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Good morning guys. Tony Maritado here, licensed physical therapist and I'm in the clinic today talking about
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low back pain or hip pain associated with total knee replacement. So it's really common that after you have your knee replaced
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the structure of the leg, the hip, the ankle, the knee is in a completely different position than it had been 10, 15, 20 years prior to the knee replacement
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So it's not unusual that you're going to develop some hip pain, whether we're going to talk in the IT band, the greater troke or hip birth
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or even pain at the gluteus medias, you know, this muscle right here, right above the back pocket
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that's the gluteus medias area. All of those areas become sensitive. One, you're more active than you were doing physical therapy, doing your exercises
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Two, the alignment of the whole lower extremity is completely different and your body has to adapt to that
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So one of my favorite self-massage strategies for all of that soft tissue, all of the muscle
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soreness, the fascia, the connective tissue, is to simply do a self-massive
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using a basketball, a soccer ball. Yes, you can go down into the size of a tennis ball or a
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lacrosse ball, but what I find is that some of those start to become two-point specific
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and if that area is too sensitive, it just hurts too much and patients don't want to do it
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So it's nice to start with kind of a big broad surface like a basketball, and all I'm going to do
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is I'm going to put it behind my body between the wall and the back of my hip
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Now, if you have a condition like lumbar stenosis or if you have a history of low back pain
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this is a great solution for that as well. But basically what I'm doing is I've got it kind of right on my belt line to start
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I'm going to roll side to side. I'm going to do the involved side and the uninvolved side just to get a sense for what everything feels like
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I can go horizontal up and down or sorry, horizontal side to side
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I can go up and down Then I move it more toward that gluteous medius area and if you want to look up that term you see a picture of the muscle But now I working more kind of right over the top of the back pocket
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If somebody's experiencing some sciatic-like symptoms or a pyriformis syndrome, you can go even lower
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So I'm right on or below the back pocket. I'm just applying a gentle pressure
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The other nice thing about an exercise like this is it gets you moving
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So if you think of my hip, my knee, my ankle, everything is moving kind of rotationally
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If I go up and down, I'm getting like a mini squat, so I'm activating some of the musculature
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that was involved in the surgery. If I have pain in the hip burso, which is a really common place, sometimes it's before surgery
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you have burstitis that persists after. Getting the ball on the side of the hip is a great way to do it
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So I'm working side to side. sensitivity and discomfort in this area is pretty normal. You don't have to push to the point
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of pain, but the point of discomfort is a reasonable expectation. As I roll down, I can start
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to attack the IT band a little bit. All I'm doing is desensitizing the area. I'm not applying
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even probably 10 to 15 pounds of pressure through the ball, so I'm not really doing
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anything to affect the tissue on a mechanical level. But, but I'm not really doing anything, but
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But I'm stimulating some of the touch receptors, the nerve endings. There's something called a gate theory where if I bump my elbow, first thing I do is I rub it
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because the rubbing sensation kind of confuses the information that would have been perceived
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as pain. So you can really work any of the areas. I've got other videos showing you how to do similar with the rolling pin
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This is just another way to do it. And usually people will have a basketball, a soccer ball, a volleyball, somewhere around the house
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If you do, this is a great opportunity to get it out and just kind of do a little self-massage
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I'll catch you on the next video
