♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet. - In our opinion, of course,
- And we're serious about that.
Today, we're gonna talk about sacroiliac, low back,
and pelvic girdle pain.
We got four expert exercises to fix at home.
- That's right.
We've got an expert,
Dr. Debra Rizzo. - Rizzo.
- She's written a couple of books on this,
excellent information,
particularly for the lay person to self-treat at home.
- We also had her on our podcast
and we also had her on our channel and interviewed with her.
And we talked about a lot of these books
and she's an excellent therapist with regard to this area.
- Right, let's carry on.
- Yeah, by the way, if you're new to our channel,
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- Right here we got a section.
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go to the giveaway section, or you go to Facebook.
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Go to Twitter, Instagram, or TikTok
if you want a 60-second version of our program and yeah.
Check out our podcast.
And we see the interview
and hear the interview with Debra on there.
- Yeah, you can do it while you're driving.
- So you have 700 tiny mattresses, air channels.
It's cool.
It's the most comfortable mattress I've ever tried
that on a dog.
- You just tried it, huh?
- No, I've used it.
- Every night, right?
- Yeah.
- Okay. So here we go.
This is Dr. W like you said, the podcast
you just interviewed her last week or
- Two weeks ago, I think...
- Two weeks ago.
And she's very nice. Isn't she?
- Yeah.
- And her and her daughters is the model in this book
- Yeah model, she is a professional model.
- So they've got some nice photographs,
really good instructions of the exercises.
We're gonna go through the primary four exercises.
I'm gonna demonstrate.
And I believe I've got a SI problem
sacroiliac problem right now that's helping me treat.
- Let's just say, Brad, this is for women and men.
- Right
- This is this is...
- The sacroiliac one is for women and men.
- This one's more for women.
- But the exercises happened to be
- The same
- The same but you may, depending on your symptoms
you may do the exercises in a different series.
- There's other ones she has
in this one, additional extra stuff.
- So if you're a woman and you have problems like postpartum
or even pre this is an excellent book for that.
- It really, it really it's written for the lay person.
So you can follow along easily.
And the, these are fairly inexpensive.
So they're below the video links.
So what should we talk about Bob?
We should show where the SI joint, the sacroiliac
so it's clear because that is it's, you know
it's a big word there
and it's kind of confusing for, for..
It was for me until, you know
I looked at Sam, the skeleton
we got the sacrum is where the sacral comes from,
the ileum which is this bone part of the pelvis.
So sacroiliac joint. - And there's two of them
- Two of them, one here, and one here.
It's not a joint that moves like an elbow joint.
It's actually has very little motion.
- Some say there's hardly any motion
because there's really tough ligaments holding it together.
- Yup. And the musculature around here
some of the exercises are to help support it.
So we got that.
And this is one of those things
where the pain source, we got low back,
it can be hard to diagnose as a pain from the SI joint.
Is it from the low back?
Is it from the pelvic girdle or the pelvic floor?
The muscles that are right in here between the ischials
which are part of the, the pelvis.
So these exercises are going to address all this.
So she's got a lot of years of experience
and she's really got a good system.
- So one, one thing they call is Fortin's Sign
where if you take, and you can find a spot on your low back
and you point like right here, and that's where it hurts.
If you come right back to that spot again, that's positive.
That means that you possibly do have an SI problem
that it's just really localized and really one area.
Now with hers, I'm not going to get too detailed on her
self-assessment because it would be too long
of a video I'm afraid, but it is in here.
She talks about the SI joint or the ASIS
which is this bone...
- This bone right here.
So what basically, she said, there's a lot of muscles
and ligaments that tie into this tendons or ligaments.
And if these muscles are tight on this side
that's going to make that bone tender.
So you find that bone on you and see if it's tender
you're going to then go
to the back and see if the bone back here
which is the PSIS is tender
- Right where I'm touching here.
- And you all can reach down to the pubic area here.
Yup. And see if that's tender.
Now, if it's tender just one side and not the other side
you're going to start with this first exercise.
If it's not tender, if it's tender on both sides
then you can start with the second exercise.
- Skip the first one?
- You can skip the first one.
We're going to do just the..
We'll show you in case you are tender on just one side,
you should do this first exercise
to try to help rebalance things out.
- And my situation right now
I was reading this and I thought, Oh, you know
I don't have any point tenderness,
a little bit back here,
but I think I read in there that
if you have pain in this area without much point tenderness
go ahead with the first exercise.
And actually it feels good when I do it.
So that's a good sign.
- You're gonna get on the floor.
- You know, we, you couldn't,
you're not supposed to do these on a bed.
- You're supposed to do a hard surface.
- I could do it up there,
but I thought because we want to be more realistic.
So you're going to lie flat.
I said, lie, there you go.
Lie flat on your back.
Now you're going to always start,
and I thought this was interesting,
with the right leg down.
- Exactly. We talked about that.
She just said that they found that's the one that works.
- Yep. And actually for, for me
it's my right side is where I have the pain
which she mentions there.
Now this leg comes up to here with your knee bent.
You're going to take this hand and push
and I'm going to push my knee towards my shoulder.
I'm going to do an isometric with my hand there.
And then at the same time, I'm going to lift my pelvis
or my pelea my girdle, pelvic girdle
straight up off the floor
so I can put my hand under there while I push.
So I'm going to inhale
and exhale and lift and hold.
As I exhale, you're squeezing that butt muscle and relaxed.
Now, if this creates any sharp pain,
you don't want to do it.
And on me, it feels good.
It makes that area feel better.
So I'm going to do it again.
Now she recommends, I believe 10 to 15 repetitions.
And if you have not, if you're a person that's sedentary
you're going to be tired
by the time you get done with 10, for sure.
Cause I get tired or not fatigued, but you know
I can feel it at 10.
- You're working.
- So you're going to do that 10 to 15 times
and then you're going to relax.
Again, make sure you breathe in, exhale
while you're doing the isometric
and lifting the pelvis off the floor.
Okay.
- Well done, Brad. - Should we go to number two?
- Sure. Number two,
now this is the one that you all are going to be doing
if you have an SI problem
and you're squeezing the knee together, right Brad?
That's a good way to do it.
- So you know Bob,
while I'm doing this, there's a ball up there,
a red ball and a red loop if you want to get that.
But you're going to bring your legs like this,
your feet together, heels together,
point your heels out, bring your knees out.
And then what you're going to do is go
point, as you have watched my toes
they point together as my knees come together.
I'm going to hold that
and go back and forth like this.
Now, if you can do this easily
and it's not painful and you can, she's recommend, you know
10 to up to 30 repetitions.
And if you can do 30, which I can, it's, it's easy.
I don't have any pain.
Then she recommends there's two advanced options.
What I like to do as one of them, I, and I just say
this one is my number two.
I think she added that one as number two.
So I hope she doesn't get mad
at me for changing the order, but just lift your hips up.
And that changes the effort.
- I've seen other therapists Brad.
They actually, someone put their hands between the knees.
Yeah, or a fist.
And they, you might even feel a click when that happens,
kind of resetting the pelvis.
- But not with this exercise.
- Well, very close to what she's doing.
I, and they do it in that same order.
They do the first one kind of similar.
And then they do this one next.
So it's, it's interesting.
They're all, they're all trying to accomplish something
but they're all thinking it's doing different things.
They all work.
They're just, they're doing different things in their heads.
- Now, she recommended putting a pillow between the knees.
I'm going to use a ball that's squishy
and then using a loop strap.
And this would be the same exercise
just a little more advanced.
- So now it's working both ways.
You're going to get resistance as you squeeze.
- And then I like the ball in there.
She has a pillow, I don't think she'll mind.
- I think the pillow, the ball had worked better
to be honest with you.
- You can do it with your pelvis on the ground.
Then you're going to go apart.
Squeezable, go together apart.
If you do it with your hips up
it makes it quite a bit harder.
And again, this was right as I started doing them,
And I get fatigued.
It's definitely a good workout.
I'm not going to do 30 while we're doing it on the video.
- And we wouldn't recommend you do 30 the first time either.
You wanna start off with a lower number.
- The only reason you would, if everything feels good
it's not creating any pain, then you can.
Maybe you were active before the injury or whatever.
Okay. Now the next one,
I really like this one cause it feels good.
Now she's recommending a chair without arms.
We don't have a good chair here without arms.
I have to do it with a cushion on the chair.
Because if I scoot forward past the arms
if these arms came way forward, it would not work.
But these are back far enough
where I can get what's called a figure four position.
And so you end up like this with..
- Which painful side?
- That's a good point.
I'm doing this wrong.
My right side is the painful side.
So I should start with the left leg up.
Bob. You're going to do it there.
Good.
And I'm going to rotate to whichever knee is up.
So over here and rotate and hold.
- Can you put the hand in the back like that?
- And give it a little extra pressure.
You should, you know, if it feels like a good stretch
you can go a little harder.
- Really good posture on this.
I don't want you to bend down like this and turning.
Really good posture.
- On all these, think about your breathing as you hold
and this is a ten second hold.
So it's going to be a little bit longer and then relax.
You want to do it three times on one side
as long as it's not painful,
then the painful side is the second or the last side.
I want to do this just 'cause really
I want to balance out...
- It feels better.
- Yeah, it does.
And I'm going to stretch here and hold.
And again, 10 seconds, three repetitions.
I don't, I'm not going to do all three for the video.
People will get...
Wow.
- All right, we're still going, Brad...
- The last one is a easy one.
It's harder than it looks
but she wants you to lay supine like this.
- You were doing so well, lie.
Lie. Oh my goodness.
Sorry. Who's our English major?
- Karen.
- Karen, sorry Karen.
She recommends put one hand on your belly, one hand up here
and what we're going to do,
and the verbal cue that really sticks with me,
she says, pull in, like
you're trying to get a tight pair of jeans and zip bumps.
You gotta pull in everything in there.
And that tightens up the pelvic floor.
It tightens up the stomach and you exhale.
So the first thing you do is she says, breathe in
open up the rib cage, like a umbrella and then exhale.
And as you exhale, tighten everything up and then relax.
And this is a 10 times thing.
And get the rib cage, your rib cage to open, exhale
feel the stomach muscles tighten in and go down
- Get those jeans on Brad.
- Zip that zipper up and do that 10 times.
And that's good for that core, that pelvic floor.
And that's it.
- Yeah, that's it.
And she's got some additional stretches that you
can do later on as kind of a maintenance program.
And also, and it really
she does a really good job explaining the book
so if you're having SI problems
I'd recommend putting out the few bucks for it.
- Like did I mention Stacy was having the problems,
she's going to get these books.
She's anxious to read them and you know...
- Give them a try.
- It can save yourself...
- So did you wear skinny jeans?
- What do you mean skinny jeans?
No bell bottoms!
I like bell bottoms.
- Yeah, so did I.
- No, I didn't wear those tight jeans Bobby.
- All right, I was just wondering.
- Plain pocket from JC Pennys.
- Mom jeans are coming back aren't they?
- Who, Bob?
- I heard high-waisted jeans are coming back.
- Really?
- Yeah, been back.
- I actually now, I've seen,
my wife says nowadays anything goes.
I saw a women with bell bottoms.
I saw someone with tight legged jeans all the way down.
I don't know if I had the zipper on there
but pretty much anything goes.
- But everything comes back so fast now at 20 years things.
- Well that's because of the internet, Bob.
We got social media.
It accelerates...
- I'm glad you explained that. - People are done watching it.
- All right, thanks for watching.