♪ 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.
- You know, we're the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- My gosh today, we're going to talk
about why does my knee, we're talking about your knee,
click, creak or pop when I squat.
And we're gonna show you how to fix it.
Now this could be with pain or not, either one.
If you want, you know, usually there's something
a little bit off if there's sound coming from it.
- Right, right.
It's always better if it doesn't hurt though.
- Yeah, it's better if it doesn't hurt, sure.
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We're going to show you in a minute what it is.
- Oh, yes.
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if you want a 60 second version of our program.
And yes, sir, we got podcasts now.
- A podcast.
- So, yeah, we're assuming that you have
some structures that are probably tight,
your knee cap might not be tracking well.
So we're going to treat both
above the knee and below the knee.
Because that's how you treat the joint.
- Right.
- Up stream, down stream.
- The muscles that support it,
they cross the joint and they come from
both directions and we're going to cover it all.
- Now, a lot of this is based on,
I want to give credit where credit is due, Brad.
- Absolutely, because it's not me.
- A lot of this is based on the book
The Supple Leopard by Kelly Starrett, awesome book.
Really, I mean terrific.
I was changing my mind on everything I saw.
- Yeah, he's quite a guy.
- Yeah.
- A brute.
- Let's talk about the first one that we're going to do.
We're going to stretch the quadricep
because especially the rectus femoris
because it crosses the knee
and can put increased stress on the knee.
- Sure.
- If it's not being stretched.
- You want to show the strap and I'll show the chair?
- You bet.
- So.
- You know.
- Standing, I guess I could.
- You could use a belt
and make a loop out of it.
We use a stretch out strap
because it works quite well for a number of reasons.
Yeah, this is one where, if you have trouble
with mobility and getting around,
the strap really works well
because you don't have to reach through the joints
but if you got the loops, I really like it.
When I use mine, I always just go like this,
I don't grab it, pull it like a rope.
It's so much easier.
- [Bob] It's easier on your hands.
If you have arthritic hands, we're always
trying to transfer the weight to the larger joints.
- You know, let me do it this way
so they can get a better view
of what's going on with the knee.
- Brad and I didn't call each other up,
we both have similar pants, buddy.
- Well, you know how it is.
- We liked these pants because they show...
- Hey, two for the price of one,
we got them on sale.
- Yeah, both the same height.
- So when you're laying down like this,
I'm getting a really good stretch.
And if I lift my knee up
and pull that really gets aggressive with it
but you're probably just going to do it like this.
Or you can do it lying on your side.
If you don't want to lay prone,
if it's uncomfortable for you.
- Now you said it first, right?
You said lying on my side,
then you said, if you don't want to lay prone,
you had it right.
- Well, I know I'm working on it.
I'm a slow learner Bob.
- You're doing better.
- Yeah.
- A lot of times I just grab my leg,
with the opposite arm,
I don't know why, it works better for me.
And I do a stretch like that,
but lately what I've been doing is actually
I go up to my bed, believe it or not.
- Yeah.
- And I put my foot up, like this
and I...
- Can you do the other leg, Bob?
We can see it better.
- That makes sense.
I put it like this and I stretch like that.
- You got a pretty short bed then.
- Well, yeah, yeah, kinda.
- Well, one way or another you get it,
it's got to be like cushy.
- Yeah, it's cushy.
- You could use any chair.
- Yeah, if it's one of those really high beds,
it wouldn't work.
- You'd be really tall then.
- Chair would work.
- Or you could boost it up.
- Now you could too, if you want to work the rectus,
a little bit, femoris.
you could use what our giveaway is, Brad, here.
- Sure.
- So we're giving away the handheld massager.
The advantage of this one over like the massage guns,
one is you have a handle
so you can get the spots that you can't get to.
But two, this one's really inexpensive, I mean,
and it does a good job.
Little bit less aggressive.
- Right.
- Then than the others.
But you can work the quadricep here.
We're going to show you how you can use it
for some other areas of the muscles later on.
- And if you're a thin person or a little older.
- Yeah, that's the baby for you.
- These are typically strong enough.
- So the next one is we're going to talk about
the supra patellar pouch.
It's right above the knee.
It sometimes can develop into a bursa too.
- I'm going to show a little leg, Bob.
- Yeah, there we go.
- Yeah, so you got that knee cap there
and so we're right there, just above it.
- [Bob] Now that can get bound down,
that can get adhesions in it and scar tissue.
And that can cause noise, you know,
especially if it's tight.
- [Brad] Yeah.
- [Bob] I had this problem.
I thought it was a tendonitis
but I think this is what I had.
- Sure.
- And what took it away from me was massage, again.
So I actually took one of these
and I hit right over to the top of the knee.
Well, if you're showing off your knee,
I can show off the knee.
- Oh, yeah, we can have a little comment on
who's got the better knee here,
but you know, one thing, I think we wanted to mention
the stretch, before you should stretch it for, you know,
15 to 30 seconds for the quadricep before you would do this.
Yeah, I'm sorry about that, Bob,
but I know people are going to ask.
- [Bob] So I just go right along the edge of the bone
and it felt good for me.
Now that's the key to this is
that if it increases your pain, you're not going to do it.
- [Brad] Right.
- [Bob] I mean you actually want it to start,
the pain start leveling off after about 30 seconds,
maybe even getting better.
- Right.
- So, and Brad, you kind of came up the idea
of actually not hitting directly on
but going off to the side like this.
- Well, particularly with these bigger guns,
they have more travel
and this is going to get pretty aggressive.
You can see it bouncing there.
That's gonna beat the heck out of your pouch.
We don't want to do that.
This feels like very nice.
Now that one just doesn't, it's not as aggressive,
and that ones good.
- [Bob] Right, right.
- And you had this.
- [Bob] This is the kind I had at the time.
- I don't feel like stopping, Bob.
- Do plenty.
- I'll keep working on it.
- Well, if you don't have the money, you can use a ball.
- Oh, yeah.
- You can, Brad, actually,
do you mind holding that for a minute?
I'm going to get onto the mat here
and you can actually,
you do this on the floor
but you could take a lacrosse ball,
you could probably use a tennis ball too
but you can just work at like this, you know
roll on top of it.
You put another leg on top of it
if you really want to get aggressive.
- There you go.
- Probably can't even see it.
- Oh, yeah, it's coming right.
Now, like we're doing it on this soft cushion,
you probably wouldn't want to do that.
You'd want to be on a carpet, or floor.
- Yeah, get a little more aggressive,
but that's the, you know,
if you didn't want to put out the money for it
which I understand, give that a try.
And one thing you could see if it helps at all.
So, but give it a shot.
Next one, Brad, we're going to,
actually the other muscle that crosses
over the knee is actually the calf muscle.
One of the calf muscles anyway, the gastrocnemius.
- Right.
- So the only thing about that, again, you can use the ball,
you can roll on the ball,
but beware of going right behind the knee.
There's a lot of nerve, artery and veins there.
And so you want to do is kind of go off
to the side right here, Brad,
if you're going up really high.
- Oh, I wanna work there.
- Right, so inside or outside?
kind of hitting that spot.
If you're down here.
Yeah, you can let it roll.
- Sure, work it back and forth and everything.
And then when you get up high one side
or the other, same thing with the gun.
- Same with the gun, same with the massager.
- That's the popliteal fossa, Bob,
we want to stay away from that.
- There you go, sounds like Mufasa
- Ooh!
- Mufasa.
- Who's that?
- (laughs) From the lion King.
- Oh, I was thinking about that.
- You knew that right?
- I haven't seen that one for a while.
My daughter's pretty old.
- Well, that's about time, it's really popular.
- Yeah, I know, I watch, it sounded familiar,
it rang a bell.
- All right, next one we're going to do
is actually called gapping
the joint, Brad.
And this is in case something's going
on in the joint itself.
Where's my towel?
- So, does this popping hurting your system?
Or is it, what's going on in there?
- It could be hurting.
It could be something inside the knee.
I've had good luck with these next two
if it's something like a piece of cartilage floating around.
- A floater or something?
- Yeah, so this is just called gapping the knee.
You're going to take a little towel,
and you're going to stick it
in the popliteal fossa.
And you're going to actually get it nice
up in there and you're going to work it like this.
And you're really.
- Excuse me.
- Gapping that knee.
- [Brad] I'm just going to say, well, if you put this here
it'd probably, maybe more comfortable for ya.
- Right, right. but I'm just giving it a good stretch,
gapping that knee.
And a lot of times, if you're lacking flection,
this will help you regain some of that flection.
- So you have to be careful with that one,
don't just plop your weight down quickly.
- All of these, all of these, we don't want pain.
You know, you want, if it's increased pain
don't do it.
It's not for you.
So the last one is a Mulligan technique.
This is by Brian Mulligan,
he's out of New Zealand.
I think he's still alive.
Brad and I saw him at a course.
- He was old when we saw him.
- 10, 15 years ago.
- But he was a character, wasn't he?
- Yeah, he was a go getter.
- He was fun.
- He was exciting.
- So, what you're going to do is actually
what you don't realize, the knee,
you may not realize is that the knee
doesn't just bend and flex.
It's actually internally rotates
and externally rotates too.
- Not a lot, but it does.
- And a lot of times what people are lacking is
that internal rotation.
And so they're kind of stuck
in the external rotation and that throws the knee off.
- Sure.
- So what you're going to do is,
I'm going to show it right here,
because it's going to be easier for you to see.
You actually do this standing
and put the one foot up on the bed
or, not on the bed, but on the...
- [Brad] I can demonstrate it would be like this.
- Yeah, but what you're going to do is
you're going to turn it
in towards the other knee,
that internal rotation
and then bend the knee at the same time.
- So you're actually trying to turn the tibia.
- Yeah, trying to turn this bone,
you can see the ridge here.
- So you got to get a hold of this.
- Turn it this way.
Yeah, you got to turn pretty hard.
Make sure you point your toes in that direction too.
- Yeah, that helps.
- Yep.
- Oh, yeah.
- Then you go ahead and bend at the same time.
It's a lot better.
Yeah, I mean, you can do it like this
but it's better to do it weight-bearing.
- Yep.
- Brian Mulligan always emphasized that,
it was better to do it weight bearing.
- Be careful with this one again,
if it hurts, it makes a sharp pain in the joint,
- It's supposed to be pain free.
- Stop, yeah, it should feel better.
Yeah, sure.
- If it hurts and you keep doing it
don't blame us because, you know, we told you not to.
- That's right, there you go.
That's our disclaimer.
- So those are five techniques you can try.
You don't have to do them all
but I would give them all a try first
and then see which ones, you know, if your quads tight,
keep working on that
and you don't have to stretch muscles if they're not tight.
- Yeah, just compare it to the other leg.
- Right.
- And you know, especially if your other one
is not painful or asymptomatic,
then you have a really good benchmark to compare it to.
- And remember, Brad and I can fix just about anything.
- Except for...
- A broken heart.
- Right, but we're working on that.
We still got a few more chapters in the book.
We didn't get any started yet.
So we got more than we thought we did.
So just be patient.
- Thanks for watching.