- Greetings greetings.
Today we're gonna talk about hip pain from arthritis.
Now Sam is gonna help us out here, but if you have hip pain
from arthritis, you've been to the doctor,
your x-rays show the joints looking a little rough
and we're looking at the joint right here.
The ball, there's actually a decrease in space.
The doctor will show you that and they'll say
that's not good.
Look at the good side.
Look at the bad side.
We're gonna show you some exercises that you can do
to improve the pain, get you walking better,
and then sometimes even avoid the surgery.
- You guarantee that?
- At least delay it.
- Right, okay.
Okay, very good.
We got 9.3 seconds to work with Sam to get 'em ready.
♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists on the internet ♪
- Okay, let's look at the joint of the hip a little closer
with arthritis.
We're looking at the ball of the hip, again with the model,
you won't have these steel straps in here
that we need for the Sam for the model
but the ball will look nice and shiny.
It fits in the socket space.
- Nice and smooth.
- Yep, a very nice fit.
However, when you look in arthritis
you're gonna see that things don't look so smooth and shiny
but the biggest thing in our x-rays you're gonna notice
is on a healthy hip there will be a little bit of a gap.
We can't really show it on Sam, but you'll see it.
The doctor will point it out.
There'll be a gap between the bone of the acetabulum
and the bone of the femoral head.
On an arthritic, particularly a seriously involved
arthritic hip that gap disappears.
- Right. - And that's when they say
bone on bone and those bones become rough like sand paper.
- And flaky.
- Yeah and it becomes a very painful situation.
We're gonna show you exercises to open that gap.
Stretch the tissues for range of motion
as well as get the synovial fluid,
the lubrication that keeps it healthy
are all gonna be a system.
- The body's natural oil.
- That's right.
Everything is gonna be addressed with these exercises
and they're not that hard you can do 'em at home.
Okay, this is one of my first go-to exercises
for hip pain for someone, for relief at home.
If you have a stairway like this
and most people have one available at home,
what you do is if this is the hip I got the weight down here
is the one that's painful with the arthritis
that one is gonna be dangling like this, like a pendulum.
Okay, you can do this with a weight around your ankle
to get a little more traction on the joint up here,
but you don't have to, you can do it without that.
I have it there just to show you plus you can designate it.
Okay, so the key is, is that you learn to relax the muscles
around the hips so that the joint can distract,
open up that space, get the fluid, the synovial fluid
in where it belongs.
- [Bob] You're getting motion without pain.
- [Brad] Yep and that takes a bit 'cause there's,
it's a painful hip.
The natural tendency is to contract and you don't have to
you're not even thinking about it.
So sometimes you can just massage these muscles
really relax, breathe.
You're not gonna have the TV on.
You're not gonna be talking to someone.
You need to do this quietly, breathe, relax.
And then you're gonna feel things loosen up.
I've had good success with this.
- You just had a patient Brad, right?
- [Brad] Yes, I did.
Matter of fact, I treated her on texting
and over the internet too.
- Just texting.
- Yeah, cause she lived too far away
and she just wanted to get some exercises,
very much a self doer and this is what she did.
And she was grateful.
We've got a couple of exercises that worked well with her.
You'll do this for about 30 seconds to a minute.
Okay and then you're gonna do it throughout today.
Not just once a day, every couple hours.
- Give yourself for some relief.
- Absolutely, open that space up.
Use a little traction.
Going on to the next one, number two.
I like this one because it's easy to do
and you can do it in bed before you get outta bed
but you'll wanna do it throughout the day as well.
I call it the figure four.
Bob has a painful hip.
The pink represents the hip or the side with the pain
and he just lifts and puts his ankle above the kneecap
if you have the range of motion
and then allow gravity to let that knee go down.
Now, if these create sharp pain, it's too aggressive.
It's not for you, things are too far gone
but you should be able to do it hopefully
and just gently allow it to relax.
You're gonna hang out like this for, you know
a couple minutes up the three minutes at the most.
If you wanna just bob it up and down gently.
Sometimes that helps loosen things up.
Again, we're trying to get the synovial fluid in that joint.
Allow it to free up.
And then if this becomes easy you're going to lift up
the other leg and then do the figure four again.
There you go.
And things are feeling better.
If you'd like to get some extra pressure
you can take this hand and just push on that knee.
There you go.
You like it, Bob?
- I do this one, Brad.
- Oh, that's right.
That's really for the, that's even more advanced.
- Advanced. - Yep, exactly.
- So there we go.
That's that one, again, multiple times a day.
You can do it on the bed, on the couch, on the floor.
We're gonna go to number three.
Okay, the third option.
Now this option, it does take a second person.
As a matter of fact, that same patient I had,
I taught her husband to do this and it's very easy to do.
You just have to be careful.
So here's a painful leg.
I'm gonna grab the leg.
It'll be done on the bed, of course.
They actually bought a plinth for their house because-
- Oh really? - Yeah.
'Cause they use it a lot.
So you gently grab the ankle here
and what I'm going to do is just gently pull out
and it's not a, you're not pulling as hard as you can.
- And no pain.
- Yeah and so the person pulling must listen
to the other person. - Right.
- If they say yes, pull more, pull more.
Or if they say, oh it hurts, you respect that and back off
and maybe even stop.
Should not increase pain at all.
You only continue it if it feels good,
clearly a good stretch.
So I'll pull like this.
- And I wouldn't to it on anybody with rheumatoid arthritis.
- [Brad] Right, yep.
- Or loose joints.
- [Brad] Yep, yeah, it's really now, I'll pull like this
and I've done this with many patients.
Sometimes what I'll do is I'll rotate.
You see the foot, I'll rotate a little bit.
And then, and if they say, oh, that feels a little better.
And then when I pull on it, they say, oh, it feels better
with it rotated that way I'll do it.
If it doesn't, I'll go back to the original
or you can rotate inwards a little bit and then pull
- Again, pain free.
- Again, you're gonna hold for about a minute.
And that's about all you're gonna want to
'cause the person doing the traction gets tired.
You need a break.
Other things I do do is you may go out to the side and pull
and that's another little trick that may gap that joint
and get that fluid in there and make it feel better.
So, very good.
- Now I'm six foot eight on this side.
- Yeah, we just lengthened Bob on one side,
he's gonna walk crooked.
Just kidding, just kidding.
Okay, this next one is very easy.
Simply bring both legs up.
We call it hook line position
and I call these the windshield wipers.
- Ankles together.
- Yep.
Knees together gently and just go back and forth.
- And shoulders stay down.
- Yes, right they are stationary here.
If you look, there's a fair amount of motion.
So relatively it's not aggressive
but it can be really helpful.
Plus it loosens the back up.
And if you'd like to take the painful hip
and bring that knee up to the chest,
stretches that hip out this way.
Do that five to 10 times and it gets the knee range as well.
It's kind of a double benefit on that one.
Now, if you do this and your walking and walking
continually irritates this, it really is beneficial
to get yourself a cane or a crutch
or whatever you'd like to use some,
in some cases it would be a walker.
But if my right leg hurts
the cane will be in the left hand.
And then you walk and it takes weight off
of that joint, opens that gap.
It doesn't allow that rough joint
to grind against each other, it takes it off.
And that Bob, I would say-
- We're not saying it's permanent.
- No, no.
When you have sore days, relax, give that joint a break.
- Or maybe just at home.
- Sure.
Yeah, absolutely.
The cane can be your best friend, don't forget that.
Okay, the last recommendation,
and this is gonna depend on how you respond to it.
If you respond well to heat to that hip,
to loosen up the muscles, improve circulation,
which is critical if any injury,
if you use a hot pack it feels good.
The hip is a deep joint.
There's a lot of muscles around to really get into it deep
you should use a far infrared heating pad.
The disadvantages they are relatively expensive,
but they do work, they get in deep.
I did have a hip patient, he was gonna have hip surgery
in six months because of COVID.
It was delayed.
He used this every night and he just loved it.
- It was his savior.
- Yeah, it allowed him to get the sleep at night
so he could sleep well, loosened up the muscles.
So what you can do and you can use this in a chair
he used it in bed like this and you wrap around,
maybe put a pillow here so you maintain that.
Any position you can to get that.
The nice thing about this particular Thermotex far
infrared is you can use it on your hip,
you can use it on your knee.
- Back. - Ankle, hands, back.
It's universal and you're gonna leave that on
for 45 minutes.
It's gonna get deep into that joint.
Relax the muscles and just make it feel better.
Again, it's an option.
Keep that in mind.
So used and field tested.
All right, Bob, what else do you have to say
about hip pain with arthritis?
- I'm, I said it all.
- All right, now, hip pain, real uncomfortable.
You can really prolong how long it's, you know
decrease the pain.
- Right.
- Lengthen out before you need surgery.
If it's that bad, good luck.
- And allow you to sleep.
- Yeah, sleep's important.
All right.
Very good, behave, be careful
and remember Bob and I can fix just about anything.
- [Both] Except for.
- A broken heart.
- That's right.
And this hip stretches, aren't-
- Gonna help that. - Do squat for it.
- Oh, that's not a family show thing.
- Squat?
- My filters falling apart.
- Oh, right, I see that.
- Yeah, I know, it's getting worse.