♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heinick, physical therapist.
- Together we are the most famous physical therapists
on the internet.
- In our opinion, of course, we are spot on.
- Today we're talking about quadriceps tendonitis or tear.
The single best treatment you can do yourself.
This is an updated video.
We actually did this in the past and do a better job now.
- Absolutely
- Smarter and better, right?
- Well, say no more, Bob.
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Yeah. We don't take vacations Bob.
Well, at least on the videos.
- Yeah.
- So Bob, we want to talk about quadriceps.
One of the largest muscle groups
they'll work together pretty much in her body's right here
in our thigh and those can, you know, get strain.
They can have a tear, micro tear.
That's what we're going to talk about, so.
- I could actually be the poster child
for this video, right? - Okay, 'cause you know more.
- Because I had tendonitis on both quadriceps
and it was from lunges.
I apparently I was doing right,
but I did them too fast and too quickly.
And I had trouble with this for a long period of time.
- I don't think you were doing them right, Bob.
- I was doing them right.
- (laughing) I know I'm just kidding.
- At my age things happen.
Where are we going now?
- Now we want to talk about
where these quadriceps are. - Okay sounds good.
- We're going to get Sam over here.
And cause where the muscle actually attaches
on both ends is, can be really helpful in all,
as far as how we're gonna treat this.
Now, if we look at these red marks on the femur
that's where three of the muscles actually attaches
on the femur and then they all, and then there's one rectus
the rectus femoris, which that actually connects up
to the pelvis right at that point.
- [Bob] So it actually flexes the hip too.
- Yap, so it's a bio articulate muscle.
We don't want to bore you at all.
But the thing that I want to make a point is,
all four of these muscles come down
and all four of them actually connect to the kneecap.
And then from the knee cap,
they go from the kneecap to the tibia.
So they cross the knee joint here.
But that area right there
all four of them go to that point.
Oftentimes that is the point of the tendonitis quadriceps.
- That was me, that was the case of me exactly.
It was right in this area, here.
- So if we look at a real leg and I do have a real leg
but it's not really worth looking at, but just bear with me.
Here's my patella or my kneecap,
so all these muscles connect down right here.
We've got the VMO, the vastus lateralis.
I don't even have a rectus femoris that you can see.
- [Bob] They connect via a tendon.
- [Brad] Yeah.
- [Bob] So tough fibrous cord that goes
from the muscle that attached to the bone.
And there's actually another tendon below the patella
or the kneecap that be attached to the lower leg.
- That would be the infrapatellar tendon.
But we're not talking about that.
Now you could have a strain
up in the belly of the quadriceps up in here.
- That'd be more of a tear. - Or a tear.
And you're going to actually treat that the same way.
Obviously, if you've injured your quadriceps
and you'll know where it where you did
by the location of the symptoms or the pain.
- Yeah, where the tendon is.
- Right, if it's really painful
and you push on it, whether it's here or up in the belly
and it's really tender
and you can hardly walk, you're limping.
You're going to need to rest it.
put a cold pack on it, give it a day or two to relax.
Once it starts to feel better
and you're able to walk a little better on it,
then you can get into what the actual treatment
we're talking about is the cross friction massage.
- Right.
- And this is no magical treatment that just came out.
Cyriax, Dr. Cyriax came up with this decades ago.
- Right, he's long gone.
He's been gone for 30 years I think.
- So again, let's assume that the pain is down here
by the patella or the kneecap.
And you know, that's commonplace the fibers of the muscle
and as well as a tendon go this direction.
So we're going to go on this area, find that painful spot.
And if you can push on it
and we're gonna go across the fibers this direction.
If you can move back
and forth across, or no, you could use both hands
or your fingers like this.
Now, if you push down in it,
we're not going to go superficial on the skin.
We're going to push into those fibers.
What we're going to do is break up the scar tissue.
That's starting to heal as it's getting better.
And we're going to make that scar tissue heal up
in a healthy, strong manner, right?
And we're not going to get into a lot of details.
- [Bob] And you also get more blood flow to the area,
which helps it heal faster.
- Exactly. Now, if this is a painful spot and you go over it
and it's like, Oh God, that really hurts yet.
Hold off on it.
You may want to just work
you can work above it, you could go below it,
but you're getting into the kneecap.
You're not going to massage your kneecap,
but you can't get up above it and let these muscles relax.
Get the muscles to relax.
That takes pressure off of the injured site as well.
- And you can do this throughout the day
because this is a difficult massage to do with your hands.
- Exactly. - They fatigue.
And there, they just don't really get
into the muscle because this is a big heavy muscle.
- Right.
- One of your biggest muscles that you have.
- Let's say you've got that injured spot there
and you start to go on it and it hurts,
but now I want you to pay attention
if after about 15 to 30 seconds it starts to feel.
Oh, it doesn't hurt so much anymore.
It actually feels kind of good or it feels kind of numb-ish.
Then you're a gold in there.
You're going to keep working.
- That's the key to this. - Yeah.
- If you do this and it starts hurting worse
and worse and worse, it's too flared up yet.
You're going to want to go ahead and back off,
maybe ice it some more.
But if you're able to tolerate this
and it actually starts to improve, like Brad said.
This is the exercise or the massage for you.
- And you'll do it, Cyriax says up to 20 minutes
which is pretty much impossible
because your fingers get really tired.
Then you get tendonitis in your fingers.
Or a problem with your finger joints.
But you can do this until your fingers get tired.
Give it a break
and then come back a few hours later and do it again.
- Now yeah, I had a personal experience with this,
- Sure. - so I was doing that,
and I was also doing eccentric strengthening.
That's supposed to help it.
And I did this for quite a long time
and it didn't help because it was just too much
with the massage to use my hands.
So I went to a massager, - Right.
- And I,
- We needed mechanical advantage.
- Yeah, mechanical advantage.
This massage guns work really well
because they really translate.
Is that what you call Brad?
They percuss quite well.
- Right, right, you've got this motion, and you know this
and then you have to get a massage gun that does it.
Not one that just vibrates.
You have to have one that's traveled forward and backwards.
Yeah.
- You can see. - Go ahead, Bob.
- Well, you don't want to skimp on these either Brad.
Cause my nephew just bought one of these.
- Yeah.
- And he said it was just junk.
- Yeah. - So I sent them one of ours.
- Well Of course.
Yeah. So we actually have some
of ours actually, good quality, they're great price.
And they have our name on them too, Bob and Brad.
So if you want to get one that you know is going to work.
These will.
- Well, that's kind of a cute little one, Brad.
But it's still pretty powerful.
- Yeah It'll do the job.
- This one's better.
Now when I was doing this
I would do it not only to the end of the muscle,
I did actually go onto the kneecap a little bit.
Believe it or not and that's where this round head
it comes with a bunch of head attachments.
- They both come with five different heads.
Obviously, you know, you're not going to use this one
around your patella, yeah that's a whole nother.
- So I just gently rolled on top of the patella.
There have been some scar tissue there Brad.
So if you look at Brad's knee,
I'm rolling it right.
And I actually was comfortable through my clothes.
- Now see, now these travel this way
and we're doing it sideways for a reason.
Because if we went up and down.
- [Bob] Look at the bump, bumping on mine Brad.
- It's actually pretty painful.
So that's, and that's just what, you would do that,
if it was up in the muscle belly.
- Yeah, then you can hit.
- Then you may go that direction
but we're going to go sideways
and get that cross friction benefit over that tendon.
And it's not gonna irritate the patella.
And again, now,
- Now if this makes your pain worse, don't do it.
If you do it on the, hit the top of the kneecap
and ah! - Ooh.
- But it felt so good to me, I kid you Brad,
it was 80% better within two treatments of this.
- Oh really?
- I mean it seriously was.
- And your fingers didn't get sore.
- No, no. I could sit and do this all day.
I mean, it's an easy thing to do
and that's why there are certain
things when you need to do a massage
where a mechanical massage works a lot better.
I mean, it just, it just does
especially when you're, you got the big muscles
piriformis, a hamstring, calf.
No, I think you, you need the massager.
- And the other thing is, if you're an active person
or you have an active family or other people in the family.
Your other people are gonna use these.
It's not like you're going to use it
for your tear and then leave it set.
- Yeah. And they're actually good for pre-workouts.
- Yeah.
- Because they really get the muscle pliable.
So if you're having a problematic muscle
that explores like your hamstrings,
make sure you massage it before you actually work out
or you participate at sporting event,
so you can make sure that you're much less likely
to tear it.
- Yeah. This morning I went for a run
and I actually kinda irritated my calf muscle
that they kind of bothered me.
Cause I got a week of good running yet
before snowballs coming down, I think.
So I'm going to work my calf muscle and it just feels great.
It's just, fun to do.
You can--
- I bet everybody loves watching us uses this thing.
- But seriously for the quadricep, like we mentioned
that's the treatment of choice that we recommend.
But again, they're just a nice device.
- The thing is you can certainly start with your hand
to see if you get some relief from that, right?
To be honest, I didn't get much relief from it Brad,
cause it was just too much.
It's too hard.
- And once it starts to feel better,
you can go to Google, Bob and Brad,
quadricep or leg strengthening.
And you'll see the next step
when it feels better to start strengthening that muscle.
- Yeah. You remember Brad and I can fix just about anything.
- Except for. - A broken heart.
- And we're continuing to work on that.
- We're so qualified.
(laughing)
- From the neck up.
Yeah, whatever. Yeah, carry on.
- Thanks.
(upbeat music)