♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists on the internet ♪
(claps hands) - Hi folks,
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We're the most famous physical therapists on the internet.
- In our opinion, of course, Bob.
- Today we're gonna talk about the top 10 things
you should try with knee arthritis pain or not try.
I'm gonna throw a couple of things on the end
that you shouldn't try. - Okay sure.
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- All right, this again is for my sister Karen
who is also havin' trouble with carpal tunnel.
We just did a video for her.
But she's one of my eight sisters.
And she's number four.
She's having trouble with her knee.
She had an accident when she was younger.
She actually broke her femur.
They did a meniscectomy on one of the knees.
The other knee is also givin' her a little trouble.
- It always comes back to haunt you, doesn't it, Bob?
- It does; it does,
like wrestling and football and all that, right?
- She did wrestling and football?
- Yeah she wrestled with the guys.
(chuckles)
- She's gonna kill you. - Never mind, Karen.
All right, number one,
I'm gonna go over these fairly quickly.
I already mentioned this to you, Karen, walking.
If you're walking on your treadmill,
do not put it at an incline. - Sure.
- You wanna stay on flat surfaces.
You wanna avoid uneven surfaces.
You wanna avoid hills.
If things flare up, you may even wanna use
a walking stick-- - Oh yes.
- or a cane until it calms down again.
'Cause a lot of times, knee arthritis flares up,
and then it calms back down again.
- Sure and you need to be nice to it
while it's flared up.
Take a little weight off of it at that point.
- So yeah, talk to me sometime,
and I'll get you a Booyah Stik, Karen.
- There ya go. - All right,
next thing is, you wanna make sure
that the hip and the knee on that side
are as strong as possible.
Often what happens when you get knee pain,
because you start to favor that leg,
the hip also becomes weak.
So I'm just gonna show you some three simple exercises,
strengthening exercises, easy to do.
The first one is just a straight leg raise.
So you can just go ahead, and you lift up like this.
And this way, you're strengthening the hip
and the knee at the same time.
- [Brad] So should she do that in a seated position,
like that, or laying down on her back?
- You can do it laying down on your back.
I'm wondering if she could even do it in a chair
a little bit though, Brad. - Sure.
- You know, while she's sittin' in her chair, workin'.
The ideal position is this way.
Brad is correct.
This is workin' on these.
So we're gonna do.
And then, you could go right into the next one
which I'll pretend it's this one now.
You can lay onto your side and go,
and do hip abduction. - Right.
- Again also workin' the knee a little bit.
- [Brad] That's workin' that stabilizer on the hip
which affects the knee directly.
- The more your hip is strong,
generally the less stress is gonna be on your knee too.
And the last one is bridging.
So this is gonna get your gluts and your hamstrings.
You're just gonna lift up like this.
So you can do these in bed
before you get outta bed in the morning.
- And I would recommend between 10 and 20 of each,
depending on how it feels and what kind of shape you're in.
- Yeah you could do a fair amount of those.
I sometimes will do like 30 of 'em, just as a--
- Right. - And then,
you get to the point where you need to add weight
and stuff like that.
Next thing, Karen, I want you to check,
check your motion of the knee.
'Cause quite often, what we'll find is,
if you compare a good knee to a bad knee,
like you see how much it bends.
And if you find out your bad knee doesn't bend as far,
you need to regain that motion.
Because what'll happen is,
even if you gain back a little bit of the motion,
that tends to knock the pain down.
So for knee bending, let's say you find one is tight.
Really simple for you to do in your chair,
you can just do pressure on, pressure off,
pressure on, pressure off.
Just stretch it every so often.
- And I just gotta mention, yesterday,
I literally had a patient, exact same situation, knee pain.
And she was about 15% tighter on the painful knee.
She is doing this exercise,
and I'm gonna recheck her on Thursday.
We're gonna see how things
have progressed. - Well Karen,
my wife Linda, she had a knee episode like you did.
And she actually was lacking some flexibility.
But she was also.
Can I have that other chair
over here, Brad? - Oh yes.
- She was also lacking some straightening.
So you're gonna wanna also check the knee.
So you check one.
This one goes all the way flat.
And you can compare it to the other one.
And you look at it.
It might be just a slight difference.
This one doesn't go as.
Yeah it doesn't go all the way down.
So what you'll wanna do is every so often,
put it up on a chair or stool
and pressure on, pressure off, pressure on, pressure off.
Little variations of that is sometimes
'cause my wife found this out.
Her pain was on the inside.
It helped if you turned your foot this way, out.
And then pressure on, pressure off.
If the pain is out here, you might even turn the foot in,
pressure on, pressure off.
You can do a good set of 10 of those.
You can do those every hour even
until the pain starts to go down.
- If for some reason, it flares up,
it probably meant you were pushing too hard.
Then you're gonna wanna give it a break
for a day or so and then, get back at it, but not so hard.
- Yeah generally, it is something that feels good.
And people are a little bit surprised,
just by doing that stretch,
how often it can knock the pain down.
Next thing is pretty simple to understand.
A heating pad works out pretty good.
They don't really recommend using cold
even though there's some swelling in there sometimes.
Because heat and arthritis tend to go together
a lot better than heat and cold.
Now you may try some oral NSAIDs.
Karen used to work at a pharmacy, so--
- Oh sure, so she's familiar with that--
- Yeah like ibuprofen.
I mean, we're not doctors,
but I would take it for a short period
of time, at least, to try to calm things down.
And you always wanna make sure you're takin' it with food.
- Right. - You always wanna make sure
you have a piece of bread or toast or something like that.
- Milk. - Milk, that's right.
- There ya go. - Pharmacy--
- Pharmacy, you know, that's a good basic thing.
- If things don't get better,
I have no qualms about, and this is based upon studies,
is doin' a corticosteroid shot.
And they have it now
that you can only get so many a year because--
- Side effects. - The side effects.
Steroids are tough on your ligaments and stuff,
over time, so you really wanna make sure
that you don't go crazy on it.
Oh-- - Tie.
- The signal, the tie is off. - There ya go.
- (chuckles) All right, next one,
biking, especially like.
Well biking or even there's an elliptical bike.
We have the ones that you can sit down and work on.
It's just a great way of getting motion in the knee
without putting a lot of stress on it.
- You wanna get that synovial fluid,
the lubrication, moving in there.
Joints like to be moved even with arthritis
if it's not real severe.
- Yep and number 10, you wanna make sure.
This is such an easy thing to do.
You just buy a shock absorber, an insole for your shoe.
It's gonna take some of the stress off the knee.
This isn't gonna make a world of difference,
but everything helps. - Yep every little bit.
- And you wanna make sure you're not wearing any heels.
I mean, you don't wanna wear high heels.
That's gonna be hard on your knees.
- Don't they call those pumps?
- Yeah pumps, is it pumps, Liz?
I don't know. - Liz said, yeah
it's good enough. - Yeah we're good.
All right, so I do wanna talk about a few things
you shouldn't do.
You really are not supposed to have arthroscopic surgery
believe it or not.
This is the recommendation
of the Royal College of Australian GPs.
They put out a guideline for management
of knee and hip osteoarthritis.
And they said, unless your knee is locking up,
you shouldn't have arthroscopic surgery,
so no debridement, no meniscectomy.
So this is a big change from what they used to recommend.
- Right right. - They found out.
It really just generally doesn't help in the long term.
You're back to square one after a little while, anyway.
The other thing is, Karen had asked me about this.
Really they do not recommend the rooster comb shots.
Brad and I were just talking about it.
There's a lot of people that we see that get this.
Very little evidence that it helps out.
- Yeah if the therapist sees 'em,
that means it probably didn't help.
Otherwise they wouldn't be seein' the therapist.
- It's also called viscosupplementation.
But again, I'm just going by what the doctors.
I mean, these guys looked through all the studies
that were out there.
And these are smart guys as a group.
- (chuckles) - You know what I mean?
- But individually, they're not?
- No but you know what I'm sayin'. (chuckles)
- (chuckles) Just kiddin'. - Oh I see what you're sayin',
as a group. - Just kiddin'.
- But you know what I'm sayin', Brad, is that--
- Yeah I know. - this was not just one person
looking at studies. - Right.
- This was a group of scientists looking at--
- Overall studies. - Right so.
You thought it was gonna take a long time.
Look I'm done already.
- Wow this is good, Bob,
only 8.54 seconds.
- Remember we can fix just about anything.
- Except for-- - a broken heart.
- Good luck, Karen, on that knee pain.
- Yeah good luck.
(upbeat electronic music)