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.
Caught Brad off guard today. -Exactly right
Today, Brad, we're bringing another person in
We're bringing in Alexa.
Alexa say hi
Alexa's shy, Alexa tell us who you are, Hm I'm not sure
That's exactly what I'm saying Bob, you can't rely on technology, Alexa set a timer for ten minutes
What are we gonna do Bob? Alright today Brad we're gonna talk about ending low back pain, 7 stretches and strengthening routine
that you can do and this is if you have
well really if you have chronic back pain this would be a good thing to try
Right if you've been working with back pain for months or even years
And it's not going away, this is a really good seven step sequence
And it covers all aspects from stretching to strengthening the posture to lifting
Which are all components of back pain
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Okay back pain you got back pain, let's say it's acute phase, whether you've had chronic back pain and you did something you knew you shouldn't of did
but you did anyway and it's hurting like crazy
Or you just got back pain because of whatever reason, so it's flared up
You've got chronic back pain but now it flared up, and you're in that point where it's all ow and it's tender and it's hard to walk and
Just to sit and bend, one of the positions that almost always works for most back pain people I'd say 90% or more
Is a nice leg wedge like this
And a cold pack
so you put the cold pack there, the leg wedge here and these leg wedges aren't that much, they're like $25 on Amazon
If you go down below I have a list of products that Brad and I like, or love
That's in the list there so look for the description there. I have one of these in the clinic and I have one of
these in the clinic and it's not uncommon for me to put someone on there and it
Puts a smile on their face, you put the cold pack not directly on your skin but your shirt is adequate
Right on the spot and make sure you get this tucked up right up to your butt and like this and
You can use a pillow whatever is comfortable for you and you're gonna lay there for 15 to 20 minutes and Just
Just relax and it should feel real good, it's rare but once in a while I find someone that doesn't
tolerate this but boy the vast majority are comfortable with this,
Alexa tell a Joke, Oh Geez
When Is a door not a door? When it's ajar.
That's funny, while you were laying there I thought it was a good comedy relief
That's called the Echo Dot
My wife and I have been using this for like a year and a half, I believe it,
All right, directional stretching, so people talk about stretching for back pain,
But as therapists we know that stretching can be good or it can be harmful
Oftentimes it'll help in a certain direction and
there's one stretch that we like to give intially to start with
We call it hook line rotation or low back rotation
It's just a nice stretch, you can do this one getting out of bed in the morning
Where you just rotate your hips back and forth, shoulders stay flat
When we say directional,
say for example you can go back and forth, and it doesn't bother you each way, it feels like a good stretch, that's fine, but oftentines
Maybe to the left you get some pain there so you're going to avoid that you're gonna go
the direction that feels good and then work that direction, you're trying to find the movement that feels good
It's as simple as that, because it's so important to keep movement in your back
Now what you can do is after you've been working the pain-free direction you can go back the other way and
see if that feels better and oftentimes that will, just getting it moving in the pain-free direction, the other direction
can improve, now that's not only true with this particular stretch but
Actually I can do it this way
Low back if you want to stretch It and what we call flexion, this would be a flexion motion to the low back
Now if this makes things worse, a lot of times what I have people do Brad, I have them start with one leg and
Then even a lot of times when I do both legs, I'd bring up one leg
Then bring up the other leg. Sometimes it hurts to bring up both legs at the same times
Good points all these little tricks we've learned as therapists over the years and we're
Hoping that they're gonna help you out as well and for some people this is gonna make your back pain worse
So you don't do it at all then
You might be able do the one leg or you may not be able to do it at all, Do you want to show the strap Brad?
There's a number of times we'll have people either who are older or
They're overweight and they have a hard time getting their knees up
Because they can't reach very well to their shoulders, maybe their arms aren't as long
And they're proportioned differently so we got a strap like this down below it's called a Yoga Strap
It's works out real well, it's a little bit different kind but
It works out nice because it has loops where you can put your hands in
Makes it a lot easier, you don't even have to use your hand grip and then you can use your hands to do the stretch
Like this while relaxing your back which can be real helpful
You can do this with your hands or you can use a towel roll as w ell if you don't have one of these
If this is painful though don't push it
You do three or four reps and it's just getting worse stop right there then you're gonna go
the opposite direction, Bob's gonna do this one cuz my back doesn't tolerate this
This is a direction Brad does not like, his back does not like, and I do like this direction
So you can start off with the prone prop, talking about where you are just
Propping on your elbow, if you tolerate that
And then you're gonna go ahead and put your hands underneath your shoulders and you're gonna go ahead and press up like this and
Now what you're trying to do here is not lift the butt up or the pelvis off the floor, keep it down
Again if you can start by just working in a little range, let's say I get up to this point and it hurts
Then I can just go back down again and keep working it in this range, pain free range
Then eventually you want to hope to get all the way up to here, if you want again go back to the yoga strap
This thing gives a little over pressure and a lot of times it helps
When you're having trouble getting that motion
This will help progress things along
I'm into the loops again
And now I can press up and I can work my back in different levels here, yep so you know he may start low at
L4 and L5 and work his way up to L3 and L2 and
You'll know it's the right place cuz it's gonna feel like a really good stretch and we do talk about pain centralizing
Where it feels like it goes more towards the center of the back and then you're golden, you know you're right on, I feel bad Brad
A guy from Dublin Ireland
Contacted me on Facebook and he wanted to get one of these and he can't, Amazon doesn't have it over there, oh Really?
It could just be a matter of time
Then you'll have to use a towel, that's what I told him
There's always ways to do this
The next thing and this is a real simple one is simply walking, yeah lots of walking as long as you tolerate it
It Goes well, don't walk too far
Don't overdo it, but typically on a flat
Walking up and down hills or grades one way or another are not what you want, a nice flat surface to
Keep that pelvis steady when you're walking, thirdly and this is real common
Hamstring stretch
It's really to take the pressure off the back and focus on the hamstrings, I really think this is probably one of the best ways to do it
I just read a study, Brad
They said the three muscles that helped with back pain and stretching, one of them was hamstring, sure yeah
I wouldn't doubt it a bit, of the most commonly tight muscles in the body, one that was a surprise was the quadratus lumborum
I like doing this laying down on a firm surface
Because it takes the pressure off of your low back and it allows you to focus the stretch on the hamstrings and with this strap
As long as my knee is straight and i'm down, my back is straight flat on the table i'm really focusing on
That hamstring group right now and I can do this with my leg relaxed and I can just hang out here, with the strap with the loop
I don't even have to grip and it's not like I'm getting tired hands at all
Yeah the way I do it I just put mine up against the banister and I'll lay flat on the ground
But this works better because I have to keep moving my butt closer, to stretch it
I have had people go up against the door so their leg
Say the wall is here, then your leg goes through the door
But I tell ya Bob if someone closes the door and they don't know you're laying there
It's a problem, you can see i'm starting to get stretched out more and more as time goes on here so make sure
you do both legs when you do that otherwise you'll walk in circles
That was a better joke than Alexa
okay core strengthening
oftentimes when you're doing core strengthening for the back wouldn't you say the focus is on the abdominal muscles
versus the back muscles, when you strengthen these muscles
Holy Cow that's a nice little jingle there okay, there's one right behind you Bob
What do you think of the red and black contrast? Nice
Red black and green, nice these are exercises I like to do because it flexes my core which helps me
and it really works your abdominals, I'll start with this one
And you're really supporting the back and then I'll go to this one, i'm not gonna go through all these, again these have to be pain-free
you're gonna start out with
Ten to fifteen of them and then you're gonna work up to 30, 40, or 50 of them
Then as they progress those are the beginning ones, this one where you do both at the same time is a little bit harder and
then I always like to get the obliques I'll go back and forth like this
Again pain free, why don't you get set up for the next one Brad, I'm gonna show real quickly
Core strengthening on the ball this way, just go opposite leg, opposite arm, so this is just a good one for the back
So real simple to do especially with a ball, the ball really takes the stress off the back
Works out well for that
Next one is seated posture, This is probably one of the biggest things for
most people that they need to focus on and correct is
What we have found is that
back pain has become more of a sitting problem
than a lifting problem, so you got to correct that sitting, so there's a couple different lumbar supports
You can start out with a round one like this or you may want a roll towel
Yeah we've got a towel roll right here
for this specific example
Roll up a towel and put some duct tape around it
and you can determine what thickness you like then, so you might want to start with less or more depending on what your tolerance levels are
I would probably buy one like this, but for myself personally
These don't work so well, I like a broad support that's got an arch
that supports the back, he's got one with memory foam, we got one listed below
The thing about this is I don't like this in my car, I don't like it at all
but I liked it in my office chair
For me I'm the opposite, I love it in my car, I use it on my riding lawnmower and
It's really made a big difference on
How I fit and how I feel when you get up, it shows you preferences
Depending on your back depending on, I mean there's not really one that's good for all, that's the problem
So you're gonna have to work with it and leastly but not lastly, lastly but not leastly
Body mechanics When you're lifting, and I don't whether you're lifting up a 20-Pound bag of salt
You want to make sure that you keep your legs wide apart like this and you're gonna bend down, you're keeping this part straight
You're not bending this, it's like this is in a cast and
I'm gonna bend down and I'm actually keeping my head up
I'd only wanna lift down because I put my head down my back curls so i'm not gonna hit you with this Bob
We won't do it on you because of white on white, oh sure, plus I just wanted to do it
okay
Three points of contact, one two three, if you're lifting correctly, so I'm gonna bend down like this
Because if I go like this it's one point of contact
We can tell them that little trick, the golfers lift, right if it's something light, instead of going like this you simply do this
See how he's got three points of contact, well we missed it on the head
But that takes a lot of stress off the back anyways, you just have to watch out who's behind you when you bring that leg back
So go through each one of those and make sure that you make it
Make each one make improvements for your back and it's gonna
This is how we should approach our biggest problem
How we can solve just about anything, except for a broken heart, but this is a good seven step model
We're working on that and we're working on this. It's gonna work Bob. Alright, thanks.