- All right. You ready?
(Brad sniggers)
Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together, we are the most famous physical therapists
on the internet.
And we're joined today again, Brad.
Oh, you forgot your last line.
- Well, in our opinion,
of course Bob. - In your opinion,
of course, yeah.
Today we're joined by "Bone"apart
or Bonehead as Brad calls him now.
And we're gonna talk about
why does your hip pop, snap, crack, make those noises?
- Right.
- Snap, crackle, pop, just like the cereal, right?
- Sure.
- So, we're gonna start off with why it does that
and then we're gonna show you some ways to stop it,
especially the most common thing that it normally is.
- Sure.
- And we're gonna go talk about
what is least likely causing it.
And the first one is what we call,
we'll go from least likely to most likely.
- Sure.
- The least likely is called femoral impingement,
femoroacetabular impingement.
- Sure.
- FAI. - That's a mouthful, Bob.
- That's a mouthful.
- Let's look at this. - Yeah.
- Here we got the full hip and then we just took off
the femur and the ball,
and now we're gonna look at the
socket. - Socket, yeah.
Basically, you have a ball and a socket.
Here you have the hip with the ball
and here you have the socket on the pelvis.
With femoroacetabular syndrome, really, impingement...
- Yeah.
- I'm really having my
mouthful problems here. - We need a speech therapist.
- Yeah.
With that, generally what's happened
is one of these bones is misshapen.
Either, the socket is misshapen a little bit
or the ball's misshapen.
So it doesn't fit real smooth
and doesn't run real smooth.
And because of that, eventually,
especially if you're an athlete,
it starts to give you trouble.
It starts to pinch on the labrum
or it just starts to get inflamed.
So there's not much you can do about it.
- Right.
And in your hip you don't have a screw
sticking out like that.
That's a good point, Brad.
So, what was that noise?
Oh, we're okay.
All right.
So that one's least likely.
If you do have it,
surgery is about the only thing
that's gonna take care of it.
The second thing that is,
probably most likely is if you're old,
is if you have arthritis in there, Brad.
- Right. Likely over 60
- Right.
And there's a little covering on this bone here,
that hyaline cartilage that can start to wear down
and things just aren't as smooth as they were.
- Yeah. So it's (makes grinding sound)
making that Rice Krispie crackle, crackle, yep.
- Another less likely thing
is that there's a little ring of tissue here
called the labrum that helps hold the ball in.
And sometimes that gets torn,
and it would probably be the result of an injury
or some type of -
- Trauma. - trauma, yeah, so.
The most likely thing that you're having
is what we call snapping syndrome or dancer's hip.
And in that case,
Brad, do you have the ligament by the way?
- Yes, I do.
- Oh, good. I didn't see it on you, so.
In that case, one of the ligaments,
and muscles become narrow up and they become ligaments
and then they attach to bone,
one of the ligaments...
- Tendons, Bob
- Ligaments.
- Muscles become tendons.
- Oh, you're right. Muscles become tendons.
I'm having a great day here today.
(Brad laughs)
The tendon starts to snap over the bone.
So that's what, one part of the bone.
- Let's look at that.
Here's just a model of it.
- I'll hold this.
- The greater trochanter.
This is part of the hip,
this big bony part right here, this knob.
And there's a lot of tendon connected to there.
And this is just an example.
So, move the hip
back and forth, Bob. - Yeah.
- So when it goes back,
it may just snap over the top
of that. - Over the greater trochanter.
- Yep.
And that's just a model.
that's not exactly what's going on in there.
- Generally, what happens, Brad,
when you start it in the hip in the bent position -
- Yeah. - and you bring it down.
That's when it snaps.
So if your hip is up
and then you straighten it and it snaps,
and it's just irritating.
It can be even some pain with it.
- Sure. Yep.
- So, what we're gonna do is we're gonna cut away
and we're gonna show you the three stretches you can do.
And also, what you can do as far as foam rolling for that.
- Foam rolling? - Yeah.
- Hold on for that. - But real quickly
before we do that though, Brad,
one thing that quite often is found,
is that if a person has one leg longer than the other,
that side they often have
the snapping hip syndrome on there.
So, you actually may wanna correct that
by putting a lift in the opposite side.
- Right.
- So, that's something to keep in mind.
- And we have a video on...
- We have a video on that.
I'll link that up right here so you can take a look at that
if you wanna figure out whether or not
you have one leg
longer than the other. - Right.
- And if it is longer on that side,
on the side that you're having the snapping,
then again you may wanna put something in the left shoe
to help even you out.
- Right. Yeah. - So.
- All right, we'll cut away and we'll do the exercises.
Okay, the first stretch we're gonna be doing
is of the hip flexors and that's real simple.
I just usually throw a pillow on the floor, Brad.
And I'm gonna go ahead and stretch this muscle right here.
I'm keeping good posture.
And I'm gonna go ahead and lean forward like this.
And that really stretches that hip flexor.
- Yeah.
The good posture,
I tell people think about there's a rope right here,
pulling on your belt.
- Yep.
- And this is a really,
if you got this much flexibility
you're doing pretty good.
- And I stretch it every morning so that...
- Sure.
- And you can even it out by doing the other side too.
- Right.
- Good. What, 30 seconds to a minute?
- Yep.
- You can go longer if you want.
- Yeah. That's a long time on it's own.
- Yeah, okay.
So then we're gonna jump into the piriformis muscle.
So I'm stretching this side.
And all I'm gonna do is bring my knee up
and to the opposite shoulder.
- Okay.
- And that stretches that piriformis muscle.
That's a little tight, you know that.
- And you're gonna feel it right in there.
- Yeah, I do feel it right there.
- You bet. It's a good stretch.
- I don't usually stretch that one.
so maybe I should start. - Wow, Bob.
Stretch. Stretch, Bob.
- All right.
Then we're gonna stretch the IT band,
that's the one that often is the culprit
in this syndrome.
- Sure.
- I'm gonna cross over my leg.
Cross the ankle over the knee, okay?
And then I'm gonna actually pull this one up.
And believe it or not,
that's stretching this IT band right now.
- I call it the figure four stretch.
There are some other IT band stretches.
- Yeah, There's a lot of 'em out there.
This is the one I like.
- If we don't have a video on that,
we should make one, Bob.
- Yeah. - Just for IT band.
- I know we've done it.
- Yeah.
- So it's somewhere.
- All right. - Archives.
All right. Brad's gonna show the foam roller now.
How you can go ahead and use that
- Six-inch foam roller.
You only need one about 18 inches long.
You don't need the big long one.
And we're gonna work the same three muscles.
Hip flexor, that's the one where your put
your hands in your pocket,
it's right under your palm there.
Best to do it on a carpeted floor.
You can even use a hardwood floor, would be okay.
And I'm gonna do the right side,
so I'm gonna lean a little bit to the right.
- [Bob] And remember to avoid the furniture there.
- Yeah.
- [Bob] Or the package, whatever you wanna call it.
- Yeah. (he chuckles)
Yep. We all take care of that business, Bob.
There we go.
Yeah, it feels good too.
- Yeah, if you don't have a foam roller,
we would highly suggest you get one.
- Right.
- I mean, these are fantastic, they're...
- Six-inch diameter, usually is best.
They have different density.
Some are soft. I would get the firmer one.
It depends on how sensitive you are.
But if you're pretty active,
usually the firmer one is better.
- [Bob] And different contours they have now too.
- Yeah.
- [Bob] Some of them have like...
- Now, I'm doing that piriformis.
It's like you're sitting on it like this,
but I'm gonna do the right side
so I'm gonna tilt over here
and get right in that muscle part of your buttocks.
And you'll feel it in the piriformis,
it's usually a little more tender.
- Yeah,
this is an intense one, - - And right there.
- isn't it, Brad?
- Yep.
But I got one hand here adjusting the amount of weight.
Works well.
- [Bob] And you're also using the other leg
to adjust the amount of weight too.
- Yeah. Right here to here.
This one's kind of just hanging out.
- [Bob] Yeah.
- And now the IT band, which is on the side.
This one too.
- [Bob] Watch for your mic there.
- Ooh. The mic, yeah.
Hope you can hear me.
And then we're going this way, all the way on your side.
And this one,
a lot of weight on this elbow and on this foot.
You can see, I can adjust the pressure
so it's not too painful,
'cause this will get kind of aggressive.
Hell yeah. I got it now.
Yeah, we're gonna do that for about 30 seconds
on each one as well.
All right.
And then for a bonus, seeing how you're here,
I always like to do the back.
It's got nothing to do with what we're talking about,
but it sure does
good for the back. - That is a great one.
- Yeah.
- [Bob] I do that one twice a day.
I love doing that. - It's a bonus.
- Yep. - All right.
- All right.
And remember Brad, we can fix just about anything
- Except a broken heart. - Broken heart.
But we're working on it, Brad.
- Yeah, be careful and subscribe.
And yeah, we gotta get some classes on that.
Maybe with some continuing ed
thing going on. - Yeah, that'd be cool.
- Yeah, anyways, we'll talk about it later.
- Thanks.