Bob and Brad the two most famous physical therapist on the Internet [Music] hi folks I'm Bob show physical therapist Brad hanok physical therapists feel real the most famous physical therapist on the internet in our opinion of course Bob hey Brad we're gonna talk about seven big lies about treating knee arthritis you should know there's a little controversy we'll talk about it as we go through it sure by the way if you're new to our Channel please take a second to subscribe to us we provide videos on stay healthy fit pain for you and we upload every day also you want to join us on our social media channels because we are always giving something away always and right now we're giving away the ergonomics innovation donut cushion and this is great for sit bone pain or tailbone pain or just some people just like it if you broke your tailbone or fractured a lot of pain there and you need that hollow spot there to relieve the pressure it's there I guess it would work for hemorrhoids too wanted absolutely Bob so this is a study that was first done in 2009 I should say a study they looked at hundreds of studies Brad this this is the Royal College Royal Australian College of General Practitioners so they got this huge group they said they look at hundreds of maybe thousands of studies sure a regarding knee arthritis and actually hip arthritis – okay they first did in 2009 they redid it in 2018 so its guidelines for non-surgical management of hip and knee arthritis today I'm just gonna talk about knee arthritis since that's the title they what they do is they do various degrees of recommendations like they'll say strongly against or conditionally against which is not as big not as severe then they also go strongly for or conditionally for so there's a grey zone yeah right sort of speak so let's start off with the first one Brad cuz I get a lot of people that ask me this should I use glucosamine and chondroitin and what this study said they said they were against the use of it there just there was no they didn't see any benefit to it and concerning the cost and so I was strongly against I'm sorry I don't remember I just put recommended against I didn't do the conditional ones on those I I don't think what those there's any particular bad side effects no it wasn't but again they're like you know why do things that aren't gonna help basic right all right they're scientists the second one is going to be maybe surprise you a little bit recommended against use of an ice pack comedian always makes because I mean a lot of times arthritis is inflammation so you think you want to put ice on it but the thing is generally they found out a lot of people like with arthritis they like the heat sure a lot better they recommended against use of an ice pack I have to admit I had a patient that severe severe knee arthritis couldn't even walk and she did not like heat and she was very alert and she said she kept ice packs in a room and we put on so there's there may be exceptions to the rule right this is the biggest one I think of the seven Brad okay they recommended against arthroscopic meniscectomy –zz cartilage repair all these surgeries unless the me was actually locking so a mechanical yeah clarity and you say well how could they recommend I'm having a lot of pain they found out that if you had the surgery like five six months later you're back to right where you were before okay so we're not talking about knee replacements not knee replacements we're talking about just arthroscopic surgeries are they going and replace or trim off the meniscus and right this is a big one I mean because a lot of people I think they still do recommend you'll find doctors that do recommend this right go in there clean it up a little bit and you know things but I have to be honest a lot of the people that I know that did have it done yeah they were back to where square one right fairly quickly it's a little discouraged they wouldn't go to the therapist if it worked but no and that's the thing the earliest want to recommend conservative things to try further before you try things like that sorry um they recommended I kind of through three of them together here number four they recommended against acupuncture kinesiotape and topical capsaicin so that I just heard of it I never used it topical capsaicin yeah just um well I believe you put on I got some kinesiotape you see it very popular you see the Olympic athletes wear them everything's all boy that's really cool but the studies have just not held up on these sorry and we have people comment that they love their kinesio tape that helps i personally if it works and you really think it helps I don't think there's any negative side if no there's it's a placebo effects sometimes if it's a placebo it works you know placebo it's better than taking pain pills at it that's for does that Alright knowledge that was the thing to say well they had a whole bunch of things they recommend against little ones I kind of singled out but here I'm gonna give you some things they recommended okay unfortunately with the me you are limited you know there's not a great amount things they strongly recommended land-based exercises what is that that's mean versus water-based exercises so they thought it was better that you actually exercised out of the water than in the water so walking walking muscle strengthening and Tai Chi was really hard they were commanded or was recommended okay such a slow form of exercise you do not do it at all no I've it's a martial art I've trained in a different style quite a bit drastically different but from what I understand you go through moves very slowly make sense you were it's gonna help with your balance or you've got a shot but definitely the walking they also number six they recommended and this makes sense it's just shock absorbing Footwear when something in your shoe and no high heels because you know that's gonna put right here yeah so you you're gonna stop wearing high heels bread no no no sticker your fashion ah alright number seven no surprise you either recommended weight loss and while you're trying to lose weight you know sometimes this is a motivator you could use a cane or a crutch or a walker you know my wife was having some knee pain and it was to the point where first she said there's no way I'm gonna use a cane or a crutch but she ended up using a crutch because it was so bad that she was limping so bad she couldn't walk so what the crash it was much much better yeah this was actually the one she used I actually got some padding for right you know the arms gets really sore and your hands get really sore from using all the time it was very very nice of you but I was so your wife but she after a while I calmed down and now she's back to walking and it's issue I did some manual things on it too well you don't have to get into that but what are you talking about just said let's go honest carry out that was it Brad that's number seven you gotta try to take some of the weight off of it so you again use the cane or a crutch or a walker well I did want to say one thing I wanted to back up a few steps I'm really surprised that the water exercise would be good for it because it's you know that was a yeah I'm surprised they talked about it I don't remember if they actually recommend it against it or if it was a it was a recommendation but it was a lesser recommendation it's just I think there's something about actually taking the full weight through the leg and the effect that it has on the knee and you know creating some of the oil they're racing or lost their that's okay chopped off anyway I'm saying if you got a swimming pool and it feels good to get into an exercise can I recommend that to my patients but the problem is is very few people have that option right and I think that's part they take into account everything they hear into account the convenience of it the cost of it and so they'll recommend things that are a lot easier to do but you're more likely to sure that makes all is that right so so that then I concur all right well we welcome all your comments and sorry for the little you know pause there I had it thanks for watch enjoy [Music] you ♪ Bob and Brad ♪ ♪ The two most famous ♪ ♪ Physical therapists ♪ ♪ On the internet ♪ (claps) – Hi folks, I'm Bob Schrupp, physical therapist.
– Brad Heineck, physical Therapist. – Here we are, the most famous physical therapists on the internet. – In our opinion of course, Bob. – Today Brad, we're gonna talk about seven big lies about treating knee arthritis you should know.
– There's a little controversy, we'll talk about it as we go through it. – Sure. By the way, if you're new to our channel, please take a second to subscribe to us. We provide videos how to stay healthy, fit, pain free, and we upload every day.
Also you wanna join us on our social media channels 'cause we are always giving something away. Always. – Always. – Right now, we're giving away the ergonomics innovation donut cushion, and this is great for sit bone pain, or tail bone pain, or some people just like it.
– If you broke your tailbone or fractured, a lot of pain there, and you need that hollow spot there to relieve the pressure, it's there. – I guess it'd work for hemorrhoids too, wouldn't it Brad? – Absolutely, Bob.
– So this is a study that was first done in 2009. I shouldn't say study, they looked at hundreds of studies, Brad. This is the Royal College, Royal Australian College of General Practitioners. So they got this huge group, they look at hundreds, maybe thousands of studies.
– Sure. – Regarding knee arthritis, and actually hip arthritis too. – Okay. – They first did it in 2009, they redid it in 2018. So it's guidelines for non-surgical management of hip and knee arthritis.
Today I'm just going to talk about knee arthritis. Since that's what the title is. What they do is they do various degrees of recommendations, like they'll say strongly against or conditionally against.
Which is not as severe. And they also go strongly for or conditionally for. – So there's that gray zone? – Yeah right. – So to speak. – So lets start of with the first one Brad, 'cause I get a lot of people that ask me this.
Should I use Glucosamine and Chondroitin? – And what'd the study say? – They said they were against the use of it. They didn't see any benefit to it, concerning the cost. – So it's strongly against? – I'm sorry I don't remember, 'cause I just put recommended against, I didn't do the conditional ones on those.
– I don't think with those, there's any particular bad side effects from taking that product – No. But again they're like, why do things that aren't going to help basically. – Right, right, they're scientists.
– The second one is going to even maybe surprise you a little bit. Recommended against use of an ice pack. To me, it always makes sense, because I mean a lot of times arthritis is inflammation. – Mhmm.
– So you think you wanna put ice on it, but the thing is it generally, they found out a lot of people with arthritis, they like the heat. – Sure. – Feels a lot better. They recommended against use of an ice pack.
– I have to admit I had a patient that had severe, severe knee arthritis. Couldn't even walk, and she did not like heat. And she was very alert, and she kept ice packs in her room. And would put it on, so there's- – There may be exceptions to the rule there so.
– Right. – This is the biggest one, I think, of the seven, Brad. – Okay. – They recommended against arthroscopic, meniscectomies, cartilage repair, all these surgeries. Unless the knee was actually locking.
– So a mechanical clarity- – Yeah. And you say, well how can they recommend, I'm having a lot of pain. They found out that if you had the surgery, like five, six months later, you're back to right where you were before.
– Okay. – So. – We're not talking about knee replacements though. – Not knee replacements, we're talking about just arthroscopic surgeries, or where they go in and replace or trim off the meniscus and all that.
– Right. – This is a big one, 'cause a lot of people, I think they still do recommend, you'll find doctors that do recommend this. – Right, go in there and clean it up a little bit and see how things hold off.
– Yeah. But I have to be honest. A lot of the people that I know that did have it done, yeah, they were back to square one fairly quickly. It's a little discouraging. – They wouldn't go to the therapist if it worked.
(laughs) – No, and that's the thing. You always wanna recommend conservative things to try first – Sure. – Before you try things like that. – Right. – They recommended, I kind of threw three of them together here on number four.
They recommended against acupuncture, kinesiotape, and topical capsaicin. I just heard of it, I've never used it, topical capsaicin. It's just a rub, I believe. – Yeah, here. I get some kinesiotape on here.
– Yeah, we got the kinesiotape. You see it, very popular. You see the Olympic athletes wearing them. Everybody thinks, oh boy, that's really cool. But the studies have just not held up on these, sorry.
– And we have people comment that they love their kinesiotape, it helps. – Yep. – I personally, if it works, and you really think it helps, I don't think there's any negative side effects to using it.
– No, it's a placebo effect sometimes. And if it's a placebo, it works, placebo. – It's better than taking pain pills if it does that. – That's right. Alright, that was the things they- Well they had a whole bunch of things they recommended against.
Those are the ones I kind of singled out. – Sure. – But here, I'm gonna give you some things they recommended. – Okay. – And unfortunately with the knee, you are limited. There's not a great amount of things.
They strongly recommended land based exercises. What is that? That means versus water based exercises. So, they thought it was better that you actually exercised out of the water than in the water. – So, walking.
– Walking, muscle strengthening, and tai chi was really high in the recommended, or was recommended. – Okay, so that's a slow form of exercise. – Do you know how to do it at all? – No, it's a martial art, I train in a different style, quite a bit drastically different, but from what I understand, you go through movements very slowly.
– Very slow and controlled. – Which makes a lot of sense. It's gonna help with your balance, range of motion, strength. – And your strength. Give that a shot, but definitely the walking. Also, number six, they recommended, and this makes sense, just shock absorbing footwear.
– Mhmm. Put something in your shoe and no high heels. 'Cause you know, that's gonna put great stresses on there. – Right, yep. – So you're gonna stop wearing high heels, Brad? – No, not me.
(laughs) – Stick them right on. – You're gonna stick with your fashion. (laughs) – Alright, number seven, no surprise here either. Recommended weight loss. And while you're trying to lose weight, sometimes this is a motivator, you could use a cane or a crutch or a walker.
My wife was having some knee pain, and it was to the point where, at first she said, "There's no way I'm gonna use a cane or a crutch." But she ended up using a crutch because it was so bad that she was limping so bad, she couldn't walk.
– So with the crutch, it was much better. – Yeah, this was actually the one she used. I actually got some padding for her. – Right. – 'Cause Under the arms gets really sore, and your hands get really sore from using it all the time.
– That was very nice of you. – Yeah it was. – Bob, to do that for your wife. – But after awhile, it calmed down. And now she's back to walking. And it's not an issue. – Sure. – I did some manual things on it too.
– Well, we don't have to get into that. – What are you talking about? (laughs) – Just saying, let's go on. Let's carry on. – So that was it, Brad. That's number seven, you gotta try to take some of the weight off of it, so you can use the cane or a crutch or a walker.
– Well, I did wanna say one thing. I wanted to back up a few steps. I'm really surprised that the water exercise wouldn't be good for it because it's- I think most people would question it.
– Yeah, I'm surprised they talked about it. I don't remember if they actually recommended against it or if it was a recommendation, but it was a lesser recommendation. – Right. – I think there's something about actually taking the full weight through the leg, and the effect that it has on the knee, and creating some of the oil there.
– You lost everybody. – Yeah, I lost it, I lost my thought. – (laughs) That's okay. – I'll get chopped off anyway. – I'm saying if you got a swimming pool, and it feels good to get in there and exercise, 'cause I recommend that to my patients, but the problem is it's very few people that have that option.
– Right, and I think that's part- They take into account everything. – Sure. – They take into account the convenience of it, the cost of it. So they'll recommend things that are a lot easier to do.
– Right. – You're more likely to do. – Sure, that makes sense. – So right. – Then I concur. – Alright, well we welcome all your comments. And sorry for the little pause there I had (laughs). Thanks for watching.
– Enjoy.