- All right, today the topic is hip and hip pain, why it hurts, and we're gonna show you some stretches on how to eliminate it. If you'll notice over age, and we notice it as
therapists, the hip tightens, the hip can gets painful, and we need to observe
what's going on with it. So as we age, the hip ages, but it doesn't have to
if you treat it right. - And in this video we're
gonna show you five stretches to help combat these issues and tell you why you wanna do them. - That's right. Sam, what have you got to say? He's a little shy today. We'll get right at it. (upbeat music) All right. So I want to talk a little bit about hip pain and where it comes from. Now I think we all understand
if you have a history of an injury in your
hip when you're younger, or if you've worked at a
very physical, laborsome job say working in construction, et cetera, it makes sense that that hip wears out from use, overuse, et cetera. But what about people
who do not have a injury, they have jobs that are not aggressive, and they still have hip pain? That's what the group we
wanna understand as well. - So this is commonly
causing pain for those people because they're not moving enough. If you're sitting all day
long in a flex position, you're not getting blood flow
to the area or circulation, you're not healing any
problems you have in there with ligaments, tendons, you're also not getting
the synovial fluid moving within your joint capsule. These are all essential. Movement is good for the body. So not moving is just
gonna make things tighter and possibly worse. - And we're gonna show
you in close the details of the anatomy of those
structures that get tight from sitting and not moving enough. Alright, let's take a look
at the anatomy of the hip. It's a ball in socket joint
and it's a deep socket and it's got a fair amount of
actually excellent mobility and a healthy hip like this, you can see the hip obviously,
with the metal in here that we can't remove,
it's not in your body, you don't have screws and hardware, but it does move very well
and it's an incredible joint. Now, if we look at the actual ligaments and there's a tissue called the capsule, which actually goes
around the whole joint, holds the synovial fluid
which lubricates the joint, that capsule and ligaments
as well as the muscles from sitting like this for too long, they can get tight and then
things do not work as well. And there's actually a syndrome that has been discovered where the hip starts to move forward. We can't see it with
the ligaments in the way but it actually gets out
of the socket slightly and the mechanics no longer work properly causing excessive wear. And Mike, do you have some more
to say about the cause here? - This can also be problematic if you're sitting for a long time 'cause it's gonna cause
your hip flexor muscles which are in the front
of your hip to get tight. - Good point. - This will start limiting
how much extension or backwards motion you have. So if this is tight, your butt muscles might not start working as much as they should. So you're gonna have tight hips, your butt's not firing as much. It's gonna cause this
femur to move forward in the socket causing
all sorts of dysfunction, pain and muscle imbalances. - That's a lot to be throwing at you. And they actually have a name for the the glute muscle
not firing, gluteal amnesia. So we got anterior femoral head- - Dysyndrome? - Guide syndrome, sorry. And we've got gluteal amnesia. Technically we're gonna
show you some stretches to help eliminate and
combat some of these things. Oh, Sam. Almost lost him for a second. Alright, now that we've
covered the brief synopsis of what can go wrong with the hip, why it does these things that create pain, boy my mouth is really
not working well today. But now we're gonna
show you the exercises, but Mike has some important
information you must focus on and listen right now. - Before we get into this, if
you've had a hip replacement or any type of back surgery, you wanna check with your provider if some of these stretches
are safe for you, they may not be for everyone. Also, if anything is increasing your pain, then that stretch is not right for you or you're doing it too aggressive. So be cautious. - Right. These stretches should
feel like good stretches, not painful stretches,
especially you guys out there. 'Cause a lot of people
think no pain, no gain. It's usually us men. So, you know, calm things down. All right, the first exercise,
we're gonna show two options. One in bed or laying on the floor. Lying on the floor or in the chair. Go ahead Mike. This is for hip flexion. - So this is called single
knee to chest stretching. What you do is bring one knee up towards your chest just like this. It's gonna stretch your buttock a bit but it's gonna also work on
increasing your hip range of motion going up, which
is called hip flexion. You're gonna hold this for 30 seconds and then relax and make
sure to do the other side. Now if you struggle to reach your leg, so you have limited range of motion, you can grab a belt, a bed sheet, a towel, something you can either
put underneath your leg and pull up like this with your hands or you can also wrap it around top and do it this way as well. Try to do three to five sets of 30 second holds on each side. If you're unable to do this laying in bed, Brad has a good option in a chair for you. - Right. If 30 seconds is too
long, you can shorten that up. The big thing is that you
get the stretch there. In the chair, this is where
we do say actually slouching and scooting your butt
forward is acceptable, 'cause it just positions
the hips more properly. Bring the knee up to here. You can go over the top and pull here. If the 30 second thing is
too long, even a on and off if that's all that's
tolerated, works well. You can go, a lot of
people I've worked with, their knees are too tight
and that hurts their knees. So go underneath and that
takes the stress off the knee. Then you can focus on the
hip, which is what we want. You can do a little noodling up here, which is what I'm doing right now. - Yes, some people can't
go as high up straight up so you might have to go out
to the side, especially males, and you can get a little more
range of motion that way. - That's right. Do both legs. And you're done with that one. We're gonna go to number two. Alright, the next one, this is another one you
can do in two positions, whatever works best for you. It's to get the femur or the
hip to externally rotate. It's called the figure four. I like it a lot. It's very functional as well. Mike, go ahead in bed
or lying on the floor. - So external rotation means
letting your hip go out or pointing your toes out, if your leg is straight like
this, just for clarification. But to do this stretch,
you're gonna bring one foot, put the ankle on the knee here, and then you're gonna
push down on the knee to get a little more stretch. If you're really limited,
you may have to only go here if you can't lift your hip up high enough. If you can, certainly lift it up here. Hold like this. If you want even more of a stretch, you can grab here and
then I really feel it now. Again, you can hold this 15 to 30 seconds and then relax and make
sure to switch sides. If this is hard for you in
bed, you can also do it seated. - That's right, actually
show if you're really tight, you can actually bring this leg down and just doing that may be all is, you know, your hip will
tolerate and that's okay. In the seated position, I like this one. You can go like here, gentle
pressure down on the knee like this, hold and relax. If you wanna hold 15 to 30 seconds, as long as it feels like a
good stretch, it's not painful. Again, if you had hip replacement, you're not doing this unless
you talk to your doctor first. And it's maybe been a
couple years since surgery. So I like doing this one on a daily basis when I put my socks and shoes on. I can put my shoes on,
stretch a few times, do the same on this leg. And it's involved with your
daily chores as far as dressing. So let's go on. Anything else on that one, Mike? - It's important, if you have one painful
side versus the other, take note if one has
limited range of motion and work on that side a little bit more. - Yes, good point. All right, we're going to number three. All right, moving on Mike. We're going to number three. Okay, we're gonna talk
about internal rotation. The femur is gonna rotate
the other direction. It's important, lying in bed. Go ahead, show 'em. This
is a nice way to do it. - So you can bring one leg up and just let it collapse
in towards the other leg. You should feel a stretch on the outside of your hip muscles here. If this is enough stretching
for you, you can stop here, hold it for 15 to 20 seconds. If you'd like to get a
little more stretch in there, you can bring your other leg,
cross over and help pull down. Notice my low back is still on the mat. I'm not lifting it up like this. That's not gonna help the stretch. Keep a nice flat back. Hold that again for 30 seconds. This is a little more advanced. Just make sure you're gonna do both sides. You don't wanna be lopsided. - That's right. You'll
walk in circles, otherwise. If you wanna do this in a seated position, in a chair like this, a
firm chair works best. It's very simple. This is for people who have tight hips, maybe have a hard time getting around. You can simply roll in this way and that's gonna be helpful
if you have a stool, if you get your hip up a little higher, sometimes, this is a
little more tolerated. And then on the other extreme, if you feel like you're pretty
mobile and your hip is loose and you want to get more, Mike is gonna show the advanced version. - So the advanced version,
you can sit down like this. You can do it on the floor, but it's a little easier on the mat. So I'm gonna stretch this leg. I'm gonna try to just bring
my shoe and foot up on the mat and I'm gonna try to sit
up as straight as I can. I'm not that flexible
in this range of motion. So you can see I'm kind of tilted. I kind of struggle to get up straight. People that are really mobile and flexible can sit
up perfectly straight. But I feel a good stretch here. - Again, this is advanced. If you look at this and say," I don't think I want to do it." Don't do it. Do the other ones. That will be more than adequate. This is for the overachievers or those extra flexible people. Okay, number four, we're gonna talk about
the hip flexor muscle that Mike mentioned earlier on. This is really critical.
This is an important stretch. And there's two ways to do it. Mike's way is a little more aggressive and probably the better way of it, but it is dependent on
what you have to use. If your bed's firm enough or if you can use a table,
which is challenging. I'm gonna show an option seated in a chair which is gonna be a little easier to do and probably for more older people, that's the way they'll do it. Go ahead, Mike. - So if you're on a bed or firm table or even island countertop,
whatever you have to lay on, you need to be able to get
your legs to kind of dangle off the edge here. So in order to do this, bring
both knees to chest to start. You could start at the top of the bed and scoot your buttock down. You don't have to go the way I did. I'm gonna stretch my left leg here. So I'm gonna lower it to the ground. As it's going down, I'm
keeping my leg straight. I'm not going out or it's kind of hard
for me to go too far in, but try to keep it nice and straight. Now, you'll see how tight this is. Once I bring this knee to my chest, it'll start pulling up on here. Now what I wanna try to
do is flex this knee, try to get to 90 degrees. I don't think I can 'cause I'm already feeling a
hamstring cramp doing this. So I'm gonna hold whatever feels
okay for me for 30 seconds. After that, I'm gonna bring this leg up, reset my back slowly, and
then switch to the other side. See if you notice any
difference between sides. Try to do two to three sets of
30 second holds on each side. If one side's tighter, pay a little more attention to that side. Give it an extra stretch. - Let's go back to the other leg. Mike, I just wanna bring up
one point that you mentioned. When you're here, just
relax, let gravity go down. Now the point where Mike says if you really wanna get
aggressive is you pull this under, which he said that could
cause a hamstring cramp. If you have any indication that your hamstring is
cramping, it's very painful. Simply straighten that leg out
and that cramp will relieve. And then do not do it again. Just continue without pulling it under. You wanna avoid those cramps.
They're no fun at all. So that's only for probably
more advanced people. How you feeling with that Mike? - Good, now that I'm not
bending my knee on it. (Brad chuckles) - There we go. Now the option, so you don't
have to worry about that. If you have a chair, works best on a chair that does not have armrests
'cause they get in the way. Take that, a throw pillow like this. We're gonna put that on
the floor right there. You'll see why in a second. Scoot your bottom, come
to the edge of the chair, good posture, scoot your
bottom off to the right. I'm gonna be stretching my right hip. I'm gonna bring this
knee down to the pillow. It's just for comfort. You don't have to have a
pillow if you don't want. And then I'm going to go like this and scoot my bottom forward or
bring my knee back like this. I'm feeling a stretch. If you put your hand in your pocket, that hip muscle, hip
flexor is right in here. It's deep. It's really a deep
muscle and you'll feel it if you go back this way, a stretch gets a little more aggressive if you bring the knee
back and again hold it for 15 to 30 seconds, this is one that's kind of
hard to do the pressure on, pressure off, because it's
a little more cumbersome to get that stretch. So holding it is what I prefer to do. Again, to do other leg, you
simply do the same thing. Shift to the opposite side of the chair, move the pillow as needed. And there you go. That's
stretch number four. Any comments Mike? - No, we're ready to go on to five which is kind of a variation of this. - Okay, number five. Now this one is a little more advanced so if you don't feel
comfortable watching us do it, maybe you shouldn't do it. (Mike laughs) But what we need is a chair with two arms, a good sturdy chair, a solid
seat pan chair is desirable. Or you can use steps and I'm gonna show another
version with a stool or something you can
use outside like I do. So you're just gonna put one foot up. Now the nice thing about chair
steps is go ahead, tell 'em. - The higher you lift your foot up the more aggressive it's gonna be. 'Cause I'm stretching the leg
that is back here right now. So when I do this, if I'm gonna start easy,
just stand like this. You wanna have a nice straight back. Don't be flexed over too much. That's not gonna stretch a thing. Don't be way arched back either. Just go nice straight
back and bring that leg. Now I don't feel much here, so
I'm gonna bring this foot up and I'm gonna stretch this way. Obviously, if you don't have good balance, don't lift up as high. Make sure you have good sturdy handrails so you're not gonna fall over. - All right. Now if you use the chair,
it's the same thing, you grab here. And there is one thing
you can add to this. It's a little something we call, we learned from a advanced
physical therapist. I'm going to take the chair out because there's one option you can use. I would not use a stool, but what I use at home is I
have a retaining wall outside that is about this tall. It's made out of concrete, holds the puts holds the flowers up and all that kind of thing. I avoid the flowers. (Mike laughs)
I want to keep my wife happy. But it's a very solid and happens to be about the right height and then you can do that stretch. Now when you do it aggressively, I'm stretching the hip
back here, the hip flexors. But then this hip is also
getting stretched as well. So I call it the shotgun technique 'cause it's stretching your hips all over. Now, this is advanced. If you wanna move this knee out and in, that's called noodling. So you're just stretching that hip. When I go out like this, it feels good. So I give it a little extra stretch 'cause it feels good. If it hurt, I would not
even go that way at all. If going deep like this
hurts, don't do it. If it feels good, like mine feels really
good when I do this. And it always helps my SI
joint as well as my hips. And of course do it both ways. Again, do not use a stool. If it wobbles like this, that's no good. - You okay back there? - So something very solid
and steady is critical. Mike, anything to finish off? - I would say I kind of like the noodle and the end range here
and kind of isolate back and oscillate back and forth like this versus just standing
like this the whole time. It feels a little better for me, so- - That's right. - Do what feels good for you. - Absolutely. Now what I'd
like to say is stay tuned. We're gonna have, coming up
within the next week or two, I don't know the exact date, we're gonna have a follow
up video on this one. It's gonna be the five best
hip strengthening exercises. Once your hip is loosened up,
you need to strengthen it. It's gonna help stabilize
that ball and that femur, eliminate problems with arthritis, hip, tight hip, piriformis syndrome. Can you think of anything else, Mike? - You were talking so fast I only caught half the
words you were saying. - I couldn't understand myself, anyway. (Mike laughs) Good luck. Really good stretching
exercises for the hip. Only do the ones that feel good, probably pick out two or three of them. - Yes. And thanks for watching. - That's right. (upbeat music)
