(upbeat jazz music)
- I'm Bob Schrupp, physical therapist.
- And I'm Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion.
All right, so working Joany, here,
looking you you're not having... What's wrong?
- [Joany] Chair's in the way.
- Oh, well, we're gonna be using the chair,
(chair scraping) - so it's gonna be in the way.
- [Joany] Oh, all right.
- We wanna see it.
- So we got a lot of our toys here today.
What are we gonna talk about today, Bob?
- Well first, before, I wanna remind you,
if you haven't subscribed already,
you wanna subscribe to us on YouTube
because we're gonna be talking about,
for those of you who are 40, 50, and older,
we're gonna be talking about
fitness and health well into your older years.
So, you wanna make sure you subscribe to us.
- Absolutely, we're gonna have a lot of
good information- - We're the experts!
We're experts. We work with the elderly, we are elderly.
- (chuckles) You are.
- Okay. We're gonna talk about today is,
what I would call mid-back pain.
Not low-back pain, mid-back pain.
Why don't you turn around Brad? We're gonna talk about...
That's what we call the thoracic area.
First seven vertebrae are called your cervical,
or your neck, vertebrae.
The last five are your lumbar.
The 12 in between are your thoracic.
So we're talking about from here to here.
If you're having pain, that's the kind of pain
we're gonna talk about trying to get rid of today.
- Right?
- And it's tough,
because those vertebrae are attached to ribs.
- Yep, they-
- and they don't move that well,
and a lot of people have trouble with this.
It's a tough one to-
- Sure. A lot of therapists have problems with it.
- Quite often, what we find when you have pain
in that area, is that you're having trouble with turns.
- Right.
- That's one of the things we're gonna look at
and we'll find quite often is that,
well I can turn this way well,
but I can't turn this way well, or vice versa.
- Sure.
So, one of the things you wanna try
is maybe try to restore those turns.
- Sure. - That turning.
And should we do the laying down one first?
- Yeah, and and I think I'm gonna take one step back...
- Okay.
- There's general posture, you know?
- Oh, absolutely.
- I think, Bob, that's something
that we think of so commonly we overlook it,
but we gotta talk about it.
You know, if you're slumping, well you gotta change that.
- No, that's probably how it was caused.
- Right? Exactly.
- In fact, it probably was caused
by you slumping and turning.
- Yeah.
- Those vertebrae are all kinda locked into place,
and when you get in this position
they can actually turn and go outta place
and give you troubles and facet problems.
- Yeah.
- So yeah, this is key.
You've gotta-
- Get up, shoulders back-
- Yeah, posture's number one.
- You're in the army now type of thing.
- So, all right, why don't we show the rotationals first.
Brad, do you wanna do that or should I slip my shoes off?
Yeah, I can do it.
- Yeah, yeah, I did that last time.
- And we still smell it.
(Brad chuckling)
Okay, so, believe it or not,
if you want to turn your back,
one way to do it is actually you lay flat,
you bring your knees up,
and when I turn my leg this way
I'm actually rotating my back to the right.
So this is just a gentle way
of restoring rotation to your back.
Now, if you want to get the mid-back
you gotta bring your legs up fairly high.
- Yeah, get 'em up.
- If I'm down like this,
I'm just really getting more of the low back.
- Right.
- So you gotta get 'em up pretty high.
And again, just start gently going back and forth,
and then if it feels all right,
you can bring the leg over like this.
A real advanced move would be to go like that.
- Right.
- As you can see, I'm actually holding onto the mat here,
or to your bed if that's where you're doing this on.
And then you can work the other direction and...
- Right.
- stretch it that way, too.
- One point I wanna make,
if you're not gonna go to that advanced level
and you're going over like this,
think about keeping this your shoulders
down on the floor or the table, wherever you're at.
And this hip actually comes up and over.
That's where you get that twist in the back that's stretch.
So you should feel it here. This comes off. This stays down.
- Exactly. So that's one way of, of getting rotation.
Another way would be,
you wanna grab one of the canes, Brad-
- Sure.
- And show how you could do that
with a cane in a seated position.
- All right. You gonna do it or...
- No, you go ahead.
- Okay, this is what I like to do with people
to get some rotation movement in that mid-back.
First of all, you need to be seated.
Seated with good posture, naturally.
And then you take a dowel stick, a piece of PVC pipe,
a cane, whatever it is,
and you're gonna put it over your shoulders like this
and hold it here.
Okay? Sitting down locks your pelvis in place,
so that is not moving.
Holding your arms back here, keeps your shoulders stable.
And then you'll rotate back and forth like this.
Okay?
If you go this direction, you get a sharp pain,
and you go this direction and it feels okay,
I want you to work this direction 5-10 times,
and then go back this way
and see if you've gained range as a result of it.
Sometimes, you can work through that pain form
but if it gets worse as you do it more,
it's not the thing to work into, okay?
So that's one way to work rotation with the back.
Anything add on that, Bob?
- [Bob] No, but that's a very good point.
We actually work it into the range you have already.
- Right.
You know, if it feels really good going this way,
work it that way.
And it is amazing how it seems to also work...
- Right.
You know, help increase the range another way.
This is a Thera Cane.
I think the Pressure Positive Company
also makes devices like this,
but it's got a little knob on the end.
And this is a great way, also,
that you can do turns with this.
Get into your good posture
and you can actually find some of the tender spots
on your back and push into the back.
While you're doing this, put a little pressure on it
and then do a couple turns like this.
- Bob, why don't you turn around
so they can see your back side?
- Sure.
- So they can see where you're using that.
- Sometimes they call, what's the other name,
the Backnobber or something?
- [Bob] Yeah,
there's a whole bunch of different names for it.
- Yeah, okay.
- [Bob] This one is the Thera Cane, though.
- You're not gonna go right on your spine, on those bones.
That's gonna be uncomfortable.
You're gonna get into the muscle part.
- [Bob] Exactly, and a lot of people have that trouble
between the shoulder blades.
- Yep.
- So I'm pushing right on the spot here
and here I turn with it.
And it just seems that combination really helps
work some of this stuff out at times.
- Yep, the combination of moving with the pressure on it.
It's something that usually are gonna get that information
from a therapist. It's not usually in the literature.
- And again, yeah, stay off the bones with this.
This would not be comfortable...
- Yeah, you keep it on the muscle.
- All right.
Another one that we do, you're gonna love this one.
All right, because quite often what you find out,
the problem with the mid-back is 'cause
you were having posture like this.
What we often find is by doing the opposite of that,
moving the back in the opposite direction,
actually helps cure the pain.
So this is flexion.
We're actually gonna take the back into extension.
- Yep.
- And so what we do is what we call the Hallelujah Stretch.
You know, you're in church, hallelujah.
So you're bringing your arms back-
- Do that again, Bob.
- Hallelujah. You know?
Now some people can just go put their hands back here
and go back like this.
But what's key with this is
you need a chair that hits you about in the mid back.
- Right.
- If it's too high, it's not gonna work.
You're just gonna be going like this on the neck.
And if it's too low, it's not gonna hit you on the right...
You can need a fulcrum, basically.
- Yeah, I find
those lower computer chairs actually swivel back.
They're a little more comfortable.
They're a little padded.
If it's too hard of a surface here
it's a little uncomfortable sometimes.
- Yeah, you gotta go by with tolerances.
If this makes things worse,
if any of these things make it worse,
you can't do it.
- It should feel good.
- It should feel good, or at least somewhat good,
like you're heading in the right direction.
Now, you can do the Hallelujah Stretch.
The other thing I do,
and I got a fair amount of flexibility,
is I'll do it throughout the day,
and I don't know if you can pick this up Joany,
'cause I'm tall,
but I actually take my fists,
put 'em way up here like this,
and I just lean back.
There, my back just cracked.
- Yep, I do the same thing.
- I do this one all the time.
It's just a great one
and it prevents that incident from happening
where your back locks up in the wrong direction.
So...
- I do the same thing.
I usually just pull in like this and, there it goes.
- You don't really have any flexibility there, Brad.
- That's called cavitation. Would you just leave me alone?
I got one thing I wanna say, though.
- All right.
- I just worked with the gentleman and he is active,
in the sixties, and he is having these problems,
but he had shoulder problems,
and he was unable to do this, just because he had problems
with his shoulders, chronically, long-term.
So you don't have to go back like this.
Your arms can stay up here, or here.
But again, it's that stretch back here
and work with the height of the chair.
You got something else you're interested in, Bob?
- [Bob] Oh yeah.
- All right, here we have a sock.
This is a nice, simple exercise.
I've just used this in the last two weeks
with a patient with a similar problem.
This was a very key part of his exercise.
You get yourself a tennis ball, actually two of them.
You put 'em in in an old sock.
Make sure it's a clean sock, though,
make sure you don't get a dirty sock.
Nice clean sock.
- [Bob] Okay, I'll get outta the way.
- Now, you're not gonna do this on your bed
but you do it on, typically, a carpeted floor.
Okay? Now these two tennis balls-
- [Bob] Brad is showing you for demonstration purposes,
why he's on the mat.
- Right, exactly, yeah.
This is a little too soft.
- [Bob] You need a hard surface.
- Why don't you come here, Bob?
- [Bob] Sure.
- Face that direction, please.
We're gonna get these balls right here,
one on each side of the spine, in the muscle area,
not on the shoulder blades and not on the spine,
but in this muscle area here.
And there you're gonna use it for a pressure, okay?
We're just put some pressure on there for-
- This is an aggressive treatment.
- Right. I think it's be like soft tissue mobilization,
we call it.
Okay, and-
- [Bob] What I have found, Brad, is I have found
that people either love this or they hate it.
- Yeah.
- They absolutely hate it, so it may not be for you.
- And what you'll do is you'll roll your body
up and down and you'll find the spot where that knot is,
and when you get on that spot
it's gonna feel a little uncomfortable.
But if it's the right thing
it's gonna feel like that good pain.
It hurts so good type of a thing.
And you'll lay there for about 20-30 seconds
and that pain or that knot should release.
It's gonna feel better and then you're done.
Don't lay on it for an hour or anything like that.
20-30 seconds, maybe a little more
if it's really feeling good.
And you might go to another spot.
You can also take this, put it on a wall,
and I've done this. - Oh, sure.
- Here, can you get that camera over here Joany?
Yeah? Are you starting to shake like it's an earthquake?
Okay, are you steady now?
So I just, simply put the the ball against the wall,
the tennis balls, and you could roll up and down.
Actually, oh, I like that.
Oh yeah, I had a little tension
dealin' with that insurance company.
Got rear-ended last weekend and those insurance companies...
That's why they make money,
'cause they make to do things like I had do this morning.
I was getting ornery.
- Okay. - That's good.
Okay, one more.
- All right, one more thing, kinda along the same vein,
would be the use of a foam roller.
If you're not familiar with these
you may wanna look at our video on that.
These are kind of a dense foam.
They're used for a lot of self massaging
and stretching of muscles.
This is, again, pretty aggressive.
You can start by just keeping your butt down
and rolling back and forth on that mid-back range.
And then you get a little more aggressive
you can even go like this and roll back and forth.
And a lot of times when I do this
I can just feel the cracking going on there.
Any other cues or tips with this, Brad?
- Relax. You can tell way Bob's talking, this is aggressive.
You're- - Yeah.
- You know, you need to be fairly mobile
and have some strength to begin with.
- Yeah, this is not gonna be somebody who's, you know,
70 or 80 years old.
I'm not gonna put 'em on this, but-
- Or if you're real sedentary
and you're just getting going on things.
- So again, those are some things you can try,
give it a shot, see, you know, what works for you.
- Yeah. We're running out on time, Bob.
We gotta get going, so...
- All right, peace.
- Take care.