♪ Bob and Brad ♪
♪ The two most famous ♪
♪ physical therapists ♪
♪ on the internet. ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the more the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- So what is causing your knee pain?
We're kind of doing a series of videos on this.
How to know is it patellar tendonitis
or quadricep tendonitis?
So we're both talking about tendonitises, tendonitises.
- Inflammation of the tendon.
- Right?
- This is just one possibility of knee pain.
- Yeah, so your muscles narrow down
and attach to the bone and through a tendon.
- In this case, it's these quad muscles.
There's the kneecap.
- Yeah, or actually, in this case,
it's really attached from bone to bone.
- Right? Could be here above the patella
or below the patella.
- Now we're using the word tendonitis
and that means inflammation of the tendon,
but you could also have tendinopathy now
that when a tendinopathy, the tendon is actually
wore out a bit, it's actually a wearing of it
and you're going to have kind of identical symptoms.
So we're just going to treat them both the same.
- Right, that's pretty typical.
- All right, they're both usually caused
by stress or overuse of the tendon.
Like if you, as you age and if you don't have
enough muscle tone, that can, affect it
we also see it like in, they called jumper's
jumper's problem or jumper's syndrome.
- Basically an overuse with stressful activities,
jumping you know, going up and down
a lot of steps possibly.
- And what I, I got quadricep tendonitis
from doing lunges and I was doing them every day
and I was doing too much I'm like you sometime,
and I don't have a down time.
- You always gotta kind of stress,
hit the limit and see how far you can push your body.
Don't do that.
- So as Brad said, there's two types,
common types of tendonitis in the
one is felt at the top of your knee cap, directly above
so that's right where right
- Right on the borderline of that.
- [Bob] Right on the borderline that's the one I got.
- [Brad] Right there.
- [Bob] The next one is actually patellar tendonitis.
So you have the round or oval shaped kneecap
- [Brad] Hmm
- [Bob] Depending on yours, you're sick.
Yeah well, we don't know what your shape it is
but right below that, especially if the leg's relaxed
you can feel a tough tendon there.
- [Brad] So yeah, or if you tighten it,
I can distinctly feel it.
You got to remember the quadriceps,
four big muscles, pretty big muscle, one is a smaller one
but they all come down and they connect all of them
connect to the top of the kneecap and the patella
and then the kneecap, the tendon below it
it's actually all part of the same unit.
- [Bob] Yeah.
- [Brad] So this one down here is very strong
and it's very distinct and you know,
I can clearly feel it right there is the edge
and you actually you can kind of see it
a little bit right there the sides of it
and then it connects up to that tibia bone right there.
- Yeah. Tuberosity. Yep.
All right, so the first thing you're gonna want to do is
actually just take your hands and feel
- Yeah.
- Are you tender in those spots?
- Yep.
- That's probably the best indicator
whether or not you have problem.
- Right.
- You want to feel on the painful side.
- Yep. Yeah.
- Then the non painful side.
- Compare and contrast.
- Now, in my case, I had them both were tender
- Oh, really?
- So that didn't help.
- What were you doing?
- Lunges.
- Oh, with both legs.
- Yeah. Yeah.
- That's a good thing.
- Why I'll tell you it lasted quite a while, too.
- Like weeks?
- A long time. I finally took, the massager took it away.
- Did you quit doing lunges?
- Yes.
- Oh, good.
- Yes, I did.
All right, so we are gonna go above the kneecap,
down low the kneecap.
You can also have Osgood Schlatter's disease.
- Mmmmmm
- If you have tenderness over the bony bump itself.
- [Brad] Yeah.
- [Bob] So I'm going to use the kneecap again,
the tendon runs down and attaches to the bump.
If you're like age, typically in boys, it's 12 to 14
- [Brad] Mmmmhmmm
- [Bob] And girls it's 10 to 13, it's that growth age,
where they're growing so rapidly, the tendon can't keep up.
- Sure.
- And so it's pulling on that bone unusually hard
and it's actually irritating that area.
- And you can get actually a bump
- Yes.
- Or a bony bump, fair of growth
as a result of that the body's
- Cause it's pulling on it so much.
- The body's trying to get some calcium there
- Yeah.
- To make the area stronger and it's a problem.
It's not fun.
- Now, if you hop on one leg or two legs,
and that brings on the pain
- Sure.
- That's a sign, too, of a possible tendonitis.
- Mhmmm
- So, which makes sense again, if it's a jumping injury
- Yeah.
- Like you, if you're a high jumper
and jump off the same leg again and again.
So also sometimes when you, if you do a quick stop
on the leg, you know, you're walking along
and all of a sudden you stop
- Then turn direction
- Yeah, and you might feel it cause that's the
the quad is really kicking in
- Hmmmm
- and so is the patella, tendon there so
if you have increased pain with prolonged sitting
especially if your knee is kind of bent
- Yeah.
- You know.
- Yeah, if you're sitting like this
and put your feet underneath that's stressing that area
a little bit more, you know?
And then if you straighten it out
and it relieves the pain.
- Right.
- That would be a good indication.
- Now, tendonitis and tendinopathy
often also feel a little bit better
once you warm up a little bit.
- Mmmmhmmm
- So that's another sign that the pain from the tendonitis,
so feel it will better after you,
you've got some blood flow to the area.
- Right.
- So, but again, big thing is palpation.
- Yeah.
- Feel it, feel it.
- And you gotta, you just don't touch the skin.
You got to kind of push in there.
- Yeah, you gotta be aggressive
- Get right along the edge of the bone and in
between the kneecap and that tibia on the bottom side,
like I'll bet you probably, the vast majority
will experience
- Yes.
- tenderness when you're palpating.
- If you have tendonitis.
- Yeah.
- By the way, this video is part
of a series of videos on knee pain by Bob
and Brad go to bobandbrad.com go to the program section
and we got a bunch of programs there
sciatica, tens, hip pain, neck pain.
- Well neck will be coming
- Coming on, yep.
- So if you look at this and it says not complete yet
- Yeah.
- At the bottom, we've got, you know, 20, 30 videos on
- We have to upload one a day. It takes awhile.
- We have a PDF printout
- Yes.
- Which takes a little time to get that in there, too.
But the big benefit is you can print
out a review of the whole video.
You can refer back to it ad-lib, as you'd like to
- Right.
- And there's not even a charge or even a request
for email for any of this, it's completely free.
And it makes it so nice.
You can go to all these needs programs
pick it out from the title, saves a lot of time.
- Pick out the ones that pertains to you.
- Right.
- It's frictionless.
- Frictionless?
- There's no friction on their part.
- Well, we even put some WD-40 on there
so it even makes it less.
- You need on your knees sometimes.
- I had a patient I'm not kidding,
he would take WD-40, he was an older guy,
he would spray it on his knee,
and rub it in and he swore that that helped his arthritis.
- In his mind it helps so that helped.
- Yeah, the placebo effect at it's the best.
Anyways, he was a nice guy.
Thanks for watching.
(upbeat music)