♪ 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 are the most famous physical therapists
on the Internet.
- In our opinion, of course, Bob.
- Today, we're going to talk about
what is causing your hip pain.
We've done a series of videos like this
on what is possibly causing your hip pain.
Today, we're going to talk about tendonitis and how to know.
- Right.
- It can be very difficult to assess, tendonitis.
- Right.
- And there's two muscles that tend to be the problem
but we're going to give you some clues
and we're giving you some tests.
So first of all, what is tendonitis?
- You're asking me?
- No, I'll tell you if you want me.
(Brad laughs)
- So you have a muscle that narrows up
and it becomes a tough fibrous cord
that attaches to the bone.
That's how a muscle...
- Which is the tendon.
- Yeah, which is a tendon.
That's how muscles attach to bone.
So those tendons over time,
if they get worn or they're going over a bone,
they can become frayed or degenerate
and wear down and become inflamed, which it becomes...
- "Itis"
- "Itis". Right. That's how it becomes tendonitis.
- Right.
- And they unfortunately, the tendons have
poor blood supply so they heal slowly.
- Right.
- And that's why they're white in color
because they don't have a lot of blood in them.
- I never thought of that.
- But that's how I remembered it.
- Yeah. They're very tough though.
Yeah. They're very tough.
So, anyway, tendonitis often occurs
with an increase in training or exercise.
So like if you're getting into something
too quickly, too fast, you're going...
- Right.
- And you're not incrementally going into it.
- The other one, particularly of hips,
if say you got hip pain on your left,
possibly like tendonitis.
It might be because maybe your right knee
or ankle or something on your right leg
is irritating, so you start walking
differently, Olympian.
- Right.
- And that can also cause it.
- Our body is an amazing thing.
They adapt, but they also can wear...
- Wear down.
- Wear down, yeah.
So training things like walking upstairs,
high-level cycling, sprinting, kicking, jumping, squatting
especially the HIIT workouts, high interval
- High interval, sure.
You're really putting some stress on them.
- High intensity interval training, spin classes,
StairMaster, you know, would obviously be
one that would do it
- Right where you're really lifting up.
- They still have StairMasters, Mike?
- [Mike] They do.
- They do.
- Oh, yes, Bob.
- All right.
- Revolving ones, OK.
So two common muscles are the iliopsoas.
These are both hip flexors.
They flex your hip.
- So lift your knee up in the air
- And the rectus femoris, rectum dinarichillum
- Wow, Bob. Why, Bob?
So should we talk about the iliopsoas?
- Sure.
- That's a real common muscle that as therapists,
we think about it, and I think people are more aware
of it, but it's a deep muscle.
It's really, it's in the abdomen
underneath the intestines.
If you will, the inner parts, visceral parts
and it connects to the...
- Back. The transverse processes here.
little bumps, like I think all five of them, I believe.
- Yep. From the spine to side of the spine
as well as the ilium or fossa,
the pelvis right there.
And then it comes down over
and then the tendon part is right over the hip.
- Yep. And that's where the problem comes
in and it attaches to the lesser trochanter
up here.
But that's where the problem is.
If your hip is a little bit, let's say sloshy,
- It's not.
- Yeah, it's moved forward a little bit,
which is quite,
it happens quite often with weak glutes.
- Sure.
- Your gluteus maximus is weak.
That hip doesn't stay in place like it should.
And that can cause that increased tendon
or increased pain on the tendon,
increased stress on it.
- Sure.
- And it can actually cause it to snap,
to kind of snap over your hip.
- You get that clunk in when you lift up,
my sister had that clear, I could hear her.
- Did she?
- Yeah.
- So that's snapping hip syndrome.
- Right, hers wasn't real painful,
but you could hear her.
- Sure. Now the iliopsoas, the rectus femoris,
I'm sorry.
The rectus femoris actually comes
from this bone right here.
- So that's, you would call it the pelvis.
- We're gonna show you how to find that on you.
because you want to know where that is.
And actually it's going to attach
into the rest of the quadriceps.
It's one of the part of the quadriceps.
- Eventually the ultimate end of it
goes to the kneecap, right?
- Right, but this is where the tendonitis occurs.
And this is where the tendonitis occurs down here.
One of the first tests we do is actually
called, we're testing hip flexion, basically.
So we're, we're putting the muscle
under stress and the tendon under stress.
- The therapists call it a manual muscle test.
- It's very easy to do.
You're gonna lift one side, probably do the side
that's not painful first, so you can compare.
- Right.
- And push down on it as hard
as you can and resist it.
- Yep. Lift up three inches, hold it there, push down
push down and see if it hurts.
- Right. And compare it to the painful side.
- Right.
- And if that one bothers you,
it's one possible sign that you, I mean
you could have tendonitis, you could have a tear too.
- Right.
- So number two, we're actually gonna have you
try using your hands, palpate a little bit.
And that's where you're going to have to
watch this real closely here.
I'm gonna move my fingers along the pelvis here.
So you're gonna have to find your pelvis.
- Yeah, I'm gonna kinda...
- Yeah, sure.
- Yep. So yeah, you could find that,
that bone up here.
- Right.
- Right where Bob was feeling , just kind
of turn sideways.
- Now the first bump that you find right there.
That's where that tendon attaches,
the rectus femoris.
Now you go three inches below that.
It doesn't exactly.
- Hey, Oh, one, two.
So we're looking right down in there.
- Right across there and see
if it's tender there because if it's tender there,
that's the rectus femoris tendonitis.
- To get into the iliopsoas tendon,
you really got to get in deep.
- Yeah, it'd be right over the hip itself
and how the hip is not, you know,
don't think over here, think over here.
- Right.
- We're on the front.
So pretty, pretty tough to tell.
The last test you can do is actually put the hip,
these muscles on stretch a little bit.
- Sure, yeah.
- So what are you going to do is I'm going to
test this one here
and I'm leaning forward and stretching it.
- Yep.
- And if that hurts, another sign that
you might have tendonitis.
- In the location of a pain
if you feel it more in the same locations we just mentioned.
- Right. Right.
Or, and it kind of recreates the pain
you've been feeling.
- Right, there you go.
- So you can obviously test both sides.
It's going to go like that.
And I'm keeping really good posture
while you're doing this.
I'm not going like this,
I'm going to sit up straight.
- And make sure you're consistent, one leg
to the other as far as your posture.
- Right. Right.
- So yeah, again, comparing the good side
to the bad side is always,
it's what therapists do all the time.
- And lucky for you, we're actually doing
another video on the top five treatments
for hip tendonitis.
- Exactly.
- So that'll be coming up. So watch for it.
Remember this is actually,
or you maybe not know this,
this is part of a series of videos on hip pain.
So all you have to do is go to BobandBrad.com,
go to the...
- Programs.
- The Programs section, I was gonna say "giveaway".
- Click on that.
- Click on that and look for, we have
different titles: sciatica, plantar fasciitis,
and look for the hip one.
And we'll have a whole series
of videos you can look at, absolutely free.
No, no signup for it.
- And there's a PDF printout.
So you can print out notes from the video.
I mean, it's a heck of a deal.
- Why am I kneeling down here?
- I don't know Bob.
I thought maybe you were gonna propose or something.
- I didn't want Mike to go above,
to lose my head here.
So. All right.
Thanks everybody for watching.
("Bob and Brad" instrumental jingle)