- All right, today the topic is hip
and hip pain, why it hurts,
and we're gonna show you some stretches
on how to eliminate it.
If you'll notice over age,
and we notice it as therapists, the hip tightens,
the hip can gets painful,
and we need to observe what's going on with it.
So as we age, the hip ages,
but it doesn't have to if you treat it right.
- And in this video we're gonna show you five stretches
to help combat these issues
and tell you why you wanna do them.
- That's right.
Sam, what have you got to say?
He's a little shy today.
We'll get right at it.
(upbeat music)
All right.
So I want to talk a little bit
about hip pain and where it comes from.
Now I think we all understand if you have a history
of an injury in your hip when you're younger,
or if you've worked at a very physical, laborsome job
say working in construction, et cetera,
it makes sense that that hip wears out
from use, overuse, et cetera.
But what about people who do not have a injury,
they have jobs that are not aggressive,
and they still have hip pain?
That's what the group we wanna understand as well.
- So this is commonly causing pain for those people
because they're not moving enough.
If you're sitting all day long in a flex position,
you're not getting blood flow to the area or circulation,
you're not healing any problems you have in there
with ligaments, tendons,
you're also not getting the synovial fluid moving
within your joint capsule.
These are all essential.
Movement is good for the body.
So not moving is just gonna make things tighter
and possibly worse.
- And we're gonna show you in close the details
of the anatomy of those structures that get tight
from sitting and not moving enough.
Alright, let's take a look at the anatomy of the hip.
It's a ball in socket joint and it's a deep socket
and it's got a fair amount of actually excellent mobility
and a healthy hip like this,
you can see the hip obviously, with the metal in here
that we can't remove, it's not in your body,
you don't have screws and hardware,
but it does move very well and it's an incredible joint.
Now, if we look at the actual ligaments
and there's a tissue called the capsule,
which actually goes around the whole joint,
holds the synovial fluid which lubricates the joint,
that capsule and ligaments as well as the muscles
from sitting like this for too long,
they can get tight and then things do not work as well.
And there's actually a syndrome
that has been discovered
where the hip starts to move forward.
We can't see it with the ligaments in the way
but it actually gets out of the socket slightly
and the mechanics no longer work properly
causing excessive wear.
And Mike, do you have some more to say about the cause here?
- This can also be problematic
if you're sitting for a long time
'cause it's gonna cause your hip flexor muscles
which are in the front of your hip to get tight.
- Good point.
- This will start limiting how much extension
or backwards motion you have.
So if this is tight,
your butt muscles might not start working
as much as they should.
So you're gonna have tight hips,
your butt's not firing as much.
It's gonna cause this femur to move forward
in the socket causing all sorts of dysfunction,
pain and muscle imbalances.
- That's a lot to be throwing at you.
And they actually have a name
for the the glute muscle not firing, gluteal amnesia.
So we got anterior femoral head-
- Dysyndrome?
- Guide syndrome, sorry.
And we've got gluteal amnesia.
Technically we're gonna show you some stretches
to help eliminate and combat some of these things.
Oh, Sam. Almost lost him for a second.
Alright, now that we've covered the brief synopsis
of what can go wrong with the hip,
why it does these things that create pain,
boy my mouth is really not working well today.
But now we're gonna show you the exercises,
but Mike has some important information you must focus on
and listen right now.
- Before we get into this, if you've had a hip replacement
or any type of back surgery,
you wanna check with your provider
if some of these stretches are safe for you,
they may not be for everyone.
Also, if anything is increasing your pain,
then that stretch is not right for you
or you're doing it too aggressive.
So be cautious.
- Right.
These stretches should feel like good stretches,
not painful stretches, especially you guys out there.
'Cause a lot of people think no pain, no gain.
It's usually us men.
So, you know, calm things down.
All right, the first exercise, we're gonna show two options.
One in bed or laying on the floor.
Lying on the floor or in the chair.
Go ahead Mike.
This is for hip flexion.
- So this is called single knee to chest stretching.
What you do is bring one knee
up towards your chest just like this.
It's gonna stretch your buttock a bit
but it's gonna also work on increasing your hip range
of motion going up, which is called hip flexion.
You're gonna hold this for 30 seconds
and then relax and make sure to do the other side.
Now if you struggle to reach your leg,
so you have limited range of motion,
you can grab a belt, a bed sheet, a towel,
something you can either put underneath your leg
and pull up like this with your hands
or you can also wrap it around top
and do it this way as well.
Try to do three to five sets
of 30 second holds on each side.
If you're unable to do this laying in bed,
Brad has a good option in a chair for you.
- Right. If 30 seconds is too long, you can shorten that up.
The big thing is that you get the stretch there.
In the chair, this is where we do say actually slouching
and scooting your butt forward is acceptable,
'cause it just positions the hips more properly.
Bring the knee up to here.
You can go over the top and pull here.
If the 30 second thing is too long, even a on and off
if that's all that's tolerated, works well.
You can go, a lot of people I've worked with,
their knees are too tight and that hurts their knees.
So go underneath and that takes the stress off the knee.
Then you can focus on the hip, which is what we want.
You can do a little noodling up here,
which is what I'm doing right now.
- Yes, some people can't go as high up straight up
so you might have to go out to the side, especially males,
and you can get a little more range of motion that way.
- That's right. Do both legs.
And you're done with that one.
We're gonna go to number two.
Alright, the next one,
this is another one you can do in two positions,
whatever works best for you.
It's to get the femur or the hip to externally rotate.
It's called the figure four.
I like it a lot.
It's very functional as well.
Mike, go ahead in bed or lying on the floor.
- So external rotation means letting your hip go out
or pointing your toes out,
if your leg is straight like this, just for clarification.
But to do this stretch, you're gonna bring one foot,
put the ankle on the knee here,
and then you're gonna push down on the knee
to get a little more stretch.
If you're really limited, you may have to only go here
if you can't lift your hip up high enough.
If you can, certainly lift it up here.
Hold like this.
If you want even more of a stretch,
you can grab here and then I really feel it now.
Again, you can hold this 15 to 30 seconds
and then relax and make sure to switch sides.
If this is hard for you in bed, you can also do it seated.
- That's right, actually show if you're really tight,
you can actually bring this leg down
and just doing that may be all is,
you know, your hip will tolerate and that's okay.
In the seated position, I like this one.
You can go like here, gentle pressure down on the knee
like this, hold and relax.
If you wanna hold 15 to 30 seconds,
as long as it feels like a good stretch, it's not painful.
Again, if you had hip replacement,
you're not doing this unless you talk to your doctor first.
And it's maybe been a couple years since surgery.
So I like doing this one on a daily basis
when I put my socks and shoes on.
I can put my shoes on, stretch a few times,
do the same on this leg.
And it's involved with your daily chores as far as dressing.
So let's go on.
Anything else on that one, Mike?
- It's important,
if you have one painful side versus the other,
take note if one has limited range of motion
and work on that side a little bit more.
- Yes, good point.
All right, we're going to number three.
All right, moving on Mike.
We're going to number three.
Okay, we're gonna talk about internal rotation.
The femur is gonna rotate the other direction.
It's important, lying in bed.
Go ahead, show 'em. This is a nice way to do it.
- So you can bring one leg up
and just let it collapse in towards the other leg.
You should feel a stretch
on the outside of your hip muscles here.
If this is enough stretching for you, you can stop here,
hold it for 15 to 20 seconds.
If you'd like to get a little more stretch in there,
you can bring your other leg, cross over and help pull down.
Notice my low back is still on the mat.
I'm not lifting it up like this.
That's not gonna help the stretch.
Keep a nice flat back.
Hold that again for 30 seconds.
This is a little more advanced.
Just make sure you're gonna do both sides.
You don't wanna be lopsided.
- That's right. You'll walk in circles, otherwise.
If you wanna do this in a seated position,
in a chair like this, a firm chair works best.
It's very simple.
This is for people who have tight hips,
maybe have a hard time getting around.
You can simply roll in this way
and that's gonna be helpful if you have a stool,
if you get your hip up a little higher,
sometimes, this is a little more tolerated.
And then on the other extreme,
if you feel like you're pretty mobile and your hip is loose
and you want to get more,
Mike is gonna show the advanced version.
- So the advanced version, you can sit down like this.
You can do it on the floor,
but it's a little easier on the mat.
So I'm gonna stretch this leg.
I'm gonna try to just bring my shoe and foot up on the mat
and I'm gonna try to sit up as straight as I can.
I'm not that flexible in this range of motion.
So you can see I'm kind of tilted.
I kind of struggle to get up straight.
People that are really mobile
and flexible can sit up perfectly straight.
But I feel a good stretch here.
- Again, this is advanced.
If you look at this
and say," I don't think I want to do it."
Don't do it. Do the other ones.
That will be more than adequate.
This is for the overachievers
or those extra flexible people.
Okay, number four,
we're gonna talk about the hip flexor muscle
that Mike mentioned earlier on.
This is really critical. This is an important stretch.
And there's two ways to do it.
Mike's way is a little more aggressive
and probably the better way of it,
but it is dependent on what you have to use.
If your bed's firm enough
or if you can use a table, which is challenging.
I'm gonna show an option seated in a chair
which is gonna be a little easier to do
and probably for more older people,
that's the way they'll do it.
Go ahead, Mike.
- So if you're on a bed or firm table
or even island countertop, whatever you have to lay on,
you need to be able to get your legs to kind of dangle
off the edge here.
So in order to do this, bring both knees to chest to start.
You could start at the top of the bed
and scoot your buttock down.
You don't have to go the way I did.
I'm gonna stretch my left leg here.
So I'm gonna lower it to the ground.
As it's going down, I'm keeping my leg straight.
I'm not going out
or it's kind of hard for me to go too far in,
but try to keep it nice and straight.
Now, you'll see how tight this is.
Once I bring this knee to my chest,
it'll start pulling up on here.
Now what I wanna try to do is flex this knee,
try to get to 90 degrees.
I don't think I can
'cause I'm already feeling a hamstring cramp doing this.
So I'm gonna hold whatever feels okay for me for 30 seconds.
After that, I'm gonna bring this leg up,
reset my back slowly, and then switch to the other side.
See if you notice any difference between sides.
Try to do two to three sets of 30 second holds on each side.
If one side's tighter,
pay a little more attention to that side.
Give it an extra stretch.
- Let's go back to the other leg.
Mike, I just wanna bring up one point that you mentioned.
When you're here, just relax, let gravity go down.
Now the point where Mike says
if you really wanna get aggressive is you pull this under,
which he said that could cause a hamstring cramp.
If you have any indication
that your hamstring is cramping, it's very painful.
Simply straighten that leg out and that cramp will relieve.
And then do not do it again.
Just continue without pulling it under.
You wanna avoid those cramps. They're no fun at all.
So that's only for probably more advanced people.
How you feeling with that Mike?
- Good, now that I'm not bending my knee on it.
(Brad chuckles)
- There we go.
Now the option, so you don't have to worry about that.
If you have a chair, works best on a chair
that does not have armrests 'cause they get in the way.
Take that, a throw pillow like this.
We're gonna put that on the floor right there.
You'll see why in a second.
Scoot your bottom, come to the edge of the chair,
good posture, scoot your bottom off to the right.
I'm gonna be stretching my right hip.
I'm gonna bring this knee down to the pillow.
It's just for comfort.
You don't have to have a pillow if you don't want.
And then I'm going to go like this
and scoot my bottom forward or bring my knee back like this.
I'm feeling a stretch.
If you put your hand in your pocket,
that hip muscle, hip flexor is right in here.
It's deep.
It's really a deep muscle and you'll feel it
if you go back this way,
a stretch gets a little more aggressive
if you bring the knee back and again hold it
for 15 to 30 seconds,
this is one that's kind of hard to do the pressure on,
pressure off, because it's a little more cumbersome
to get that stretch.
So holding it is what I prefer to do.
Again, to do other leg, you simply do the same thing.
Shift to the opposite side of the chair,
move the pillow as needed.
And there you go. That's stretch number four.
Any comments Mike?
- No, we're ready to go on to five
which is kind of a variation of this.
- Okay, number five.
Now this one is a little more advanced
so if you don't feel comfortable watching us do it,
maybe you shouldn't do it.
(Mike laughs)
But what we need is a chair with two arms,
a good sturdy chair, a solid seat pan chair is desirable.
Or you can use steps
and I'm gonna show another version with a stool
or something you can use outside like I do.
So you're just gonna put one foot up.
Now the nice thing about chair steps is go ahead, tell 'em.
- The higher you lift your foot up
the more aggressive it's gonna be.
'Cause I'm stretching the leg that is back here right now.
So when I do this,
if I'm gonna start easy, just stand like this.
You wanna have a nice straight back.
Don't be flexed over too much.
That's not gonna stretch a thing.
Don't be way arched back either.
Just go nice straight back and bring that leg.
Now I don't feel much here, so I'm gonna bring this foot up
and I'm gonna stretch this way.
Obviously, if you don't have good balance,
don't lift up as high.
Make sure you have good sturdy handrails
so you're not gonna fall over.
- All right.
Now if you use the chair, it's the same thing,
you grab here.
And there is one thing you can add to this.
It's a little something we call,
we learned from a advanced physical therapist.
I'm going to take the chair out
because there's one option you can use.
I would not use a stool,
but what I use at home is I have a retaining wall outside
that is about this tall.
It's made out of concrete,
holds the puts holds the flowers up
and all that kind of thing.
I avoid the flowers.
(Mike laughs) I want to keep my wife happy.
But it's a very solid
and happens to be about the right height
and then you can do that stretch.
Now when you do it aggressively,
I'm stretching the hip back here, the hip flexors.
But then this hip is also getting stretched as well.
So I call it the shotgun technique
'cause it's stretching your hips all over.
Now, this is advanced.
If you wanna move this knee out and in,
that's called noodling.
So you're just stretching that hip.
When I go out like this, it feels good.
So I give it a little extra stretch
'cause it feels good.
If it hurt, I would not even go that way at all.
If going deep like this hurts, don't do it.
If it feels good,
like mine feels really good when I do this.
And it always helps my SI joint as well as my hips.
And of course do it both ways.
Again, do not use a stool.
If it wobbles like this, that's no good.
- You okay back there?
- So something very solid and steady is critical.
Mike, anything to finish off?
- I would say I kind of like the noodle
and the end range here and kind of isolate back
and oscillate back and forth like this
versus just standing like this the whole time.
It feels a little better for me, so-
- That's right.
- Do what feels good for you.
- Absolutely. Now what I'd like to say is stay tuned.
We're gonna have, coming up within the next week or two,
I don't know the exact date,
we're gonna have a follow up video on this one.
It's gonna be the five best hip strengthening exercises.
Once your hip is loosened up, you need to strengthen it.
It's gonna help stabilize that ball and that femur,
eliminate problems with arthritis,
hip, tight hip, piriformis syndrome.
Can you think of anything else, Mike?
- You were talking so fast
I only caught half the words you were saying.
- I couldn't understand myself, anyway.
(Mike laughs)
Good luck.
Really good stretching exercises for the hip.
Only do the ones that feel good,
probably pick out two or three of them.
- Yes. And thanks for watching.
- That's right.
(upbeat music)