♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet. - And now Penny,
of course, Bob.
- Today, Brad, we're going to talk about hip pain
and hip arthritis, stop pain with simple exercises.
- Right.
- A lot of times, simple is better.
You don't have to get too complex with this
and sometimes, you may avoid surgery,
even if you do some of these exercises.
- Exactly! If you've got nothing to lose,
I want to talk about this a little bit, Bob,
and this is something a lot of
our patients,
as well as our viewers, I'm sure experience this,
with hip or knee pain, particularly.
They go in, they get x-rays, and the doctor looks at it,
and says, "My goodness, you've got arthritis in your joints.
As a matter of fact, you got arthritis on both hips,
and it looks like your right hip's a lot worse
than your left."
And then, the patient will say, "Well,
but my left hip hurts more than my right hip!"
- You hear this all the time.
- Yeah.
- It could be hips or knees.
- Right.
- I see that all the time, they'll say,
in fact, they'll go in for knee replacement surgery
and they'll say, "Well, actually, it looks like
the other one's worse."
But they end up doing the one that hurts the most.
- Right. - Generally.
- I get people asking me, "Well, what should I do?"
And so, then it all boils down to this adage
in the medical community.
Do you treat the x-rays or treat the patient?
Because, the patients say, "I want the painful knee
- Right.
- operated on."
The x-rays might say, "Oh, this looks worse."
In therapy, we don't have this issue.
We always go after the painful side.
- The pain, absolutely.
And quite often, sometimes when you take the pain away
from one side, it maybe even improves a little bit
on the other side because you're not limping so much.
- Right. You're mechanics, or your gait mechanics improve,
it makes everything better.
- By the way, if you're new to our channel,
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- Okay, so, we already went through the scenario.
We went through half of our video before the intro.
- Yeah, that's right. - That's okay.
So, we're going to talk
about how do you treat it.
Let's say your right hip is very painful,
particularly when you walk on it,
very common with arthritis.
Now, this is something a lot of people do not want to do,
but just take some stress off the hip when you walk
by using
a cane.
- Yeah, absolutely. This is, I find with some people,
because arthritis tends to flare up
and it tends to calm down, a lot of times,
by using the cane, it tends to calm down faster.
- Because you're taking weight off,
it's not irritated as much. - Right.
And so, we're not telling you that you're going
to use it permanently.
- Right.
- And we're not even saying
that you have to do it everywhere.
If you don't feel like you want to do it in public,
just do it in your home
for a while. - Great, limp instead.
(laughs)
- Yeah, limp instead, which people think they look better
when they're limping than using a cane.
- Right. So if you got to, you know, get a cane,
you adjust it so it's about at wrist level
and you're standing tall.
If it's your right hip, you use it in your left hand.
That's one thing that a lot of people get confused,
and just walk normal.
When the right leg goes forward,
the cane goes down, taking weight off the painful hip.
We have some videos on how to walk with a cane,
how to adjust and walk with it, you can look at those.
We want to do some of a few more other options here.
The other one is
a little pendulum exercise or kind of, traction on the hip.
So, you go up to your stairway.
We don't have a stairway here. - Yeah this is a great way
to start getting some movement in the hip.
- Yep.
- Without hurting yourself. - Right.
So, my right side is the painful hip.
So I'm going to go up with my left,
you're going to have to hang on to the handrail.
In this case, I'm going to use my Booyah Stik for balance,
because you need something for balance, for most people.
Now, I'm going to let this leg, the sore leg,
completely relax, like all the muscles are jello,
and I'm just going to gently swing it forward and backwards;
and the reason you want the hip to relax,
is the weight of your leg, through relaxed muscles,
is going to distract, or pull the joint apart slightly,
so you don't have that bone on bone.
- A little bit of traction.
- Right, you get a synovial fluid.
If that's working out great,
you may want to put a little weight on.
You can use an ankle weight.
Now, I've had people just
put their winter boots on, up here in the North world,
you know. - Oh, that's a good idea.
- You know, a boot usually weighs a pound or two, at least.
- Nice!
- And, you don't have to go out and buy anything,
and then, your leg, your hip doesn't know
if you've got a boot on or an ankle weight.
And, you know, do the same thing, you got to swing it
for a minute or two,
and I find people have success with that.
It's pretty much a temporary thing,
but it reduces things.
It's a good way to treat it. - Safety first and it starts
getting some movement in the hip,
which you may not have had for a while,
because it's been sore.
- Right.
- So.
- Now, Bob, let's go on to the next one.
Along with pain in the hip, particularly with arthritis,
usually there's a loss of range of motion.
- Right. It usually concurs.
- Right. - So, if you happen,
at the same time I should say.
- And if you can regain that range of motion
in the hip joint, that can also make you feel better.
- It's amazing to me that even if you regain a little bit
of motion, a lot of times it knocks the pain down
at the same time.
- Right. - So, it really pays
to do these stretches.
- So, let's show them.
- Okay, which one do you want to do first?
- Well, why don't you just, you're going to have to get off.
- Oh, I'm going to have to get out of the way, okay.
- Yeah, this is nice. You can do it sort of laying in bed,
and that's what we recommend. - Yeah, wake up and...
- You could do it on the floor,
but then you got to get on the floor.
It works just as good in bed, and you know,
simply lay like this,
and then you're going to see how far
you can bring your knee up
and to your chest.
Now, if you can bring this knee all the way up like this,
and this one you get about this far, and all of a sudden,
oh it hurts, or there's a, we call a hard end tail,
doesn't want to go any farther,
that's the knee, or that's the hip, you're going
to want to work on.
So, and I am doing it with the right hip.
Let's say this one goes way up to here,
and this one stops here and it's tight,
and it's a little painful,
but if you stretch on it, oh good to relax,
and after about 10 repetitions you notice the hip
is starting to go up farther,
similar to the other leg,
then you're going to want to do that stretch, well,
at least once a day, but I'm going to suggest
two or three times a day,
assuming it doesn't get real sore
from the stretch.
The first couple times you stretch it,
you may want to give it,
you know, wait until the next day.
- [Bob] And I wouldn't expect that it would react that fast.
It may take weeks or even months
before you start to equal the other one again.
- Sure, right.
- [Bob] That's a tough fibrous material
that is holding the hip together, in the socket,
holding the hip in the socket.
So, it's not always that easy to stretch.
- And so, along with that, what you may want to check
what we call the external rotation of the hip,
and I'm going to go this way so you can see what I'm doing.
So, with this leg, I'm going to go over the top
of the knee like this,
and I'm going to let the knee drop this way.
So, you can see, I can go this far,
and the hip that has the pain may only go this far,
as oppose to like this, like the other leg.
So here, all we're doing is gently push the knee,
and relax, pressure on, pressure off.
And if it feels good to keep the pressure on,
you may use that option and hold it 15 to 30 seconds,
and not do it maybe as repetitions.
But don't, number one thing you don't want to do,
is spend 20 minutes stretching your hip.
10 repetitions on and off, or three times
15 to 30 seconds is probably a good place to start.
- [Bob] And what's nice about that one,
you actually can do that one seated too.
- Oh, right.
- Brad's going to actually show how to do hip flexion
the other way too.
You can actually just cross the knee,
cross the ankle over the opposite knee,
and you can go ahead and just push down like this
and give it a bit of a stretch.
A lot of people tell me,
that last patient that I had that had hip arthritis,
they can't even get that leg up there.
- Yeah.
- That's how tight it's become.
- Sure.
- So, they might even have to start with the knee down,
like this, a little lower, and press it down.
But, they know right away what I'm talking about,
because, like you said, they can maybe get the one up there,
but the other one, "I can't get that up there."
- Right.
- So, it's a great stretch.
Are you going to show the hip flexors?
- Well, before I go to that, I just wanted to mention,
if taking a warm shower or, you know, a hot pad helps,
one thing, because a hip has got a lot of muscle around it,
depending on the individual, there may be other soft tissue,
kind of padding that area.
- Sure.
- So you want to...
One option that you could do
is get a
a hot pad that goes in real deep.
- Right. - And, to do that,
you're going to need an ultra, or...
- Infrared!
- Infrared, not ultraviolet,
but here, we put that there,
and Bob is going to show
how deep it goes. - Yeah, I'm going to show you
how this, we always use a demonstration.
This is a Thermotex infrared pad, heating pad.
Now, normal heating pads only go skin deep.
They just barely penetrate the surface a couple millimeters.
This is how far the Thermotex goes, 2.36 inches.
So, what you can see here, what a big difference that is.
That can start to go into the joint itself.
If I look at Mr. Skeleton here, Mr. Sam,
if I'm going through here,
you can see how that can start getting
into the joint itself, where this one just is going
to heat up the outer surface,
and mainly not do much of anything.
- And then, you would do the hot pad for, you know,
you can go up to 45 minutes with these,
and do the stretch afterwards.
You're probably going to find the stretch goes much better.
- That's right. - After you warm it up.
- And, you know, Brad and I just use this
on a regular basis for our back.
We just put them in our chair and we lean against them.
Thermotex has been really good to us.
They got a really great discount for the people,
our subscribers.
- Right.
- So we'll put a link below so you can check it out.
- You bet.
The next one, now this is for people probably more mobile.
They got hip pain
and they got fairly good balance.
You see, you can go up to a stairwell
or, in this case, a stool,
but I'm going to stretch my right hip.
I'm going to come up to here
and I'm going to go like this,
and what's going on is my hip is flexing.
You see how my knee is coming towards my chest?
So, that's a lot of hip flexion and it drops in.
You know, this has got to assume you have a good knee too.
But it will stretch your knee
if you need some working on that.
You get two joints at once.
- The stairs work great for this, Brad,
because I've had even really quite elderly people able
to do this one, because they start off on this first step.
- Yep.
- You know, they start there, and a lot of times
there's two railings.
- Right.
So they got to hold on. - Yeah, they got to hang on to
and I have found most people can do that.
If they can climb stairs, they can usually do this stretch.
- Yep, as long as there's hand railings.
- Yep. So, it's a fantastic stretch.
- Now, I do mine way up like this.
Of course, I'm younger and I'm...
But, it really helps I've got a side joint from.
So, you know, this is not only just doing the hip,
it could be, you know, work the nether muscles
in the joint as well. - Well, what's nice is
he's actually stretching the hip flexor
on the opposite side.
- Right.
- So, you're actually getting two stretches in one here.
- You can see it better here.
You're getting this muscle and you're getting
this bright. - Which also helps hip pain.
You're getting a double bonus there.
- There you go. - A great stretch to do it.
- My mike's falling off.
I don't know if people could hear me!
- Oh well, that's all right. - Sorry about that.
- No, Lykes has his... - Lykes said, his hand, or
- Go, we're good.
- All right.
- Well, Brad, remember we can fix just about anything.
- Except for...
- Broken hearts.
- But, we're working on that.
- Well, we'll figure it out someday.
- We'll persist.
- All right, thanks for watching.
(short bouncy music)