- Bob and Brad the two most famous
physical therapists on the internet.
- Hi folks. I'm Bob Schrupp physical therapist
- And I'm Brad Heineck physical therapist.
- And together we are the most famous
physical therapists on the internet.
Wake up, Brad. Come on, let's go.
- In our opinion of course,
Bob look, rough night last night.
- All right, today, Brad, we're gonna talk,
I don't wanna hear about it.
Today, we're gonna talk about 10 exercises
and tips for knee pain relief by physical therapist here.
- You bet
- So,
- And, but the knee pain we're talking about
it could vary from arthritic pain that, you know
they could have tendonitis.
So this is gonna cover quite a range.
- A big variety of yeah.
Could be in the joint itself.
So we don't know what's going on with your knee.
Maybe you do.
If you do know, then maybe you wanna go
to one of our videos with that specific problem.
- Sure.
- But if you just having general knee pain
try some of these.
- Right.
- See if it helps.
- And these are, you know
if they make it feel good right away, you know it's right.
If they irritate or give any sharp pain
I want you to stop them and and forget about that exercise.
- Good advice, Brad.
Okay. The first one, Brad, is actually for,
it could be for knee arthritis,
or even if you have a little bit
of a meniscus problem, this sometimes works.
Especially if you can't bend the knee, like you should.
- Right.
- You know, it doesn't wanna bend all the way.
- Feels like it, maybe it locks up.
- Yep.
- Yep. So what you're gonna do,
I'm gonna actually do it on this leg here.
And Brad, what I'm gonna do
I'm gonna go ahead and flip this up right away, Brad.
- Yeah. Look at that leg.
- So what I'm gonna do is
I'm gonna turn the lower leg inward.
- Sure, rotate that tibia up.
- Yeah. So I'm grabbing on the fibula here,
which you don't know what that is probably,
but I'm gonna turn and while I'm turning
I'm gonna actually bend the knee.
- There you go.
- Okay. And you can do this 10 times.
- I'm turning the leg the entire time.
- Okay.
- I'm not
- Twisting
- I'm rotating it the whole time as I go forward,
and as I go back. As I go forward,
and you try to go further and further, Brad.
- Right.
- Eventually you try to see if you can make it go further.
- And you'll do this if you can do it and it feels better.
- Right.
- It's like each time you do it.
Oh, it feels better each time.
Then the pain is less.
- Exactly. We don't want increased pain,
And like you said, Brad,
like Brad alluded to the fact that
the good sign is if it actually feels a little
bit better after you're doing it for a while.
- Yep.
- I just had a nurse do this
and it worked out really well for her.
- Oh, good.
- Again, something was going on in her joint
and it just seemed like she got, you know,
more and more motion
- Sure
- and less and less pain.
- Yep.
- All right, the next one.
This is for what we'd call a Patello-femoral problem,
underneath the kneecap itself.
- Sure.
- It's giving you trouble.
- Yep.
- And this is just a simple test you can do.
Let's say you go up some stairs, Brad.
- Watch your head, Bob.
- Yeah.
And you come down again,
but every time you go upstairs, the knee hurts.
- Right.
- All right, this is a simple test.
I think you've done this one, right Brad? Or not.
- Sure, I think.
And, and usually oftentimes would you say
it hurts more going down the steps than up?
- Quite often it does and there's a
biomechanical reason for that.
- Yeah.
- So we're wondering whether or not
you have some pain underneath the kneecap.
Now, you know, that pain can be anywhere
around the kneecap itself.
It's it's kind of a weird,
gives a weird sensation to people.
- Yeah.
- So what you're gonna do, the simple test here.
I already put some tape down.
Yeah. You want to be fairly close on this one, Lonnie.
I might actually from this angle, maybe.
So I've already put some underlying tape on.
What do they call that, underlayment tape?
This tape is, you know, will not irritate my skin.
- Right.
- It's hyper-allergenic.
So what I'm trying to do here. Brad.
is I'm trying to take the kneecap
and I'm moving it towards the middle
- Beside when you put the tape on you're gonna pull
Start here and pull it this direction.
- Yep.
- So the first you can do is even stretch
the kneecap a little bit, Brad.
Take, just push on the edge of it like this,
and the idea is sometimes that the kneecap is
riding too far out to the side.
- Right. There's a groove it's supposed to be in
when it's working properly and it's not in the groove,
it's mechanical irritation.
- Yeah, so we're pushing it more towards the middle.
I don't know, I suppose we could show it
on this knee too. But eventually I'm going to
go ahead and pull the tape over and see if it helps.
Now I know there's probably therapists
out there that are screaming that are purists about this.
Cause there's, you know, this could be tilted
or this could be
- Right
- You know, one way or the other.
But honestly, a lot of times if you just take the tape
and you put it on the edge of the kneecap
on the outer edge and you push it over, Brad.
- Yep.
- And then pull it down and tape it.
A lot of times it'll pull it over enough to
- Right.
- To see if it helps.
- And you'll know, you'll get some wrinkles in the skin.
You're, pulling that far, and I've done this
with people where they have them go up and down stairs.
This is a good test.
Say your pain's at a seven or an eight
going up and down the steps.
Tape it and then go up and down the same steps.
And they say, oh wow does that make a difference.
- Yeah. And I usually double tape it, Brad, by the way.
- Sure.
I'll usually do it again.
I'll push it over again and then pull it down like that.
- Yep.
- And then, yeah.
Then you just go ahead and I go back up the steps,
you know, and I step back up and I go,
oh, you know what? It didn't hurt as much that time.
You know, I'll go up five, six steps.
- Sure.
- We don't have five, six steps here.
So this is always the part that's fun, isn't it, Brad?
- Yeah.
- Owie.
- Yeah.
- So that's the second exercises tip you can try.
All right, the next one, Brad, is
- But, but Bob there's people that
haven't seen us before. I think...
- Oh yeah, hi. Welcome to our channel. And by the way,
if you haven't been to us, our channel before,
we ask you that you please subscribe.
- Right, and we're gonna have videos like this
every day, right Bob?
- Yep, we upload every day.
Videos on how to stay healthy, fit, pain free.
And the subscribe button is somewhere over here,
depending on who you are, apparently.
All right, The next one, Brad is,
this is also quite often with arthritis,
but it might be even with some people
if your knee is not fully extending, straightening
- you're right.
- It's putting extra stress on your knee
throughout the day. So,
- Yeah, I'll show them from this view.
- Yeah. That'd be good, Brad.
- Yep.
I don't know if they want to see this leg, but,
so you go like this, and this is fully straight.
But let's say it only goes about that far,
and it's lacking about 10 degrees or so.
- Yeah, one way to test, unless your both knees are bad.
Sometimes you can put both legs up there.
- Right.
- You see one is higher than the other
- Yeah.
- and that's a sign to you that
that one's not straightening out all the way.
- Sure.
- It really behooves you.
Yeah, using that word there.
To actually get that, to straighten all the way.
- Right.
- Because it does spread the force out in the joint
- Yep.
- I've seen people get relief from this, Brad.
So there's two ways you can stretch it out.
One is a sustained stretch where
you just let it stretch, you know, for
- Just let gravity
- Yeah. Let gravity do it.
You can put a weight on there. If you want.
- Sure.
- You can put something to give a little extra stretch.
- Sure.
And the second one is what we call
pressure on pressure off.
So you're gonna go ahead and you can grab, you know,
top and below like this and you know,
you can do it yourself.
- Yeah. It's usually, people are more relaxed
if they do it to themselves.
- Right.
- So you're just gonna push down, pressure on,
and just like Bob was saying,
you see pressure on, pressure off.
Pressure on, usually about 10 times in a row
- Yeah.
- And then come back later on.
- The first day I would only do it one set
because I, I still remember this.
I did it to somebody that, you know,
- Yeah.
- the first time and it was really working
and we did like four sets.
He was so sore the next day, I mean.
- Yeah.
- And then it ended up working, but he almost
didn't want to come back to therapy
because we got him so sore.
- So yeah, start gradually.
- Yep, and again, like he said,
pressure on tells you how long you're supposed to push.
- Yeah.
- Pressure on, pressure off.
So that gives you indicator of how long.
- And, and typically by the 10th one
it goes down farther and it feels better overall.
If it gets worse and worse and worse, just stop.
- Now, this may seem a little counterintuitive, Brad,
because we just told you to get your knees straight,
but when you're standing, I don't want your knees straight.
- Sure.
- Because if you stand,
all right Lonnie's gonna love me,
Do you wanna stand, Brad?
- Yeah. I want to stand.
- Lonnie doesn't have to get up as high then.
- When you stand, don't lock your knees, you know.
Keep them slightly bent.
What helps quite often is if you stagger your stance.
- Yep.
- So one foot in front of the other.
Just slightly, Brad, you know.
- Sure.
- So it looks a little normal.
- Yep.
- But if you stand all day and,
like I had a worker that he worked at Subway,
and he stood all day, and he would lock his knees
and they were stretching out further and further.
All we did with him, Brad, is we had him stop that.
- Sure.
- Took away his pain. That's all we did.
- Would you say usually these are people that kind
of have hyper-extended knees?
- Yes.
- Naturally?
- Yep. And a lot of them become hyper-extended,
the reason I know it, Brad, because my knees
do not hyper-extend now, but they were
beginning to hyper-extend.
- Oh.
- I mean,
- Sure.
- Just from doing this, they seemed like
they always tightened up.
- Yep.
- So, all right.
The next thing is what we call is cross fiber for pain.
This is for pain above or below the knee.
So let's say you're getting pain right below here.
- Yep.
- The tendon there, you know, wanna make sure
that you don't have Osgood-Schlatter,
or anything like that if you're a younger kid.
But if you have patellar tendinitis,
but you can also have a quadriceps tendonitis,
which is on, on top of the knee,
where the muscles come in.
- I've had this, so I'm very familiar with it.
- Sure. Yep.
- So he's saying the knee, and it means the kneecap.
- Yeah.
- So you look at the kneecap and there's
the tendon right below it, or the tendon
where it connects. Then tendon above it
is one of those really wide tendons.
It's not like a bicep tendon.
- Glad you clarified that, Brad,
because I don't think people were clear on that.
I mean seriously.
- Sure.
- Yeah. Good things.
So on either side, what you can do
is what we call cross fiber massage.
- Yeah.
- Cross fiber friction massage.
- This is by far, I think, one of the best
techniques that people can do at home and have success.
- Right.
- You know?
- Yep. They can do it themselves.
- Yep.
- Yep. Should we show them how to do it?
- Sure.
- On the cross you're gonna take, you know, one finger
put it over on the top of the other, or two side by side
and you're just gonna rub very deeply, very,
you know, a lot of pressure.
- Right, aggressively.
- Going across the tendon.
Again, what you're looking for here, Brad,
quite often is that the pain after a minute or two,
is going to start calming down.
- Right.
- If it just keeps getting worse and worse,
then you maybe need to ice it for a while.
- Give it, it needs more time to rest.
- So you're going to go ahead and rub that
and you're going to go, you know, you can go up to like,
four or five minutes, and something like this,
you could do it daily even. Four times a week, maybe.
- Yeah. Your fingers wear out before too long.
- Yeah.
- The same with this one, you know, you can do the rubbing.
The same thing you're looking for is that you're looking
for things to calm down after a little bit.
- And on the one above you can actually use both fingers
like this and it's a broad, broad area sometimes.
It all depends on how it feels.
- Yeah. All right, next one, Brad,
is eccentric strengthening with the ball.
- Ah.
- You want to give me the ball back there?
- Yeah.
- I'm going to go to the wall here, Lonnie.
I'm gonna move this out of the way.
- This is the ball on the wall exercise.
- That's right.
So this is the one I used, actually,
for my quadriceps tendonitis.
- Sure.
- So I'm going down, and that's where
the stress is on, Brad.
- Yep.
- And then on the way up, I would lean to the
opposite side and put the pressure on to come up.
- So this one's doing the work coming up,
- Yep.
- The involved one, the painful one,
- Is doing the work on the way down.
So it's eccentric. Its' strengthening
while the muscle is lengthening.
- Right, yep.
- So then I'd lean over and come up like this.
Now, if they're both that way, which I had both that way.
- Yeah, what'd you do?
- There's not much you can do. (laughter)
I mean, I was just going and working it a little slower
on the way down and I'd come up a little faster.
- One thing I think you could do is, you know
put a cane on each side.
- Yes you could. And you could push up.
- Or chairs so you can use your arms to assist.
- Yep that's a very good idea, Brad.
I could push up like this and then work it on the way down.
- Yep, yep, yep.
- But I did these and it took a while.
It does take a while for this to give relief,
but it does work.
- This isn't one of those quick two or three days.
- All right, the last two, Brad, are
you know, it's very good to keep the knee moving
almost with most problems.
If you do bicycle or elliptical,
- Sure.
- It could be very good.
- Yep.
- And also, isometric exercises are really good.
- Sure.
- You know, just laying down and
- Yeah. I was just, do you have any that
you particularly use?
- I think just the, you know, you can do
lots and lots of these, you know.
Just holding it up like these.
- Yeah, a simple on just holding it.
- Yeah. Yeah.
- Another one, I don't use a lot of these,
and I probably should more in my practice,
put your heel down. You could put something
like your fist under the knee,
and if you don't have someone to put their fist under,
so he's squishing my knee while his heel back here
is staying close to the, or right on the table.
You can get a ball, probably a little bit bigger one
than this would work best, but that would work too.
- Squeeze. Yep.
- Squish.
- A ball, towel, anything like that.
- Yep.
- All right.
- Wow.
- And with that, we can fix just about anything.
- Except for that
- Broken heart.
- But we're working on it. Thanks a lot.