- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Brad, today let's get right to it.
We're gonna talk about the top three treatments
for a painful hip and arthritic hip.
We've done some of these exercises before
as part of other videos
but we're gonna put it all together in one.
Got a friend that's complaining about a painful hip
so we're here to help, right?
- You better believe it.
- All right. First thing you're gonna do
when you have arthritis,
the thing about arthritis, Brad is it tends to flare
up and it tends to calm down.
- Sure.
- It doesn't just flare up and then stay up
there generally, unless you're irritating it.
- Right.
- So the first thing you want to do,
and a lot of you are not gonna like to hear this
but we're trying to get it to calm down.
So one of the best ways to calm it down
is not put as much weight on it.
- Right.
- So if let's say I have pain in my right hip
in order to take some of the weight off that right hip,
one, you could use a walker, but two,
the least intrusive method
would be to used a cane.
- Right.
- Can you still see me, Nate?
- And you and I know Bob that we've had patients
when you say something about a cane
they are just not gonna go there
because they just feel it makes them look old.
But boy, if it's gonna take some pressure off that hip
and reduce the pain.
- Right. And it's not permanent.
We understand that.
We're just having you do it
until the inflammation calms down,
until the pain calms down.
You're a little bit shorter than I am.
- Well, yeah, little bit.
- But the thing about it is, it's not permanent.
Okay. You're just gonna do it
for a little while, until it calms down.
- Right.
- So you're going to use it on the opposite side.
Brad, you wanna just show how
you would use it just real quick.
- If this is the painful hip,
you do it in the opposite arm, and you're gonna walk
with it when you take a step forward, there, right leg.
The cane goes with it. And almost always in the clinic.
I have people, I just tell them use it
in the opposite arm and I say, walk with it.
And they automatically sequence properly it seems to be.
- Yeah. I try not to even give too many cues.
Cause they seem like they pick it up real quick.
- Yeah. If you give them cues then it gets confusing.
So just put it in the opposite arm and walk naturally.
Make sure it's adjusted right.
Standing tall, cane, should be right
at the crease right there.
Yeah. That's a great way to decrease.
- I have quite often found Brad that, that alone
can calm things down.
And also avoid steps, avoid hills,
I mean, all those things are gonna put more stress
on the hip right there.
- Sure.
- Then to calm down. Okay. That's number one.
Number two, Brad, is motion.
We want to get some motion in the hip.
You're gonna find out arthritic joints, joints
with arthritis, like to have movement,
especially if it's not too far along.
- Right.
- If it's really far along that you need
a hip replacement, then the movement's gonna probably
make it worse.
- Sure.
- But generally the more movement there is in a hip
and this is a hip joint on the pelvis.
The more the synovial fluid is created
as one person called it snowmobile fluid.
But it's just a kind of a grease, right, Brad?
- Right.
- Helps the lubrication, So the more movement
you have, the better it's gonna be off,
the better off it's gonna be.
- Right.
- So let's show some movements, Brad.
- You better believe it.
- Can you get out of the way?
- Oh yes, I can Bob.
- Okay. We got the Packer ball.
It's good for one thing, a pillow.
- Don't listen to him, Packer fans.
- All right. Exercise number one.
Before you even get out of the bed in the morning,
this is for you, buddy, Mike.
I want you to start getting some movement in that hip.
And so all you gotta do is roll your hips back
and forth like this.
You're also getting some
motion in the back, which isn't bad for you either.
- You better believe it. Two for one.
- Keep your shoulders down and you can even stretch
a little bit, can't you?
Because this is range of motion and stretching you can add
into. And if I'm gonna stretch, what you can actually
do is bring it over like this and even bring the one leg
over a little more and stretch it.
Even the hip a little more.
You can also go this direction, but I'm gonna hit a wall.
So, all right. That's one stretch.
You can do one range of motion.
The second one is I want you to put one leg
down and you can bring the other one up and stretch.
Now don't make these hurt.
You go up to the pain, stop and then back off again.
All right. There's nothing to be gained by
ow, ow, ow. I mean, just go into the pain,
come right back off, good three-second stretch.
You don't need to stretch it that long.
You do longer stretches too, if it doesn't hurt
- You have to listen to your body.
If you have sharp pain, you avoid it.
But sometimes with repetition each time it may get less.
- It'll start getting more movement, less pain.
All right. Go with the other hip.
Again, we're kind of stretching into extension here too
Brad, aren't we?
- Yep. Again, we're stretching out both sides
if you keep this leg down.
- Okay. Those are the two main stretches you can do.
There's another one you can do,
you can do a hip extensor stretch,
but I'm just starting to get some movement here.
- Keep it to the basics now on this.
- So the third thing we're gonna do is the stronger the hip
is the better off it's gonna be also.
The more the muscles can stabilize the hip
the less pain there's gonna be.
So we're gonna show just a couple strengthening exercises.
Brad, you want to show one with a chair?
- You better believe it.
I got to find a chair.
- He's got really a lot of enthusiasm.
- Well Bob, you know, I ate my Wheaties this morning.
Okay. So it's nice to have a chair, something to,
if you have a walker chair, something
so you have a balance it covered and we're gonna work
on strengthening that hip and one direction.
That is a nice direction that goes
out to the side like this.
Okay. And we're gonna do 10 to 15 of these
and be careful not to do this where you get your body
like a teeter totter.
- You actually kind of look like a penguin almost.
- Yeah. Anyway, we will not be penguins.
We will all be therapists and doing good exercises
and you'll feel that muscle right up in here.
And the next one I like to do is just go straight behind it.
You're going to do 10 of these.
Not, not like this bending the knee,
we don't want to work the knee.
We want to work the hip.
And again, with this one, some way the cheater compensates
is to do this.
And that's not what we want to do.
We want to sit up tall and work those hip muscles
right there. You're gonna feel that, 10 of those.
And then you can turn sideways, so you don't hit the chair
and just do this, like a single leg march
and do 10 of those.
And you get three directions of the hip
which really encompasses
75% of the muscles in the hip.
What do you say to that, Bob?
- Looks good. And just to give a couple of finer points
that we maybe didn't cover the first go-around here.
Lot of people complain about using a cane, Brad.
- Sure.
- But what's amazing to me is because they're having pain,
a lot of them are walking like this.
- Yeah.
- And what do you think? looks older, Brad,
walking like this or walking with a cane
and walking straight up and not having any ...
- I think you look old either way, Bob.
No, seriously. when you start walking like that,
the cane gives a person a sense of dignity.
- Yeah. That's right.
- The English gentleman, right? Yeah.
Don't be afraid to use the cane.
- All right. The other thing I was gonna point out
with the movement, why you want to try to get more movement
in the hip. If your hip is limited
and let's say you're only moving this much.
Do you wanna come on in for this one, Dave?
Yeah. Let's get a closeup.
- [Brad] Not of me, of the hip.
- [Bob] I bet you do.
- [Brad] But if it's just moving like this,
what is gonna happen, it's gonna wear out
in that little spot.
- [Bob] Sure.
- [Brad] But now if I spread the forces out
now the forces are spread out through the whole hip.
And so it won't wear out as easy in that one spot.
- [Bob] Sure.
- [Brad] So that's why you wanna keep the hip stretched out.
You don't want to have it just moving in that little range.
Okay.
- [Bob] Any other fine details you wanna bring up, Brad?
- [Bob] Well The only other thing I can think of, Bob,
if you're 40 and over and you want more information
like this for yourself or your parents
we are gonna be offering this, we do this on a weekly basis.
- We do. Yeah. We're always trying to put videos up,
almost a couple a week normally.
- So take care and subscribe.