♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet. ♪
- Howdy 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.
- Strange opinion, indeed.
- That's right.
- Today we're going to talk about simple solutions
to sacroiliac, SI for short, joint pain.
- Sacroiliac, that's something my mother said
when I was a child.
"It might be your sacroiliac".
And I'm not even sure she knew what she was referring to,
but we knew it was like back pain.
- I think they said that on Gilligan's Island too.
(both laugh)
- Could it be where she got it, I don't know.
- We actually don't have any giveaway today.
We always do a giveaway every week and we have a one day
hiatus and it'll start up tomorrow.
So check out our Facebook Page or bobandbrad.com
and go to the giveaway section.
- That's right. And they'll show you there.
You can sign up and have a great time.
Hiatus, that reminds me of hyena.
- Very good.
- Yeah. Anyways, let's carry on.
I just wanted to share that with people.
So low back pain, the SI joint is this bolt right here.
There's one here and there was one here.
We'll show you on the skeleton, flip it around.
- Okay, I'm facing just like Brad is.
- [Brad] So it's low in the back, below the belt line
and it's actually the pelvis here and the sacrum.
So the sacral iliac, this is the ileum.
So on sacral iliac joint, it's here.
It's not a joint like other joints in your body.
- [Bob] Pretty fixated.
- [Brad] It is. It's fixated with a lots of heavy,
heavy duty ligaments.
And in your, if you can get it to move a little bit,
that might be a problem.
- [Bob] Right.
- [Brad] So that's the issue, a little movement,
except for if you are pregnant and you have that's when the,
actually the hormones in your body loosen up those ligaments
so that it can move for the birthing process.
- Those hormones are called relaxin.
- Oh really?
- Yes
- Wow. Excellent. You did some homework.
- I did.
- Excellent job. So that is a joint that can cause problems.
Now, as far as symptoms,
if you have an SI or sacroiliac pain,
typically it'll be on one side.
It may be in the area of the SI joint, oftentimes refers
down into the buttock down the leg,
but typically not past the knee.
- Right.
- So if it's going down the leg, you might think
oh, maybe sciatica because sciatica can go any far,
any length down the leg,
but it can easily go down to the foot.
But SI joint, typically not.
What irritates sciatica or SI joint-
- SI joint.
- a lot of times walking.
- Right.
- You're putting weight to that joint,
standing, those types of weightbearing activities.
- The reason it may have came up.
Oh you were already going into this.
- Go ahead.
- The causes. You could step off a curb.
- Right.
- You could fall on your butt.
- Yup.
- A motor vehicle accident.
I, you can also get it Brad,
from sitting uneven for a long period of time.
- Sure
- Like day after, day after day.
- If you're one of those people that sits
like this a lot, where it puts a stress on the SI joint.
- Right, putting a stress
on more on one ileum than the other.
- That's right. In the car accident,
you people that say, "well, what happens there?"
Is you go forward and if your knees go into the dashboard,
that'll put stress directly on the SI joint.
- Makes sense.
- Yeah, I had one, I remember clearly,
she was about a 40 year old woman
and she had that from a car accident
and traction actually helped her.
It was really a-
- Oh interesting.
- it was a fun one to work on.
She, she did very well.
So let's see other things that we want to talk about.
No, that that pretty much covers it.
- That's it.
- Yep. Oh, we want to talk about treatment.
- Treatments, right! That's what you came to this video for-
- We're gonna go over three treatments now, SI treatment.
You know in the therapy world,
you can probably go to four or five different courses
and learn four or five different treatments.
Some of them overlap, some are different and it's amazing.
It's not like one's good and one's bad.
- Right.
- It's how you approach it and treat it. So.
- Now, we should warn you, we don't know
what type of SI problems you have.
- Right.
Sometimes it's too loose.
- Right.
- Sometimes it's too tight.
So we're going to have you try these things.
- Right.
- If they hurt, you just don't do them.
- Right. You follow the symptoms.
Sometimes one may be rotated there.
- Right.
- Mutated-
- Mutated, yes.
- all these different terms
that we don't need to bore you with.
- Right.
- But, so there's different reasons that your SI may hurt.
- Kinda locked in place all the times that I, you know,
again, after a pregnancy it's too loose.
- Right.
- It's moving too much.
- So, what we've done here,
the first option I'm going to give you
is from a physical therapist,
she's a doctor of physical therapy.
She's very well-spoken and well-read.
We did the pod bot, but a podcast with her.
- Podcast, yes.
- Here's a book she has written
for people with SI problems.
- Yes.
- For the lay person.
So if you have problems after this video-
- [Bob] Want me to share her name?
- [Brad] Oh yeah, please do.
- [Both] Deborah
- [Bob] Riczo
- [Brad] Yes. Yeah.
- [Bob] R I C Z O.
- Yep.
And we do have this in our website-
- Will be a link below, yeah.
- and it's not really expensive,
it's a really good referral book.
So the exercise, cause I have,
I've got a history of SI problems
and I usually find out a way.
And I've got three or four different ways
that work really well for me, I've discovered.
And we'll get to that in a little bit later.
- A little later.
- The one, that exercise
that she has a protocol of exercises,
but one of the exercises in particular,
I'm going to show you that.
- I believe it's her first one. Isn't she?
The one she starts with.
- I believe so.
- Right.
- And there's a specific way she does it.
And the reason, another reason I want to bring it up
is she says, almost always,
you only do it this specific way-
- Right.
- because that's the way she's had
the greatest amount of success.
And she's worked with a ton of SI people.
- [Bob] Right.
- So she says, lie on your back, on the floor,
carpeted floors probably better, a little more comfortable.
Your right foot goes down and you're going to push
through your right heel down into the floor.
- [Bob] No matter which side the pain is on.
- Yes.
- [Bob] You put the right foot down.
- Exactly. Which was surprising to both Bob and I-
- [Bob] Right, it was.
- but she's the expert. This hand goes against this knee.
You're going to lay down like this.
And what I'm going to do is push down with that heel
into the floor. At the same time, I push this knee.
- Push it down with this knee.
- Yup, push it down that way with this knee,-
- [Bob] Sure.
- heel into the floor, not your toes.
She said the heel. Push here and just push that first.
- [Bob] So basically they're going like this.
Just spread it apart almost.
This one's going that way and this one's going that way.
- Right.
So the ground stops that foot on the heel.
The palm stops this knee.
And as you feel better with it, you can go up to here.
Now, the first time you do it,
she's recommending three sets of five.
- [Bob] Sure.
- And you're going to want to go up to three sets of 10.
- [Bob] You hold for how long?
- Just for a few seconds.
- [Bob] Oh sure. Okay.
- Let me see here.
- [Bob] Three sets of five.
- Yup. And I wrote that down.
- [Bob] Two times a day.
- Yeah. And it can go up to three sets a day.
Once you find out if it's being progress,
it's feeling better.
- Sure.
- Three sets of 10-
- Sure.
- per day.
So that one actually-
- That would be 30.
- feels pretty good right now, actually.
- Oh wonderful.
- Not that it was really bothering me,
but it certainly didn't irritate it.
- Sure.
- All right.
- Again, we're looking for the fact,
that fact does it bother you? Don't do it.
- Right.
And it's just moderate pressure.
You're not pushing as hard as you possibly-
- Sure.
- can. Just that moderate pressure.
The next one,
we want to refer to another expert in the field.
And we're talking about,
- [Both] Steve August.
- Yes. He just did a podcast.
I've done two podcasts with him.
- Right. And he's a doctor of physical therapy.
- Yes.
- In, from New Zealand.
- From New Zealand, yes.
- And those New Zealand PTs-
- They are good PTs, yes.
- They are.
- They really are.
- Yeah. They're, they really do a lot of-
- Manual therapy.
- manual therapy. Exactly.
- It's hands-on they actually like,
do manipulation mobile session.
- Right. Sometimes chiropractors get mad at it,-
- Yup, that's right.
- but that's all right. It's all good.
- He said in their country, they all get along.
- Yeah. Well, yeah. That's good. Maybe we should move there.
I thought about visiting there someday.
So the back part is what he has invented,
it's for a number of different treatments.
But when you use it for sacroiliac pain,
it's a very simple way to treat it.
There's a specific di-, or design to this
that works really well for treating upper back, mid back
or-
- Costochondritis.
- costochondritis mid back, and this is for the sacrum.
So this is going to go right here, right in the middle.
- [Bob] Right on the sacrum.
- [Brad] Exactly. Right on the bony part.
And we're just going to lie on there
for two to three minutes. It's a really easy treatment.
- [Bob] Yes it is. And again, should not be painful.
- [Brad] Right.
- [Bob] It might, you might feel a little discomfort.
- Right.
- But it should not sting.
- [Both] Right.
- Or if it initially hurts, you feel it dissipating.
- Right. Right.
It feels so good.
- Should I show them how to do this?
- I would recommend that, Brad.
- [Brad] So, I'm putting it right there,
right on that bone, right in the middle below the belt line.
Yeah.
- Yeah. What's nice about this is the simplicity of the,
of the exercise.
- Yeah.
Now, I've thought and thought,
is there some way to get something else that you could use?
You don't have to buy one of these
and I don't know if you can, because it's a specific.
- [Bob] It really is a specific size and feeling.
- Yup.
- And he really,
he kind of got lucky on that.
He was, he had a brother-in-law designer, I believe,
and just hit a home run the first time he did it.
- Yeah, well that is, I mean, for me right now,
this feels like good pressure on my sacrum.
So again, two to three minutes there,
and that can be done two to three times per day.
- [Bob] Again, that is not going to feel good on you.
If you have a kind of a loose ligament, you know.
- Right.
- The sacrum is moving too much.
- Yup. If it's 'laxed.
And this is another thing where it's not going to fix it
in one or two treatments.
- Right. Right.
- You're going to have to use over a period of weeks
to get it to loosen up.
- Exactly.
- But he has, you know, along with the backpod,
he's got a really nice book and all the other ailments
that you can use the backpod for.
It's well-written for the lay person.
I really like it.
- It's good for posture overall.
- Yeah.
Now the last thing,
I just want to go through the three things
that work really well for me.
One thing I found out with my,
when I not sit down after a walk or running,
if I sat on a concrete step right outside my house,
and I put all my weight
on one of my issue tuberosities and I pulled down,-
- Oh
- it hurt.
And it's like, well, that's gotta be my SI
cause that's the only thing that's changing.
So that's not one of my treatments
that just helped me zero in, I knew it was SI problem.
But if I go to a stool or actually outside, I do a step,
a tall step. It's actually part of the, the lawn curb.
And I go like this and I push down here.
And actually right now this feels, it just feels good.
And it always feels good when I do it.
- So you put the leg up-
- on my right side.
- that you're, you're painful on the right side.
- Right. The right side hurts.
I do this, so it's putting a little rotational force-
- Sure.
- on that-
- Makes sense.
- on that ilium.
And if it feels good while you're doing it,
and then after you walk around,
do you notice a good exercise?
If it hurts while you're doing it,
or if it feels good while you're doing it
and you walk around, it hurts afterwards.
It needs to feel good, while,
and afterwards.
- After, yes.
- Okay, the next thing that works well
is a simple lying down like this.
And I'll grab here and I push my knee out that way.
I hold here, it's called a muscle energy technique.
I usually do that one
because it's a lot easier than this one.
- Right. Right.
- And it works really well. But you can try this.
I'm going to push hold for about six seconds
and then relax.
Again, while you're pushing, it should feel good.
It's like it's releasing the pain or getting rid of it.
The next, not probably the most fun-
- Oh, massage gun
- but it does cost a little bit.
But you know, if you have one or if you want it,
you can use this for so many-
- Right.
- muscle parts and melodic.
- Ailments, right?
- But when you use this on your side joint,
you have to have the head, that's the air cushion.
- Right.
- There's-
- All the massage guns come with five heads.
- Yup.
- And this one is the air head, which is the most gentle,
I would say.
- It is.
And you need that because there is no muscle over your SI.
- Right.
- It's just, you know,
some skin-
- Boney.
- and little soft tissue ligaments.
And if you use a plastic head,
it's going to cause pain and problems,
but you can just work that on there.
And I'll work that around that SI joint.
And it's just one of those things that it feels great,
gets it loosened up.
You know what, you can do this
and then do one of the other treatments-
- True.
- to mobilize it.
And wow, I could do this for another five minutes, Bob,
but we got to finish the video.
- No, I think we're, people are going to be glad
that you're coming to an end.
(both laugh)
- What advice, Brad!
I think these are some good techniques.
Hopefully one of them will work for you.
- Yeah, absolutely.
There's nothing better than a pain-free SI.
(both laugh)
- That's what I always say.