Hi folks, I’m Bob Schrupp physical therapist Brad Heineck, physical therapist. Together we are the most famous physical therapists on the Internet, in our opinion of course. Knee bursitis stretches and exercises We’re also going to go over whether or not we think you have it, we’ll show you little ways to tell, a little way to diagnose at home Yeah, we’ll talk about the four main bursitis’ that you could have in your knee. There’s PES anserine That’s a big muscle. Suprapatellar, prepatellar, and infrapatellar. Really not that hard to show here We’re gonna show them on my knee here, so you got to put up with that Brad Let’s just see what happens. All right by the way before I go any further and now that I got my knee out If you are new to our Channel, please take a second to subscribe to us We provide videos on how to stay healthy, fit, pain free, and we upload everyday Also, if you get a chance, go over to Facebook and “like” us because Brad and I as children were not liked. It’s really quite sad and now we’re trying to turn around. It’s all coming back now It’s getting better. What goes round, no that’s not the right word All right, let’s show where the bursa is. Well first what is a bursa? That’s a big thing because you hear the term bursitis and people I think get over excited about it Some people actually say I got bursa in my knee, but it’s actually bursitis. You’ve got bursas all over your body, around your joints They’re fluid-filled sacs, so this might be somewhat of a representation of it And it’s between the bone and the soft tissues, so it helps to act as shock absorbers Or it helps the tendons glide over the bone it just makes everything work really well. if you think like a tendon going over a bone and the tendon is rubbing over the bone, after a long time it would wear out, like a rope getting frayed going over the edge of a piece of wood, where you put the bursa on there and You got some lubricant and then It goes lovely and it lasts for your whole lifetime, as long as it doesn’t get irritated And That actually brings it to one of the reasons Why it might hurt is because if you have overuse, like they call jumper’s knee and you jump jump jump And after a while the bursa gets irritated. I like the example you brought up before we were talking, someone whose putting flooring and carpet layering, that kind of thing, where they’re on their knees all the time, working on those Yeah, we’ll talk about that. Let’s show where they’re at first so we’ve got four of them so Supra means above, patella is the kneecap, supra is above. So you got one right here. I don’t think it’s that big And then you got one pre patella that’s right in front of the patella, so it’s right on the kneecap itself Hope this isn’t gonna be hard to get off. Don’t worry about it You can just pull your pant leg over. Then there’s infrapatellar, so that’s one right below the knee. Infra meaning below and Then you have PES anserine and that’s right in here Did you look up where that word comes from? Yes, it means goosefoot. Goosefoot? Yeah PES. So there’s three muscles that come together here Brad one two Three and they form like a goose foot. You are an artist Bob Sartorius, Samba tendonosis, and gracilis I’ve done my homework. So here’s the four bursas that can give you trouble and One possibility is trauma. So like if you were doing a sporting event, you landed hard on your knee You might go ahead and inflame that bursa itself I think I did that to my knee in wrestling once. That’s the other one is an occupational thing and that’s what you eluded to before. If you’re what they call a clergyman’s knee, a priest Probably a Catholic, they do a lot of kneeling, and then also I’ve heard it called housemaid’s knee, and yeah if you’re a wrestler, it certainly could happen that way I knew a therapist that got this because we did a lot of work with patients on mats and he’d be kneeling a lot if you lay tile or if you lay Carpet all those things make sense don’t they? When you’re down On your knees working on over and over yeah, and then like we said if you get an overuse injury We’re like you’re constantly using this tendon like with the jumpers knee you can inflame the the bursts all along with it I would think if you had to go up and down steps a lot. It may be a good indicator Now there’s also a chance a lesser chance that you have an infection in the knee now that would you generally would have to break through the skin somehow to get it into the bursa. Now you were mentioning Brad, how if you had a knee replacement And you were starting getting some redness like this you definitely need to see the doctor for that. when you get artificial parts or foreign parts introduced to your knee, They attract the infections. You don’t even have to cut through the skin it can like dental work You know you can get an infection and you replace them. Yeah, so if you’ve got redness around that knee and warmth and you have a replaced knee, even a few years ago and all been going good you better see a doctor to tell whether or not you have bursitis. To tell if you have bursitis, are you tender here or here here, or here? I mean especially here This is a common one because I’m off the knee joint im down below here. That’s quite often PES anserine bursitis So what do you do? You can do ice You put put ice pack on there you can use an anti-inflammatory. Ibuprofen something of that nature. if you Have an infection you obviously you do an antibiotic if it gets bad, and you know it’s really swollen up They might stick a needle in there and take some of that fluid out of there. If it’s really bad They sometimes do surgery and actually take the burst out. But we’re going to show you stretches today. Stretches and strengthening that helped the need generally with bursitis So let’s get started with that. Okay, then the first one is The calf believe it or not goes all the way up into the knee and so it’s always good to stretch that .I’m going to show one way to do it you can take a towel or Some people take a dog leash we got the yoga strap here Which will list down below in our products a section of Amazon, but you can go ahead I always like to put it right where the tag is here and You can hook through the loops here real nicely, and you can just pull toward you here, and there you got this good calf stretch. Getting a nice stretch like Bob said the calf muscle Goes all the way up actually crosses over the knee Okay, you want to show on your board there Brad? I personally really am a big fan of the incline board for stretching. Like this and you can relax and put all your weight on that leg Straighten the knee out and you get a nice stretch, and it’s very easy and easy to relax If there are a runner especially and you stretch every day like that. That’s a great one to have Even if you’re a walk or one way or another And make sure you get the right angle around 20/25 degrees I find that most people is the best angle. Alright then we’re gonna go right into a hamstring stretch Brad, so same thing we can do it with a towel or belt I’m gonna go ahead and bring it up what I like about this brad is I can I got the loops here I can actually push down and then relax push down and then relax And the knee being straight is critical if you bend the knee it takes the hamstring out of it You don’t get as effective as a stretch, and I do this one every morning did it this morning already Brad Alright next one is the quad stretch Brad now you can do this one without the band or with the band very Easy way to do is just lay on your side And you just grab onto the ankle like this and pull it back now if your way up like this You’re not getting a quad stretch You got to pull it way back like this. So if you look down and you can see your knee out in front of your Stomach it’s too far back. You can up pull it behind it and you’ll feel that stretch When you do that. Now you can do it with the band I mean you, can you can hook it up, and put it around your foot. It’s just a little more complicated then lay on your stomach, and you can pull like this. I like doing this one You got some pretty good leverage there, and you know it laid flat forces You to have good mechanics in your hip all right next one is hip adductors Brad, and this is especially important for for the PES anserine So basically, you’re going to sit like this You can use your elbows here Brad and push down like this and lean forward. ooh. I really feel that one I do it laying down flat on my back And I probably should do it this way because I can feel it is stretching more All right, I think that’s it for the stretches Brad now. We’re gonna go ahead and show strengthening We’ll do a straight leg to start off with Thanks, Bob Okay So this is working the quadriceps and this is Harder than it looks if you do it properly, so this leg is just supporting It’s best to have the opposite leg up in this position And I’m gonna come up to here and go back down, but not rest it I’m gonna go about two or three inches from the floor or the table and come back up And then if you want to get more aggressive you can start doing It’d be like a plyometric and you can definitely feel those clouds working again The knees gonna stay straight while you’re doing this if you do this for 20 to 30 reps You’re gonna need the rest I can guarantee you. All right So the bottom leg is gonna be bent this one’s gonna be straight, and we’re not gonna bring the leg out here It’s gonna be straight in line, and I’m gonna work toes pointed straight forward This is this is what most people like to do because your body normally takes the easy way out And that’s a lot easier than the hip adduction And you’re gonna feel that’s right up here Those hips are going to be working nicely and into that IT band strengthening that across the knee Well you can do a hip adduction too So we’re switching from leg to leg here now. We’re strengthening this leg we were strengthening this one, so we’re doing the outside now We’re doing that groin muscle the inside adducter. That’s the muscles that come into that PES anserine bursitis so We can strengthen those muscles Yeah, that’s that goose foot again. Is that a latin term? Usually it is with medical terminology. Call up one of your Latin friends and let me know. All right hip extension Well while you’re in this position why don’t you do clamshells. And this is going to work that hip where the posterior fibers of that hip adductor. And again 10 to 15 repetitions of all these is typically a good number. I’m feeling that work right now right there I think that’s actually enough Brad Yeah, when you take a break when you’re sleeping, especially if you have PES anserine bursitis and you’re sleeping on your side you want to take pressure off that Bursa by putting a pillow in between your legs. I personally like todouble up. Thanks. Everybody take care. You