- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion, of course.
- I think I got better legs than you, Brad.
- I don't know, Bob.
Maybe we can have some people comment on it.
- All right. All right. Let's start off, Brad.
We're gonna talk about patellofemoral syndrome
and very simple, what patellofemoral syndrome is,
is probably kneecap pain.
- Right. Right.
- The kneecap is the patella. - Sure.
- And the femoral is the bone that it rides on.
- Here. Let's circle it. - Oh, all right-
we're gonna circle it. - Yeah.
- So a lot of times, that's where you're gonna feel pain
is around the knee or it feels like
it's underneath the kneecap.
So we're gonna show you three stretches.
The reason this came about, by the way, Brad,
the reason I came up with this example,
my wife was having trouble with grinding in her knee
when she'd walk on steps. - Yeah?
- Not pain yet, just grinding.
- She could feel it? - She could feel it.
And I ended up measuring her kneecap.
And interestingly enough, one of her kneecaps
is bigger than the other. - Ooh.
- So, anyway, that's a little bit of a problem,
but her biggest problem is she had tight muscles.
The muscles were pulling that kneecap
hard onto the femoral bone. - Mhm.
- And so that's why it was grinding especially when
she was doing stairs. - Sure. Right.
- So we had her do these stretches and sure enough,
it went away and I'm the great husband again.
(Brad laughs) - So let's start off-
- You scored big points there, huh?
- Let's start off with stretch number one
where we wanna stretch the quadricep muscle.
- Right. - Right, Brad?
Four muscles that make up the quadricep
and they're gonna, they attach into the kneecap.
- Right, the kneecap is actually part
of the tendon of the quadriceps. It's very interesting.
- Right. Do you wanna show the way
you used to stretch it, Brad, when you were in karate
or tae kwon do or what'd you call it?
- Bob it's karate. And by the way,
we're just finishing my book on how to stretch for karate.
It's very good book, actually.
We'll get into that another day.
But, if you can get into this position,
kind of like a hurdler stretch,
but instead of going forward, you're gonna pull this back,
and then lean back this way. And as you go back this, oh,
there it's starting to stretch right there.
And now here your wife would've-
- Yup, that's a very good stretch.
- Never been able to do this. - I don't think she would've.
- Not right away. - She was so tight.
She was probably the one, I think,
that we started her on is this way.
It just had her bring the leg up and then pull like this.
Okay. And that's stretching the quad.
- And where did she start?
- Started working on- - Like when she started she-
- Oh, I don't know where she started at,
because she started, this is, this is the one
we eventually want you to do, is to go like this.
This is a great stretch to do - And standing.
- She started, honest to God. She was like this.
She could not reach down, and what we started her doing
is she reached down with her opposite hand,
she'd grab her pant leg and then she'd bring it up
like this. - Ah.
- Eventually, she was able
to get up, now she's up like this
and she's able to stretch it. And she's no longer
having the pain, or the grinding.
- So we can either do it prone, lying down.
- Yup. - Or standing,
or in that hurdler's position. - Right, one of the three.
- One thing I wanna bring up is, if you do it like this,
you're not getting the stretch.
- Right. - You need to bring it down
and you'll feel it. - And good posture.
- Yeah. - You don't want to
lean forward like this. - No, not like that.
It's up here, and here and now it's starting to stretch,
or in prone, that forces you to have the proper position.
- Right. - So.
- The other thing is, the other stretch we're gonna do is,
we're gonna stretch the IT band.
- Mhm. - It's the band
that runs along the lateral side, I'm sorry,
outside of your leg. - Right.
- And the best way I like doing this one, Brad,
I'm not gonna even show any other ones.
- Yeah. - I just like this one,
you just take, I'm gonna stretch this one.
I'm gonna cross it over on my knee like this.
- Mhm. - And I'm gonna pull
this leg up like this. Just an easy way to do it.
It really stretches the band here along that length.
- Hits the piriformis, too.
- Hits the piriformis, too. Sure.
- Figure two birds with one stone, all for the price of one.
- All right. The last thing we're gonna do,
and we're gonna use the diagram here
to show you what happens here.
All right. Oops. It's up upside down.
- Yeah. - All right.
This would be me standing like this, left leg, right leg.
- But these represent the kneecaps.
These are the legs. - Right.
- This is Bob's artwork, by the way.
- It's just not very good, but.
- Right leg, right leg, left leg.
- The kneecap, what you may not know,
is actually moving up and down
when you bend and straighten your leg.
Okay? And quite often with people who have pain
underneath their kneecap, the kneecap
is riding too far over this way.
- To the outside. - To the outside.
So instead of being here, that's too far off,
because that's actually off. - Right.
- But it would be right here. - Right.
- There's a groove in the femur and the joint
that is supposed to go in between.
- Right. - It's riding out
on the edge of the groove. - It's riding out too far,
So quite often we tape it over this way.
So tape it over towards the inside of the leg
or what you can do is actually just stretch it.
You can stretch it yourself. - Sure.
We've got a video on how to tape that as well.
So you can look at it, if you're interested.
- You can get rid of that, Brad.
- Sure. - This is,
this is a little creepy for some people.
- Yeah. - Wouldn't you say?
Some people don't like doing this.
- Yeah. - The legs gotta be relaxed.
Can you see this Nancy?
I don't know if you can see this or not.
So, but you're actually just gonna take your kneecap,
and you're gonna push it over and stretch it out.
- Yeah. Get right down in, and you can see
here is the edge of the kneecap coming way over.
Now. Let go, Bob. And it, it probably pushed it over-
- Yeah. - Well over half an inch.
- Yep. So quite often, especially if you're a person
who's prone to having this, you may not even
push over very easy. - Right.
- Cause these structures are real tight.
And then, when they do surgery they actually often-
- It's called a lateral release.
- Yeah. They actually release the structures that,
so you can just give it a good push.
And this is what I started having Linda do-
- Yeah. - But her kneecap is so big.
- Mhm. - It didn't help her.
So this, but this would help some people,
I can guarantee you. - And, and how many times
or how long would they do that?
You can do it for quite a few minutes, Brad.
You can just keep stretching it like this.
If it's not painful, right. - If it's not painful.
- Right. - Sure.
- So, those are the three stretches
for basically kneecap pain, Brad.
- Sure. - Right.
- Kneecap, patellofemoral.
- I don't know why I do air quotes.
- I don't know- (Bob laughs)
why you do that, Bob. That's another video.
- All right. Good luck to you.
(laughing) (upbeat piano music)