A bursa is a fluid-filled sac that cushions the bones, tendons, and muscles near your joints. If the bursa becomes inflamed, it is known as bursitis. The most common bursitis in the hip is trochanteric bursitis. This bursitis covers the bony point of the hip called the greater trochanter. (point of the hip or greater trochanter) Causes of trochanteric bursitis: Direct injury to the point of the hip. This could occur from falling, bumping into the hip, or even just lying on the hip for prolonged periods. Repeated overuse or stress to the hip joint area from work or play activities (running, stair climbing, bicycling). Poor positioning of the hip during sitting, standing, or walking. For example, one may tend to lean mostly on one leg while standing or sitting. Medical diseases or conditions: Gout, rheumatoid arthritis, pseudogout, etc. Previous surgery around the hip, including hip replacement. Bone spurs or calcium deposits on the tendons that attach to the greater trochanter and irritate the bursa. Leg length discrepancy: If you have one leg significantly longer than the other, it can affect your walking and irritate the bursa. Rarely it can be caused by an infection. Do you have trochanteric bursitis? • More common in women and in middle-aged or elderly people. Pain on the outside of your affected hip. Pain when you are lying on the affected hip. The pain often worsens when getting up from a low chair or when getting out of a car seat. Pain with the use of stairs. Single best test you can do yourself. Press on the outside of your hip (over the bony part). If bursitis is present, pressing on the area would result in increased pain. You may also feel warmth and swelling. Bursitis can easily be misdiagnosed. A muscle or tendon tear or tendinopathy could present in a similar fashion. Check out the full Hip Pain Relief Program series of videos along with downloadable guide sheets for each video on our website here: https://www.bobandbrad.com/health-programs/hip-pain-relief-program

This article is a transcribed edited summary of a video Bob and Brad recorded in July of 2023. For the original video go to https://youtu.be/9jMl3V7OPN8 Mike: We received the following question the other day on Facebook. "I have trouble getting out of a chair. It takes more than one effort. Do you have any exercises I can do?" Brad: So if you're having trouble getting out of a chair it's very likely it's a result of weak legs. Now, if you're not sure if your legs are weak, there are tests you can do at home to figure out if your legs are weak compared to other people your age. We're going to show you this at the end of the video. It's very easy and anybody can do it. Mike: But before we get into the test, we want to show you three very important exercises that all seniors should master to really strengthen their legs. Brad: Now we have selected these three exercises from many, many exercises over many years of experience working with people with weak legs. So we think you'll enjoy them and they'll work very well. Mike: We think these three exercises are perfect because they're good for beginners as well as advanced individuals. You don't need a gym, weights or bands. Brad: You will strengthen each side equally. Mike: The exercises are functional. Brad: You can strengthen all muscles in the legs in five minutes. Mike: So the first exercise is known as the split squat and Brad is going to show the beginner variation to start with. Brad: Alright, for this you're going to have to have something to stabilize yourself. The back of a chair or a countertop works very well. One foot is in front, the other foot is back and you go down slowly. When you feel like you are down enough, go up. Your hands are there just to assist. But they're there to protect you in case you would go down because you overdid it. So, 10 of these with your left leg forward and switch and do 10 of these with your right leg forward. It's an excellent leg exercise. Now to the intermediate version. Mike: For the intermediate variation of the split squat I'm just going to hold onto our Booyah Stik or cane for balance. If you need a countertop still, that is fine. The purpose of this exercise is to go the full range of motion now, bringing the back leg all the way down to the floor. If your knee is kind of sensitive there, you could certainly put a pillow down there for some protection and now it feels nice and soft. Again, you're going to want to do 10 repetitions. Notice I'm holding the pole on the opposite side of the leg that is forward. Go nice and controlled, and do 10 repetitions on one leg. Make sure to switch to the other side. Mike: Now, for the advanced version, you're going to need some sort of weights. So you can just take a duffle bag and fill it full of stuff. Make sure you can hold it, though. To perform, we're going to do the same thing. I'm just going to hold the bag at my chest for a variation. I'm going to do the lunge, go down slow, and up. Keep my back in a nice good posture. Again, I want to do 10 repetitions on one side and then switch. Brad: So the second exercise is for the anterior tibialis. It's a muscle in the front of your lower leg. Mike has a good one. You can actually see the muscle belly work right there. It's very critical for walking and balance. Go ahead, Mike. Mike: So, for beginners, if you struggle to do the standing, you could start in a seated position. We're going to try to do 20 repetitions, and you can do it throughout the day, morning, midday, and evening. Brad: Okay, the second and more advanced version for this is to stand about 12 inches from the wall. You'll put your feet out in front of you, your buttocks, and your back up against the wall, and then you simply pull your toes up as far as you can and back down. That's one repetition. Now, to make it more difficult you simply bring your feet farther away from the wall, and easier, closer to the wall. One word of warning, if you start going farther out, it's important that you have shoes on so they grip to the floor, so they don't slip out and you end up falling. So it's really critical. It's nice if you want to have something to grip like a cane or a chair, and we just simply do these. Keep your knees locked, isolate that muscle. 10 of them should work out well. Mike: So the third exercise is going to be calf raises for beginners. We're going to start in a seated position. And all you're going to do is lift up your heels and go up on your toes just like this. Go nice, slow, and controlled. Start with 10 reps, maybe work up to 20, and just take it easy. If this becomes too easy, Brad's going to show you a harder variation. Brad: All right, we're actually going to do an intermediate and transfer right into an advanced mode. So you go up to some stairs or hold onto something solid, a countertop, whatever it may be, and you simply stand feet shoulder-width apart, and go up exactly the same thing. Now we have the weight of our body going through there. We're going to actually go for 10 repetitions. What you're going to do is progress to using the steps. You have to have your shoes on, okay? Something with rubber soles so they grip. You're going to go to the edge of the first step. You're going to go back so that the ball of your foot, the forefoot, is securely on the step. And then you drop your heels down. You'll get a little stretch in the calf muscle, and you work all the way up. Now, this is really advanced. It's nice to get the stretch and you get a complete range of motion, which is desirable. Now, some people may never get to this because it's going to be too challenging. If you have carpeted steps and you feel like your feet are going to come off, obviously that's not going to work. So 10 repetitions of this as well, if you get to this. Otherwise, on the floor is fine. Mike: Now we're going to move on to the testing portion of the video. This is called the 30-second sit-to-stand test and Brad is going to tell you how to set it up. Brad: All right, so this is an official test. They've done this in studies. We're going to go through the actual setup. So it's the way they do it in their studies. First of all, you need a good chair without arms. It needs to be solid. And even with it being solid, still put the back so it's up against the wall. It assures more stability. The height of the seat pan to the floor should be 17 inches. Now you can measure that. This chair is actually a little taller than 17. It's okay because you're not going to buy a new chair for the test. Just when you do the next test, use the exact same chair so it's all relative. Mike: So once you have the proper chair set up, in order to do the test, you want to sit off the back of the chair with a straight back. Do not lean back against the chair. Again, I want my feet shoulder-width apart for optimal standing position. The hands, you're going to cross at the wrist and place on your chest. Again, you're not using your arms. If you use your arms, you get a score of zero. So we're going to get in a proper position. Now, we're going to stand. Mike: You have to stand all the way up with straight knees. This does not count as a full repetition. I'm not standing all the way up. Also, when you're sitting down, don't just fall into the chair. That does not count either. You need to be controlled. Now what you're going to do is you have 30 seconds to do as many proper sit-to-stands as you can. Once you get your number, you're going to compare it to the chart. Brad, you want to talk about that? Brad: Sure. So you get your number. If you cannot do 30 seconds worth, you're too tired, just stop and you'll use that number. The chart is going to be categorized in age groups starting at 60 to 65, or whatever the chart says. You look over in your age group and compare what the average number is. It's not one number, there's a range. And see where you're at. That's not too important. What is important is after you do the exercises for a week, go back and repeat the same tests the same way and you're going to find out that you'll get stronger as a result of doing these exercises the way we said to. Brad: Okay, for those people who cannot stand up without help of the armrest, your score is zero. But that's okay. There's going to be a number of people like that. It doesn't mean that you're a zero, your score is. Do the exercises as we explained, and in a week come back and do it. You may find you can do the exercise with your arms crossed and without using the chair. The whole point is that you get stronger. Mike: So if you found this video helpful, we do have other videos on leg strengthening. So we'll link that down below, pinned to the top comment and you can check out that video as well. Brad: That's right. It's another wonderful video. And get stronger, be happy, and let's go. Mike: So I heard you had a dad joke for me. Sam the Skeleton: Yes. My wife said I should do lunges to stay in shape. Mike: Why? Sam the Skeleton: That would be a big step forward. Mike: Oh my gosh. Sam the Skeleton: Ah, ha, ha, ha, ha, ha, ha. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin, Mewe, Minds, Vero, SteemIt, Peakd, Rumble, Snapchat, Clapper Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Holy Cowabunga Cream Uni Massage Gun D6 Pro Massage Gun Back Massager Posture Pad Lite Foot Massager EZBack Massager Fitness: Resistance Bands​ Pull Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stress Balls Stretching: Booyah Stik Stretch Strap Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material on this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2023. For the original video go to https://youtu.be/ZHgNcYdTyeQ Brad: All right, there are conditions in the foot related to swelling, edema, and skincare that can lead to sepsis and infection throughout the whole body. I know this from personal experience as well as professional. Mike: The good news is that this is easily preventable and we will show you what you need to know. Brad: If you have chronic swelling in your ankles, and you're concerned about it, the first thing you need to do is see a doctor, and have it properly assessed. Make sure it gets treated properly. The doctor will guide you. Mike: And if you've already seen the doctor, you need to make sure they're monitoring the amount of swelling you're having and the skin appearance as well. Brad: That's right. The doctor will have mentioned this but we're here to help remind you of things you want to avoid. Okay, so this is something you'll really want to watch out for. Personally, I've had experience with this, not through me but through my mother. She has chronic swelling in her ankles. She had dry skin and it was actually flaking. Now, what can happen, I was not aware of this, with dry skin, flaky skin, and tender skin, and especially if you're older, infection or bacteria can get through the skin even if there's not a visual opening. The dry skin has micro-cracks in it, if you will and that's how the infection can get in and cause sepsis, or in other words an infection in your blood throughout your system. Okay, so I'd like to let you see an actual picture of what this looks like. Now, if you have not seen visually, in pictures, or in life what a swollen edematous leg looks like that's dry and maybe reddish, it's not something that is really pretty to look at but it's the way it is. And if you've seen it, you know what I'm talking about. So look at the dry skin in this photograph. That is where you have to have that addressed. Brad: So at that point, you are going to call the doctor, talk to the doctor's nurse, and find out what kind of lotion to put on it to eliminate the dry skin. Typically, they're going to say, at least in my experience, just put any type of lotion on it that's going to eliminate that dry skin. It should not have perfume in it. It should have no other chemicals or additives. I just use Eucerin. Vaseline works, or anything like that. I've talked to nurses who work with this regularly. They have similar advice. Okay, so after you've seen the doctor and the doctor looks it over, one of the very common treatments is to use compression garments. Now what that means is either a sock like we have on Mike here. Brad: Now, these have actually specific compression, typically 15 to 20 millimeters at the toes. And that actually gets less up to 20 to 30 millimeters around the calf. Listen to what your doctor prescribes, and buy the proper ones. Something that's actually more often prescribed particularly if you're elderly, is Tubigrips. The reason they call it Tubigrip is because it's a sock that comes in a long tube, it's all rolled up. You cut it the proper length. It goes from the toes all the way up, just below the knee. Brad: Now what you really absolutely need to do is keep your ankles and feet clean and dry and then moisturize the skin. So every day you're going to moisturize it with a lotion like we talked about or prescribed by your doctor. And what I have found is if you wear shoes all day, now sometimes people will put a stocking over the foot because what happens when you put your shoes on is it gets caught and rolled up because of the shoe. So if you put a stocking, a short stocking over the foot you don't get that roll effect. But what happens is the feet can become very sweaty and it's not a good thing. A lot of bacteria can form in there. So every day, new socks, take the old ones off, and wash them by hand. If you're using compression socks, you can wash them in the machine or however is recommended. Every day do that. Now, in the other case, look at the shoe and put your hand in the shoe. Some people perspire so much that the shoe actually becomes damp and the insert will become damp. Very, very good environment for bacteria and other things to form causing infection. So actually, we're doing this with my mother right now. We have two pairs of shoes. I put her shoes on a shoe dryer and every week that pair dries out. And then I put the other pair on and we alternate shoes. She puts on clean socks and clean compression garments every day. And you're going to have much better luck. I am amazed at how much better her legs look now that we're really maintaining this. Mike, you've seen this before in the clinic. Mike: I have seen it a lot. I would suggest if you have the socks you're going to want to get two or three pairs because you're going to alternate them every day. And oftentimes, if your edema is to the weeping point where fluid is coming out, you're going to really need to keep up on cleaning them. Brad: Right. And definitely be in contact with your doctor regularly. These compression socks actually are kind of hard to get on and off. The Tubigrips are much easier, easier to clean and they're cheaper as well. But that's up to you. Brad: If you happen to be diabetic that adds a whole other complication because it's very, very critical that you do not have anything rolling up with your feet. Make sure your shoes are very clear and clean inside. Definitely, you're going to need to see a professional, a therapist, or the doctor, the doctor's nurse and have you go through this in more detail because diabetes and foot problems go together. Mike: If any of this helped or you have any other suggestions, if you personally have edema, feel free to leave a comment down below and let us know what you think. Brad: That's right. Or any other suggestions for other people looking at the replies. We can all help each other by chatting back and forth. It works out very well. All right. Very good. Be careful. Be safe. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin, Mewe, Minds, Vero, SteemIt, Peakd, Rumble, Snapchat, Clapper Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Holy Cowabunga Cream Uni Massage Gun D6 Pro Massage Gun Back Massager Posture Pad Lite Foot Massager EZBack Massager Fitness: Resistance Bands​ Pull Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stress Balls Stretching: Booyah Stik Stretch Strap Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop The Bob and Brad Community is a place to share your experiences, ask questions, and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material on this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced to help you make the best choice for you.

Femoroacetabular Impingement (FAI) is a condition where the bones of the hip joint are not shaped normally. FAI is usually present at birth and may lead to hip pain in athletes (of all ages), adolescents, and adults. The hip joint is a ball and socket type of joint. In FAI either the ball, or the socket, or both are misshapen. This causes the bones to rub together, create pain, and possibly damage the cartilage that provides cushioning in the hip. Some people will require surgery to repair the damage and deformity. Some people will have no symptoms of FAI. Others may present with the following symptoms: • Stiffness in the hip joint • The hip joint may lock, click, or catch. • The patient may limp. • Hip pain or aching (usually located in the inner thigh or groin area) • Pain will often worsen during physical activity. • Pain may also worsen with prolonged sitting (for example- in a car). • May experience increased pain with climbing hills, or stairs. Tests You Can Do: Your doctor will probably do some imaging tests at some point (X-rays, MRI, CAT scan). This test can be done (prior to imaging tests) to give you a preliminary indication as to whether you may have FAI. FADIR test (flexion, adduction, and internal rotation) test. You will need a family member or friend to perform this test on you: Start by lying down flat on your back with both legs straight and relaxed. Test both legs and compare results. Have your right leg lifted (without your help). The hip and knee should be lifted to a right-angle position (while supporting the knee and ankle). This is flexion. PHOTO A Once in the right-angle position, the leg should gently be pushed across the body toward the opposite leg. This is adduction. PHOTO B And finally, while keeping the knee in position, the foot and calf should be moved away from the body (abduction) PHOTO C. People who have FAI tend to feel pain with the foot and calf being moved away. Repeat the test with the left leg. Check out the full Hip Pain Relief Program series of videos along with downloadable guide sheets for each video on our website here: https://www.bobandbrad.com/health-programs/hip-pain-relief-program

This article is a transcribed edited summary of a video Bob and Brad recorded in July of 2023. For the original video go to https://www.youtube.com/watch?v=Y2bEDaYZuLs&t=3s Mike: This is Bob and his wife Linda. And within this past year, Linda has developed some bad back pain. Brad: Let me tell you, as a physical therapist, it is embarrassing and it is just hard on you when you cannot help a family member. And this is where Bob was. Mike: Bob's first intuition was to give his wife the prone press-up exercise made popular by Robin McKinsey. But after doing this exercise for a while, she was seeing no success. Brad: So he went to plan B, he went to Dr. Stewart McGill, who has done extensive research on back pain. And then he gave her the exercise that he often recommends, the cat/camel. Mike: Again, she saw no success. Brad: And a third thing, Bob, that he gave the typical exercise by Dr. Stewart McGill is walking as long as it's tolerated. So she did that as well. Mike: And after consistently doing these exercises for two weeks, she actually got worse. Brad: Now with Linda's situation, things were getting worse and it really affects a person. It was getting so bad that she was considering giving up bowling and activities she really loves. Mike: So Bob was dumbfounded and didn't know what to do. So he turned to a friend, physical therapist Rick Olderman. Brad: Now Rick Olderman is not just any therapist. He's actually a specialist. He's written a number of books and he has some key options for situations just like Linda's. Mike: In Bob's world or his mind, he believes that most back posture is caused by too much flexion throughout the day whether you're standing or sitting and slumping in a chair. And in some cases, this is correct. Brad: So with Rick Olderman, he actually believes the opposite can be the case where people are actually arched too much in the other direction causing the back pain. Mike: So what did Rick do? He gave her three exercises to help decrease this lordotic arch in the low back. Brad: Okay, the first component is stretching the hip flexors. We're going to sit on the edge of the bed just like Mike is here. Feet off of the edge. Go ahead, take it over Mike. Mike: So to perform this stretch, simply lie on your back and you're going to bring both knees up to your chest. You're then going to bring one leg down and stretch the hip flexor on my left side here. Notice I'm keeping my right leg up towards my chest and I'm trying to bend my left knee back. If I'm too far up and hit the table, I can just scoot more toward the edge and perform the same stretch. You're going to want to hold this for 30 seconds, and keeping it in this position should make your back feel good and not have any pain. Then you're going t reset in a neutral position and stretch the opposite way. Mike: Another important thing to look at is to make sure your leg that is down is in a straight line, not going too far in or too far out. Brad: Nice work, Mike. Good explanation. So with this stretch, Linda was doing it two to three times per day. Things were going well and she continued with it. All right. The second exercise that Rick had Linda do was the all fours rocking. Show it, Mike. Mike: To perform this exercise, you're going to get in a quadruple position on my hands and knees. I'm going to keep weight through my palms as I am getting into a sitting position, bringing my buttock to my heels. Once I get down here, I'm going to hold this for three to five breaths and be in a relaxed state. Then I'm going to come out of it and come back to the starting position. You're going to perform three to five repetitions of this spread. Do you wanna talk about how it helps with your low back curve? Brad: Right. So you can see his back is actually flexed. That's the opposite of that arched or lordotic position we're technically talking about. So also this can be done on a bed. If it's too soft, it's going to make it difficult. Probably a carpeted floor would be preferred in that situation. All right. The next exercise that Rick had Linda do is something called glute pumps. It's going to help strengthen the proper muscles to get the goal of no pain. Go ahead. Mike: So to begin, you're going to be on your elbows and knees. You're then going to lift one leg and kick up toward the ceiling. Notice that my heel is pointing toward the ceiling. You're not going to go through the full range of motion all the way to the mat and all the way up. You're just going partway up and doing little oscillation movements for 30 seconds or 30 repetitions. Make sure to stop and then switch. While you're doing this, you should feel your butt muscles firing and engaging, not your hamstrings. Mike: So in addition to the exercise, Rick wanted Linda to fix a few habits she may be doing that are causing her back pain. Brad: So in the seated position, we don't want to overarch the back and actually allow it some comfort. We're going to use a simple pillow from the bedroom, take that, put it lengthwise in the chair, and then lean into that. That offers support. It's comfortable and allows the back to flex actually in a good, healthy position. Brad: The last habit that Rick had Linda do was something known as soft knee walking. Go ahead, Mike. Explain it. Mike: So when you typically walk in heel strike, what you're doing is actually increasing the arch on your low back. If you are going to land on your forefoot with a bent knee, it's pretty hard to actually extend my back. I would have to be walking kind of awkwardly. So in order to prevent the low back arching, you just simply land on your forefoot more, and then you can bring your heels down. Mike: In order to do this, you're going to have to take shorter steps. And you're also probably going to have to look at your footwear because if you have a large heel on your shoe, which most shoes have, it's going to be kind of hard to do. So in your house, you can either try going barefoot or using sandals. Brad: So the big question is, what are the results? Did Linda get better? Mike: Within two days, Linda's back pain was better and within a week, she was back to bowling, 100% pain-free. Brad: But the question is, what were her bowling scores? Mike: That's the real question here. Brad: Actually, she is feeling much better. We don't worry about the scores. Bob said it was a whole change in her life. She was grateful. Mike: And he said a happy wife is a happy life. Brad: There you go. Nice work Bob. Good work, Rick. Mike: So if you want to learn more about back pain and try some stretches in bed check out our video "5 Best Stretches For Low Back Pain In Bed. Do Daily." Brad: That's right. Good luck! Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin, Mewe, Minds, Vero, SteemIt, Peakd, Rumble, Snapchat, Clapper Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Holy Cowabunga Cream Uni Massage Gun D6 Pro Massage Gun Back Massager Posture Pad Lite Foot Massager EZBack Massager Fitness: Resistance Bands​ Pull Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stress Balls Stretching: Booyah Stik Stretch Strap Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material on this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in May of 2023. For the original video go to https://youtu.be/1wOuuvKG7r4 Brad: Greetings everyone. As physical therapists Mike and I have worked with hundreds of people with back pain as a result of compression fractures and they're always related to osteoporosis. It weakens the back and causes a compression fracture in the spine. It’s very painful, something you do not want to experience. Mike: So if you are able to strengthen your core you can prevent this problem from happening. So we're going to show you three core exercises you can try if you have osteoporosis, to strengthen up that whole muscle group and prevent this from happening. Brad: And we're going to show a few extra tips as well. Mike: So if you have osteoporosis, oftentimes your bones become very weak in the vertebrae especially and they're at a higher risk of having a compression fracture. Brad: That's right Mike, so things like flexing forward is probably the biggest stress put on the back and causing those compression fractures, so posture and body mechanics, how you work with your body makes a big difference, as well as the core. So we're going to touch on both of those things- strengthening as well as some posture and mechanical bending issues. Mike: So the importance of strengthening your core when it comes to osteoporosis is it helps prevent the compression fractures from happening or even getting worse. When your muscles are strong it'll take stress off of the vertebrae itself, putting less stress on them, preventing these from happening. So the muscles we're talking about here are the abdominal muscles, the back muscles, and a little bit of the hip flexor muscles as well. If these all become strong they'll take pressure off of those problem areas. Brad: And a really important thing that we're going to teach is how to do these in a non-aggressive or intimidating way. People think with core strengthening they're going to be doing sit-ups with all these gyrations. We're actually going to teach them in a very subtle manner that is being done in bed. They're isometrics and they're done by an expert, Sara Meeks, who is an expert in osteoporosis and strengthening of the core. Anybody can do these. Mike: The first exercise Brad is going to demonstrate here is going to target the transverse abdominis which is a deep abdominal muscle group. It kind of wraps around your body and it's like a natural back belt for your body. So Brad, take it away. Brad: All right so you do this in bed in the position I am here. I call this hook lying. You're going to take one hand and you're going to put it palm down and you're going to do that right underneath where your belt is, your lumbar spine, and you want to make sure that you have a natural arch in the spine so if you look here and I push down like this, we don't want that and we don't want to arch up really high, we just want a natural arch and it should feel comfortable. Brad: Now this hand is going to monitor so the spine stays in that neutral position minimizing any stress on those vertebrae. The other hand is going to go on top of the stomach. Now this hand is going to stay stationary and as I breathe out, my stomach goes down. There's a space between the hand and the stomach. My back on the bottom has not moved and I tighten up as tight as I can for eight seconds doing an isometric working on that transverse muscle. So this part right here getting that down, hold, can you count to eight Mike? Mike: One, two, three, four, five... Brad: That's good enough. Actually do hold it for eight. Eight seconds and then relax. I'd like you to do that five times and then you're done with this first exercise. Again the transverse abdominis and really think about the belly button goes towards the spine keeping that gap but the spine stays stationary monitored by this hand. Good work. Mike: The next exercise we're going to do is going to target the oblique muscles. What these do is help stabilize your spine when you're doing rotation-type exercises or even slight lateral bending like this. So Brad's going to show you what to do. Brad: Okay now with this exercise again it's done lying on your back in your bed. I'm standing just to show you how to think about engaging those muscle fibers so that it works the way we want it to. So to think about your right rib cage right here and your left hip, the front part of your hip, that's called ASIS. We won't get into why we call it that but it's a long name and we're going to think about bringing these points together. And then the opposite points together and that's going to engage those fibers. Brad: We'll show you how to do it right now. Again, lying on your back you can bring your knees up in hook lying. I'm going to take those diagonal points and I'm going to think about pulling it together and actually, you're pulling in and you're squeezing everything together. You can actually take your fingertips and feel those muscles in there. With your fingers just push in there. If you happen to have a little soft, you know, we'll call it fat, you push right through that and get in there and feel those muscles work. That'll be a really good indication that you're firing those and here I'm going to start it. And I'm squeezing in. I feel those muscles working and I'm going to count to eight seconds in my head or you can count out loud whatever really trips your trigger. Or you can have someone like Mike count. Brad: Okay and relax, again eight seconds and relax. Do the same thing. Think about bringing those points together. Feel the muscle fibers work. Five repetitions on each and then you're done with a second set. Then we're going to go to the third. Mike: So the last exercise is going to target the rectus abdominis. Those are the front six-pack muscles most people think of. They help slightly flex the spine forward in order to activate them and Brad's going to take it away. Brad: Okay so with this exercise, again the same position. And I want you to think of bringing your belt line and your lower ribs and we're just going to squeeze straight together and compress but with this one, you do want to monitor with the hand behind the back so that your lower back does not push real hard into the bed. There will be a little movement but not a lot and you squeeze and I'm feeling that six-pack right there go and again eight seconds I'm going to count it out in my head. When you get to eight seconds relax and you know take 30 seconds, whatever you would like to do between each isometric. And go ahead and do it again. Brad: Now if you have not done any exercises like this in the past, you may only want to do one or two sets. If you happen to feel any cramping in there you want to stop, give it a break, and probably start again the next day. Breathe deep and let those muscles relax. That usually doesn't happen with abdominal muscles but it could. So that are the three exercises for strengthening those core muscles. The next thing I do want to mention is really important to avoid this kind of bending where you're bending forward, even if you've got strong core muscles and you bend like this to pick something up, it compresses those vertebrae and that could cause a compression fracture. Also when you sit we want to go over that as well. Mike: So with osteoporosis while sitting down it is important to avoid any flexion for prolonged periods of time when sitting or when standing up. So when sitting, most people will think of flexing like this leaning forward, maybe looking at your phone. This is a bad posture, you want to avoid. But a lot of people also lean back in their chair and if you look, I'm still flexing my spine, there's still a curve here. Mike: So it is important to make sure your low back is touching the chair or couch, whatever you are sitting in. If it doesn't touch, maybe put a pillow there for some support and have a nice neutral spine, do not be flexed over. Now when standing up it is also important not to have a rounded back. So if I lean forward, my back is flexed and then I'm getting up, flexed the whole time and then I'm trying to extend. That's a lot of compression forces. So try to scoot to the edge. If you have armrests, certainly use them, but try to keep a nice neutral spine as you're standing up and pushing up through the arms and legs. Mike: Try to keep it nice and straight and it goes with sitting down too. Don't sit down all bent over. Try to sit down nice and slow, reach back, and sit down. Brad: Good, good points Mike. All about keeping the back in that neutral position. Armrests are a really good idea. Use chairs if possible with armrests because they're there to help and it's a good habit to work with. All right so we got three good isometric strengthening core exercises, you have your body mechanics to maintain and work with, and remember a healthy spine is a happy spine, as well as you being able to keep up moving and be active. Mike: So if you want to check out more videos about osteoporosis, we do have a whole program done by Sarah Meeks on our website. You can pick which videos you think pertain to you. Some of them are the core exercises we demonstrated, some of them she goes a lot more in depth and is much more knowledgeable on the subject matter than we are. So if you have osteoporosis it'd be a good benefit to watch those. Brad: She's the expert for sure. Mike: Thanks for watching. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin, Mewe, Minds, Vero, SteemIt, Peakd, Rumble, Snapchat, Clapper Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. 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This article is a transcribed edited summary of a video Bob and Brad recorded in May of 2023. For the original video go to https://youtu.be/WQHIBf-C-2w Brad: You ever get up in the morning, you feel a little stiff and sore, maybe 10, 15 years older than you really are? If so, this video is for you. Mike: We're going to show you five stretches that you can do in bed to help alleviate this pain and start your day out on the right foot. Brad: Yeah I bet you don't feel this way yet. Mike: Not yet. Brad: Give yourself another 20 years. Alright, now this is mostly common in the older population. I'm saying 55 and above. That's when I started to feel it. The big thing about lying down and sleeping all night, typically eight hours, is that the body is non-weight-bearing. There is little movement relatively speaking and the muscles, the tendons, and the facet joints in the back are all starting to tighten up from that. And also a big thing you may not be aware of is the discs in your back actually start to grow. They call it inhibition. It's where fluid imbibes or sucks into the disc. It's a natural part of keeping the disc healthy. Do you want to talk about it more Mike? Mike: So when you first get up in the morning and start moving, these stiff joints, muscles, and discs filled with fluid aren't necessarily ready to start moving right away. So it can put your body kind of in a shock, that’s what causes that pain you're experiencing. It could be any of these issues. It may be one and maybe all five. So a good thing to do is to do a quick warm-up routine while you're still laying down, to get those muscles moving and it won't be as painful when you finally get up. Brad: That's right and it only takes a couple minutes. Alright, so I want you to remember this phrase, “motion is lotion”. So you probably don't know what I'm talking about. There is a physical therapist, he's a doctor in PT. He's an expert in pain management and that's a phrase that he uses with his patients. In other words, if you get your body moving, it's going to soothe the pain like putting some lotion on your body. That's going to mitigate and eliminate the pain. So motion is critical, the key is what kind of motion. That's what we're going to show you here with these exercises before getting out of bed. Alright, we're going to show you five exercises in bed. Do all five of them, try them. All of them might be good for you. But there may be one or two that create some aches and pains, particularly if you have a history of low back pain, hip replacement, or something of that nature. They all should feel good. Otherwise, skip the one that does not feel so good. Mike: So the first exercise is called “hook lying rotation”. So you get to lay on your back like you're in bed still. You're going to bend both knees like this, feet flat on the ground, and you're going to start rotating side to side. One way might feel better than the other. You may not be able to go all the way down to the bed. You may just go partial range. Whatever feels comfortable for your back is the right option for you. Brad: That’s right. So again these are going to be in bed. Mike mentioned ground. Your feet are going to be in bed and it works best if your feet are close together. If your knees are gently touching, your legs do not separate, and this is really important what Mike is doing here. He's actually letting the hip come over and separate from the bed. That allows that low back to rotate. Now you may find out that going in one direction hurts, so don't go that way. The other direction may feel better. Go that way as far as you tolerate. Do not go into pain. And then after you do this, a few repetitions, you may find that the other side, the painful side, will ease up and that's what we're looking for. If on the other hand, that painful direction starts to get worse, then avoid it and just go to the pain-free side. It's a critical concept. With time, things should loosen up and you'll be doing full hook-line rotations and very happily. Mike: The next exercise is called single knee to chest or double knee to chest. That is a progression. So to begin, you're going to be lying flat on your back in bed, not the ground, I got it right this time. You're going to bring one knee up towards your chest. You can put a little pressure on your arms if that feels good for you. If it only feels good part way, just hold it there, that's perfectly fine. Hold it for a couple of seconds and then go back down. Try to do five to ten repetitions on each side. Mike: Now some people may not be able to reach their legs, so Brad has a towel here. You can also use a belt, bed sheet, or whatever you have handy. You can just wrap it underneath your leg, grab the towel with your hands and then pull it up. It makes it a little easier. Also, you can try it with a stretch strap if you have arthritis, it’s another good option. So after that, if you want to try doing both legs, you simply switch to the other side. Perform it as well, five to ten repetitions, holding for a few seconds on each stretch, and then you can progress to both legs if that is feeling comfortable and good for you. Mike: So you're going to bring both knees up and hold it just like this for a few seconds and then relax. Now if that becomes easy, you don't feel much of a stretch, you could certainly hold it longer. You can go 20-30 seconds, whatever feels comfortable for your back. Brad: That's right, this is a great stretch particularly for people if you have stenosis. This is going to separate those facet joints and open up where the nerve exits out of the spine. It should feel very comfortable. We're going to show you a little bit about the stretch strap so that there's no confusion. Mike: Now if you have arthritic hands and you can't grip well, l a stretch strap would work out nicely like I talked about earlier. They have a bunch of different loops. You can just feed your hand through the loop, and make sure it's underneath your leg. Then you're just going to pull up with your wrists and arms to save the pressure on your hands if you're having any pain there. Again hold it for a few seconds and repeat five to ten times. Brad: Right, they work very well and they're not that expensive so it may be an option for you. Number three is for the shoulder and the upper back. It's great for posture and breathing. I'm going to start out lying on your back. Hands will be down and simply reach up and over your head. Now watch as Mike goes back. He's going to arch his back just below the shoulder blades and then come forward. You can do five to ten of these. Brad: Now there are going to be some people that are going to say one or both of the shoulders are stiff. What you'll do is use the strong arm to help the weak one. So grab together there and go up and allow the stiff shoulder to stretch. Do not push it. Do not get a painful range of motion. Just go up to the point where you feel the pain a little bit, bump into it, and then come back down. And Mike is doing an excellent job of relaxing and when you come back up, breathe in, and as you come back down exhale. How you breathe in relationship to your body motion can really make a big difference in how you relax and the effectiveness of the exercise. Mike: For the recommended time, just do what feels good. This stretch, I like to hold it longer. Some people might just want to hold it back here for five seconds and then come back. Just do what feels good for you. Brad: That's right. Again five to ten repetitions in general will be good particularly to start with. How are you feeling, Mike? Mike: Good, I like this stretch. Brad: Yep, it's a wonderful one. Alright number four, this is for the upper back, the thoracic spine. We want to get some gentle rotation in that area to get you moving. Simply as Mike is lying on his back, think about keeping the pelvis stationary, the feet stationary. He's going to come up with his right hand and kind of like reaching for his coffee mug in the morning or cooler and going back down. Now go the other direction. He's reaching the other way. Go through a couple of these. Mike: You just kind of reach, you don't have to hold it like I was doing for demonstration purposes, but the whole point is to lift your upper back off the mat and get some rotation up there. And I wish someone handed me my coffee in the morning when I woke up like that. Brad: This is also great for the abdominal muscles, that's going to get those stronger, which is always a benefit. So let's go on the number five. This last one really focuses on the shoulders and the scapula of the shoulders to get things moving which is critical for posture, breathing, and just pain reduction. One side you can do first is simply think about the shoulder to the ear without moving your head. So we're not bringing your ear to your shoulder, you are bringing your shoulder to your ear. We're doing this five times on the right, five times on the left, and then you can do the complete shrug and it's optional if you just want to go right to the complete double shrug go ahead it's up to you. Go ahead and show them lying down Mike. Mike: So the important thing is to keep your head in the same place and bring your shoulders up and down. You're not bringing your neck down, so shrug up and then shrug down. You can hold it, you can go in a circle if you want, or just straight up and down, whatever feels good for you. Brad: That’s right. This is one of those things that a lot of people are not aware that their shoulders and shoulder blades actually move across their rib cage and once you get that sensation it's going to make a big difference in the quality of motion and pain-free movement in the shoulder complex. It's really an important stretch that's forgotten. Alright, now this last is not an exercise. This last technique is for those of you who have back pain, particularly a history of back pain. How to get out of bed in the morning to protect your back so you don't wrench it or irritate it right away in the morning. So lying on your back, the first thing you want to do is to bring your legs up into the hook line position. Tighten up your core muscles, and all your stomach muscles, go ahead Mike. Can you feel them with your fingertips? That's what I tell patients. Push it in there. Push your fingertips in there. Some people got a little more chubbiness here and they need to get through that and feel those muscles tighten. At that point, you need to know how did you explain this, Mike? Roll like a log? Mike: You roll on your side like a log. It's almost like you're stuck in a turtle shell. The whole body has to move together. You don't want your feet to move separately. Keep that back nice and tight so the core is engaged. And then you're going to rotate over to your side. Then after you're in this position, you're going to bring your feet down while pushing up with your right arm and left elbow. So I'm keeping my spine in one continuous line. Then get in a good seated position. Get your orientation. Make sure you're not lightheaded. Make sure your back's okay. Scoot to the edge of the bed and then when you stand up don't flex over. Try to keep a nice straight back and push up, keeping your spine aligned the whole time. Not flexing too much will help protect it and prevent aches and pains from happening. Brad: Now this is one that can make a big difference that people forget. Bob always talks about the story with a gentleman, he had a patient and he taught him this. He had severe back pain and this alone made a tremendous difference in reducing his pain. Instead of getting up in the morning irritating it, you got it properly and allowed the back to heal on a day-to-day basis. Very critical point, that's a bonus! We didn't say that we were going to do that before, did we? Mike: It was a secret. Brad: Alright good luck with those stretches before you get out of bed and how you get out of bed. Mike, what say you? Mike: Let us know in the comment section down below what exercises you preferred or what works for you in case we forgot. Brad: That’s right. Feel Good. Bob: And cut! Brad: It's a wrap.

Got a Headache? Try these 3 drug-free ways to find relief. If you're anything like me, you know just how much headaches can ruin your day. Those throbbing temples, the tension in your neck - it's the worst! When I started getting more frequent headaches, I knew I didn't want to rely on medication to get through them. I tried every natural trick in the book until I found a few go-to techniques that really work for me. If you're looking for drug-free ways to beat headaches, you've got to try these: 1. Ice It Down Putting something cold on your head and neck can work wonders! I just grab a gel cold pack from the freezer, wrap it in a thin towel, and place it either on my forehead or the back of my neck. A homemade rice bag you can heat up or toss in the freezer works great too. The cold helps constrict the blood vessels and numbs the nerves that are causing that throbbing pain. Try it next time you feel a headache coming on - sweet relief! 2. Get Your Massage On When I don't have a headache, I forget how many tension points I hold in my neck and shoulders. Using my fingers and hands to massage my temples, neck, and shoulders releases all that built-up tension that causes headaches for me. I'll use small circular motions at my temples, then long gliding strokes down my neck, and some trigger point moves on those stubborn shoulder knots. Hurts so good! 3. Let the Eye Oasis 2 Do the Work As much as I love a good self-massage, the most effective drug-free headache solution I've found is an air compression eye massager called the Eye Oasis 2. I slip those soft cushions over my eyes, turn it on, and let the gentle air pressure work its magic on my temples while I chill out. It's like a targeted scalp massage without having to lift a finger. Those pulses of air relax my muscles and get circulation moving. Between the massage, soothing heat, and calming music, I'm headache-free in no time thanks to the Eye Oasis 2. It delivers a spa-like experience right from my own home anytime a headache strikes. If you struggle with frequent headaches, I can't recommend the Oasis 2 enough. It's been a total game-changer for getting fast relief without medication. Give it a try - your head will thank you! Ready to say goodbye to headaches? Get your own Eye Oasis 2 eye massager today! Get an extra 10% off using code: OASISRELIEF

What is tendonitis in the hip? Hip Tendonitis is an inflammation of a muscle tendon. Muscles attach to bone through a thick fibrous cord which is the tendon. The tendon of a muscle can become frayed and begin to degenerate over time with overuse and repetitive type activities. Rubbing over a bony area can also cause the tendon to begin to wear down and become inflamed. The blood supply in tendons is poor so they tend to heal slowly. What types of activities cause hip tendonitis? Hip tendonitis typically occurs when the tendon is under abnormal stress from activity that you are not used to doing. So, a sudden increase in training or exercise can over time lead to tendonitis. Repetitive motions that can eventually result in hip tendonitis include those used for walking up steps, sitting up from lying down, and walking. In sports, higher-level cycling, sprinting, kicking, jumping, and squatting can over time result in an inflamed tendon. High-intensity interval training (HIIT) workouts, spin classes, and the use of a Stairmaster can also leave you at risk for this type of injury. Once the tendon is inflamed, positions that place the muscle group on stretch can also be painful (like lunging forward with the painful hip in the back). Two common hip muscles that can get tendonitis are Iliopsoas and Rectus Femoris. In addition to feeling pain in the front of your hip, you may also experience a snapping or clicking sound at the hip during movement, which is why it can also be referred to as a “snapping hip.” Five Self-Treatments 1. Stretching of hip flexors. Can be done both by lying on a bed and kneeling on the floor. See examples: Massage can also be used to lengthen muscles (foam roller or massage gun). 2. Cross Fiber friction massage if the rectus femoris tendon is affected. Find the bony hump on the front of your pelvis on the side of the hip pain. Photo of Pelvis Feel for a tender spot approximately 3 inches below the bony hump. If tender perform cross-fiber friction massage over the area. 5 minutes every day. Pain and tenderness over the tendon should begin decreasing after 30 to 60 seconds (or at least not getting worse). If getting worse, stop and use ice and anti-inflammatories if recommended by your doctor. 3. Proper use of your gluteus muscles (maximus and medius). It is difficult to explain how the gluteus muscles can adversely affect the hip flexors. Let us just say that if the gluteus muscles are weak or not able to perform up to their potential, they can place increased stress on the hip flexors. The hip flexors can be workhorse muscles. They often pick up the slack if the gluteus muscles are not working up to their potential. So, these three exercises are helpful: A. Clam Shells (5-15 repetitions or until fatigued). B. Gluteal Pumps (prone lying or quadruped) (5-15 repetitions or until fatigued) Shown with a resistance band. Can do without it. Lift toward the ceiling. Lying on the stomach. Shown on all fours with a resistance band. Can do without it. Lift toward the ceiling. C. Walking correctly (engaging the gluteus muscles). Push off with the back leg to engage the glutes. Shorten stride. Initial foot contact should be mid-arch and not heel. Not really an exercise but can help immensely. 4. Avoid painful activities that can increase the stress on your hip flexors: Sitting with hips flexed beyond 90 degrees. In sports, higher level cycling, sprinting, kicking, jumping, and squatting. High-intensity interval training (HIIT) workouts, spin classes, and the use of a Stairmaster can also leave you at risk for this type of injury. 5. Strengthen the hip flexors in a lengthened and shortened state. Attach one end of resistance tubing to an ankle cuff and the other end to a wall anchor or some type of stable surface. On all fours bring knee to chest. Return the foot slowly to the start position. Feel resistance both ways. (2 sets of 10 repetitions or until fatigued) Check out the full Hip Pain Relief Program series of videos along with downloadable guide sheets for each video on our website here: https://www.bobandbrad.com/health-programs/hip-pain-relief-program

How to Know It can be difficult for you to assess whether you have hip tendonitis, but we can give you some clues and general guidelines. What is tendonitis in the hip? Hip Tendonitis is an inflammation of a muscle tendon. Muscles attach to bone through a thick fibrous cord which is the tendon. The tendon of a muscle can become frayed and begin to degenerate over time with overuse and repetitive type activities. Rubbing over a bony area can also cause the tendon to begin to wear down and become inflamed. The blood supply in tendons is poor so they tend to heal slowly. What type of activities cause hip tendonitis? Hip tendonitis typically occurs when the tendon is under abnormal stress from activity that you are not used to doing. So, a sudden increase in training or exercise can over time lead to tendonitis. Repetitive motions that can eventually result in hip tendonitis include those used for walking up steps, sitting up from lying down, and walking. In sports, higher-level cycling, sprinting, kicking, jumping, and squatting can over time result in an inflamed tendon. High-intensity interval training (HIIT) workouts, spin classes, and the use of a Stairmaster can also leave you at risk for this type of injury. Once the tendon is inflamed, positions that place the muscle group on stretch can also be painful (like lunging forward with the painful hip in the back). Two common hip muscles that can get tendonitis are Iliopsoas and Rectus Femoris. In addition to feeling pain in the front of your hip, you may also experience a snapping or clicking sound at the hip during movement, which is why it can also be referred to as a “snapping hip.” Other symptoms include Hip stiffness in the morning or after long periods of rest. Pain that lessens as you warm up. Pain that begins to worsen with prolonged activity, as repeated irritation causes the tendon to become inflamed. Three signs you may have tendonitis in the hip In the seated position lift the painful hip as though you were marching. Try to hold the hip up in the marching position while simultaneously pushing down on the knee with your hand. This resistance will often aggravate the tendon and elicit pain. Take your hand and look for a tender-to-touch spot right over the front of your hip. Another possibility would be a “tender to touch” spot approximately 3 inches directly below the bony bump felt on the front of your pelvis. Kneel on both knees using a pillow. Lift the nonpainful hip leg and lunge it forward placing a stretch on the hip flexors of the painful hip. The stretch may increase or elicit pain. Check out the full Hip Pain Relief Program series of videos along with downloadable guide sheets for each video on our website here: https://www.bobandbrad.com/health-programs/hip-pain-relief-program

This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2023. For the original video go to https://youtu.be/XzR2CGTh-Mg Brad: All right, if you have swollen legs or one leg is swollen and it's from lymphedema, what you would like to do is eliminate that. So one of the biggest mistakes that I've seen in my decades of working with patients is what we're going to explain to you. Mike: You can fix it very easily with just a little bit of advice. Brad: Okay, so let's clear up what lymphedema is, lymphedema is swelling in the legs. It's very visual, you'll see it actually swell. It's different than if your leg is swollen up from say an ankle sprain or something traumatic like that. It's very important to understand that the arteries and the fluid or the blood are actually still going down into your leg, and it's returning back up into your system as it should. The lymphedema or the fluid in there is not. So we'll talk about what that fluid is, go ahead Mike. Mike: So the fluid in lymphedema is called interstitial fluid, that's a mouthful of say, and it naturally surrounds your body tissue and cells all throughout the body, not just in your legs. And this is a normal process and it's supposed to flow out and flow back in, and it carries nutrients and helps bring oxygen to healthy tissues. Brad: That's right, and the thing that really is important to think about with lymphedema, this interstitial fluid, it is superficial as it flows back. In other words, it's just under the skin. As it comes back up it'll go through your lymph nodes located in the groin area, your lymph nodes filter it and it goes back up into your system, and the cycle starts all over again. But the whole point is, it's superficial, it's just under the skin. And we'll tell you why in just a minute. Okay, So if you do have the swelling, you do not want to self-diagnose your problem, go to a doctor, make sure it's diagnosed by a doctor, that it is a lymphedema problem, and that you do not have other things going on. A real common prescription that the doctors will order is compression garments that will help maintain the size of your legs so that the fluid does continue to work back up into your system. Mike: So that can be done in a couple of different ways. We have Tubigrip here, which is a nice easy thing to slip on. Some doctors actually have you wrap your legs, that's a whole other animal. Or some type of compression socks. Usually, there's more compression in the toes versus up at the calf muscle, but a large problem we see with these is they start to roll down creating a tourniquet. Now this tourniquet, as Brad said earlier, it's not going to be so tight that it cuts off your blood supply, we don't have to worry about that. But this interstitial fluid is so close to the top layer of the skin that it's going to start pooling in there, so if you actually take it off you can notice there's going to be big indentations where these are rolling down. Brad: Right, and, remember, the interstitial fluid will get into the ankle into the foot, however, on its way back where it's just under the skin, it hits that tourniquet there, and it bumps against there and it causes all of this excessive fluid. So the compression garment will do its job and help, but with tourniqueting, it actually negates the whole benefits of the compression garment and can make it worse. So you'll see in the photo below that there is the ring, the tourniquet, and then I pull that down and, Mike, you cannot see it but on a real leg where you have tourniqueting, you will literally see a dent all the way around in a ring, and you can clearly understand that that tourniquet is limiting the flow of that fluid back to the trunk or the lymph nodes. Mike: So what are some solutions to this? Brad: Wait, even before we get to that. The solutions are very simple and easy to do, which is really good news. Sorry to interrupt. Mike: The first solution for the patient, or me in this case, is to simply check the wraps they have or their Tubigrip, and just make sure if it's rolled down like that to unroll it if they are able to, not everyone can. So what's the other option, Brad? Brad: Well, the other option is if the person does not remember to pull them up or they're unable to reach down and pull them up, is hopefully there is a caregiver around that will periodically, every hour or every two hours at the most, will actually come over, check it, and then make sure they're in the right position. If that is not an option and the person will forget or cannot do it, or there isn't another person to help, then we have a pretty easy solution for that. Mike: So this is called Coban. It's not really a tape, it's a type of wrap that sticks upon itself only, it does not stick on your skin. And what you do, so if you have Tubigrip and it's up, is you simply wrap it around the top portion of it. Now you don't wanna get super tight and cause another tourniquet, just nice and loose and gentle, and see it sticks upon itself like this. So wrap it around just a few times and then you can simply tear it or cut it with the scissors. And, there we go. Brad: So, again, now this is one inch, I would actually recommend the two-inch wide, it works better. For this situation, it's better to use the 2-inch wide, but it is the same material. You can buy this online, you can get it in medical supplies. Actually, if you want a hint on how to get it cheaper, buy it from a veterinary supply, and this is what I've heard from people who got certified in this. It's exactly the same product but they use it on animals and they sell it cheaper, so you can get it quite a bit cheaper. So wherever you get it from, make sure, you know, you'll just find out it works well, this is actually made by 3M. Again, it does not stick to your skin but it does to itself, and you have a nice way to hold it up. Easy to take off, you simply throw it away and use some more. All right, very good, so simple little tricks to help that tourniqueting problem and really help the lymphedema problem go away. And I've done this with patients, I'm working with this with my mother right now, and, boy, it is really working well if you stay consistent with it. Mike: If you have any questions or comments, mark them down below. Let us know if this works for you or if you have any other suggestions because the audience feeds off of each other. Brad: That's right, there are other tricks besides this, I am sure. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin, Mewe, Minds, Vero, SteemIt, Peakd, Rumble, Snapchat, Clapper Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Back and Neck Massager Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Holy Cowabunga Cream Uni Massage Gun D6 Pro Massage Gun Back Massager Posture Pad Lite Foot Massager Fitness: Resistance Bands​ Pull Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stress Balls Stretching: Booyah Stik Stretch Strap Wellness: Hand Warmer Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material on this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in May of 2023. For the original video go to https://www.youtube.com/watch?v=ULqk9PpG4qk&t=235s Brad: Greetings, greetings. Today, we have a very interesting episode. We're going to talk about the hundreds of people that we have worked with with broken hips. Now, I've narrowed it down to the two biggest reasons for falls causing these hip fractures, and we will get into those in just a minute. Mike: So in this video, we're going to show you two different balance exercise routines that you can do at home to help prevent these falls from happening, and it should only take a few minutes. Brad: All right, now over the decades, Bob, Mike, and I have all worked with these people with broken hips, and we always talk to them and they're more than happy to share their story of how their hip was fractured. It's so repetitive where what happens is someone is getting out of a chair, they stumble, or they're getting up, there's activity in the room, and they're not paying attention to where their feet are, or they're walking, and a rug is caught, a throw rug or their pet is on the floor, and they're shuffling their feet, and down they go as a result of that shuffle. These are all things that are so common, and we hear them time and time again, and I think we can get onto the next segue, Mike. Mike: Having poor balance is not a good thing, obviously, but the real problem is when you fall and then you fracture something because then you're going to be weaker, and your balance has become even worse for a period of time. So in this video, we're going to show you some balance activities that you can do to help prevent these falls from happening in the first place. Brad: Right, and it's going to happen to all of us. Our walking, which we call gait, and our balance get worse with age, just like vision or getting gray hair. However, the good news is we can show you some things to correct it and really minimize the risk of falls. All right, we're going to break down the three most common causes of these falls in a little more detail as a therapist looks at it. Mike: Number one is tight ankles. Oftentimes, if you can't lift your foot up and you have a tight ankle, it's harder to walk, and you probably aren't walking in a nice, correct pattern, increasing your risk of falling. Brad: Right, that's where even just a crack or a lifted sidewalk, a 1/2-inch little lift can catch that on your toe because you're shuffling, not dorsiflexing enough, tight ankles, down you go. The next thing is poor gait habits. It segues right into that. That's the shuffling. When you get old, you ever find yourself shuffling along, and you think, "What's goin' on?" You have to pay attention to what's going on down there. Get those feet moving, and lifting, and things will go much better. Mike: And the third common cause is poor balance or proprioception deficits. So that means maybe you have peripheral neuropathy, or you don't have good sensation in your feet, and you can't feel the ground, as well. That's a common cause of falling. Brad: And that's where a lot of people that are diabetic, which is more and more common all the time as we age, that's where that proprioception and that neuropathy is a big deal. We want to address that. All right, one of the big solutions that can really eliminate falls is simply using an assisted device, in other words, a cane or a walker or some kind of walking stick. That's really helpful and eliminates a lot of the exercises necessary. However, there are people in that gray area, where they don't really want to use an assisted device, and maybe they don't need it, but they're in that area. So Mike, do you have anything to say about these devices? Mike: These devices often will allow you to not shuffle, as we talked about earlier, and correct your walking pattern. So just using one, even though you may not feel like you need it, it's better to have one and not fall than to not have one and take a tumble. Brad: Right. Again, a cane is one thing. A walker is a very big difference because they are more cumbersome to take around throughout the community. So that's where these exercises really are advantageous when you do not want to negotiate a walker. All right, the first exercise, the routine, what we're going to do is address the ankles, those tight ankles we've already talked about. Simply, you start out in a seated position, lift your feet up off the floor so they’re in the air, and you pull up, dorsiflex, and push down. Really focus on pulling the toes up. That's the most important part because that's where those falls happen when you cannot pull the toes up. You'll feel a stretch. Do 10 of these. Brad: You can do these throughout the day, every now and then. Just do 10 of them at least five times a day. It's very quick. Now, the next thing you're going to do to strengthen the ankles once you stretch them is done in standing. Have something to hold onto to balance, a chair, a cupboard, something of that nature. Mike: Then you're going to do some ankle exercises. So you're going to go up on your toes, and then you're going to rock back on your heels, and you're going to do 10 to 20 repetitions each way. This is going to work on your balance a little bit. It's going to work on your strengthening, and it's going to work on your range of motion within your ankles. So you're getting three positives out of one exercise. Brad: One word of caution with this is when you are rocking back on your heels it's really critical that you have something solid to hold onto because you may want to fall backward, particularly if you already have a balance problem, and that could result in a broken hip or something of that nature. So really make sure there is something solid to hold onto. Stay safe. All right, the second routine, this is really critical. This is to stop that shuffling that you may not even be aware of until that trip comes along, and the first thing we're going to do is you need some sort of support for balance and safety. You may just use a cane or a stick. I have the Booyah Stik, or just a chair but, again, a solid chair, a cupboard, a solid counter base or a sink where you can put your hands around the sink is really ideal because it really gives you support in directions, especially backward. So the first thing is simply marching. Mike: So this is going to work on your balance a little bit. This is going to help with the shuffling because, if you pick your feet up more, you're less likely to trip. Brad: Right, and really get those knees up as high as you feel comfortable because, again, we're going to do this 10 to 20 repetitions. The whole idea is to get your mind aware of what your legs are doing. If you want to work your balance, simply hold it up and go slower so you're balancing on one leg a little bit. Again, if you feel like you're really wobbly, that's too much. You need to have more support. It should just feel like your ankles are working a little more, and you feel a little wobbly, but you feel safe. We want to stay safe with all of these. Now, we're going to go on to the next start by stepping sideways, which is a really big thing that makes falls. Okay, now we're going to go on to sidestepping because this is a very high or frequent cause of falls. We're stepping sideways. We don't pick up the foot, and down you go right on the hip, and there you got a fracture. So if you have something to hold onto, like a handrail, do that, or a countertop that you can hold onto, that works fine. If your balance is fairly good and you feel comfortable using a stick or cane, that's fine, too. Now, we're going to work sidestepping, and actually look down and see what your feet are doing. Some people are not aware of what's going on down there, and they're not aware that their feet are only 1/8 inch off the floor or maybe even dragging because you can't feel it if you have diabetic neuropathy. So I want you to really make note of picking those feet up. Go about four or five steps to the right, four or five steps to the left, and repeat that a number of times, and it's one of those things that, after you do this a number of days in a row, that muscle memory is going to kick in, and you'll start doing that without thinking about it, minimizing your risk for falls. A very important part of this. Mike: And the last option is a little more advanced. It's going to help with stairs and especially lifting those feet up and prevent the shuffling. So you're going to need some type of step as Brad has here or a staircase. Make sure you're using rails or some type of support like Brad is, and you're going to simply bring one foot up, tap the step and then bring it down. Now, you can just work one leg at a time. Try to do 10 repetitions and then switch. If this seems easy, you can try alternating. So you're going to go right and then left. This is a little more challenging because each time you have to shift your weight to the other side, working on your balance. What do you have to say, Brad? Brad: Well, if you feel more advanced and you want to get a little more exercise, as well as a balance challenge, go up to the next step and do that. Again, you need to feel stable and not unsteady when doing those. So don't overdo it. Good judgment is absolutely crucial, so whichever step you want. Yeah, this one I really like because, again, it doubles it. There are a lot of people that do, when you go up a stairway, you catch your toe because you didn't lift high enough, and then you stumble forward. So very good, work that one, if it's available. Take care and enjoy. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin, Mewe, Minds, Vero, SteemIt, Peakd, Rumble, Snapchat, Clapper Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Back and Neck Massager Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Holy Cowabunga Cream Uni Massage Gun D6 Pro Massage Gun Back Massager Posture Pad Lite Foot Massager Fitness: Resistance Bands​ Pull Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stress Balls Stretching: Booyah Stik Stretch Strap Wellness: Hand Warmer Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material on this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced to help you make the best choice for you.