♪ Bob and Brad ♪
♪ The two most famous physical therapists on the Internet. ♪
- Hi. Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are rolling.
Together, (Brad laughs)
we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Okay, Brad, today, we're gonna talk about
top three signs your hip pain is coming from arthritis.
And by the way, if it is in our next video,
we're gonna show you what to do about it.
- Sure. - Some of the stretches you
can do. - Mhm.
- But, Brad, you wanna show first off
where the hip is? - Right.
- A lot of people think it's
somewhere else. - Right.
- Don't they?
- Some people think
that the hip is part of their pelvis up here.
They point up here and it's actually lower.
And it's right down here,
which on me is is way down by where the pocket is.
And it's a really deep socket and a big ball,
and into your femur.
And it's got good stability Bob.
- Right. - So, it's not
like the shoulder joint.
It really is a- - Doesn't pop out as easy.
- Exactly.
- All right. First thing.
The first sign you're gonna look at,
whether or not your hip pain is actually arthritis
and not another, you know, all the hundreds
of other things it could be, (Brad laughs)
is the location of the pain.
Now I read, Brad, is that the most common location
for hip pain is actually in the groin.
- Mhm.
- But I have not found that myself specifically.
I found it more that it is on the side here. Lower.
- Yeah. - Me personally.
- Right? - Just people
out of (indistinct) - And clinically,
out of personal experience, you know,
I don't know Bob,
'Cause you know, when you're looking at hip pain,
there's so many other reasons
that- - Right.
- I'm unwilling to say it's mostly here
and mostly there - Yeah.
- for arthritis. - I less commonly is it
in the back? - Mhm.
- Especially - Yeah.
- if you have back pain and butt pain.
I'm gonna be looking that it might be more back.
- Sure, a referral. - Um,
but the other thing you gotta keep in mind,
I had a friend that this happened to, he actually was having
a lot of knee pain, - Mhm.
- and it was from his hip.
- Yeah.
- And he ended up having a hip replacement
and his knee pain went away.
- Yep. Yeah. - So that's got,
you know, that gets a little tricky.
The one that works out a little better,
I think, is you can look
at range of motion, Brad. - Sure.
- 'Cause that's
- That's what we can do at home.
- Yep. So Brad, why don't you lay down flat first.
- All right.
- Okay. (Brad exhales)
And straighten your legs out.
One of the most common losses of motion
with a hip arthritis is internal rotation.
And that's when your feet turn in like this.
So what you can do is you can lay down,
and you can turn the one foot in.
You can turn the other foot in.
And compare the two.
So you're gonna turn 'em both in Brad.
Turn that one in too.
And see, does one go less than the other?
- So, I'd say right now,
this one goes farther
than that one. - Right?
So if this is- You have trouble
with that hip, by the way?
- Actually, not yet.
- (laughs) Okay.
- This could be a sign,
or it could be that's the way I've been all my life.
I don't know.
- Right. It could be.
But the loss of internal rotation is a big sign of that.
- So if it was a problem,
you might see this and this one won't go
in any more. - You can't turn it at all.
- Right. - Yeah.
The other way to measure,
and this is a little more difficult,
like if I'm bringing his leg up like this,
and the leg goes like this.
The foot starts drifting over here.
That means it can't turn this way very easy.
That's often a lack of internal rotation too.
So it goes up like this.
You can't bring it up straight like this.
It just won't.
It won't go that way.
Let's try this one on you Brad.
No, you're fine.
- I'm fine.
- Yeah.
I think, so, just to clarify, Bob was saying,
it's just natural, and it's easier,
and less painful to do this. - Yeah.
Right. And if you bring it up straight like this,
it tight, or it won't go that way at all.
- Right.
- So, alright.
Let's turn the mat, Brad.
We had a big argument of whether or not we should do this
off film or not.
I said we're running live, baby.
- Yeah.
We spent 20 minutes discussing (Bob laughs)
that issue.
- Okay, another test.
This is a very easy one to do
if you're lacking external rotation
on a leg. - So,
let's talk real.
What is external rotation? - That's turning the hip out
this way. - Okay.
- So if you take your hand
and you have trouble putting your ankle
up on your knee like this,
doing like you're sitting cross-legged.
And you put this one up like this.
And that one's fine
but you put this one up.
And it goes like this,
or you can't even get it up. - Yeah. Right.
- That means that you're lacking external rotation.
And that can be a sign of arthritis
in your hip. - Right.
And like I said, it could be.
There are a lot of other things that could cause that,
but this is where gets a
little tricky. - You're starting
to narrow it down,
I think. - Right.
Mhm. - So,
why don't you lay down flat Brad.
And- - I like that job, Bob.
I'm good at laying down.
- You know, another one is just plain old lacking flexion.
If this hip is coming up like this,
and you can't go very far.
And this one goes all the way up like this.
You know, again, it's a sign that something is happening
in the joint, and it's not allowing the motion
at all. - Sure. Yep.
- The last direction is whether
or not the hip actually goes back like this at all.
And the way you're gonna test it out,
we're testing this hip here that goes off.
And I'll make sure you don't fall off the bed here
when you do this one. - Oh, yeah, lets.
- So when I bring this leg up now,
if this one is tight,
this'll actually start to lift up along with it.
And you might see a little bit of that anyway,
'cause you see it on Brad don't you?
Or you are you faking it?
- I'm faking it just to- - Oh, you are.
- show this will be normal for me or for a lot of people,
but if it's all tight from arthritis,
it's gonna lead up - Yeah.
It's gonna be up like that.
- And, of course,
we didn't talk about the very common thing
about arthritis in a hip,
is weight bearing activity is almost always painful.
- Right? Exactly.
If you're standing on the leg,
it's actually worse than when you're sitting.
- Right.
- So going out to the side too,
by the way, - Sure.
- can be restricted. - abduction.
- All right.
Two tests we can do. - Two. Okay.
These are a little more involved,
but I mean if you have, you know,
a spouse or somebody, or a friend that you want
to go ahead and test it a little bit,
you can do two tests.
Go ahead and lay down flat Brad.
This is called Stinchfield's Test.
I'm sure it must have been named
after a doctor. - Sure.
- We gotta get something named
after us Brad. - Right. Exactly.
- I dunno how we're gonna do that.
All you do is,
you're gonna have the person lift up like this.
About 30 degrees and you're gonna push on it.
(Brad moans)
And if he has pain up in the hip or in the groin,
that's more likely hip.
If it's going in the back,
or in the SI, sacroiliac,
then it may be more from there, from the back.
So very simple.
Bring it up, give a little resistance.
- Ow.
- And it hurts right there.
Most likely hip.
The other one Brad and I do is we just take it up like this.
Bend the knee, and we push down through the knee like this.
And we move the hip
around like this - Ow. Oh.
and we call it, we're grinding the hip.
- Yeah.
- So it's real simple to do. Just push down.
And I often feel how smooth it is too Brad.
- Yeah.
- Brad, I think your hip is fine.
- I thank you Bob.
I have a good clear diagnosis of hip.
- So again, if you're finding out
that you're having some of these are positive,
go ahead and watch our next video.
And we'll give you some ideas on how to stretch these.
- Excellent Bob.