♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ on the internet ♪
- Hi folks, I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- And we're the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today we're going to show you
how to stop hip bursitis pain without seeing a doctor
or having an injection!
- Right.
- We're certainly going to give you some advice here
on things to try before you go that far.
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because right now, once again,
we're giving away a huge product this week.
We're giving away the Teeter Inversion Table.
- Right.
- This is really a cool table
that you can use for decompression.
And Brad and I are just amazed;
it's made by a guy named Teeter.
- Right!
- Now what are the odds that, you know,
it teeter-totters!
- Roger Teeter.
- Yeah how is it that he come up with it,
to have that name and to come up with that product?
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We do it every day.
- There you go.
- We never stop.
We're like a hurricane, I don't know.
Or like a Juggernaut?
- [Brad] You're babbling, Bob.
Now they're gonna holler at us.
- Alright.
- Okay, Bob, this is why I wanted to do this.
Two reasons.
We did a nice video on this six years ago.
I looked at it; it's a little burlar-y.
There was some information that we can add to.
That's one reason.
The other reason is I was doing some research on it,
and almost all the research I could find
was talking about injections
and all this invasive, aggressive treatment
you need to go to the doctor for.
And I really think that if you approach it properly
you can avoid all that
and get rid of it.
Because bursitis can be real debilitating, you know?
It limits your walking, hip pain, et cetera.
But if you understand it--
- It can affect your sleeping.
- Oh right!
We're gonna show you why it happens.
There's something called an IT band that comes down here,
and you have some other connective tissue
that goes over the greater trochanter,
this is part of the hip.
And what happens is when you walk and you move,
the tissues slide back and forth over that bone.
Now if there was no bursa there,
a bursa sac,
that would become very painful,
and things would wear out very quickly.
So what we have is a bursa sac
which is represented by my little piece of paper here
to allow it to slide back and forth real easily.
If this bursa sac becomes inflamed and irritated,
that's where the pain is.
That's the source of pain right there,
so we need to get the pressure off of there,
allow it to calm down, heal, and get back to life.
- Yeah, and the thought process is, Brad,
we believe that if you have what we call a Trendelenburg,
like you're kinda walking with your hips waddling
back and forth,
that's putting the increased stress on that bursa also.
- Right.
- So we want to, at some point, strengthen things.
Or, should I jump to this one, Brad?
- Well, go ahead, Bob!
- Actually if you use a cane right now,
that can stop that waddling from occurring,
and that can also stop some of the stress on the bursae.
- Right.
- So quite often what you would do if you have bursitis
just in one hip,
let's say we have it on my left side,
you're gonna use the cane on the right side.
- Sure.
- We won't go into the mechanics of that.
There's a whole physics behind it, right?
- But it's true; it takes pressure off the opposite hip.
- So when you're moving the left foot forward,
you're moving the right cane forward at the same time,
and that will help straighten things out,
and it'll definitely take some of the stress off.
And a lot of times, if you can calm things down,
it stays calmed down.
I'm amazed at how quite often just a cane
can make a big difference.
- Yeah, we do this with our patients.
- All the time.
- Have them use a cane.
The pain was at a six before,
now it dropped down to a three just with the use of a cane
as a temporary thing.
- Yep.
_ It's not like you're going to use it
for the rest of your life.
- That's right, we're not saying that you're bound to it.
- Right.
That's one of the options you can do.
Now we're gonna give four options,
and then some exercises.
The second one is simply, if it's irritated and sore,
get yourself a cold pack.
I brought mine out like this, but Bob says,
"You gotta have a bigger one than that!"
- Come on, what is this?
- Well the bursa's not that big.
- For a girly man--
- You could use one like that.
But yeah, if you got a big one, get like this.
You know?
And you can lay on your side.
This I'll make my sore hip.
You could do this in a recliner
but you need to get that cold pack directly on your hip.
But make sure you have some layer of clothing.
I just had a patient yesterday,
he got burned from a cold pack.
- [Bob] He did?
- Yeah, he didn't have the layer of clothing.
So you've gotta be careful.
Twenty minutes.
- [Bob] Like frostbite.
- Right, exactly.
20 minutes on there,
and that should help calm that down as well.
Number three is avoid activities that irritate it.
So if walking irritates it,
you're gonna obviously have to walk,
but you're gonna limit.
You're not gonna go on long shopping sprees,
or go our for a walk and think you're gonna walk through it.
- That's where the cane might help.
It can help you walk further.
But the other thing that is very common.
Quite often people will have bursitis,
and they tend to sleep on that side.
- Right.
- So you definitely want to avoid sleeping on that side.
Let's say you're avoiding it,
but you still need to do this adjustment,
otherwise you're still putting stress on it.
So let's say your bursitis is on the right side here,
on the upper leg,
and you're doing the right thing.
You're not gonna sleep on it.
Well if you take this pillow away,
this leg rotates and it pulls on the hipbone here.
The muscles do.
So you definitely want to use a pillow
between your legs,
and that'll take the stress off that area
and it'll help it calm down.
Get that good night rest,
and it's going to allow your body to heal a lot better
and faster.
- Right, and then the other thing that you can do,
it just depends on you,
if you respond well to NSAIDs like ibuprofen.
Take that for-- I don't like to take those long-term.
I think if you do it three times a day
for three days in a row,
it's going to do what it's going to do
while you're doing these other things.
- Yeah, and you have to make sure you're allowed
to take them.
But we've had pharmacists that recommend
that you might take kind of a higher dose.
You should ask your doctor or pharmacist.
- Right.
- Take a higher dose for three days and then just stop,
and really try to blast it.
- Always take those with food,
but again, get that okayed with your doctor so you're not--
- NSAIDS, Non-Steroidal Anti-Inflammatory... Drugs?
D's, right?
(laughs)
- They're anti-inflammatory drugs.
- We just call them NSAIDs.
- NSAIDs, yeah.
- Anti-inflammatories.
- Ibuprofen's probably the most common.
Now let's get to the exercises.
- Sure.
- Stretches, okay.
- So we're going to try to stretch
to take some of the stress off that bursa
so there's not as much pressure on it.
- Now these stretches we won't get too aggressive with.
Depending on how inflamed it is, or how sore it is,
but this is one you can do this on your floor or bed
or even your couch.
And you do cross like this,
and you're gonna pull this knee across your body like this.
You can see this right here, the white stripes on my pants,
represent that IT band and some of the other tissues
that are gonna cross that bursa.
And stretch them out.
Now if you do this and it hurts,
and it's so inflamed it hurts, you need to rest.
Don't do it.
It should just feel like a nice comfortable stretch.
Hold, and do this, you know, five to ten times,
and it should feel good.
You know, and then give it a break.
Do that three times a day.
The other one is,
you lay down like this with your knees up.
You can have a pillow; you can do this one in bed easily.
And you cross,
put your right ankle just below your left knee like this.
I call it the Figure 4 Stretch.
And you're gonna bring your left knee,
my left foot comes off the bed,
and you pull gently like this.
Don't get too aggressive with it.
You should be relaxed.
And hold and stretch.
- [Bob] Come on, Brad, let's say you're unable to do those.
Let's say you're not as mobile.
You could just start off like this,
and bring it over and give it a good stretch like that,
keeping your back down,
keeping everything and allowing it to stretch that.
This is kind of a gentle, a good start-stretch.
- Right.
That's a good point, Bob,
because we do have, particularly some of our older people,
do have a hard time.
- [Bob] Getting into those positions.
- Yep, thank you.
- [Bob] That's a real pretzel there.
(laughs)
There's also the standing wall stretch.
Should I show that one?
- Sure, you bet.
- So you could try this one too,
if you're maybe a little less flexible.
You go up against the wall.
You're gonna be about, I don't know,
I'm about three feet away from the wall.
It's going to depend on your height.
I'm gonna lean against on my forearm.
I'm gonna stretch this one, the right one,
so I'm gonna cross this one over like that.
And then I'm just gonna lean like this.
I'm gonna lean my pelvis into the wall.
And so this is one most people can do.
I mean a variation of this
is just to go ahead and lean this way,
and not even cross it over.
But I always find it a lot easier, and it's more stable,
and it's just easier to do.
So obviously you do both sides, too.
You cross over, and go like this, too.
So you can see both angles.
- Yeah and you're gonna spend a minute or two
doing that stretch,
and you can put the pressure on, pressure off,
and work with that.
Um, what was I going to say?
- I was just thinking of a joke.
I think this was in Reader's Digest.
A lady was stretching, going against her car,
and a guy comes up to her and starts pushing the car,
he thinks that she's--
- Helping her out!
(laughs)
- This is Minnesota, that's what's gonna happen.
- Right.
Or I suppose they're gonna try and push the wall over.
- Try to push the wall over for you.
- Now the other thing,
we've got a strengthening exercise.
To get those muscles strengthened in that area.
This works good if you have one of these loop bands,
like this that stretches, I'll show you.
You can start without one of these.
- Yeah I, in fact, would recommend you do start without it
because these are small muscles
and to build them up you want to do a couple reps
for a couple weeks probably.
If you jump right into the band like I did,
and I was doing it every day,
I got a little sore.
- Got a little sore.
So you're gonna lay on your side.
So this would be the involved side.
Things are starting to feel better,
it's a little calmed down,
we want to start strengthening.
And we call this the clamshell,
because it looks like clamshell.
You're not gonna do them real fast.
It's up and then bring them down.
And if you can, keep a gap between here.
Don't let it touch and rest.
Up, and there you got an inch or two in between there,
and at about a pace like this
you're gonna do 10 to 20 of them.
You'll feel, as a matter of fact,
right now I can feel that muscle right there.
Like Bob said, we're working some small muscles.
We're not going the glute maximus here.
And when you get tired, you give it a break,
and then you can do another set of 10 to 20.
You can do three sets of those,
as long as it's not too much.
When that gets too easy,
you can see I've got my little loop band right here.
- [Bob] He moves it down.
- Yeah, put it down by your knees,
and that'll definitely give you the extra resistance
you need.
You're gonna probably cut down to 10 repetitions.
- [Bob] These come in different colors.
Generally, the lighter the color, the easier it is.
Like you get up to black, and that's where you start to--
- Oh boy, I can feel that working.
- I was using black, I went right to black.
I thought, "Oh I'm in good shape."
And I was doing it every day for a while,
and and like, oh my God, I got so fired up I couldn't sleep
on that side.
I had to ice it.
I had to massage it.
- That's the price you pay for being a man.
- Yep.
(laughs)
- It's a guy thing.
- What does that mean?
- It's a guy thing; guys always overdo it!
- Oh yeah sure.
We're idiots.
(laughs)
- Remember, Brad and I can fix just about anything.
- Except for...
- Broken hearts, but we're working on it.
- Good luck!
- Thanks.