Bob and Brad the two most famous physical therapists on the internet
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 Bob
Today we have for you three core exercises for back pain
You must know this if you have back pain because this can help take it away, right
Right, Bob
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It's Bob and Brad. There you go. Thank you
Bob you know, I've been doing a little research just to see what is out there
for core exercises for back pain and I think
as therapists we're think a little different than trainers and
people who are really good at getting stronger, a lot of times when people say core exercises
they think core strengthening but you can actually stretch the core too and you want to stretch it in the right manner
So as to take away the pain, so we're going to show you stretches and strengthening for the core
So one key thing is anytime you do an exercise
for the back if it creates pain makes things worse, there's a red flag. Stop doing it.
Don't think if I get my core strong enough to work through the pain that it's going to get better
It's not going to happen you need to do what we call directional preference exercise.
In other words the direction that you're moving your back should make it feel better with repetition, oftentimes right away
and that may vary a little bit. So we're going to walk you through this. So there's three directions
we're going to be looking at. So the first one is basically
trunk flexion and you can do this laying down. I'm not going to have you do it standing up.
And the way to do it laying down is you actually
in order to get my back to flex
I'm gonna actually, you can start off with bringing just one knee to chest
Eventually you're gonna have to bring both knees to chest and you're gonna do it repeated
So I'm gonna do it the first time it's like no it hurts a little bit
But as I keep doing it, it actually feels better
then that's the stretch you're going to do, now if you have like sciatica
This is probably going to make it worse more than likely, herniated disc or a bulging disc and
what you're going to be looking for is the pain down the leg actually gets worse when you're doing this, then you would not do this one
This is the one you would not prefer. Anything that makes the back pain and when we say back pain
we're talking low back pain here
not up by the neck
If you know your diagnosis if you have stenosis or spondylolisthesis or arthritis
This one often will help. This one actually is going to feel better
And this is the exercise you'd be doing, you can do pressure on, pressure off, pressure on
pressure off again. You might start with one knee right, and I'm going to suggest, go ahead and do it again Bob
but if this does feel good you're gonna let go the knees and with good control let your feet all the way down
Both feet all the way down, there you go, to the start position
What am I doing Brad? There you go. Now go ahead and do full, do the exercise
There you go and let them go down to the start position. That way you're getting some strength to go along with it.
Yeah, I wouldn't go all the way out like this.
That's where it was throwing me off, so you can start
yeah, you're very correct Brad in saying this because this doesn't take that much strength to do so
but it's very good for the core so you can strengthen it at the same time
So let me go to the other one Brad
This is one that generally most people can do and it is good for them is doing trunk rotation
So and you know, I'm going to go in both directions and rarely do I find someone that can't do these
I don't know if I have found one that can't do these and
sometimes they have to start in a real limited range, yeah just back and forth a little bit and then they can work
their way out further and sometimes they find out that they hurt in one direction
but they don't hurt the other direction
so we just have them do that direction and I just had a lady yesterday
she hurt going to the left, but she can go to the right. Sure
and so I said just work on going to the right then, I said eventually we can try to get to the left but right now
I'll just stick with that and along with this
It's not an intense exercise, but there are core muscles that are exercising to do this
So we're working in the pain free range of the directional preference and we're getting some, yeah you're getting some obliques to some extent
Now the one that you know, I would say is gonna help like 80 percent of people with back pain is actually back extension
So you're gonna start off with and again
If you're getting pain down your leg you want to make sure this is actually feeling better, that the leg pain is actually better
Yeah, we're going to start off with
you maybe just laying here for a bit and let your back settle in and then you might even get up on your elbows
And see how that feels, does that feel better
Does that feel worse, does that feel tight, you know
And then eventually you're gonna work up to hands underneath the shoulders and you're going to start doing press ups
And you want to make sure the pelvis is not coming off the bed with this we're going to get into some strengthening exercises
So these are progressional exercises, we're showing the first set of exercises which is you know
basically the stretching and the stretching you want to find out which one of the three that you want to do
You might be able to do the rotation and these or the rotation and the flexion but
most people aren't doing both flexion and extension
Yeah, in other words this and the one we're bringing the knees to the chest, those don't mix together
Sometimes they do but usually not. And you can do these quite often you can do these five times a day if you want.
A set of ten and maybe even a few more so
once you've found the direction of preference that feels good in your back, whether it's
extending backwards or bringing your knees to the chest and that's feeling pretty good
Then we go to some more core strengthening step it up a notch. Which pole do you want? The red one.
So if it happens that bringing your knees to your chest continually feels good and that's getting too easy
and you want to work more core
I like to use the ball and I'm going to go like this because it supports the back and hands here and simply
do exercises like this and I'll do you know, 15 20 of these and this is good for people with spondee and stenosis
It wouldn't be good for herniated discs probably. The big thing is is if you haven't gone to the doctor
You have no idea what your diagnosis is, you're going to do what makes your back feel better and that's the bottom line
Okay, now if you want to strengthen your back and you're doing the press ups and we want to work through those extensor muscles
You can lay like this and then we're going to work
This is working the core but instead of the stomach we're working the back side
Which is just as much as your core or stomach and I think some people think core
they think stomach all the time, but it's not, we do want to work this as well and
How high you go up, you can put your hands here and help with your hands and as you get stronger
you can take your hands off go across like this.
And now the back is working a lot harder, right and where you position yourself
on the ball is a really nice feature of the ball because you can make it harder if you're doing them here versus here
You're not working the muscles as much, which is a good place to start and you progress going forward
The other thing to get if you work in that rotation, here we can work
opposite elbow to opposite knee or right elbow to left knee left elbow to right knee
and then we're getting some obliques and some of that rotational component
That's gonna tend to be the person who likes flexion
That's the one that's probably going to like that one, right exactly now
If you're afraid of getting on the ball, yeah you aren't ready to get on the ball or you know
If you don't have any pain and you like planks because you don't want to you know
I think that you need that
Core strengthening, right core strengthening without movement, which I'm perfectly comfortable with, are going to show you two options for planks.
Simply you can just start here and hold it for 30 seconds to a minute, whatever you can do to get that core exercise
the way to your tolerance, you know, if you want to do side ones like this now
I personally cannot do planks very well. I've tried them. They hurt my back. I got spondylolisthesis
So I never do them this direction because I know the next two or three days I get a very sore back
So I go to the vertical plank, which I tolerate much better
And by that, I mean you do have to have some resistance bands connected to the wall or using our wall anchors I used
and right now I'm going to tighten my stomach and I'm going to hold it like here
And right now my stomach is working this hard
It probably is when I'm doing the push-up plank where I'm holding it like here and then you can get movement with this as well
And I like doing that also
If you want to work some of the rotational component, you can put it to one hand and work here
but still maintain that straight core plank, so you get a double benefit here. You get some arm strengthening some chest strengthening
Plus you're getting the core strength, right exactly. And you know, you're working your balance as well because you're upright
You can do these actually on one foot and then you're working balance and core
People are often very surprised a lot of times how much it works your balance, right
This if you have it done, you'll say alright that wasn't too hard
But once you do it, my ankle's working quite a bit and then you're doubling up things, you're getting core
strength balance and you know making a whole exercise routine real functional
I'm getting tired Bob. Good job Brad! I appreciate everything you do.
Thanks for watching.