♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Here we are, the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today we're gonna talk about
when to see a doctor about hip pain.
Now this could be chronic pain,
or something else otherwise.
- Right, and Bob, we're gonna actually show you
when to see the doctor,
but if you're in the gray zone,
we're gonna show you some simple exercises
you can do that we've found
to be very helpful to get you through that pain.
- But that's gonna be at the end of the video,
so you gotta listen to us, right?
- They have to put up with.
- Put up with us.
- They can always fast forward. (laughs)
- Yeah, if you wanna go ahead,
go to the end of the video.
We'll show you some self-treatment.
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- All right, so Bob,
hip pain, very common,
particularly as we get older,
people in their 50s, probably more so 60s, 70s, et cetera.
Oftentimes it's arthritic problems.
- Should we talk about location a little bit, Brad?
- That's a good point.
- Yeah, where is hip pain?
- Right, 'cause hip pain,
as well as low back pain can oftentimes can be confused.
Not only by a person, but even the therapist
or the doctors, because it's not that easy.
- A lot of people think hip pain is right here,
and that tends to be more back pain.
That's very unlikely to be hip pain.
Hip pain tends to be here or in the groin,
very common in the groin.
- You should show your other side, Bob.
- Why? - You got,
your shirt's not tucked in there.
- Oh it does look sloppy here, oh my god.
- That's part of it.
- Bob the slob.
Okay, pain here, probably not hip pain.
Pain here, hip pain,
pain here could be very likely hip pain, too.
Especially hip arthritis.
- Hip pain sometimes will refer down the leg.
Even occasionally below the knee,
but usually not.
Oftentimes hip pain is focused here.
If it's in the joint, that more anterior,
or in the front, I would say is more common,
wouldn't you, Bob?
- Yeah, and even down the leg it's more down the front.
Wouldn't you say?
- Right, right.
- If it goes down the leg down the back,
then I start thinking sciatica.
- Right, well, we're getting off on a tangent here.
- Yeah, we're getting off on a tangent.
- Okay, so but the thing is
that number one, if you fall.
- Yeah, if there's trauma. - If you're trauma,
and you get up and it hurts, you can walk on a broken hip.
It's gonna hurt, and it'll be not a--
- We don't want you to.
- No. - But we're warning you
that you could've broken it and not realized it.
- Right, it could be it's not a complete fracture,
a greenstick fracture or whatever,
but if you walk on it after you fall
and it continues to be painful,
you really should get that checked out.
- You could fracture even the greater trochanter,
which you see quite often,
that little bump on the hip.
- Oh, right. - And so it's not really
a fracture through the entire bone,
it's just a little piece of bone that got fractured off.
- So if there's any question,
any pain after a fall, with particularly weight bearing.
- If there's trauma, you gotta have it checked out.
- Go in there, X-rays are simple,
they're not that expensive.
So make sure you take that bout.
Now the next thing is the night pain.
Let's say you don't have any pain throughout the day,
walking whatever, and then you go to sleep
and you wake up and hip pain wakes you up.
If it's associated with laying on it
and having weight on it is one thing,
but if you just, no matter how you lay it's painful,
you need to go in and get that checked out.
- Yeah, especially continuous night pain,
like you said.
Like you can't find a position to get comfortable.
You know, when you lay on your side,
you can put a pillow between your legs.
That definitely helps take stress off the hip,
and don't lay on the side that's painful.
I mean, those two things can really help.
Yeah, nighttime pain is what they call a red flag.
You always worry that there's some type
of infection or something going on
that's a little nefarious.
- Which brings us into the next number three.
Redness, swelling, a fever, if it's warm around there.
- Or if you have a fever.
- Right, yeah, exactly right.
So the hip, I always have people say
back in the olden days,
you threw the cigarette on the ground when we were kids,
and then this is how you,
and I'd say do that with your foot.
Go back and forth and then put your hand right here,
and you're gonna feel a bump right there
and that's your greater trochanter.
That's part of the hip, the lateral aspect of the hip.
If that part right there is tender and sore,
you know it could be nothing more than a bursa,
a bursitis, but if it continues
to be sore, even if it is bursitis,
it's a good idea to go in and get it taken care of.
- You're getting close to right
on the hip joint there is what you're saying.
- Right, exactly. - As opposed to, again,
the hip's not back here.
You're not gonna feel it here.
- Yeah, it's not in that muscle,
the glute maximus.
- And did you mention especially
if you've had a hip replacement?
- Yes, if you've had a hip replacement,
there's hardware in your hip.
For some reason, and I don't know if you understand it,
if you've heard, if you have an infection
in your body, it'll oftentimes--
- The hardware attracts it.
- Migrate to the hardware,
whether it's in a knee, or a hip,
or wherever it may be.
- Happened to my mother-in-law.
I mean, she got MRSA, and it was right in the knee.
- She had a knee replacement.
- Yeah, so if you gotta hip replacement,
and you got pain like that, redness, swelling,
get in, get it checked out soon.
- And that was a good example
where she had debilitating pain,
and it would not go away, no matter what position,
and I mean, it can drive you crazy.
- And they can do a revision.
In other words, take the old hip out,
put the new one in.
It's something you like to avoid.
- Sometimes what they do is they take it out
and leave it out for six--
- Yeah, I wasn't gonna mention that, Bob.
- Okay, sorry, didn't wanna scare people.
- I've worked with a number of people like that.
Not a lot, but yeah,
but you can do a revision.
You like to avoid it, so get in early
and get the--
- Get the infection taken care of.
- Exactly.
The next one, consistent pain slowly getting worse.
You can live with it, it's not bothering you too much,
but over a period of, I'm talking months,
six months to a year,
there's probably a good chance it's just arthritis.
But if you wait too long,
and the ball of the hip
and the socket get wore out too much,
it just makes it more difficult of a surgery.
And plus you're going through a lot
of unnecessary pain.
How many times have you got a patient
go through a hip surgery
and they say, "I wish I would've done this years ago."
- Yeah, and knee surgeries, too, knee replacement.
- Knees too.
But hips are even easier surgery than a knee.
- Yeah, they are, and one thing that I found out,
my grandpa, he ended up being 94.
Never went in to have his hip replaced,
ended up being non-mobile after awhile.
I mean, he couldn't walk at all.
So two things can happen,
one that could happen,
or two, you can get some medical issues
so that you're not able to tolerate the surgery anymore.
- Right, exactly.
- I'm not big on pro-surgery.
I definitely would try therapy first,
and we'll show you some things at the end of the video,
but if it's time, it's time,
because you're just giving up quality years
of your life, and you may give up the opportunity
to even do it.
You may get a heart issue or something
where you couldn't tolerate the surgery.
- Exactly, and now it is time, Bob.
It's at the end of the video, we're gonna show.
If you've got some of that chronic,
slow-going pain that you're pretty sure is arthritis,
and you haven't done anything about it
as far as therapy, we're gonna give you a couple hints,
and these are,
we've had pretty good success with them.
- Yeah, we do.
- You wanna show 'em, Bob, or?
- What do you want me to show 'em?
- Let's do the supine.
So, you do this actually on your bed.
Lay on your bed.
If you got a really soft bed
with soft sides, it doesn't work so good,
but you'll have to work with that.
Maybe have someone stand by you,
'cause we don't want you to obviously fall off the bed.
- So we're checking hip flexion first.
- [Brad] Yeah, range of motion.
- So we wanna see how your hip moves.
So you're gonna check one.
You grab on the knee like this,
or you grab underneath the knee like this.
- And grab the good leg, the hip that doesn't hurt.
- Yeah, check that first.
And see how far it goes and kinda give a sense
of how far it goes.
Then compare it to the other leg,
and if this one, you can see it doesn't go as far.
Now actually, this is my problem hip.
I don't know if you can see any difference.
- Well, bring it up.
- Here's this one.
- So we're going right to there.
I'll be the spotter here.
- And I'll putt on this one.
- Yeah, you're off about four inches.
- And I can feel a little bit of pain with this one, too.
I have to massage this one daily,
stretch it daily.
I'm doing these same things
that we're gonna recommend today.
Next one, you wanna do like a figure--
- Should we show a treatment for his one first?
- Sure, sure.
- The treatment is the same as the test.
You just simply work your stretches.
Should we just tell them the hold and relax?
- Yeah, or you could, yeah,
contract relax you mean, or?
- No, just hold.
- Oh yeah, pressure on, pressure off.
Pressure on. - So we're just trying
to get more range of motion.
- Now you can do this.
You wanna show it on a stool, Brad?
- [Brad] Oh sure.
This stool is pretty high.
I'm not gonna recommend this to anybody.
- This would be too high for you.
- But if you go on a stairwell
and you have handrails to hold onto,
you're gonna have options for how high to go.
I would probably--
- A chair with a back, too,
you can hold onto the back of the chair, and you,
yep, stretch like that.
That's how I like to do it,
to be honest with you.
I do it in the stairs.
- I do this for a different reason,
but it's the same, does the same in the hip.
I really do enjoy this, especially my right side,
but that's just my personal.
- Now you can also measure how much the hip extends,
and one way to do that is you keep your shoulders completely
on the bed, you bring your legs off to the edge,
and you let the one leg hang off the bed.
Now, I'm a little bit tall for this mat,
but you grab the other one and pull it up like this,
and you can give a sense of how much this bends down.
Now you compare it to the other side,
and again, you might find a difference,
and this is the stretch you would do.
- And this is, yeah,
so now you're just letting gravity stretch
that hip right here.
This is the one, actually that one is getting a stretch too,
so both sides, it's kinda like the shotgun approach.
- Yeah, you're getting the hip flexion,
you're stretching the hip flexion here.
- Now if you're elderly, or a little frail,
weak, and you don't feel comfortable doing this one,
do it with someone that's able bodied to help you out
so you don't fall off the bed.
Obviously, that's not worth it.
- You can do it on your knees, too.
It works best with a pillow,
but this floor's actually kinda soft here.
So, it's this way, right?
- [Brad] Yep.
- So I'm gonna go ahead and just bend forward like this.
This is a great stretch.
I just love this stretch. (laughs)
- Yeah, and again, for older people,
maybe with knee arthritis, you may not be able to do this,
and then they just can't do it.
It's not safe.
- Right, but you put a pillow down,
it helps a lot of people.
I actually take my hand and push my pelvis a little bit,
and I also turn my foot out a little bit.
- Yeah, so right back here.
That gets that iliacus muscle. - I cracked my back
there, too.
- [Brad] Oh, bonus, a bonus.
- Get to my age, lots of things are cracking.
- Now this is my favorite one,
the figure four.
You can do this easily on bed, anybody.
- You can check it this way
to see how much it bends.
- So he's talking about the knee going this way.
- That way, yep.
Now compare it to this one.
- [Brad] You're pretty even, Bob.
- Pretty even.
This one, again, I feel a little bit of pain,
so I do this stretch, too.
I absolutely stretch it this way.
I actually do it laying down in my stairwell, again.
I put one foot in there.
But Brad's gonna show it in a chair,
how you can use it.
- Now I'm on a taller stool, and I can do it here,
but it works better
in a typically 18-inch size standard chair,
like Bob has.
- Works for me, yep.
Just pressure on, pressure off.
What's nice, you can do this throughout the day.
- Yeah, and you can see,
you can do this without workout clothes on.
- Yep. - The ones laying in the bed,
you have to make sure you have pants
that are not tight,
especially when you do the hip one
where you have the knee off the bed.
I was gonna mention that,
but Bob wouldn't stop talking. (laughs)
- It's amazing what a difference this can make.
I honestly, although we just said
that a lot of people wait too long,
I think some people could've waited longer
if they would've stretched their hips out.
- With less pain.
Their quality of life would've been a lot better.
- Exactly, yeah, this figure four one,
whether it's seated or laying down,
I think, is one that really can do some good for people.
- Yep, give her a shot and let us know
in the comments below how you did.
Remember, Brad and I can fix just about anything.
- Except for.
- A broken heart.
- That's right.
- And I think if Brad would uphold his,
then we'd get it done, but he's slacking.
- I know, Bob, but I'm busy.
I've got things to do, and I don't always think--
- I bet you do.
Thanks for watching.
(deep music)