(upbeat music)
- Hi, I'm Bob Schrupp, physical therapist.
- And I'm Brad Heineck, physical therapist.
- And together,
we are the most famous physical therapists on the internet.
- In our opinion.
- Of course, I'm a little more famous than Brad,
but we won't argue about that.
- Well you're taller than I am, though.
- Yeah.
- Okay, the subject today, Bob,
I want to talk about retroverted hips.
- All right.
- Or, just the fact...
Op, Nancy's writing something down here.
Hold on, hold on, people.
- Oh, you wanted to show something?
- Yeah, I want to show something.
Let's go down to the feet,
'cause I don't want to get wadded down
with the terminology.
But people that stand like this.
A lot of times, I have patients that come in and say,
"My son, or my daughter, or my spouse,"
or even about themselves,
"My feet are like out this,
is there something I can do to correct it?
I think I've got a problem,
because my toes are out normally."
So, I want to talk about why that can be,
and is it a problem,
should you do something about it,
or just leave it alone,
because that's the way you normally are?
So, if we start-
- I wanna remind you to say a little something, Brad,
real quick. - You bet.
- A lot of children start off that way,
to give themselves more balance.
- Sure.
- So I mean, it's a typical development pattern as well.
- Yep.
- When they start off with their feet out,
give a little more balance,
and generally,
they just grow out of it, basically.
- Right.
- They develop.
And if they don't, there maybe something structurally
that's causing them to be that way.
- Right, right.
- Is that where you're headed with it?
- Right, so yeah, I'm goin' into the structural part.
And the reason I do this,
because for me, to stand like this, is very comfortable.
Matter of fact, to go like this,
if I could balance, you know,
I don't have any problem putting my toes straight out.
I don't.
It's not uncomfortable to speak of,
it's just awkward because I balance it.
- And I can't.
- You can't do that?
- No, I can't get that far out.
- Right.
- Yeah.
- Right.
And both my brothers stand like this,
and my father stands like that.
Walking through the snow,
if there's three people walking,
usually you know which one is my footprints,
because my toes are out like this in the snow,
and it's the same with all the males in my family.
So I don't know if it's a male thing or not,
but that's just the way it is in my family.
- It's a penguin thing, I think.
- Don't give me that.
Let's get on with the subject here.
All right, so, as far as boney causes,
it can be the hip,
where the hip is connected here,
and the bone is actually, from here up,
everything down here might be in line,
but from here, it rotates everything else out, okay?
And if it is the way the bones are actually growing,
you can try and strengthen some muscles
to make the foot go straightforward,
but then the hip won't be aligned with the socket,
as far as-
- Oh, you're gonna be fighting it all the time.
- Right.
- It's just not gonna be natural.
- Yeah, you're actually fighting nature
to make the perfect anatomical person,
when their natural posture is this way.
The other thing it could be,
is what we'll call tibial torsion, okay,
where the tibia actually is growing
in the way that it's rotated,
and so everything up in here
might be in that anatomical perfect in-lineament.
- Right.
- But down here, it's rotated.
But one way or another,
whether it's here or here,
and if it's boney, a bone structural problem,
you're not gonna correct it,
you don't want to try to correct it.
- No. - You just leave it alone.
And in my case, I'm sure that's what it is.
I'm never gonna try to go like this.
I know when I run,
my toes automatically go forward, okay,
as opposed to this way.
- They do?
- Yeah, yeah it's just normal for me.
- They're not turned out at all?
- Nope, and it feels good, but when I walk, it's like this.
- 'Cause for a runner, it is somewhat critical,
'cause if you can correct it, you want to,
'cause you're losing that inch or two with every step
and it adds up after time.
- Sure, yep.
- And, so...
- So, yeah, that's kind of...
And I do think about that when I run,
but I never did earlier in my life
until I got to be a therapist,
and sure enough, it straightens out nicely.
So the big thing is,
now I think...
Trent, you wanna?
Why don't you come in?
Trent is a physical therapy student
from University La Crosse,
and we were talking about this earlier,
and his natural stance is like this.
His left foot is nearly in that normal,
straight ahead position,
but his right foot...
And you said this has been this way all your life?
- [Trent] Mm-hm.
- [Brad] Out to the side,
and when you walk,
does it stay that way,
or does it straighten?
Do you notice anything?
- [Trent] It'll stay out.
I think we measured it,
it was about 12 degrees or so.
- [Brad] Okay.
- [Trent] Turned out.
- [Brad] And what about when you run?
- [Bob] So, it was just one side that was 12 degrees out,
and the other side is not?
- [Trent] The other side is fairly straight, yeah.
- [Brad] So you measured this with-
- [Trent] In class. - [Brad] Swiss?
- [Trent] Yeah. - [Brad] Yep.
Swiss instruments, so you're getting it accurate.
- [Trent] Mm-hm.
- When you run, does it stay that way,
or do you straighten out.
Have you ever...
- I try, I think it straightens out pretty well.
It might, if I'm not paying attention, start to deviate.
- Sure.
- I haven't noticed too much, though.
- Okay.
It be something when you do run.
- [Trent] Sure.
- Take a look at that, it's kind of fun.
I think, as a therapist,
I'm sure you'd be interested in that.
- Right.
- Did they just measure it,
I mean did they lay you down,
try to determine what position your hip was in actually,
or did they actually just measure it out?
- What we did, actually, was barefoot,
we stepped into a bucket of water,
and then walked on paper.
- I gotcha.
- Oh.
- And then we measured,
just kind of the angle of the foot going out
with like a goniometer to...
- Okay, 'cause there's actually a test you could do
to try to determine if it's boney versus muscular.
- All right.
- And it's pretty common,
I mean it's beyond the scope of this video,
but that's what I was wondering if you did that,
but apparently not,
you just measured to see how much it was sticking out,
compared to the other one, so...
- So, as an overview, Bob,
I don't know what you think about this, but...
- Thanks.
- Typically when I tell my patients this-
- [Nancy] Yes.
- If you had no symptoms,
and you've been this way all your life,
and there's no problem with walking or balance,
or that kind of thing,
you're probably gonna be just fine,
don't worry about it.
- And this is something for the students to learn, too,
is that, when you get an elderly patient,
and they're walking in the clinic,
if it's something that they've done all their life,
you don't try to correct it.
You know, as students,
we're always trying to correct everything,
but you can ask 'em, "Do you always turn your feet out,"
and they said yes,
you don't try to get them to walk toes straightforward.
- Right, right.
- 'Cause I've seen students do that.
Maybe after a surgery,
because of weakness,
they may turn a leg out,
only because they want more stability.
and then you may want to work on straightening it.
- Straightening.
Yeah.
- For parents, it's something,
don't worry about it, just let it go.
- Right.
- But, if it's gonna correct itself,
it's gonna correct itself by itself.
- Right.
- I know they used to have kids ride trikes,
'cause they would straighten them out a little bit.
- Yeah.
- But, to be honest,
they'll straighten out on their own,
if it's gonna be, so...
- There is exceptions,
I had one patient that,
she had surgery for that,
but it's very rare,
and there was a lot of other things going on with that.
- Sure.
- But if you ask your doctor,
they'll say just let them play and have fun.
- Yeah.
- The muscles will take care of it,
the natural growth process.
- And nothing's to worry about.
- Yeah.
- Don't worry about that, so...
- So, anything else, Bob? - All right.
- About retroversion?
- No, but I was going to say something
about the heart, you know?
You can fix just about anything,
but we can't fix...
- A broken heart.
- Brad loves that line.
Thanks a lot.