♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists, on the internet ♪
- Hi folks I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the real most famous physical therapists
on the internet.
- In our opinion of course Bob.
- Today we're gonna talk about
is your hip pain coming from your back or your hip
and how to tell?
Right away we need you to say this Brad, right?
That this for a lay person,
we're not trying to make you doctors or therapists.
- Right.
- But we're trying to give you an idea anyway,
and then you can maybe say to your doctor or therapist,
hey I found this to be true,
do you think you think it's maybe coming
from my back instead of my hip?
- Right, this is one of those things where
as therapists we get people from the doctor,
the doctor says they've got hip pain
we find out, we look a little more,
and we find out it's their back
referring to their hip and then go back and forth.
So these are some of the tests we do
and things we look for to help determine
so you kind of know where we're at.
- Well, the first sign,
we'll go over some of the signs that your hip pain
may be coming from your back.
Again big may.
So if you feel the pain across the low back into the buttock
it could even spread all the way down to the foot.
- Sure.
- Yeah if you feel it here
and then going into the butt, that's not your hip,
you know that's more likely going to be your back.
So, and again, that pain could spread
all the way down to the knee or to the foot or the ankle.
- If you've got pain going all the way down to your foot
you know, it could be the hip, but that same.
- Unlikely.
- More to the back, probably a sciatic issue possibly.
- Yeah, yeah.
If it's worse, if your hip pain is worse
with sitting or bending,
that's often going to be the back.
That's one of the tests actually that we often do.
We'll show you a test
that you can do at the end here yourself.
Number three, if your hip pain
improves with standing or walking,
you won't expect that
because you're putting more weight on the hip,
so but you would expect that with back pain.
A lot of times it feels better sometimes.
- Right, yeah, with walking, you know, and the thing is
is a lot of people don't realize, but you know
the hip is really right here.
- Right good point Brad.
- And the back is here,
they're only a few inches apart,
and pain refers back and forth so that,
that's why it's.
- It's tough to tell.
- Yeah, it's hard to tell and we're,
we're helping you out.
- I've even seen people were sent to me that X-rays
showed a really bad hip,
but it still was coming from their back.
The hip was, you know, not giving them pain.
- Right.
- So number four, if you have pain in the back
at the same side as the pain in the hip,
then you know it's a little suspect, isn't it?
- Yeah, yeah.
- If they're going on at the same time,
if coughing or sneezing increases your hip or back pain
that's a good sign it's sciatica.
- Yeah, probably from the back, the low back.
We're always talking about the low back here.
- If you have an area of numbness or tingling
on the same side as the hip problem,
that again could be a suspect of a back pain.
- Sure.
- And again, maybe the sciatica.
I think that's it, Brad.
So let's go signs that it is hip pain.
- Sure.
- So number one, you have pain in the groin,
only in the groin or on the side of the hip.
You wanna just show that Brad?
- Sure, so, so it's here
like I always tell people
where you put your hand in your pocket
and that area there, here
but it's not back here.
Typically that's going to be from the hip joint.
Back pain, typically comes from the back.
It can wrap around there.
- It can, especially on a higher version, but.
- Exactly but.
- It could also this pain,
hip pain could spread down to the knee
even the back pain could go down to the knee.
- Well, you know,
these are the symptoms they lap over
and that's why it's not easy.
- Yup, that's why it's a problem.
All right number two, squatting increases your hip pain.
You wouldn't necessarily expect that with back pain.
- Particularly, I mean if,
this is not a squat
so we're talking good.
- Good posture.
- Strong posture, and we're not moving the back,
but we are moving the hip.
That would be an indication that it's hip.
- If the pain is worse with standing or walking
we just remember, we stated that
the pain if it improves with standing or walking
its more likely to be back.
If it isn't worse with standing or walking,
especially if you walk with a limp,
then we're again, thinking maybe it might be a hip problem.
But let me tell you,
I've had people walk with a limp with back pain too.
- Yeah, there's no doubt about that.
- All right let's show you some tests here.
Brad, do you mind grabbing the chair there?
This is a test called the slump test
and you sit down first and with good posture first
pull up on the bottom of the chair,
and that's going to put some the back.
- Yep, so just pulling like this
you'll feel it compressed.
- Yeah, compressed at the back.
And now do it again, but in a slump position.
And if that makes your pain worse,
again there's some backup issues going on there.
- Because the hip is not experiencing any stress,
you're actually sitting on on your ischial tuberosities.
It avoids the stress on the hip joint itself so.
- Unless you are really slouched, but
Brad, do you mind showing,
the one thing we wanna look for
is if there's a lack of motion in the painful hip,
that's a sign that it may be involved.
Show external rotation, how you can compare the two.
- Oh, so you can, you know, if you can do this
I've actually got a person right now that
- He can't even go up there.
- Right and actually he does have a hip problem.
We've confirmed.
- Can he do it with the other side?
- Yeah, yeah but he's tight on both sides,
but he's better on one side
and this side it's like to here.
- He can't get up.
- Right.
- So that's what you're looking for is that.
- So this is the motion we're looking at, right there
you know, a lot of people can get there,
then you see how far the knee goes down.
If that one goes that far
and this one only goes this far,
you know that's looking at the hip pretty specifically.
- And you can also do flexion in the chair,
just see how high it goes up.
Yep, exactly.
Use your hands.
- You know, the one thing that
we can mention it, you know, that,
you know that piriformis muscle,
that one is directly connected to the hip
and it can cause sciatic problems so that's,
- That's a tough one.
That bugger can be hard to diagnose
I hate to throw that curve ball in there, but just.
- All right, this is another one you've put,
you sit up on a bench or something
that is a little higher so again your feet are dangling.
- Yep.
- And you're going to measure your,
keeping your butt down
you're going to see how far your leg goes out like this.
- So if we put a vertical down from the knee
out there, we got that distance there
and if we went and say this one.
- And let's say it only goes that far.
- You know, I can hardly get my fist and a hand in there,
but over here, you know I can get
two or three hands in there.
- That's probably one of the number one signs
it's a hip arthritis problem
is that internal rotation is gone.
So I think that's enough Brad,
I was going to show the extension too
but if those are all positive
you don't need to.
- Yeah, we've covered this topic in pretty good detail,
particularly for the lay person.
- All right, if you've stumbled upon this video,
it's actually a part of a series of videos on hip pain.
So go to Bobandbrad.com
go to the program section,
look for the hip pain program.
We have other ones too,
sciatica and plantar fasciitis,
and check out the titles, watch the ones that you want.
- Right.
So it's just going to be strictly for hip
a number of videos, look at the titles that pertain to you.
Look at it,
if you find some good exercise, good information
there's a PDF printout
so that you can have it for your records,
put it on your desk or whatever
and you can refer back to that.
It's all free.
- It's all free.
- No email. - No email, nothing just jumping.
- It's really our gift to everyone out there, so.
- Take care and we love you.
- Happy hips.
Yeah.
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