- Hi, I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist.
- And together we have the most famous
physical therapists on the internet.
- In our opinion of course Bob
- All right. We just did a video on,
if you dislocate your kneecap or your patella,
we kind of showed you what things
you should be thinking about and whether or not
you're gonna need surgery.
I'll link that right here.
- Sure.
- And then after that, now,
basically, if you decide you are gonna
have conservative treatment
basically physical therapy, you're gonna want to
strengthen the BMO muscle, the vast, the bleakest
part of your quadriceps, that little teardrop
muscle there. You're definitely gonna wanna
focus on that. And we're gonna start showing you
how to do that.
Uhmm
Before you even do them, the three ones,
the three major ones that we're gonna have you do,
though. You should be just doing
over the first couple of weeks.
You're gonna have, have it immobilized
and you can do straight leg raises
while you're doing those.
- Sure
- So Brad's gonna show you that
- Laying on your back, these are nice exercises
because you get to lay in your back.
You tighten up the quad
straighten the knee and just go straight
up like this.
If you go up and it starts to bend
you don't have the strength.
You're not ready for this yet,
but this'll probably go all right.
And then you can go out to the side
with your toe pointed out
now emphasize that viable a little bit.
Okay. Anything else Bob?
- Well, if, if you can't bring it up
then yeah, you're just gonna keep it down
and tighten the muscle.
- Yup
- Watch your knee cap is going to pull in,
- Yup
and do quad sets.
- Okay. So after three weeks and
hopefully you're strong enough
then to, to go ahead, advance to these.
The first we probably are gonna have you do is
what we call terminal knee extension.
You're gonna need some Thera band, some stretch band
or some stretch tubing.
You can get it on Amazon.
Just put in a stretch tube or therapy exercise
- Right. You can go down the target.
- Yeah
- They're everywhere.
- Yeah.
- So we're gonna do is you're gonna hook it,
you know, around your bed post or something
and and have it hooked around like this.
And you're gonna go ahead and pull back with the knee
like that. Just as simple as that.
- And you may start out with not a lot of
weight through there, but it feels good
you wanna put your full weight through it,
no pain, little bend and
all the way back, feel those quads working.
- And while you're doing this
you actually want to squeeze your butt together.
Squeeze your buttocks together.
Yep. It's gonna help externally rotate
the hip a little bit and that's puts you
in a better position for strengthening that BMO.
- Sure.
- So good.
You can do a good 20 of these actually.
I know you're always big on 10 to 15.
- Yeah.
- If you can get it strong enough band, but
- But this is one of those muscles where you're walking
you're running lot of repetitions
- Right? A lot of repetition.
So I would say a good 20
- I could agree with you there, Bob.
- Yep.
- Okay.
- That's a nice, I like when you squeeze the butt
that does really rotate the toe out.
- Exactly.
- That's a good idea.
- All right. Second exercise.
That was number one.
You wanna bring the stool over Brad?
- Yeah.
- Lateral step ups.
- Mm hm
- So basically, I'll go ahead and do it.
You're gonna, this is the involved leg.
I'm gonna just go to go ahead, step up
and step down.
And what's nice about it is you're kind
of leaning this way
which actually gets the BMO more.
- Sure.
- So, very simple to do.
Just repeat them
And once you get good at a lower surface
you can actually go a higher surface.
- Right
- You can probably into a chair.
- You may want to start on something
half that size even.
- Yeah.
- And, and go back there again was a really
important point. I think
that we're gonna want these people to know is
go ahead, start it, Bob.
Now lets freeze right there.
The knee cap and the toe should be in line.
What happens is a lot of people will,
their knee will.
- Right.
- Inadvertently just going like that,
do it improperly once Bob
- And, ooh, god that actually hurt.
- Yeah. See.
- And it's actually hard to do it improperly
- Yeah
- On step lateral.
These are called lateral step ups.
- Sure.
- I'm going off to the side.
That's why we are having you do these
because it is a lot easier to
put the leg out this way.
- If you're doing these early on,
you may want to do it with a rail to hold onto.
- Sure.
And get some assistance,
and keep that knee in line.
- Right.
- With the whole side of the body
with the toes area.
There ya go.
- Yep.
- Good point Brad.
- All right.
The third one we're actually gonna cut
and we're gonna go over to a wall.
- Okay. Here we are
For the third exercise.
This is a more advanced exercise,
a little more difficult to do.
Probably the third one you're gonna do.
You're gonna need a little ball.
And uh, by the way, I, I,
this is not really a ball.
It's just kind of a soft, cushy thing.
It's a packer thing,
really makes you want to hit it.
- Oh, uh
- What's really nice about is
you can squeeze this
and you can get your exercise in,
and you can feel like you're squeezing
the head of a packer.
- POW
POW
- So it a double, double bonus.
- Carry on.
- Okay. Anyway, you're gonna get yourself.
You're gonna need, need a,
either a slippery surface
or you're gonna need another bigger physio ball
which we will show after this one.
But I got a towel on my back
and this is a nice slippery door.
And I'll bring myself down into
the 90 degree angle here.
And Brad, do you wanna show where the knee is
not supposed to be?
- Sure.
I, I don't want it back like this where
the knee is going past the foot.
You see that, the plum line there.
I want it so that when I'm out here,
far enough out,
that when I go like this,
the knee is not going past the foot at all.
- Right.
- We're actually,
- The toe
- We're gonna have to be specific on.
- Yeah. Not going past the toe.
Good point.
Okay.
So you're gonna get at the right angle here.
You're gonna take your ball
and you're gonna work on squeezing it.
1, 2, 3, 4, 5,
1, 2, 3, 4, 5.
Now this is tough.
- Right.
1, 2, 3, 4, 5.
I'm starting to fatigue already.
1, 2, 3, 4, 5.
1 2, 3, 4, 5.
- This is definitely, you know,
this is more for the for the younger person
or the athlete.
- Right?
- This is higher level
- Right. Once you've been able to do that,
now you're gonna go ahead and put the ball
between your leg and you're gonna squeeze
on the way down and do repetitions
Squeeze on the way down.
In some ways that's almost easier.
Squeeze on the way down.
Squeeze on the way down to ball level.
Now again, can do it with a
you can also do it with a physio ball.
- Go ahead.
I want throw it Bob.
Let, go at that packer ball.
- All right.
I still need that back now.
- (Laughter). You be nice.
- So this would be the same thing.
Squeeze the packer head.
You go down like this.
Same thing.
Just a little easier on your back.
- Sure.
- A little more functional.
- All right.
- Take my quads.
- Yeah, you're getting tired, Bob.
- All right.
Those are the three main exercises you can do.
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- And strong like bull.
- And strong, like bull... crap.