♪ Bob and Brad, ♪
♪ The two most famous physical therapists ♪
♪ On the internet. ♪
- Hi folks. I'm Bob Schrupp physical therapists,
- Brad Heineck physical therapists.
- We are the most famous physical therapist on the internet,
- in our opinion. Of course, Bob
- a little jig there, Brad or what?
- Well, Bob, it all relates.
Everything comes together in life.
- Okay. We're going to talk about,
do you waddle side to side when walking? That's called the
Trendelenburg gait and we're going to show you how to fix
- That's right.
- This is the updated video by the way,
- Yeah 2014 or 15, I think we did it last, so it was ready.
It was due.
- Oh I was a young man then.
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- Yeah.
All right So we're talking about waddling, Bob
or Trendelenburg gait and I'll just demonstrate it
right now.
- Dr. Friedrich Trendelenburg.
- What he said was Dr.Friedrich Trendelenburg.
- I'm trying to do a German.
- Yeah. Anyways, he was a doctor they named it after
and it was quite a while ago, 1844 he was born.
He died 1924.
- Yeah.
- So people walking like this for centuries and it sounds
like, so it's when you have this kind of a thing,
usually one side is you, you walk over it
and it's typically because of a weak muscle.
And we're going to talk about that and actually show you
- That weak muscle may be due to pain too.
- Right.
- It might cause the weak muscle because
you don't want to take weight on that side.
So the muscle becomes weak.
- Right. And also, you know, I've had people with this
after a total hip surgery. Yeah,
- After a surgery, yeah. Absolutely.
- So, and other people, it may be for other reasons or,
but one way or another, that's how it presents that waddle,
side-to-side, right-to-left, the muscle that helps
or maintains your stability is the
- gluteus medius,
- Thank you. Gluteus medius. And this purple tape just shows
it connects. It's a broad muscle, kind of like a fan here
and it connects down to the hip.
right there and all the way up to the top issue, not issue,
- Ilium
- Iliac crest. That's what I'm looking for.
The aging process in my memory, you know what I'm saying?
[Brad Laughs]
- So that's the muscle. If we strengthen that muscle,
it's going to help stabilize that hip and allow you not to
compensate and waddle.
- Can you see if it's strong, it's going to help
hold the pelvis up. If it's not strong,
the pelvis could actually dip down like this.
- Right. Which causes that whole trunk to go down
to the side.
- Causes it to waddle.
- All right. So let's see.
Oh, the test.
there's a test that we use and what we're going to do
is it's pretty simple. You can do this to yourself,
get a stopwatch, so you know, 30 seconds or look at your
if you have an analog, do they make analog clocks anymore?
- I don't know.
- You look at your waist level. We have a level.
You don't need this, but what's going to happen is
I'm going to stand on one leg and maintain a level pelvis
or beltLine. So you can look at the belt line.
And then if all of a sudden I'm starting to drop like this,
and then you go to the other leg and it's for 30 seconds,
- It stays.
- Yeah, you have maintained without that pelvis
dropping down, then you'll know which side is the side.
It confirms that you have a weak,
- Well that should be weak on the right side
if it dips to the left
- Right. Yeah. It's opposite.
- Right.
- I don't. Yeah, but there's another test I'll show.
Should we do that one?
- So if dip is on the right, it's weak on the left.
- It's opposite.
- Yeah.
- What just dropped?
- Your microphone, was it?
- No, It's the mouse.
- Oh
- Not a real life mouse.
- All right.
- So Bob, just lay down once on your left side,
please.
I don't want to get bossy.
I'd get that way with my patient. I'd lie down, lie down.
I want, I don't worry about it then.
Can you lift that leg up and straighten it out?
There we go. So this is a manual test that I would do.
I'd push down here, hold it, hold it, hold it.
And if you're strong and normal hip abductor,
you can hold a lot of weight and it's fine.
And I do one side, have the personal roll over
and we don't have to show them for that.
But we're going to assume you found that one side drops.
You have the waddling gait. Maybe you did a manual test
If you had someone to do that, if you like
- Sure
- But the exercises we're going to start out
actually the same position you just were for the test Bob.
- Sure. Yep.
- Go ahead
- And I can do it with a band or without a band.
- Yep.
- I'll start without a band.
- So we've decided that this is the weak side.
And what you can do is you can do these exercises on both
sides, but you'll notice the weak side.
- So I'm going to work hip abduction
and you were first going to start, especially if you got
a long leg like mine, Brad?
- Yes.
- You can start without any weight, because the weight
of the leg is going to be plenty for you for the first
couple of weeks probably.
- Right. I would say 10 repetitions.
- You put into the toe straight forward.
Don't go up like this.
Yes. I mean, no this is why.
(both laugh)
- And you're going to find out boy,
you'll feel that hip abductor muscle and 10 repetitions.
If you can do 10 good quality ones and it feels pretty easy,
then you may want to go to two options.
You can use a loop band like this,
- This is the Bob and Brad band, the boody band.
I think we call it.
- There's these other ones I made it.
That's out of a cloth elastic and there are the rubber ones.
These are a lot more comfortable. That's why we
- Oh this is a lot of work
- That's quite a bit harder.
If you move this up towards the hips, it's easier
- A little easier. Right.
Yep. And so you can adjust that, You'll get a feel for that
relatively quickly.
- It's hard either way.
(Brad laughs)
- It's a little better that way. Yeah.
- So again, and you can just see him struggling.
- Keeping it straight, yeah.
- So if you did this for another week or two,
you're going to find that gets easier.
- And yeah, if you're just starting out,
you don't do it every day.
- Right.
- And you don't go crazy the first time
because your hips can get really sore and you can actually
get micro tears in the muscles.
- So don't go too crazy.
- You're older, like we are.
- Now we're showing you some other options.
you do not have to do them this way.
There's some strengthening exercises you can do standing,
which actually I kind of prefer as long as you can do them
safely and
- It's a little more functional.
- Right? Exactly.
- You want me to show the side plank?
- Actually let's do that.
That's another option line down.
- That's a tough one, actually, Brad.
- And you do not need the loop then.
- No. You can start with just on your knees like this,
and you're gonna go like this.
Now you're working the bottom one.
- Yep.
- And you're working the top one,
- Right?
- For better abduction.
- Yeah. That is a beauty of that. Yeah.
- Now you can do it with the legs straight to it
and it just gets a lot harder.
- Yeah. That's pretty aggressive. It depends on how,
how athletic or how strong you are,
but probably starting out as first time.
- I mean, you wouldn't do on a wiggly mat I mean.
- Right. You'll probably
- On a cushion do it on the floor
- And probably not in a bed.
- Exactly.
- Unless you got a real firm bed, but again,
10 repetitions is a good goal with all of these.
And you may want to do that one on both sides.
What are you looking for, Bob?
- Our mouse.
- Oh yeah. Don't worry about it.
I found it.
So shall we go onto the next one?
- Sure.
- Okay. Now, as Brad alluded to that he's gonna do some
in a standing position, which is a lot more functional.
- It is. It is.
Actually it's easier do
- It's closer to real life
- And you don't have to do all these,
you pick the ones out that work for you that you feel
comfortable with.
If you, you do need to have a resistance band
- Of some sort.
- Yeah.
And it works out sometimes you don't need the handles
on there, but it can be helpful. You'll see why
when I demonstrate it. You stand on it and you need to have
shoes on with this. You don't want to do a bare foot.
You could, but I've, I've always had my patients
with the shoes. And then you pull up on here a little bit
and give some resistance and you simply walk sideways
and you don't have to go fast. You're probably better off
doing it slow and controlled.
This doesn't look like it's very hard.
But if you just do it, I can already feel my hip abductors
working and doing overtime work right now.
And you want to go both directions.
I usually have my patients go about 10 feet and you,
you know, you don't have to measure out exactly,
but you'll get tired. I'm already getting,
I'm starting to get tired
- And safety first. We want to make sure that you're not
going to fall over when you're you doing this
- Right. If you feel wildly with this,
it's not an option
- No.
- Unless you have someone there to hold you
but even then.
- Well, I was going to say, if you had a loop band
like that, you could hold on to a counter.
- That's a good point. So I demonstrate that.
Let me get the purple one out so it's easier to see.
- But again, these are great functional ones,
meaning that it translates to real life because you're
actually walking already.
You actually strengthened the muscles while,
while walking in it.
- So with this, you know, like Bob said,
you can hold onto a cupboard and the further down you go
again, it's more resistance.
And if I go up closer to above my knees,
it's easier to do so you start higher and go down below the
knees as tolerated and go back and forth two to three times
- Pink looks good on you, Brad.
- Well, thank you Bob. Wow.
- There's one more thing. I think this is probably
everyone should do. Pick out the exercise that we just did,
work on one or two of them.
Don't do them seven days a week, do them probably five days
a week with some days off.
- Or maybe three times.
- Right. To get started, right.So you don't get too sore.
But if you have a full length mirror in your house
in a hallway or distance to walk, look at that mirror
and observe yourself initially when you started doing it
and see that Trendelenburg gait and some people
just by thinking about it, they can improve
without the strengthening, even
- Just the feedback by watching the mirror.
- Yeah. And then when you walk, think about it as well.
Spend 20 or a few minutes walking, really focusing on it.
Because a lot of times when you walk, your mind goes,
other ways you're talking, but actually do some walking
where you're focusing on upgrade.
- You might also just take your, the camera on your phone
and video and videotape yourself starting,
and then video tape yourself later to see how
- Like three weeks later into this. And then you can say,
oh wow, I'm getting better.
- Yeah. Brad helped me imagine that.
- The good old Trendelenburg is correctable
and it's, it's gonna take some work, but you can do it.
- Yep.
- So very good, Bob, I just want to say what
we're going to talk about
- Just to be careful out there.
- I'm going to say that later we can fix just about anything
except for a broken heart.