♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Are we on?
- Yeah. - All right.
- Hi folks I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We're the most famous physical therapists on the internet.
- In our opinion of course.
- So team, this is about weak hip spread.
- Yeah, and painful.
You get that combination, are very common.
- Maybe even some tightness.
- Right. - Sure.
- Very good, it all works together.
- We'll start with the supine position,
or do you want to talk about it first?
- Well, let's talk about it. - Okay.
- You know, we wanna talk and babble a little bit.
- Sure.
- Now we're talking about, we kept some pain.
You may have some arthritic problems.
You may be recovering from an illness
where you've been either bedridden
or just not able to move around like you normally do.
- Or it could be winter and you can't get outdoors.
- Exactly.
- And you start getting weak.
- There you go.
So, and the body declines very quickly.
- Fast. Yeah, unfortunately.
- It is not so easy to regain. - Right.
- So, actually you know, there is a far friend of mine-
- Yeah, right.
- She's in the same situation. - Sure.
- She came, had some problems, and-
- Weakness? - Weakness.
- And maybe a little bit hip tightness.
- Yeah. Yeah.
And having problems getting up and down stairs.
- Sure. - It's no good.
It's a bad situation. - All right.
- But you can get through it.
- Brad to the rescue.
- Ah, well let's see what happens, Bob.
We've been discussing this. - Yup.
- And coming up with the ideal program.
So the first thing,
and you can do this while in bed.
Jump in bed,
or before you get out of bed possibly,
hip flexors to get the foot up to your step
or in and out of the car, is this motion.
And it's nice to start it, while you're lying on your back.
And you gotta go up like this.
Oh, oh. Don't worry about it, Bob.
It's just a-
- I was gonna say you can use a sheet or strap.
- Yeah. And that sheet thing is just weird for me.
But anything, a belt or something.
So yeah, if you cannot do this-
- Right, if it's that weak-
- Yup. Then you're gonna help out with a belt-
- Or strap. - Or strap.
- I suppose. You know,
if you wanna take the sheet off your bed and roll it up.
(Brad laughing)
- You can do it.
- And then you'll progress yourself from here.
You know, if you can't grab your hands or whatever,
ideally we wanna get to the point
where this is an easy 10 repetitions.
If that's too easy, then go for the heels,
not dragging on the bed.
And work on that 10 repetitions.
- The idea is that
you're really not fighting gravity too much.
- Right.
- You're kind of gravity eliminated in this position.
- So we're doing two things.
We're strengthening the hip,
and we're starting to loosen it up a little bit for the day.
And then while we're here,
we might as well do some stretching,
and get that joint loosened up more.
- Sure.
- It's gonna help that pain.
And we're gonna gently stretch.
If you go have some sharp pain with this, it's too much.
Just a nice stretch.
Gently, maybe five times pull.
And I like to pull the knee across to the opposite shoulder,
across the body a little bit.
Get some different fibers of that hip joint muscles-
- Yup.
- And then-
- And they'll think you're fortunate, right?
- Or, good point, Bob.
Take this ankle and put it across your opposite
far right above the knee, and just allow it to go like this.
Now this may be easy for some people
and other people may be an eye-opener-
- Yeah.
- And be uncomfortable. So be gentle.
- They're surprised how tight it is.
- Yup.
And if this is okay,
the next step is to bring the other leg up.
And then I'm gent-
- Working a little hard.
- Yup, gently pushing. See my fingertip.
I'm not pushing with a lot of stress.
And just stress gently, strange that out.
And then you can take the other leg if you can get that
and we're gonna push that over.
- Ah, I was gonna say it. - What's that?
- Well, if you're gonna cross it over,
you can probably start with this like down,
and then cross it over.
- I wanted to do the internal routines.
- Oh, gotcha. I gotcha.
- Yeah, which I'm kinda jumping ahead a little bit.
You can do that.
'Cause this like may be weak,
and this may be hard with the opposite leg.
But if you can do this
and that will help stretch a little bit more of that hip.
Okay. Bob, how we doing?
- We're doing great, Brad.
- We're number two.
- All right.
- So that's pretty much-
- Now you are in a seated position.
- Yup. Getting out of bed,
you're not gonna wanna do this off this edge of the bed.
It's too soft. - Right.
- Get in a firm chair.
- Firm chair, yes. - Hmm.
Armrests, like we have here.
A kitchen chair with armrests or something like that.
A recliner or a rock or anything like that.
We're gonna get on the chair.
If the chair is really low to the ground
and your knees like, like this is okay,
but you're better off being a little bit higher chair.
You can put a pillow or two.
I've got a cushion I'm gonna put here.
Elevates you up a little higher.
And then we're gonna work on that marching.
- Now your fighting gravity. - Yes.
- So, it's gonna be hard.
- Yup, this is a step up from there.
- Yes it is.
- Up like this, and down.
You may wanna-
- Give a little assistance if it's troublesome.
- All right.
If you find that you cannot do this very well,
we're gonna do some eccentric strengthening.
- Sure.
- So this is a really nice way to work muscles
and get them stronger.
Help the leg up,
get the knee up here,
and then let it down slow.
That's the eccentric aspect. - Right.
- Lift up, that's one.
Let it down, slow it across.
You can do both legs.
Five to 10 of these, then go again.
When you can do 10 of these, it becomes easy.
Then, we're gonna do-
- Try another way- - Yeah.
And even with that, up good control, and down.
We're not gonna march these fast.
You know, if you want to go alternate,
when you can do 'em both independently, that's-
- It may take you a while to get to this point.
- Yup. - I mean.
- And if this feels good,
you know, if you can go up in here,
you can add a little stretch up into here
to get that joint loosened up a little bit.
Noodle it around a little bit. - Right.
- That can help loosen that joint up
and get that pain level down.
They're eight, how's that Bob?
- I think you're doing great, Brad.
- And now we've gotta work and sit to stand.
- Yes.
- Seeing how we're here, we might as well do that.
If you need to have to push off from here,
to stand up, nice and tall, and back down.
This is really gonna be helpful
for getting up and down stairs.
- Yup, and you're gonna have to lean forward.
That will get you through this.
- Yes. Yeah.
I can't tell you how many people,
and I know Bob agrees- - Right.
- And they say, get your nose over your toes.
- Yup.
- And that gives you the leverage initially, and up.
- To move up. - Yup.
- And back down. 10 of these.
And again, once you get strong enough,
you can put hands here.
That's the next step.
If you can do 10 like that easy,
cross like this a little bit harder.
And I think the hardest one is the hallelujah.
Up like this.
And this is a nice balance exercise.
You don't have to get to this. - No, no.
- I would not worry about that.
- Exactly. - Or if you feel like you,
wanna get to the advanced stage.
- All right, do you wanna work on a stair tile, Brad?
- Yes. Now we're getting to.
I mean, there may be some people
that can skip all of that part.
- Right, right.
- And they wanna get to this.
- If you're stronger enough. - Yup.
So here's our model of our steps.
Mike doesn't like 'em very much.
The color isn't very pretty. But they do the job.
- You really wanna have steps with a rail in there.
- Yup. So, if this is-
- It really, is gonna really help.
- So if this is your stairwell,
we got two steps and make all the way up.
If, and this-
- That would be a rail. - Yup, so if a rail,
I've to get a rail on both sides, it's even better yet.
Strictly for balance and holding on.
So I'm there.
And then what we're gonna start off is just, you know,
can you get your foot up to the first step?
You know, with good control.
And we're practicing here.
We're gonna do 10 on this side.
If that's too easy, and you can do 10 on each leg,
go to the next step.
And we're just touching that step, good control.
This also gets you coordinated, and practice
or have some experience
so that when you do go up and down the steps
with that weak leg,
you're going to a specific point.
Because if you don't hit it there and you do this,
'cause your toe's omitted,
then we got a fall.
- And again if you're not ready for this,
you go back to the chair- - Yup.
- And work on those.
- Exactly.
Now you may be able to do this just fine.
- Right.
- So, but this is a part where we need the strength in here
because you can't get up with that weak hip.
Up to here, up touch the other foot,
and then back down, one repetition.
And just do 10 of those.
And you may find that one leg is stronger than the other.
- Right, then I'll do both sides.
- Yup, do both sides.
And if you got the weak one, that's a little more difficult,
use that rail.
- Well, you can even use two rails if there are two.
- Yup, exactly.
There, an imaginary rail. - Yeah.
- If you don't, and have a cane or a stick, you can-
- Sure.
- Use a rail here.
It's amazing the difference- - Right.
- That'll make.
And work that weak one
so that you can get up, get back down slow.
This is critical. This is the eccentric part.
Coming back down, don't just drop down.
Drop down slowly. That's-
- And under control. - Exactly.
That'll make a big difference.
That's what people forget often times
is that eccentric strengthening aspect.
And then you can go to the next step up.
Now, if you're doing this,
you're probably pretty advanced.
- Yup, I was gonna say it.
- And you're probably going up and down steps.
Okay, so I'm not gonna advocate this.
- Yeah. - Too (laughing), too much.
- Yeah. Right. Exactly.
- So, I get a little tired of that, Bob.
(Bob chuckling)
It's more than you think.
- Well, when you're working legs like that,
it takes it out of you.
- Right.
Oh, I did wanna mention one more thing.
Just as you're standing,
we may wanna just do some high marching.
- Sure.
- And get that knee up as high as you can.
And just back and forth.
Range of motion in the hips.
Getting some strengthening.
- Yeah you strengthen the hip at a higher level.
- Yeah, I mean, so. - Yup.
So it's particularly-
- Which we normally don't do.
- Well you're getting into a car
or sometimes we're trapped.
- Right, right.
- We gotta get that leg up there.
- Onto a horse.
- Onto a horse. (Bob chuckling)
Well, Don's got a donkey.
I don't know if she's gonna ride the donkey on the farm.
But yeah.
There's always issues that come up.
- Well, donkey riding.
(Brad and Bob chuckling)
- All right, very good.
Thank you for watching, and good luck.
- Peace.
(bright upbeat music)