♪ Bob and Brad ♪
6♪ The two most famous
♪ Physical therapists ♪
♪ On the internet. ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, a physical therapist.
- We're the most famous physical therapists on the internet.
- In our opinion, of course, Bob.
- Our opinion is sometimes right.
- Well, Bob, we're getting better all the time.
- All right, today,
we're gonna talk about top three ways to stop
inside
joint knee pain
(grunting)
and how to tell-
- Right.
- If you're having inside knee joint pain.
- Right, because you know, you always kind of wonder,
is it in the joint?
Is it arthritis?
Or is it a ligament?
Or is it the muscle?
- Is it the meniscus inside?
And it's a big difference over,
kind of your outcome a lot of times.
And so we're gonna talk about that.
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- Oh yes.
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- Yeah.
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Okay, so the first thing you don't wanna do is,
you know, this I'm talking about, you're starting,
you're humming along in life
and all of a sudden you start getting some knee pain.
- Right.
- There was really no injury.
You know, it just started hurting.
So I I'm talking about non injuries. That's, you.
- Know? Yeah.
Without falling on about, obvious twisting,
you just get up and it's like, oh, it starts to hurt.
Just gradually getting worse day by day. Or.
- Did you start getting to our age, just start this,
that kind of crap starts to happen.
You just wake up one day and your knee.
- Starts hurting. Yeah.
It's a LA yeah.
Anyways.
- Carry on.
So to me, the first thing I,
when my knee starts hurting, I'm be like, oh gosh,
is it inside the knee? Or is it outside the knee?
Because if it's outside the knee joint,
it's a lot easier to treat generally. Right.
Right. But if it's inside a knee, so we're gonna,
we got a knee here.
I don't know how close I can go to you, Liz.
What's the restraining order to say now.
- Yeah.
(laughing)
- Yeah. So I don't know if you could see,
this is the quadriceps. This is,
so this would be about right. Like this.
I, I probably just lost you, didn't I.
- This is like one of those little models,
the knee joints they have at the doctor's office.
- How are we doing?
Okay.
So I'm gonna open up the knee and Brad's gonna show us where
the meniscus are. Right.
- Well, by the way, this is, oh, this is a kneecap with the,
with.
- The, yeah.
The patella tendon.
- Right. With the tendon or the top.
So we're just gonna disconnect that so we can look inside,
get the kneecap outta the way. And in here we've got the,
the cartilage jets right. On the joint itself.
And then there's the meniscus is like a cartilage.
- Yeah. They're like horseshoe shaped, right?
- Yep. Right.
If we could tear it apart and you could look at it from the
top down, you could see.
- Yeah. They provide like a cushioning and as you get older,
little pieces of that can actually break off. Yep.
And what's interesting has happened over this past couple
months, it happened to my wife.
It happened to our office manager at one of our offices.
Sure. And it happened to a nurse.
I know.
And,
and it's all been kind of interesting the different outcomes
that they've had, but.
- These are all people, you know,
by the way, Bob.
- I know. So I'm waiting for my moments.
- You could be next.
- Yeah. I could be next.
Well, they happened in threes, so, oh.
- Three. Yeah.
Then you're fine. You're clear.
- So the, the first thing I wanna know is it inside knee,
and we're gonna show you a couple tests that you can do to
try this.
And so one of 'em is the Thessaly or for you lay people,
we'll call it the disco test. Sure.
Do you guys, do people even know what disco is anymore?
- No, well
- Young people? Yeah.
If you're over 50, you do.
Yeah. If you're, you.
- Know, around.
All right. So you're gonna hang on to the back of a chair.
You're gonna bend your knee,
just a slight about five degrees. Right.
And you're gonna twist just like this and I'm,
I'm testing this knee
and you're looking for pain.
- Right.
And I I've been using this quite a bit in the last year
with, with patients.
And what I'll do is I'll do it. And if they have pain,
it doesn't say yes, then.
- It doesn't say, but it's, it's a possibility.
- Right.
And then we'll do exercises for a couple weeks and then
we'll retest it and see if the pain is better or worse.
- Good, good approach, Brad.
Okay. And the other one you can do, I mean the same thing,
you're gonna bend it to 20 degrees and now you're gonna
twist. Right.
So now you're getting a little more into the joint and
you're, you know,
there's more possibilities there of hurting. And then Brad,
you wanna show the duck walk.
- Yes. You know,
I just had someone with this earlier in the spring and she
had knee pain and I was trying to figure out what made it
worse.
And she did this one. And as soon, soon as she started, oh,
it hurt. I was very clear.
- Again, it's not necessarily saying that it is meniscus,
but it's starting to say, you know, yes.
It's something in the joint like.
- Well, we did some of the exercises we're gonna show.
And within two weeks.
- It was better. She could do.
- It. Yeah.
Yeah. Life got better for her.
Sorry. And it was a good deal.
- The other thing you wanna do is you can go ahead and we'll
show on a real knee bread, cuz actually this is,
I hope I can get my pan leg up.
- I can. Well, that's a beautiful side, Bob,
look at that thing like, wow, there you go.
Gargoyle socks and everything.
- Argyle.
- Sock. Oh yeah.
That's right.
- All right. So you have your kneecap here.
So the,
the joint line is if you put your hand right underneath the
kneecap,
like this kind of make a smile underneath the kneecap. Sure.
That's right where the joint is. Sure.
So if you put a push along on there and it hurts on the
joint, but it doesn't hurt anywhere else.
Well that means there might be something going on in the
joint. Right?
- The joint, you know,
I went to an orthopedic knee surgeon cuz I had some knee
problems. This is about 20 or 15 years ago.
And that was his primary assessment. It was a big one.
- For him. Yeah.
And I remember when I followed orthopedic surgeon,
same thing. He, he goes, well, it hurts up here and here.
So ligament, if it hurts right along here, it's joined.
So.
- Sure.
- Yep.
So, alright.
So let's say we've determined that it may be inside your
knee,
these things that we're gonna show you are actually good for
your knee. Probably no matter what you're doing,
but so the first thing you're gonna do,
you wanna get the knee to calm down.
So you're gonna grab an ice pack.
- Behind you, Bob on the thank you.
- So they got a lot of different ice packs. You can use,
you can take a, a bag of, you know, frozen corn if you want.
I I.
- Or.
- Peas or peas.
- Depends on what you want to eat next. Yeah.
But.
(laughing)
- I suppose you can eat 'em they're in a bag.
- Well yeah. Well if you melt whatever we'll go on.
But yeah, you can, you know,
we've got a really good video if you wanna make your own
frozen.
Oh.
- Yeah. Make your ice.
- Pack. Yeah.
Bob and Brad cold pack. Wanna make your own FYI.
I think it's labeled. Yeah.
- We got a couple of 'em on there.
- So yeah, we should maybe do another one
just for the final.
Maybe should come at it from a different angle,
but this is a nice cold pack you can purchase.
- So just put it on for like 20 minutes.
You can do it a couple times a day to help calm things down.
You can take, you know,
an anti-inflammatory and a lot of times the doctors will
even allow you to bump it up a little bit and take a higher
dosage for a short period of.
- Time. Yep.
From ibuprofen.
- We did that with my wife. We,
we bumped it up for a little while. How.
- Much was she taking?
- She was taking 600 milligrams. Three times a day.
Okay.
So, and,
and when she saw she's we did have her go in and do x-rays.
They, they told her she could do that for a while, but okay.
That was her. I don't wanna say it, you know,
is general to everybody cuz people have medical issues in.
- Right? Yeah.
There's some side effects possibly with.
- That. All right.
The next thing is, and this is key and this is a lot.
This is one of that. Most of you are not gonna want to do.
My wife didn't wanna do it.
My office manager didn't want to do it.
The nurse was the only one that she was willing to.
She's like.
- Yeah she did. Yeah.
What, what are you talking about? Bob?
- Decreasing the weight on the knee and that's one of the
things that's gonna really help decrease the pain.
So one thing just avoid stairs, avoid Hills.
Right.
But then you're gonna wanna get some type of gate aid.
Do you wanna grab.
- Help Bob? Yeah.
We'll start out with this.
- So people are gonna go, are you kidding me?
I'm not gonna use a cane. Are you?
I mean, are you joking great.
- Especially if you're, you know, below 70.
- Yeah right. And, and sometimes even
if you're below, you know,
above 70.
- Yeah.
Well use.
- A cane, you know, pride to comes before the fall.
Remember that one, Brad.
Yeah. So anyway, my wife says like,
no way am I gonna use a cane? And then it got so bad.
(laughing)
She used a cane.
(laughing)
The husband's always right, right Brad.
- Yeah. We can say that now.
- We can say that now. And there's no, well,
no close wives close. Right?
- Right.
- Yeah. All right.
So we, this is actually,
she actually used one similar to this cuz her hands got so
sore. We actually bought,
you can buy this extra padding to put on top. Yeah.
- You can take a, I've used this like a,
a cloth, a wash cloth, small towel or wash cloth.
So anything for patting on there and tape it on
lambs wool.
Oh yes. So if you got a lamb.
- But to be honest with you, the crutch really didn't.
I mean, this didn't do it.
So we went to a crutch. Ah, she felt more, you know,
that felt more like an athlete,
but of course she had to put up with everybody's asking what
happened, what happened?
And she had to say nothing happened.
It just started hurting. Yeah.
I got a sore knee.
- So she went to the single crutch, same thing.
We got some extra padding for it that you could get out on
like the internet, you know,
padding for crutches cuz it really got sore and she just
needed one side and she could go along. And then with a,
when we went on a trip actually,
and it was starting to get better,
we got her a walking stick.
- Something.
- Like this, something like this, you know that she could,
it was actually even a little bit smaller so she could walk
with it out without being self-conscious about it. Sure.
- Yeah.
The key with the, any of these,
if your left knee is a painful one,
you use the device on the opposite side, which.
- Right. It generally gives you more normal
gate pattern in or walking pattern.
Yeah.
Right. So, you know,
you're going like this instead of going like Dr. House,
you know?
- Yeah. On that show.
Yeah.
- On that show. Dr.
Wonder house still around. Yeah.
I don't know if he's doing.
- But anyways,
we got him from good videos specifically for how to use
those.
- And so all right, next here
what you're gonna do is you're gonna, this is kind of key.
You're gonna wanna make sure you've got full motion
in your knee,
by full motion. I mean,
so let's say this is the involved need. Sure.
You got full flexion.
- So it's gonna bend all the way,
just like the other knee and it's gonna
straighten all the way. Right.
And you do it by comparing it to the other side.
Now with my wife, she did not have full flexion.
I mean you could, and she could feel too,
it feels tight compared to this one. Right?
So we started having her stretch.
And one of them for flexion that you can do is you can just
do this. Yeah.
You can go pressure on pressure off, right.
Pressure on pressure off.
And you can do this throughout the day.
You can do it every hour. If you'd like.
- You know, assuming this is not creating
any sharp pain and,
and irritated making it worse after a few repetition.
- Oh good point, Brad.
- It, it should feel like a, a good stretch.
And as you do more, it starts to loosen up and feel better.
So keep that in mind. It's very important.
- Yeah. Don't don't make the pain worse.
You can bump into the pain.
Do you wanna show how you can do it on the chair too?
Where you can just put your foot up and well, I guess I,
I can do the Mulligan technique. Oh yeah.
Why I do that? Yeah.
All right. So this is a little more advanced technique.
This is the, but what happens?
And I'm theorizing here, Brad,
and I'm not sure about this or not,
but it seemed to work with a lot of my patients.
Like if a little piece of the cartilage has broken off. Yep.
I, I think a lot of times by doing this,
you can kind of shovel it into a spot that it doesn't bother
you as much. Sure.
Right.
So what you're gonna do is you're gonna put the foot up here
without falling over and I'm actually gonna turn,
I'm gonna turn the lower bone towards the other knee.
So in this case,
I'm going counterclockwise with my right leg.
So I'm turning the leg and I'm bending
and I'm the whole time I'm bending. I'm turning the leg.
I'm I got a good turn on it.
- So he's trying to, can you see this?
So what he is trying to do is just put a little bit of a
turn on the tibia,
the bone below and get some more motion with that.
And again,
this is one of those things you're only gonna do when you do
it. It makes the knee feel better.
You get more motion with it.
If, if for some reason it creates sharp pain,
then you can turn the other direction and see if that is
better.
- Sure. Generally it is the turn though.
So if you're using the, using the right leg again,
you're turning counterclockwise or towards the other knee.
If you're using the left leg,
you're turning it clockwise and towards the other knee.
So I'm turning it and I'm bending it.
- Right. Turning that way typically works the best for most
people.
- So let's go into extension Brad, with extension.
What you're gonna do is you're gonna work on
straightening the knee.
So again, you can put
pressure on, pressure off,
and you can do it with the toe straight up,
but you can also try it with the toe,
turned out to the side like this,
and Brad's showing it on our knee glide,
which actually works really good for this.
Right?
- Yeah.
We we've been selling these for about a year and a half now
and they've been going very well,
but they work well because they work good for the knee.
That's why it's called the Knee Glide.
- Yeah.
Right.
So you can turn the foot out like this
and you can also turn the foot in
and see which one feels the best
for my wife. It was turning the foot out like this.
Sure.
And she doing pressure on, pressure off,
pressure on, pressure off.
We say the words because that's how long you should do it.
- Gives you a cadence. Yep.
- And it gives you about, you know, again,
we can do it every hour.
I had her doing this and I also had her doing it with the,
the, the little standup like this Brad.
Yeah. Just to get some motion in the knee.
So she just, she was just going do, yeah,
she was just doing gliding. Yep.
Like this, to get some motion in the knee.
Right. To get it, to calm down, get it to lubricate.
Yep. And, and work.
So that, that's another thing that works really well.
Right with that. So, and.
- You can go to our favorite products outta the video if
you're interested in, in looking more at these.
- Yeah.
So about,
I don't know how we ended up taking so long today,
but we did.
- Well, Bob, we have a way of doing that.
It's just a natural talent.
- All right. Thanks for watching.