♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists on the internet ♪
- Howdy folks I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Really humble, I would say.
Today we'll talk about fixed knee pain
from tight IT band.
IT band, what is that, internet?
(laughs)
- Yeah, that's the people
that fix your internet. No.
- Yeah, right.
- Iliotibial band, which is,
are we gonna get right into this?
- Sure, lets get right into this.
- Right, let's use Sam here for a little,
- Demonstration?
- Anatomy lesson.
- Sure.
- So the IT band, the ilial.
We got this pink IT band here on Sam
- [Bob] Right, this is a tough fibrous band.
- [Brad] YeaH
- [Bob] I mean really tough.
- [Brad] And it's about this wide too.
It's a wide flat band.
It goes down,
crosses the knee joint,
connects down by the head of the fibula,
over the top of the greater trochanter, the hip there,
and the black tape is to represent some of the muscle
that connects to- - Tensor fascia latae
- [Brad] tensor fascia latae,
and some fibers go actually
to the medial and the
- [Bob] glute
- [Brad] glute
- [Bob] max.
- [Brad] Max, yes.
So we've got this to deal with.
Now, if this pink gets tight,
for whatever reason,
it affects the mechanics of the body.
- I should say, you know, Brad,
we should say, not only tight,
like the muscle could be tight,
but it also could get bound down.
That's probably more common
is it actually gets bound down.
It's kind of like, this is tape, you know,
you push it down again and see, it sits there.
- And it's not working right there.
- We want to get it to loosen up so it,
- It's pulling too much here
and this causes the knee to swell up.
And you think I have a knee problem
when you actually have an IT band problem.
- So now
this video,
I have to say,
I'm doing it partially
for a friend of mine.
He's gonna be
my daughter's husband's,
my daughter's brother-in-law.
Anyways, his name is Trip.
- Daughter's future husband's brother-in-law?
- They don't care about that, Bob.
(laughs)
But this young man, he's
I believe 26 now,
his name is Trip
and a
very aggressive
runner.
- Well nuts, if you ask me.
- Well, you know, some people say
that he happens to be one of these ultra runners
that don't run, a marathon is not long enough.
- No, they run a hundred miles.
- Yeah, 50 miles is not enough.
Go for the hundred miler
and to make it even better,
he ran this most recent one in Colorado.
It's about a 10,000 foot elevation
and plus it's over a hill.
- Well, I say he's nuts.
- Well, no, he's a fine young man.
- Yeah, I'm sure he is.
- Yeah, he is but..
- But he's nuts.
(laughs)
- I don't know how many hundreds of people
out there doing the same thing with him.
A lot of them did not finish.
He did finish, but he did have this pain, so..
- On the side of his knee and..
- Yeah
- And it became swollen.
- Yeah, so this is one treatment that I think
would be worth, Trip, that you could do.
We're gonna show you a few exercises.
You don't have to do all of them.
- Pick out the ones you like- - Exactly
- that work well for you
and go forward with those.
- Right.
And if you haven't run a hundred miler,
a lot of people get this from just..
- Or like you can get it from biking too.
- Right.
Biking, any repetitive motion kind of thing.
Or sometimes if you do something new
that you haven't done before
and you're sore
and then things can tighten up as a result.
But anyways,
it's pain, knee pain,
oftentimes on the lateral side.
And, you know,
you may be diagnosed from a doctor, a therapist and..
So, shall we get on with the exercise?
- All good, Brad.
- We completely wasted three minutes right there.
- Yeah.
- Well, anyway, it's not really.
Trip's worth it.
So, he's a nice guy, I really enjoy talking to him.
I could never run with him though, he's way too fast.
I wanna do it this way.
So,
IT band,
and these exercises are actually good
for the hip too.
- So basically, if you're looking at Brad's pants,
the IT band is kind of the white Stripe.
- Exactly. Yep, from here,
except for it stops right there,
- not down to the ankle.
- Now I'm just gonna start with a hamstring stretch.
If you happen to have tight IT band
and if you have tight hamstrings,
you should get those.
So you're gonna start out here straight knee,
you know, 15 to 30 seconds there.
And then we're gonna go into the figure four stretch.
This comes up here, stretch number two.
- Now you're still stretching the left one.
- Yes, exactly Bob. Good point.
Push down here
and then come under here.
- Yeah, this can add a lot here.
- It does, this is for the advanced,
which Trip would be able to do.
- Again, not so much stretching the IT band here
as you're stretching the tensor fascia latae
and maybe the glute max a little bit.
So things that attach into the band.
- Right. Yeah.
So a little bit the surrounding structures
as well, in general.
Now I like this one,
put this leg down straight.
And then this is where you really
benefit from a strap.
You can use a belt and put a loop on the belt,
but you're gonna go over this way.
- There you go.
- And I'm pulling here to control it.
Getting that stretch all the way across.
Oh yes, this is wonderful.
Hold it for 15 to 30 seconds.
Okay.
Now,
the quadriceps maybe,
adjacent muscle to the IT band.
- Right.
- We wanna stretch that.
So, you can do that.
- Often tight, often tight at people.
It's good to know what to do.
- You don't even need the strap
if you can reach your
ankle
and pull here.
Now the trick to this one is doing this motion,
right here is not gonna do the quad any good,
but you've got to go this way.
- You're just bending the knee.
- Whoa, now it's lighting them up a little bit.
There we go.
And the last one to get the IT band,
this one actually,
let me do it this way.
If you're on your edge of your bed,
you'll take, this is the one I'm stretching.
Go off the edge and leave it hang
and use gravity
and just kinda hang out
and let that stretch right down there.
- You remember that one that your friend did,
that ran triathlons and he was..
- Oh, yeah.
- The seated one.
- Yup. Yup.
Dan!
- Yeah, that's the one thing he did.
- Yeah. Yeah, he had knee pain and this is what he did.
- He crossed over.
- And he pulled it this way.
- Again, stretching the left one.
- Yep.
Yeah, I'm glad you brought that one up Bob.
Boy, he had- - He had good luck with that
- Yeah, he could hardly walk.
He was getting to the point
walking was sometimes painful.
- It was an amazing story, to be honest,
because he was gonna give up.
I mean, he couldn't even walk
and he was gonna give it all up
and he ended up running again.
- Yeah, he went to a PT and he started doing this
and he was grateful.
And he was like 60, some years old.
He's still riding, doing his activities.
- So, want to talk about massage gun spread?
- Yeah, like
we mentioned before
if that,
say the IT band- - it's bound down
- you can stretch it as we did there.
Pick out a few of stretches,
but to break that,
if it is adhesed or bound down..
- And oft it is.
- You can get in there by your hands
and do what I'm doing here
and do some cross fiber
and get in deep
and you'll find
that that'll help.
And you also find that your hands and fingers become
fatigued after about a minute.
Depends on how tough you are.
I'm already getting fatigued.
- Yeah, I already did both sides
and you just doing one side.
- Yep.
Or, you know, if you happen to have a massage gun,
which Trip does because I gave him one.
- Sure, and this case, I would say,
this is where you want to spend your time.
I mean, and your money.
It's gonna be well worth your time and money
to use a massage gun.
- Now Bob has gone directly
and he's got.. - Pretty aggressive.
I got the bell head.
And actually this is probably
the most aggressive head.
Maybe the bull head too.
But this is maybe a good way to start.
- I'm using the one with the round ball.
Here, you see this.
And,
Bob's pretty tough.
I don't like that head.
It's a little too aggressive for me.
I'm gonna go this way and I actually got to turn it sideways
'cause this reciprocates this way
and that'll help break up that adhesive
and you can go directly at it-
- Yeah, won't bounce along too much.
- but that's too much for me.
And you know, Trip's a thinner guy so he probably
is not gonna go- - As strong as I was
- Yeah, exactly.
And as important,
if you find your hip bone here,
don't go directly onto that.
- There's a bursa there
and you don't want to irritate.
It's doesn't feel good anyways,
unless you're kinda unusual.
- We got two guns here.
This is the T-2, more for the athlete.
A big powerful gun.
And this one has plenty of power too,
but it's not as powerful as this one.
- So, we got the T-2.
- And the C-2.
- T as in Trip.
- Yeah, there we go.
And then the C-2, C as in cat.
- R-2, D-2, C-2 (sniggers)
- Yeah, so we're gonna, I like to get in here
and I just think it feels good
to get these hip fascia latae. (crosstalk)
- Ooh, wow!
- See what I'm talking about? - Yeah.
- Kinda lights you up, whoa.
(laughs)
Anyways.
- Life is good.
- Yeah.
- I'm good!
- You wanted to show the wall stretch or not.
- Yeah, I do.
- In case you're at an event
and you can't get on the ground
'cause it's was all wet.
- That's a good point, yeah.
- Quite often that's the case.
- Well, they started this race,
think at four o'clock, 4:00 AM.
And I think the goal for Trip was 24 hours
he wanted to get it done.
- Aah, can you imagine running for 24 hours?
- No, I-
- I can't even stay up for 10.
(laughs)
I said take a nap.
- He went through the race, for me like at mile 10,
he was feeling good.
By bike mile 40, If I remember right,
things were starting to ache- - Oh, really?
- It's like 30 miles ago and I couldn't even believe
he was standing, you know?
So before you know, race, you can do this.
I'm gonna stretch my right one,
so put the right leg here,
take the other one and cross in front.
That's not,
that's just hanging, there's a place to put it.
And now I'm gonna move my hips in this way.
And that pulls here
and stretches that out.
And you know, this is one I think you can do a little
dynamic stretch like this as well.
- Yeah, very good.
That's a good one before the race.
- The other one's you want to do it throughout
the weeks before,
that really stretches out.
- Right, exactly.
So, boy, Trip- (crosstalk)
excellent job on that endeavor and that adventure.
And
if you,
I'm a little cautious on saying do another one,
because I don't want something to happen to him.
- Yeah.
- Yeah, stick to marathons maybe.
- All right. - Good luck.
- Thanks for watching.