Hi folks I'm Bob Schrupp physical therapist, Brad Heineck physical therapist
Together we could not speak a word of english
Together we are the most famous physical therapists on the internet in our opinion of course Bob. Today Brad we're gonna talk about the best exercises for
lumbar stenosis, back and leg pain relief
You actually just went to a continuing education course on this. Yes, I got brushed up on a few things and it's
Helped me out. It's gonna fine-tune some of the exercises that we've been doing with it
So this is good information and up-to-date, if you are new to our channel by the way
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lumbar stenosis
What is it and why do you not really want to have it? So let's go up and let's take Leopold
Can I just say Brad it's kind of a natural
Form of aging isn't it. It is
As a matter of fact the studies show that
If you're 70 years or older 80 percent of the people have some degree of stenosis
It's kind of like getting gray hair
Yeah, it's just gonna happen, right so if you hear the term you go to the doctor, and they look at your xrays
Oh, yeah, some lumbar stenosis. You don't have to get all worried that it's gonna take your life over,
It's just something you have to have
You know it's part of growing old and the good news is we got some exercises that can help you
So let's look at the lumbar spine, Bob it's you know the bottom five spine
So it's really one two three four five rounds that stack up to make your low back right about at that belt line
Right a little bit below and a few above okay
Once in awhile some people have six lumbar. Yeah, I have a friend that has six. Oh really Wow
Well what's funny is that we used to call them long back
Before we knew it, that's what's funny about it
Is that he had a longer torso, but anyways we better get on this subject Bob
We're looking at those spines now. What happens is as you age the
Vertebra or the discs actually start to get smaller and smaller yeah, these are the discs right here
I don't know can you see that Lonnie?
That's a cushion that is between the two balls right and with the aging process
They become smaller and smaller and what happens is the bone part, the vertebra they get closer together closer together
And then the spinal nerves which exit right where this pin is they can be
The hole where they come out, the foramen, can get smaller and get pinched and that creates pain and problems not only in the back
But down the leg, now the other problem with stenosis it can be out the foraminal stenosis
Or it can be what we call central stenosis
Which if I pulled one of these vertebraes out it looks just like this and where the spinal cord
Goes right where this pin is
That's the central canal that can also become
Decreased in size and cause some pinching and stenosis and problems
and then
Typically a lot of times you have pain or symptoms down both legs because a lot of times it may be
Some numbness tingling or just fatigue if you get up
And you walk and after you walk a block or two your legs just start feeling weak and tired
That can be from stenosis, and quite often
I think it is the central stenosis in a lot of my patients
But we gotta point out Brad, it might be up a little higher because you know we got the kinda horse's tail
down here remember, right the cauda equina
A lot of our people catch that
So they're pretty bright
Yeah, so we got to know that the pressure may be happening up a little bit higher up on that central stenosis
All right well, let's get the old Leopold or whatever his name is
Napoleon
Bonaparte we actually took one of his bones apart, though, okay, so one thing about
Stenosis, we mentioned some symptoms
also people that have stenosis tend to lean forward a little bit more cuz it's more comfortable and
Typically if they're painful when they stand when they sit the pain goes away quite rapidly yeah
That's usually a great sign of it
And they call it shopping cart syndrome too Brad, if you lean over and you feel better on a shopping cart
That's usually quite often a sign
And it feels better when you sit down and it hurts more when you walk and hurts more as you walk further
And you're older
That's the first thing I'm thinking isspinal stenosis right it's just so prevalent
I mean I see so many people with it the part with this course where the instructor emphasized the legs feel
Fatigued because you know some people are you thinking well
Maybe it's because there's not enough blood flow which is another possibility or strength, endurance
and that all is a possibility
But quite ofte I see it is just merely the the pain is causing them to stop or fatigue is causing them to stop
So how do we correct it?
What happens is our lumbar spine starts to oftentimes with these people gets
Arched, we get too much of an arch and that causes the pinching in the back, because of the way the bones are
collapsing on themselves and somewhat because of the discs, the facet joints get pushed into each other and
When we get that arch in there we want to go the opposite direction and flex the lumbar spine
Okay, but that's why this is what's going on with people when they do this. They're flexing from the top down okay?
We want to flex from the bottom up, so that's where these exercises are gonna really help you out
Let's start Brad. Very good so the first one is very simple. This is the neatest one because it is simple
We do have everybody doing this one oh, yeah
Take a nap. Nope just kidding, and right away when you get up into bed if you get up into bed and you have stenosis
If you can do both knees and pull them to your chest, and you don't have to pull hard
You don't have to hold it for 30 seconds, but if you just give it a nice gentle pull hold pressure on and then back
Bob are ya leaving?
I was just gonna say as a sleeper
You might be more comfortable with one of these too by the way the leg wedge which we have
Touted quite often, it's in our products below in our Amazon section, particularly if you have a day where you're standing
Or you're walking a lot
And you irritate it a lot
You want to get some relief this would be a great way to help you out, so double knees to chest
with a stretch
That's a good way to do it now the other thing we want to do is strengthen the abdominals Bob because that's gonna help
posterior tilt the pelvis, which flexes the spine which decreases the pain and symptoms
So we're gonna do double knee to chest, but first thing we're gonna do is tighten up
The abdomen muscle push down if you put your hand back there
You're gonna squish the hand or squish into the bed or the table and then bring the knees up
Maintaining that back flat into the bed or the floor and do this abdominal strengthen exercise
But it's really important that you're squished down flat and also if you're just really quite weak
You might start with one leg like this
And work your way up to the two legs, again I don't want to see increased pain when you're doing the double leg
Yep, good point these should not create pain
They should feel comfortable and just work the muscles so
Flatten that back, push it up against the bit of the mat or the bed or
I guess you need probably to be doing this on the floor
Carpeted floor is best, if you can't get down on the floor cuz it's not safe
You might fall, then you're gonna do them on your bed, the other thing is glutes
Strengthen those glute muscles up and actually this one
You're just gonna squeeze your butt together and at the same time you can push your lumbar spine
tighten your muscles and get both at one time so
Push down here and squeeze my butt together and relax, real simple one to start off with and I do have stenosis and I can
Tell you right now. This feels good. I got spondylolisthesis, which stenosis
Oftentimes comes along with that
So these exercises were right up my alley
Okay, so that's another one and the other one
We got the mike problem here.
Let's do the straight leg raise that's right,
The neural stretching Bob. I feel confused Bob. Oh, you're doing all right Brad.
It's between Christmas and New Year's
This leg's gonna come up, watch your glasses there. Oh, yeah
This is the neural stretch Bob,
So sometimes that nerve where it goes through that foramen we talked about can get bound up
Get scar tissue, so what you're doing here is you're kind of almost doing a glide, right?
A nerve glide, exactly it helps loosen up that scar tissue over time, you don't want to again
You can maybe feel a little bit of pain with this, bump into the pain, but don't be making pain
So they are probably wondering how to do it
Yeah
So we're gonna take the leg it's gonna be straight
Now the key right here is you're gonna bring it up till you feel a little bit of a pull
And then you pull your toes towards your nose
And that's gonna give you more of a stretch here, now if you do this
And you feel it up in your back, then it's a real good sign that you have some nerve, some tightness
Some scar tissue, right break it up
So you're just gonna do ankle pumps
And you're gonna feel that pull and you can do 10 to 15 of those and as you get more loosened up
You can bring your leg up a little bit higher, and you're also gonna strengthen your quads and your hip with this
A little core with that too right so again
To repeat Brad, you take it up until you feel a little bit of stretch, and then you start doing the ankle pump
and after a while you might be able to go up a little bit higher because you might have to
Stretch that out a little bit, you're probably gonna hold your leg cuz it's a little easier to do it that way
Really good exercise to start off with that
This is a great one to do, so you need a six inch towel roll? Well the next one
I'm gonna do Bob, I'm gonna come to that one in just a second, laying on your side
We want to stretch the hip flexors because when the hip flexors get tight they make that anterior tilt on the pelvis
Which can cause the problem we're working on, so laying on your side this knee's gonna be up like this okay?
That's not the one we're stretching, we're stretching this one, now if you're flexible enough
And you have enough freedom to grab your ankle and we're gonna pull this like that
Are you looking for something so they can see better Bob? I was gonna say, he's doing this.
Yeah, except for laying down and actually you can do it standing
Just like Bob said, but a lot of people who have this are older
And that would not be easy to do, well I mean you can use this stretch out strap on here too Brad.
Which again we have listed below
This comes in real handy sometimes for these types of things yeah
instead of reaching for my foot I can just go over my shoulder and I'm gonna grab here and
Stretch, and I want to bring my knee
Back away from this knee so it's trying to get behind me so to speak
I'm gonna bring the strap behind here. He's trying to get his knee past back beyond the hip here
If we had a camera straight out of the ceiling, we're gonna have that someday Bob. That's right. It'll be our advancement
Okay, and finally and most
importantly
is
If you have a towel roll, or if you happen to have a six-inch
Padded roll like we have here
We do have a tall roller if you don't have one of these this works best, but this works
okay, just take you really got to roll it up pretty tight, we got table seats
Rolled up there
And you should get the low-density one because they're a little more comfortable
And as you're laying in there
You could do this on the bed
But it's gonna sink in and it will work
Again carpeted floor works the best, now you're not gonna put this up under your back above the belt
This is gonna go below the belt line
and on the sacrum and actually closer to the tailbone and then you're going to bring one knee up and
You can feel that right now. It's already putting my spine into a flexion my lumbar spine into flexion
And I'm just gonna gently pull here and get a stretch, only one knee you're not gonna do both knees with this one
One knee at a time
exactly
Precisely Bob. Brad this is one I haven't seen before
This is a new one for me too, and I could tell you this feels really good
I can see how this works. Yeah, there's a lot of leverage going on that and the nice thing. It's all gravity
I can't wait to try this with one of my patients
It's fun, Wow, so yeah, we learn something new all the time, hard to believe you actually taught me something,
Well the thing this is just a bonus if we had time a lot of times people get rounded over
With the posture because they're trying to make their back feel better so once we get this here
We also want to get their posture back up, so then we're gonna do this stretch here, or you can do the stretch here
So that's a bonus
Yep, and you can do that up against the wall
Which would be good, flatten your back out up against the wall and then go for your walk,
We went way over time there Brad so oh Bob again,
Alright, thanks for watching