♪ Bob and Brad, ♪
the two most famous,
physical therapists on the internet.
- Hi folks I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- A real humble opinion.
Today we are talking about understanding
bursitis of the hip and knee.
We want to stop pain now!
- That's right. Bursitis is no fun.
A bit painful, but if you understand it,
and learn how to treat it properly,
you can really decrease the time of pain.
- By the way, we are doing a giveaway
as we do every week. And just go to Bobbrad.com.
Go to the giveaway section and you'll see that we are
giving away a booyah stick.
- Yes.
And even Sam is partial to the booyah stick.
What'd you say that?
- Yes, he does.
- Yeah. He loves it.
Say no more, Bob. Shall we continue?
- All right what is bursitis Brad?
- Well, that's a good question.
Bursitis. If you look at the name,
bursa refers to a fluid filled sack and they're all over our
body, typically by the joints.
Itis means inflammation. I believe that's a Latin term.
- Right
- So it's inflammation of the bursa.
So flared up. And these bursa sacks
have a lot of nerves in them.
So they're tender and sensitive
when they get inflamed and its not fun.
- They can really hurt.
- Yeah, it is. I remember my mom had it when I was a child,
in her shoulder. And boy, she was in a ton of pain.
I really didn't- She says, I got bursitis.
Cause I had no idea.
- She couldn't spank you then.
- Wow. You know, she, she let dad do that, anyways.
(laughing)
Shall we continue on here, Bob?
- Sure
- Let's talk about the bursas we're talking about,
we're going to show where the are in the hip and the knee.
- Sure
- But how a bursa actually works.
This is just a model way for you to think about it.
Now, the bursa, we're going to talk about one in the hips,
see the greater trochanter. There's either a tendon,
or a ligament that goes over a bone.
And so when you move, they have to slide over each other,
so they're functional and it doesn't create any problems.
But like my hands, if I did this.
First, I'll start feeling some friction and some heat.
And if I did it long enough, I may even get some callous,
or some blisters.
- And you'd get irritated
- Yeah and it'd become inflamed.
And I have sore palms every time I moved it.
So what a bursa is, is like this ball.
Now this ball is one of those squishy ones.
It's got fluid in the middle.
- Yeah fluid filled sack.
- And if I put that in between there,
and squish and I rub back and forth,
almost no friction whatsoever.
And that's what we would-
- I like this demonstration Brad.
- Yeah. I thought it was kind of fun.
You can do that forever and it's no problem.
- Right.
- So should
- Go ahead.
- Well, you know, the bursa's not needed anymore.
Let's talk about the location.
- Sure.
- Now there is more than two bursas in the hip and more than
three in the knee,
but these are the most commonly irritated.
- Right
- Cause problems. I don't have my pointer,
I just I'll use my finger.
- Sure
- So there's one right here on the greater trochanter.
Okay. And then there's one little deeper inside,
and that one is called the, for the iliacus psoas.
- Right
- And the, that helps relieve pressure
and that friction there.
- ( Bob) And that's again more on the front.
- (Brad) Yeah
- (Bob) And this one's more directly on the side,
you feel the point of the hip.
- To be honest with you, Bob,
I've almost always worked with the one on the side
- Right, right. I have not seen the other one very often.
- Right. With the knee,
There's one right on the knee cap, right on,
on top of the kneecap. And if that one gets swollen,
I've seen those it's, it's pretty-.
- (Bob) It's called Like a house mate's knee.
- ( Brad) Yeah, yeah.
- That's Homer's Knee, and I mean-.
- It's not fun
- Then there's one in the lateral gastric,
That's a muscle here in the back of the knee.
Okay. And the other one, this is probably the most common,
I think, as the fibular bursa.
Which this bone is the fibula,
and it's right up here at the top.
And that can get irritated and tender.
- With IT band.
- Yes.
- Yeah
- Thanks, Bob.
- So the band runs all the way along here.
The IT band it'll be iliotibial band. It attaches to that,
the fibula.
- Sure
- And it can irritate that bursa.
- So, we'll-
- It it's tight.
- We'll show you a little stretch later on
to help cure that. But before we do that,
for treatment it's similar treatment,
for all these bursitis. Number one,
is if you can avoid the activity that irritates it.
- Especially when you're trying to get the calm down.
- Right.
- We're not saying forever, but until you
get it stretched out or, you know,
and do try some of these other things.
Avoid making it worse.
- Right. Exactly.
- Not helping.
- So hopefully that's a possibility,
if it's part of your job, that that can be a problem.
- Right
- If you can't. But the next thing is use a cold pack
over the inflamed or sore area.
So a gel cold pack is nice and works well.
Put it over for 20 minutes. Allow that to-.
And these are pretty superficial.
- Right
- They're pretty close to the surface of the skin.
So the cold will penetrate through,
a relatively good for most.
- Or a-.
- Some peas.
- Right?
- Frozen peas. Yeah.
That, you know, that's the, you know,
you use those and you've got to break them up and it works
pretty good. I've had many patients be grateful,
that they didn't have to buy a cold pack, either coroner,
peas out of the freezer.
- Right.
- The next one is a-.
- Red flag.
- A red flag. And that means if that burst,
the skin becomes red, it's tender, it's warm,
it's flamed. Then you need to go to the doctor.
- We're worried about an infection.
- Right, exactly right.
- Make sure that's ruled out.
- Right, so that's the red flag. See a doctor,
get that taken care of. Also along with the cold pack,
you can just go the over counter,
INSEAD's ibuprofen. Very typical.
- Anti-inflammatories.
- Yup, exactly. Take the right amount for your body size.
Usually it says on, right on the,
- On the bottle.
- On the bottle. Yeah.
Or you can go to Bob-, we've got a really nice video,
that's very popular.
- Right
- On the, for ibuprofen, Tylenol, even turmeric.
If I pronounced it right. The next one,
temporary use of a cane.
- And you didn't grab a cane did you?
- No I-.
- But use the booyah stick.
- Yeah. So if, if your left knee or hip is sore,
and you use a cane in the right hand and you walk with it,
that's going to unload the pressure through the opposite leg
when you walk. And that can make a significant difference,
but don't get too excited.
You'll- people do not want to use a cane, it's temporary.
- Right. Let's it just calm down.
- Yep, exactly.
- And then go back to your life.
- And I did want to mention, people are saying, well,
how are these bursitis occur? How do they develop?
Well, oftentimes it's a repetitive motion,
- Right.
- Lets say you started a walking program,
and you have not walked very much.
And you start walking a mile, you know,
relatively quickly that change can change of repetition,
gets it started.
- Right.
- The other thing let's say you injure your
left ankle and it changes your gait.
So you're limping for a few days.
Well that change in your gig can change-.
- That's amazing how little that takes.
- Yeah.
- I mean.
- So things like that, things you don't think of.
All right. Should we show some-.
- Tight muscles.
- Yes. Tight muscles. They get tight over time.
We could go on with that for another video.
- Right
- Why these-.
- In fact, that's probably one of the best things
you're going to do for this.
Also in, you know, including the other regiment,
it's actually do some stretching of the muscles all over
the knee or over the hip
- Right. So should we start with a stretch for the hips?
- Sure
- Yeah. So we're going to talk about
stretching that IT band.
One of them is when you're sitting, this will stretch it.
This may not be the best one, but it's very convenient.
Is the figure four stretch.
- Right
- I could, I saw someone called this a pretzel,
But I don't. I think it's a figure four,
either way, that'll help stretch it.
You could do this one lying down.
Like this.
- Yup.
- I like this one a little bit better.
- Yeah. It's really intense.
- You can do it like this off the edge of the bed.
Let's say this is my hip or my knee.
And bring it back like this and allow,
that leg to go down towards the floor.
And you'll get some stretch out.
- A little tricky.
- Yeah. Exactly. You can use a massage gun.
- Yes.
- But you're not going to necessarily,
get too aggressive over the top of the IT band.
You'll go up toward the muscle belly as the TFL,
which is up here and you're going to massage that.
- But, actually Brad, I've I've been reading about a lot.
- Oh you have?
- A couple of authors have talked about this,
how this band can kind of get a hest around-
- Okay.
- So you do work your way along the band itself too.
You're not going to stretch the band,
but you're going to loosen it up.
- Break it-.
- Yeah, break it up.
- So the band is actually where the stripes are.
So you could go direct in or you could go sideways.
- Right. If you go sideways, it'll be less intense.
You can almost use the airfield.
- Oh yeah. It's going to be-.
- And that's going to be a lot more tolerable.
- Especially if you're a thinner person.
- Right.
- And there isn't as much muscle there, it's more enjoyable.
So to speak. All right, next one
we want to talk about for the knee, the quadriceps stretch.
- Sure
- So depending on your balance, I, you know,
this is an example of a blue sticker.
You put your hand on the table or the wall,
and you're going to stretch that quad out like this.
Grab here and this will stretch a little bit,
but when you go down like this,
you'll get a complete stretch and you'll feel it.
- Right.
- Don't get real aggressive on these,
but stretch it out that way.
Hamstring stretches a lot of different ways of stretching
the hamstrings. What do you like, Bob?
- I actually liked to lay, lie on my back,
and put my leg foot up on a railing. You know the-.
- Right. Right. Right.
- So I'm basically like this,
and the railings right here and-.
- So if this was-.
- Exactly.
- And. This could be a wall.
- And I just move my body closer.
- Yeah. It could be a doorway.
- Yep. So this is the a wall. And this is going through.
It's a nice way cause you're so relaxed.
- Right, right.
- And it keeps the, it doesn't stretch your back
in a way you do not want to stretch it.
- Exactly. You protect your back.
- I like to stretch like this.
Keep the knees straight back straight and simply-.
- Yep. Works out very well.
- Yeah, exactly.
- You can actually just do it this way.
You can lie on your back,
pull your knee up like this and pull your foot up.
- Yeah.
- The burn of that. It gives a good stretch too, it also.
- Now, stay there Bob,
because the next stretch is,
we want to stretch that gastric the calf muscle.
- Sure.
- So why don't you go up a little bit?
You can get two at once if you-.
- Sure.
- Pull the toes down
- And try to pull the hamstring.
- Yeah, was a double header.
- Ah yeah or can just simply go like this,
and can even take a belt or a towel
and grabs a four-foot and give a good
stretch like that.
- Exactly. Or the famous infamous,
easy wall stretch. Go like this,
but you're going to need to keep the knees straight to get
at the gastric muscle, as opposed to with a bent knee,
straighten it heel flat on, toe towards the wall.
Not out to the side and lean into that and-.
- Brad, they maybe would be wondering,
why are we stretching the calf
when we're worried about the knee?
- Well, remember Bob, the second one,
lateral gastric bursa is right back in here.
So if you feel that pain in the backside,
on the outside of the backside, that would be a good one,
- That calf goes all the way up to the knee.
- Right.
- The one big gastrics.
- Exactly. Right. And it's one of those things,
just to be completed doesn't hurt to actually stretch that.
- Most of the tense up on a lot of people,
so that. Want to make sure that it is stretched anyway. So.
- Exactly. Well Bob we've bored these people enough
with the infamous bursitis of the hip and knees.
- Thanks for putting up with us.
- And once again, we can fix just about anything,
except for a...
- A broken arm.
- There you go. And we continue to work on it daily.
- We'll make the news. And when we do fix it.
- That's right. We're going to be on one of those news,
big ones, whatever they are.
- Goodbye.
- All right. Goodbye.