♪ 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 most famous physical therapists
on the internet.
- Well, Bob, in our opinion, of course.
- Today, we're gonna talk about how to stop inner knee pain.
That means on the inside, right?
Or inner, in the joint? - In the joint.
- Oh, in the joint. - Yes.
- Knee pain and avoid surgery.
We got four specific options. - Right.
So, Bob, this is something
that typically we're talking about arthritic pain.
- The joint has wore down. - Yup.
The cartilage was not doing well,
and you wanna avoid surgery.
The good news is, oftentimes,
I don't know what the statistics are,
but it's worth the effort
- Absolutely worth the effort.
- To do these steps to avoid surgery.
As a matter of fact, in my mother's case,
she has a knee problem.
She has some medical issues
where surgery is not an option for her.
- Is not warranted.
- Right, so these steps
she's working on. - She has to do this.
- Right, exactly.
- And you know, I think, you don't wanna caught up
in the idea that it's gonna get progressively worse.
It may, but it may not.
It may stabilize - Right.
- or it may even get slightly better
according to the studies.
- Right. So you go to your doctor.
You got knee pain. They take x-rays.
They say, "Oh, you've got arthritic changes."
- Maybe bone on bone. - Yup.
And then, hopefully, the doctor's going to say,
"The first option is gonna be exercise or therapy."
- Physical therapy. - Right.
And if the doctor does not goes to that,
and goes to step number two and wants an injection,
you can interrupt him
and say, "I'm thinking-" - Or her.
- Or her. Yeah, good point.
"I think maybe therapy. Is that an option?"
And oftentimes, they say,
"Oh, well, yeah, if you wanna try that,
- Right. - please do ahead."
They'll write you a prescription for physical therapy.
The exercises are not really something that's special,
and we're gonna show them to you right now.
- We have a lot of them on our website.
I mean, on our website,
which we will have on the Knee Program.
But we also have a lot on YouTube.
- Right. Just put "Bob and Brad knee pain exercise".
- and off you go. - Right.
So the big thing is to get the joint moving.
So we wanna get that joint moving
and typically, in a non-weight bearing fashion.
In other words, not walking.
We're not doing deep squats.
We're gonna try to get that joint moving
so that synovial fluid, the natural lubricant,
gets in that joint and helps make it feel better.
Get it back to moving.
- I know you mean, well by this, Brad,
that if you can walk and there's no pain, by all means.
- Right, yeah. Exactly. - Yeah.
It's 'cause if you're walking
and you're really limping because it hurts,
then you probably wanna do non-weight bearing.
- Yeah. That's a good point.
Yeah, if you can walk for 200 yards without pain,
then absolutely walk.
- Right, absolutely. - Right.
All right, so, let's say you're walking,
you've already walked your distance.
It's like, "Ah, it's starting to hurt now
and it's getting worse."
Then you're gonna give it a break
and you can start doing simple kicks
or long arc quads, we call them.
Working that joint, working the patella,
bring it up as far as you can, and back down.
It's important that you really do it
in a nice controlled manner.
You're just not kind of arbitrarily flopping.
- So, you're getting motion,
plus you're getting some strengthening.
- Exactly!
- It is a good one to do quite frequently.
- Yes.
- You could do it like every hour.
- I've had patients specifically,
I say, "Before you get up and walk,
do 10 of these on your sore knee."
- Very good point.
- And they say, "Oh, yeah, it doesn't hurt so much
when I would get up and walk
if I get it moving prior to the weight-bearing or walking."
The next thing is you can do what we call floor scrubs,
and now you can't do it on carpet because it sticks,
but in your house, if you've got a smooth floor,
you can throw a towel down.
You can go back and forth like that.
We specifically do have...
- We have a couple products,
and these are really good if you're gonna have surgery.
- Yup.
- Even if not, we've got the FitGlide.
- Yup.
- And you can actually, in bed,
you wanna slide it down, Brad,
a little bit. - Yeah.
- There you go.
This is one of the few devices
you can work your legs while in bed.
- Right. - And easily.
- Yup, and it's very light.
You know that one is for both legs.
You could use one for one leg.
- [Bob] And then you could take it
and put it on the floor in a seated position.
- Right, and you could do that with both of these.
Now, this one, people usually use that know
they're gonna have surgery. - After surgery, right.
- Either before surgery or after.
- Because you're only working on one leg.
- Right.
There we go. I wanted to get that.
So we're doing that.
The nice thing about the knee glide
is you can put it at an angle,
which does give resistance in both directions.
- It's got a little stand, like you can do it on both sides.
- Yup, and you can do it carpet, then it's not a problem.
So keep the knee moving.
Keep it strengthened.
And you can do squats
if it's pain free.
- Especially shallow ones
you may start off with. - Right.
And you may have a chair like this,
so you're gonna have your hands here, go down.
When it starts to hurt, go back up and just do mini squats.
And after time of doing this,
hopefully, you're able to go deeper without pain,
which is a good sign that it is improving.
You're getting stronger.
The joints are starting to recuperate.
- Yeah, you just touching upon it,
and there's really a lot of exercises
- There is.
- You're trying to increase the natural fluid.
- Right.
- Natural lubrication. - Synovial fluid.
- Yeah.
- The other thing, which is a really good exercise,
but most people don't have access
is pool exercises. - Pool, yeah.
- Getting in the water.
- You can do some weight bearing.
You can walk in the water, basically, you're saying,
or maybe do aerobic exercises.
- Right. There's often times classes.
- Yeah.
- But walking in water this deep
takes a lot of pressure off.
You get motion. - Yeah, resistance.
- Yeah.
Now, once you get through all of that,
number 2 is a common- - While you're doing those,
by the way, you can take ibuprofen.
- Good point. - or Tylenol.
- Some over the counter. - If your doctor agrees.
- Yup. Yeah, depending on your other medications.
But it's oftentimes a good combination.
If that's not working
or it's working but it's still a problem
and you need to discuss this thoroughly
with your surgeon or your doctor, a cortisone injection,
where they actually take an injection into the capsule,
that's into the knee joint itself,
and it's like an anti-inflammatory.
- Corticosteroid, I believe. - Yup, yup.
- And the studies have shown,
this is worthwhile trying. - Right.
- It's got benefits, especially with people extensive time.
- Right.
And in the case, like with my mother,
and I think this is pretty common with injection like this,
every three months, if it helps, it's getting better,
it won't last forever.
Hopefully, it'll get three months,
because they don't like to do these injections
- more than that
- More than every three months
because it can cause problems with the joint,
because it gets a little too aggressive for that.
- A lot of side effects.
I mean, if you do too much. - Right. Right.
And I'm not gonna get into the side effects.
You can talk to your doctor about that.
- Yeah.
- But that's a real common protocol,
and this will vary from doctor to doctor or-
- Or institution to institution.
- Exactly right.
The next injection that's the next step up, if you will,
would be the Synvisc injection.
This is typically a series of three shots.
It does not take effect
as fast as the- - The cortisone.
- The cortisone.
You may get the first injection,
and they'll say, "You may not feel any relief off of this.
It may take a week or so."
And then you get the second one and the third one.
However, if this, and I say if
because it doesn't always work,
if this system works,
usually it lasts quite a bit longer
- Sure. - than the cortisone.
- Gotcha.
- So again, this all has a lot to do
with your joint condition,
your weight, - Right.
- your strength, your range of motion.
- But there are things you can bring up to your doctor.
- Yup, so it's very individual.
So you've got the cortisone, the Synvisc injection,
and this is a newer one, at least at the hospital
that I'm familiar with - Right.
- is the radiofrequency ablation,
where they actually go in with radiofrequency to the nerves
that tell your brain there's pain in that knee,
and they ablate them or kind of destroy them
so that they're not working anymore.
And this is something that they're doing with backs now.
You just talked to a doctor.
- They're doing it with backs,
and also, we know one surgeon
that does it before the surgery
to lessen the pain while you're recovering.
- So you don't need as many pain medications.
- Right, right. - Right.
So this may or may not be an option where you go.
You can ask them about it.
- I think it's a promising area.
- Yeah. Yup. I think so too.
What they do at a facility that I'm going with my mother,
they will do injections to those nerves and get them numb.
- Oh, to test whether or not it helps.
- Right, so you inject.
It temporarily numb up, feel the same nerves.
And if that takes care of the pain temporarily,
that's a very good sign
that you can do the ablation - Sure.
- and it will be successful. - Makes sense.
- Yeah, so that's four options
and particularly if your option
for not having a knee surgery,
for what, your heart's not strong enough-
- Or if you wanna try some more conservative things.
- Yup. - These are it.
- Yeah, absolutely.
- So that's 4 things to toss around in your head.
Talk to your doctor about it.
Again, it is individual thing between you and your surgeon.
- And our giveaway today.
- Oh, yes, this is good. - By the way,
this is a big giveaway.
- I don't know if it's gonna help with knee pain,
but it's certainly gonna help with sleeping.
- Yeah, that's right.
So we're giving away the SleepOvation Mattress.
- Right.
- And you can pick out the size.
- [Brad] Yeah.
- This is just a sample of one.
- Right.
- It's got 700 tiny mattresses
- Yeah, right, there they are.
- Very much a mattress for people who are in pain.
I think, you know, personally. - Sure.
- I have heard testimonies from family members and friends
who just, this is the most comfortable mattress
they've been on.
- Because, you let them sleep in your bed?
- Well, we have one at our cabin.
- Oh, the spare bedroom - Yeah, the spare bedroom.
- People fight over it.
- Yeah, well they fight over it,
then they wanna get one actually.
- Sure. (chuckles)
No, I have one too.
I really do, as well as my wife.
We enjoy our mattress.
- Yep. And so, go to BobandBrad.com.
Go to the giveaway section.
You can sign up for the giveaway.
You can also go find that on Facebook.
- Pinned to the top.
- Pinned to the top of the page,
and you might as well subscribe to us
while you get there too.
- Right, you hit the subscribe button
and do something else. - Yeah.
- And in the podcast.
- Oh! - Our podcast.
- Can you subscribe to podcasts?
- Yes, you can subscribe to podcasts.
- How do you do that on the radio?
- It's not radio.
(Brad laughing)
Yeah.
- Well, it's kind of like a radio.
- How do you do it in the phonograph?
- Yeah.
- All right
- Be careful, whatever happens.
- Be quiet. (laughs)
(upbeat tone)