- Yeah. So the rectus femoris connects,
it's one of your quadricep muscles,
connects from your, down by your knee.
It's a narrow muscle,
it goes right up the center, and it connects up
right up here. - Right up here.
It actually attaches right here and right here.
- Right.
- [Bob] Right? On these two little bumps here.
And it's important to see this spine
because we're gonna be looking for this bump right here
on your own body. - [Brad] Right.
- [Bob] So you wanna make sure, get a visualization
of how this spine looks, see this bump?
Can you see that, Nancy?
That's the ASIS, anterior superior iliac spine.
Does that sound smart, Brad?
- [Brad] Yeah. That's a mouthful.
- [Bob] Yeah, so--
- But that's where that muscle connects,
and that's the tendon.
- Right.
- So that's why it's tendonitis,
inflammation of that tendon.
- Right. - Right in that area.
That's why it hurts there.
- All right.
- Overuse. - Pretty simple.
Brad, why don't you sit on this?
What you're gonna do is try to find a couch
that you can sit on, and you will be at a 90 degree angle.
Pretty much almost the right,
90 degree angle. - Right there.
- What that does is it puts that muscle on slack.
Okay? Now this is the hard part.
You gotta find this bump right here.
You gotta find that bump on your pelvis.
Now, Brad and I are trained to do this,
so we can usually find pretty easy.
Now you got a belt on, which probably you wanna take off.
- Gets in the way, yeah.
- I hope his pants doesn't fall down.
- No, (grunts) I'm trained.
All right. - Did your dad ever take you
(buckle jingling) behind the woodshed, Brad,
- Oh, no. - and give you a few whips
of this? - Aw, no, no, no, no.
I was a good kid, Bob.
- All right, that's hard to believe,
but right here it is. - Yep.
- That's the ASIS.
Once you find that bump,
you're gonna go eight centimeters below it,
which is about three inches, right?
A little over three inches.
So here's the bump, straight down,
straight to the feet, straight to the toes.
You go three inches from that.
And right there, you push down,
and you're gonna take your finger,
and you can put one finger on top of the other,
or you can put two fingers side by side.
Again, I find it. Three inches down.
And you're gonna go across it like this.
You're gonna rub it, really hard.
How's that feel, Brad?
- It's kind of weird feeling.
I mean, I don't have tendonitis, so it's not gonna feel--
- So I'm rubbing across it.
I did it, my son has this.
He's a runner and he felt it right away.
He felt like, yeah, I hit the spot.
So we're gonna rub across like this.
You're not moving skin.
You're getting in very, very deep.
And generally, what you like to feel is
that you're gonna have some tenderness when you do it.
But after a little bit, the tenderness starts
to maybe feel like a numb feeling, or it starts to decrease.
If it keeps increasing,
that means it might be too tender to even do this, at first.
You might just have to throw an ice pack on there.
- Right, right, so-- - To start off with it,
and let it calm down a little bit.
Probably gotta hold off on your running...
- Mhm. - if it's that tender too.
- Right.
- I think if it responds,
you could probably keep running, probably avoid hills,
and probably maybe lower your distance a little bit.
But that's it, cross fibre.
I would do it...
I mean, Cyriax says you could do it for up to 20 minutes.
There's no way you're gonna be able to do it for 20 minutes.
- Yeah, you'll get tendonitis in fingers.
- Yeah. But if you can--
(Brad chuckling) Yeah, exactly.
But if you can at least go for, you know,
2, 3, 4, 5 minutes, you know?
- Right.
- And you can even do it every so often
when you're just sitting
at your desk or whatever, and go across.
Again, I'm pushing very, very hard.
- Yeah. - So...
Other comments about it, Brad?
- No, I was gonna say,
one thing about finding that bump there,
if you have a hard time, you know,
'cause we know where it is, but...
If you're doing it to yourself or someone at home,
just have 'em lay flat,
and it sticks out more. - Yeah, that's good
to start off. Right.
- And then just keep your finger there,
and then put it up on slack, and then do your three inches.
- [Bob] You have a little more insulation here.
It's a little hard to find a bump, let me tell ya.
- You'll get through it.
- You'll get through it, yep.
All right. - All right.
Yeah.
(buckle jingling) You be careful with that.
- Packer fan.
Take care.