♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Let's get at it.
Okay.
Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- We've got high opinions of ourselves, don't we, Brad.
- Ooh.
- Today, we're going to talk about the three rules
for treating hip arthritis and pain.
These are our rules, so you need to follow them.
- There you go.
- We like it when we're in charge.
By the way, if you're new to our channel,
please take a second to subscribe to us.
We provide videos, how stay healthy, fit, pain free,
and we upload every day.
That's got three rules there too.
And you're going to want to go over to the Facebook
and like us, Bob and Brad,
because once again, we are giving away
the Thermotex Far Infrared Heating Pad.
Platinum pad, beautiful pad.
This thing, the reason why it's so much better
than regular heat, it goes so much deeper.
2.36 inches, right, Brad?
- There you go.
- Versus superficial heat.
- You better believe it.
And it's big enough to cover the back.
You can wrap your knee, the hip,
it's a very universal device.
We love it.
- Yep. All right.
So let's talk about the three rules
for treating hip pain arthritis.
The first thing you want to do as much as possible
is you want to decrease the weight bearing on that hip.
And I'm not saying that you need to do this forever.
- Right.
- But hip pain and arthritis tends to flare up
and it tends to calm down.
- Mmm hmm.
So we want to get it to calm down.
So what you want to do is, maybe for a while, use a cane.
Brad, you got this little psychedelic one there.
- Oh, that is nice.
Matter of fact, I just worked with someone Tuesday.
This problem,
I had to work with her on gate,
and her walking was like this.
- Yeah.
- She took the cane and her walking became normal.
Things calmed right down.
- I'm glad you brought that up, Brad
because so often people say, "I'm not going to use a cane."
And, you know, "I've got my pride.
"I'm not going to use a cane."
But they'll walk like this, like you said.
They're walking like this.
Wouldn't it look better to walk with the cane?
You don't think they're drawing attention
to yourself by, you know--
- Yeah, these canes, really--
- I mean, I understand it. Believe me, I understand it.
I'm not trying to be unsympathetic.
- I always tell them, you know
you look more dignified with the cane.
- That's right, a walking stick.
- Some people buy it. Yeah, some people buy it.
- And if you want to have something that maybe looks
like you're maybe more of an athlete that got hurt,
just use, you know, a crutch like this.
My wife finally succumbed to this
when she had hurt her knee...
- Sure.
- ...and she was like, "I can't use a cane. I can't."
But she used the crutch, and it worked out good.
We actually had to put extra padding on there
because you really start to rub in here,
and it really breaks down the shirt.
- Yeah. Sure. - So after a while--
- And if you don't know how to use
the cane or crutch properly,
just Google "Bob and Brad, crutch use, cane use."
We have some good videos
on how to take care of that problem.
- Right, and in addition to like using a cane or a crutch,
you're going to want to avoid stairs and hills
for that time period while you're trying
to get things calmed down
because every time you go up on a surface like that,
increases the stress on your hip.
- Right. You know, if you do need to go upstairs
simply go up with your stronger, the less painful leg
and let that side take one step at a time.
That'll significantly decrease the--
- Up with the good. Down with the bad.
- There you go.
- That's the old row.
Okay. Next thing you're going to do,
you're really going to want to make sure
you're stretching that hip.
Generally, quite often,
I had a patient yesterday like this, Brad,
he's got very poor internal rotations.
So on the one side he went like this.
- Yep.
- And the other side, that was it. He had no motion.
- Yep.
- And he was getting pain in his groin.
And if I turned it that way, he went, "oh, ow ow ow."
- Sure.
- So we need to regain that motion.
So you want to regain basically four different motions.
You want to show them laying down, Brad?
- Sure. Yep. - Why don't you do that?
- So yeah, when you're working,
the hip is one of those things that's got four ranges.
And if you're not a therapist, then,
actually, when I was learning this,
it was a little confusing.
But you know, once you get your head around, it's fine.
But hip flexion, should we go through that?
- Sure. Let's go with hip flexion.
- Okay. So flip hip flexion means
you're going to take your knee and bring it to your chest.
So that's bending the hip or flexing it this way.
And you might find out this knee is normal
or this hip, I'm sorry. - That hip, yep.
- And this one, oh, it gets tight in here.
So we want to eventually see
if we can get it stretched up to here without flaring it up.
So this may take a few days or a couple of weeks.
So we're going to work at it every day.
- [Bob] And if you have to use a belt or a sheet,
go ahead and do that.
Yeah, we're just gonna reach right in here, Brad.
There you go. - There you go.
So we just rolled up a towel,
put some tape around it,
and you know you can go like this,
and this just makes it easier
for some people who may not have the range of motion
or you know, their body isn't just quite shaped right.
So they can do this easily.
So, that works.
You can go like this around the knee and stretch it.
Again, you're going to stretch and hold and relax.
Do that, five to 10 repetitions
should be enough for one session.
- [Bob] Why don't you go to external rotation, Brad?
- Okay. This one you can take--
I always say take your ankle
and put it above the kneecap on the opposite leg
and let the leg go down like this.
This is one way to do it.
- [Bob] Yep. It's a figure four.
You can actually do it in a chair too.
I'll bring the chair in.
- There you go.
- This is, it's a really easy one to do throughout the day.
You can just put your knee,
cross your knees and go ahead
and give it a stretch like this.
- Right.
- And you'll find one that might be up like this
and the other one's down like this.
- Right.
- So you want to make sure you're stretching this one
to get it equal to the other one.
- Don't get too aggressive on the stretches.
You know, there should be no sharp pain whatsoever.
If you've happened to had a hip replacement
or procedure done to your hip...
- Yeah. You're not doing any of these.
- ...you're not doing any of these.
- Right. - Just turn this tape off
and go find something else to watch.
- Yeah, go have a beer on us.
(both chuckle)
All right, what are we doing next, Brad?
How about internal rotation?
- Oh, this is the one that,
you know, you just taught me this one.
- Yeah.
- Because this was kind of hard to do,
but both knees up like this.
Now I'm going to stretch my right leg,
the one closest to the camera.
I'm going to take this over,
my left ankle over the top of the right knee.
And I'm going to pull it away from the camera.
And this really does a nice job on this part of the hip.
And you know, you can adjust here.
You can move your foot
to get whatever feels like a good stretch.
When you've got a good stretch, it's going to feel like,
"Boy, that's doing a good job."
You may have, if you have some mild pain
but it feels like, "Oh, it feels like it hurts so good."
Or when you get done, it really feels good,
that's gold.
- Yeah, you can bump up against the pain
but don't go into the pain.
- Right.
- You can do this sitting down too.
You can cross your leg over and pull it like this.
And so I'm giving a little bit of stretch like that.
You could even go like this, just work it this way.
But internal rotation, quite often
is affected with arthritis.
It's usually one of the first ones to go.
So it's a great stretch to do.
- There you go.
Do you want to show the combination
flexion and extension, Brad?
- Right, you know, this is probably for people
who are a little more mobile and able.
- Yeah, don't fall off the bed.
Please don't fall off the bed.
Please, don't fall off the bed.
- All right. So, as far as extension,
if you go to the edge of the bed,
so you're still stable and on the bed,
let the right, in this case, the right leg
just relax and go over
and let gravity stretch that hip flex or that muscle
deep, right here where your pocket is.
Now what Bob was talking about, doing two at once.
We can grab this knee and pull this.
So we're extending the right hip and flexing the left hip.
- You can actually bring your upper body over more,
can't you, Brad? This way?
- Oh, over this way. Sure.
- Yeah, like that so you're a lot more safe.
- There you go. - There we go.
- Yep. Good point, Bob.
Again, you know, you need to feel comfortable.
This is for someone who is more mobile
but they've got tight hips. - Yeah.
- You know, if you're 75 years old
and have a hard time walking,
you know, on that stage of your life, this is not for you.
- That might be a difficult one to do.
- Right.
- You can do--
stretch the hip flexors also by kneeling down.
A lot of times I put a pillow underneath this knee.
I've got a pad right now, so I don't need to.
But as you can see, I'm leaning forward
and I'm stretching this one right here.
Or if I were to reverse and do this
and you can see, now I'm stretching this one right here.
Put a pillow down because it's hard on the knee.
- Sure. You bet.
- I'm going to lean forward.
And you were saying I have good posture, right, Brad?
- Yeah. I was, before my mic turned off.
- Yeah.
(both chuckle)
- Anyways, yeah. So he's got good, tall posture.
He has something over here he's holding on to.
This, a plant or a table, whatever there may be.
You know, be relaxed while you stretch.
If you don't feel relaxed--
make sure you breathe relaxed, nice, deep breathing.
All those little things make a big difference.
- So all that was rule number two.
Rule number three is,
you want to strengthen the hip a little bit.
Brad, do you want to just show kind of a quick scenario...
- Sure.
- ...of some hip strengthening you can do?
- That's exactly what happened.
I'm still on? Okay.
Just some simple bridging.
So your feet here, if you do this in bed,
you know, hopefully your feet aren't slipping out.
If you have your shoes on, it helps a lot.
But a simple bridge is going to work that back,
part of the hip, the extensors, the glute maximus.
- [Bob] You're going to get some hamstrings with this, too.
- Yep.
You know, and if you want to isolate or to get stronger,
just put one leg out.
Oh. And that gets quite a bit heavy.
- [Bob] That's a lot more difficult.
- Yeah. We're gonna do sets of 10.
Does that sound like a good-- - Sure, sounds good.
- Now, I'm going to go this way
so I don't lay on my back, my mic.
And, nice hip abductor.
I was just working with a woman who had a hip replacement
on this exact same exercise
because she had the waddle in her gate.
- [Bob] Sure. I do lots of these.
- Yeah. Yeah.
And you know, you should feel that muscle in that hip start,
mine's already starting to burn.
Make sure your toe is not pointed up like this.
There you go.
And you know, you can do the hip
laying down like this.
- [Bob] And you can do some hip extensions, too.
- There you go.
- [Bob] So it's real simple.
You can just, you know, go from their back to the side
to your prone, and then you've got them all covered.
- You bet.
- So. All right.
Well thanks, Brad, for doing all the work.
- Well, yeah. Anytime, Bob.
I'm always happy to lend a hand or a leg.
- Remember we can fix just about anything.
- Except for...
- ...a broken heart.
- There you go.
But we're going to continue to work on it.
We've been working on it for seven years now,
and we're not going to stop.
- You'd think we'd be getting a little closer,
don't you think?
- Well, we got a little progress.
At one time, we had that little heart thing,
and it was coming together. - Yeah, it didn't work.
- It was--
- Thanks for watching.