- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Let's try to see how fast we can say that sometime.
All right, today, we're gonna talk about bone
on bone arthritis and three things you can try
for it, you know, to help manage it.
- Sure.
- So you're not gonna make it go away.
- And probably the most two...
Most common joints that have it,
are probably the hip...
The hip (laughs)
- The hip. - And the knee. (laughs)
- Yeah, we're really good on identifying joints.
What is bone on bone arthritis?
Let's just real quickly talk about that.
On the end of the joint here or on the end of the bone,
you actually have a really smooth surface, really.
And this is a cartilage actually-
- Right?
- High end cartilage, really thin layer,
but it's it's very hard and it's very slippery.
And what can happen after a time it starts
to wear down or wear off.
- Mhm.
- Brad, give your analogy.
- Like a bearing surface of steel on steel is really smooth
and shiny with little lubrication in there it works well.
But if things start to rust, they get pitted and things,
all of a sudden start to grind and it's just not good.
And that's kind of what's going on.
- So yeah, you can get little cavities here,
capitations and you can actually...
Pieces of it can break off.
- Mhm.
- So it's, you know, little deficits there,
I guess you could call it. - You're right,
it's not good.
- All right, bone on bone you can tell, you know
it's making noise a lot of times crepiness it hurts.
So these are the three things you wanna try.
- Okay.
- Okay number one...
Maybe you wanna back up a little bit, Lonnie.
Brad, do you wanna throw me the cane there?
Number one, the thing about arthritis
it tends to kind of flare up and calm down again.
- [Brad] Sure.
- So, especially when you're having a flare up
you wanna go ahead and make sure you're using that gate aid
and by a gate aid, I mean a walker or a cane
or something to take some of the weight off the knee.
Now that's not saying that you're gonna have
keep using it forever, but we do want you to try it
just for a short while just to calm the knee down.
So we have a video on the proper way to measure a cane
and we have videos on how the proper way to use a cane.
But generally a lot of times with the knee
you're gonna use it in the opposite hand.
- Right.
- And whenever the knee's out there, the cane's out there.
- Sure.
- So you're taking weight on it.
Some people do the Dr House method.
- Yeah.
- Where they actually keep the cane with the knee
and they lean like this, whatever, you know
whatever floats your boat.
- Whatever makes the knee feel better.
- Yep, so that's number one.
You wanna decrease some of the weight on the knee
for a while to help decrease, calm it down
get the inflammation calm down.
- Sure.
- Number two, the second thing you're wanna do.
You wanna get some movement in that knee.
- Yep.
- Movement without weight bearing.
- Sure.
- So a lot of times biking works really well with that.
Brad, why don't you bring this on over.
- Sure. - This is our...
This is an elliptical machine.
This is the E1000.
I'll put a link down below to our website,
it's on the website.
The thing about this...
Brad and I, we use this in every clinic we have,
we've been using it for years
and we use it in a seated position like this.
You can use it standing too, but that's not the idea.
- Right.
- The idea is you're gonna get some movement in the knee
without putting weight through it.
- Right.
- And this is a great way to keep your knees healthy
because it's generating the synovial fluid
- Mhm. - And it's getting more oxygen
to the knee.
And you know, it helps even...
I think smooth the joint out a little bit.
- Sure.
- So this is a great thing.
You wanna get some movement.
If you don't have one of these,
like I said, you could try a bike
or I suppose even, just even some towels on the floor
or maybe some, a sheet, a pan what's that
tin
(Brad laughs) that you use
for making cookies, something like that.
- We'll get through this, Bob.
- Yeah.
(Brad laughs)
All right, so that's number two.
You wanna get some movement in the knee.
- Right.
- The third thing...
By the way this runs about
120 bucks. - Right.
- So, third thing you wanna do
is you wanna strengthen the hip and the knee.
The reason I say the hip and the knee quite often
because people are having pain in the knee
that whole leg becomes weaker.
- Right.
- And if the hip becomes weaker, it's gonna make...
It put a harder more stress on the knee.
- Right, 'cause what happens at the hip
changes the mechanics at the knee.
- Right.
So they're both gonna be weak.
So we wanna do some exercises to help strengthen.
Brad, why don't you talk about your deal,
you do with patients.
- Oh yeah.
If you have symptoms, getting out of a chair
and it hurts them,
or getting up and down in those knees,
I just had this
this week with a patient,
I said, just simply do kicks.
Okay, we call 'em learn our quads.
You just kicks like this
good slow motion, up and hold
and then come back down,
up and hold and then...
So if you've been sitting in some place for an hour,
you've been watching TV and you know,
oh Jesus it's gonna hurt when I get up.
Take a few seconds and do 10 of these.
- So you're getting some movement
and you're getting some strengthening.
- Right, and you're gonna do on each leg.
And I bet you anything when you get up,
it's not gonna get rid of it,
but it's gonna help a little bit.
- Okay. - Okay.
- All right.
Some strengthening exercises you can do,
on the floor, in bed wherever, wherever you wanna try em.
You go ahead start with some straight leg raises.
- Sure. - You can bring...
I'm actually gonna work on this one right here, Brad.
- Right.
- I wanna make sure my mic is okay.
This leg, you can put up like this,
and you're gonna go ahead and bring it the leg up like this.
- Straight leg.
- 1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
Toe straight up. - Mhm.
It really does help to have this leg up like this.
- Yeah it help.
It's easier on the back, It's easier on a position.
These are not that easy to do. - Right.
- We gonna find out that you're...
You know, it's gonna be hard work.
The second thing you can do then
is just roll over onto your side.
And now you can start going up like that.
- So again, the leg is straight out to the side.
This leg is bent.
So he's got some stability on the bottom
and how high you can go as high as you feel you can.
'Cause you may not be able to go very higher.
You can go, Bob?
- Oh, I can go higher.
- Yeah you wanna go but you don't need to go that high
but you're gonna go off. - This is working right now.
- And down.
And we're working that hip, all the way down
on the side of the knee.
- And then you go ahead and talk, Brad,
in case my mic goes away.
- Okay.
Now, straight leg again, back here, laying down, you know
if you're on your elbows or whatever you're comfortable
with here, so you can breathe and your shoulders
aren't uncomfortable.
And the same thing up and hold straight knee here.
A lot of people here will do this.
And that's not what we're looking for.
We're looking for a straight leg raise, again.
And you know, you can do that on both legs,
even if the other one's not hurting.
It's nice to even things out, I think.
- Exactly, so- - You can do about
10 repetitions typically on each of them.
- Right, and if, you know, get to the point
you can actually use some weights
to and do some quads in this position.
You can do some strap on weights-
- Right, the Velcro ones...
- Of course there's no pain.
- That go around the ankle, not the dumbbells.
- So, all right very good.
Give those three things a try.
If you have the bone on bone
and hopefully we can get some relief for you.
- You better believe it.
- Thanks.