♪ Bob and Brad ♪
♪ The two most famous physical therapist ♪
♪ On the internet ♪
- Hi, folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- 'Cause we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- So today, we're going to show you how to tape
and stop kneecap pain.
So we're talking about patellofemoral pain syndrome.
So kneecap pain, you know where your knee cap is,
your patello,
can be caused by direct trauma to it, you know,
or if you're someone that kneels on it all the time.
- Sure.
- But also it's very common for the kneecap
to get out of position.
Now you can see the kneecap moves around here
and it resides in a groove.
There's a groove under the bone.
I mean, under the kneecap. - [Brad] Yup.
And if they're on the side of the groove,
it's going to cause pain.
If it's not running right in it.
- [Brad] Right, they call it tracking.
It tracks in that groove of it.
If it's not in the center for poles one way or the other,
then oftentimes it pulls this way.
And then when it's out of the track,
it starts to wear on,
that cartilage becomes arthritic and painful
so we need to pull it and get a back in the groove.
And we're going to use some tape with that.
- Yeah, you might feel some grinding
because it's just not smooth anymore,
'cause it's been wearing out
from being on the outside of the groove.
- Right.
- And Brad showed that really well, actually.
Yeah, quite often it's tight on the outside here.
It's tight on the outside of the knee.
And so we got to stretch it this way, that way.
- Yup. - But really for you,
you should find out which way it does hurt for you
because it could possibly be on the other side.
- Yep! - And you might have
to push the kneecap away from it.
- Yep! - And you know, ideally,
you're going to have a therapist do this,
but I always think that what's the worst going to happen
if you try it.
If it hurts, you're not going to do it.
- Right, you only proceed with it as it feels better.
Oftentimes, the symptoms and the pain is provoked
by up and down steps or squatting.
- Yeah and in fact, prior to taping,
we're going to have you assess your baseline for pain.
Now you can do that by doing a squat.
- Yep!
- You know you can just do a half squat
and see how much pain is, rank it from one to ten,
and then you're going to tape it
and see if that pain level has gone down.
- Right.
What I did, when I was seeing patients with this,
I'd have them walk upstairs.
- Yep, that's what I would do.
- I'd have them walk up the stairs,
tell me how much pain do you feel,
then we tape it and have him walk again.
And very commonly it stopped hurting.
- And I found that oftentimes,
going down steps was a little more painful than going up.
I say, give me a number going up and down,
let's say three going up and five going down.
Then we had taped and have do it again.
- And it would be again,
a very common to see improvement.
So you went up the stairs and down the stairs,
and ranked your pain. - Mm-hmm.
So now ready to go ahead and try to put the tape on.
Now we use two types of tape here.
You could try kinesio tape or K-tape.
- Right, it's that stretchy tape.
You can buy it pretty much anywhere online or at a pharmacy.
- And that might be easier.
What we use is it's called the hypo fixed,
or this is called omni fixed actually.
We'll have the link below.
It's hypoallergenic so it's easy
on the kneecap and the skin.
- You won't less likely to get a rash.
- Well, I'll tell you.
I've had people who wore this a lot,
you know, three, four weeks in a row.
- Yeah. - And they started getting
a little bit of rash and you have to always watch it.
I mean, it's always a possibility,
even with a hypoallergenic tape.
- If your skin is getting red itchy, sore,
you need to just discontinue the whole treatment.
It's just not an option.
- So Brad, I usually put down a couple of pieces of this.
- Yeah, I've got some right here.
- Yeah, why don't you go ahead and put it on.
You should clean the knee first.
- Yep, now, depending on how here are your skin is,
you may want to shave the hair
because when you pull this off,
it's a lot more comfortable and it sticks better too.
It'll have to be clean skin, dry skin of course.
I'm going to go on this side of the kneecap.
I know the edge of my kneecap is right here.
I can feel it and actually see it.
- Kind of push the kneecap that way.
So we want to make sure that a little bit more that way.
- So I'm going to push here. Now, you can see by my skin,
it's going to pull you now maybe on the camera.
- You don't really need to pull this one, Brad,
this is just the underlying tape.
- [Brad] Okay.
I've always pulled it.
- Do you? - Yeah.
- Yeah, you can start.
- I mean I'm not pulling real hard
but it gets it to slap out of it, I would call it.
But this is one of those things when you do it once
or twice you'll get a feel for them.
- [Bob] I'll go a little bit further, Brad.
'Cause I'm going to hook that.
- [Brad] Oh, sure.
- Leukotape. - Yep.
- Right to the kneecap.
- So, I kind of went my first one.
I didn't go far enough this way as what Bob has seen.
So this I'm going to lap at and I'm going to come over
so we get the whole kneecap.
Little tension there, not a lot, and get it down,
and my last one.
- [Bob] Now, my daughter had this
and she would tape it herself. - [Brad] Mm-hmm.
- [Bob] She'd do it before basketball games.
- [Brad] Oh really?
- Very common in a lot of young girls.
So that's why I don't feel bad showing on YouTube
because you know eventually,
you're going to want to try these possibly on their own.
So now, we want to move that kneecap over.
I'm going to go ahead and circle around the kneecap.
- Sure, yeah, to have a good indication.
- So that's where the kneecap is.
Now, in the case of someone who's having trouble,
it might actually be over here.
- [Brad] Mm-hmm.
- [Bob] So I'm going to push it over-
- [Brad] Okay. - [Bob] With my thumbs,
and I'll grab, yeah, I'm going to do it, Brad.
- [Brad] Okay, go ahead.
Yeah, you got your system down.
- [Bob] So I'm on the edge of the kneecap,
on the outer edge,
it's kind of holding there and I'm going to pull,
I'm pushing with my thumb,
and I'm pulling with the tape at the same time.
- [Brad] It's really important
that the person loose his quadriceps, completely relaxed.
Otherwise, watch when I tightened them,
it won't be effective.
And look at the wrinkle right here in the tape,
if you can see that,
but that's good, you know- - [Bob] You've pulled it over.
- [Brad] Yep, you're got some more in there.
- [Bob] And I usually do at least two pieces
because you know you want to hold it in place.
So the same thing again,
I'm pushing with my thumb,
I'm catching the end of the kneecap.
- [Brad] So you going right over the top of that one.
- [Bob] And I pull it all over.
You know the thing is, once it's in place like this,
it's a good time to actually do
some strengthening exercise, Brad.
Because now you're strengthening the muscles
to try to keep it in the groove, you know?
So you can do quad sets
or you can do a straight leg raises and yeah.
- And we're really looking for this muscle right here,
the VMO, correct. - Right.
- That the fire in.
So, sometimes I'll even have patients kind of hold
that right there and feel that muscle tighten up
and just set tactile feedback
and get that muscle to fire better.
- Yeah, it's hard to isolate that muscle completely.
You're going to get the entire quadricep,
but that certainly gives you a little more feedback,
and you know again,
this is good for maybe 24 to 48 hours.
- Sure.
You can shower with it, but it may you know, become loose.
- So now, you could go up and down the steps again
and say is the pain better?
Worse or the same?
- And it should be immediately better?
- Right. - Or you probably
aren't going to do this?
- Right. - Or you didn't tape it right.
- Right, yep.
- You want immediate improvement.
I used to have one lady, believe it or not, Brad.
She was 60 some years or 70, some years old.
And she had pain in her knee when she climbed the steps.
- Yeah.
- And we found out that pushed her kneecap over felt better.
She pushed it over while she steps-
- So she just bend over and pushed it over
and do it manually?
- Yeah, and she said, no can't.
- Alright!
- I know weird thing but it actually worked her so.
- That makes less sense.
I don't know if you wouldn't want to squat deep with this
'cause then you'll know that tape actually let's loosen.
Once a tape let's loose,
it doesn't do any good.
- Yeah, and that's why you might try the other tape,
the Kinesio tape.
- Right, 'cause that does stretch-
- And that's for athletes.
The only thing I don't like about it Brad,
it's not quite as stiff as this.
- Yeah, it stretches. - Yeah, it stretches.
- It won't rip.
It may not give enough pull
to get that patello in the tracks.
- You're really going to have
to use the full stretch I believe to do so.
- Bob, I don't know if anybody noticed,
but did you notice my socks and my shoes match?
They're perfect, the color.
- Yeah, yeah.
- That's just my thought I bring up.
- Do I have to be impressed?
- No, I just thought the viewers are going to comment,
but, anyways, well it's the end of the tape.
I thought I'd bring that out.
- If you walk home like that with shorts on,
I hope you don't.
- Well, I'm going to, Bob. - Alright.
- But my kneecap feels a lot better.
- Alright, thanks for watching.
- Just having fun. (upbeat music)