♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ on the internet. ♪
(upbeat music ending)
- Hi folks. I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together, we are the most famous physical therapists
on the internet. - In our opinion,
of course, Bob.
- Kinda went like this, Brad.
I don't know where you- - Well, there's something
behind Lonnie, I couldn't tell.
- All right, well there, and by the way,
we also see some other new people
out there, Brad. - Yes, we do.
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We provide videos on how to stay healthy, fit, pain free,
and we upload every day.
- Excellent. - Let's get into
our topic of the day, Brad.
It's the psoas muscle.
Is your psoas muscle tight?
Is it weak? How do you tell this?
How do you fix it? Why do you wanna fix it?
All these questions.
- What is the psoas? - Right.
- The psoas is one of those, it's like puh-soas,
because it's spelled wrong.
It's spelled with a P. - P-S-O-A-S.
- Yeah, it's like puh-psychology.
Anyway. - Sort of like putty-tat.
- So the psoas muscle, let's look at it.
- Yeah. Let's take a look at it.
So I'm just gonna go this far, Lonnie.
This should be all right. Right?
The blue one. - Okay.
So it's, it's actually a very big,
strong muscle, Brad - Oh, yeah.
- [Bob] And I'm only showing one side.
This actually is on both sides, and it attaches down
to the lesser trochanter of the femur,
but it attaches to these side bones here,
and onto the side of the vertebrae,
and the discs themselves.
- [Brad] So it's attaching to the low spine,
the low back. - Right, the low back.
So it attaches down here.
So can you see, if this is a tight muscle,
can you see how it's gonna squeeze
all these bones together, Brad?
- [Brad] Yeah, maybe we can look at it from a profile.
- Sure. - So if this muscle
contracts or gets tight, it pulls this direction,
which takes the back and arches it forward 'cause it has
no other place to go. - Yeah,
it's gonna arch it like this.
It's gonna make it arch. - Get that arm
out of the way, Bob. - Some people call it-
- Arch, Bob, arch. - They call it
the anterior pelvic tilt. - In here.
- [Bob] That muscle is tight,
and it's not hard for that muscle to get tight, Brad,
because it gets tight while you're sitting.
- Right. - So, if you sit a lot,
- Right. - And you don't stretch.
- [Brad] Sure, now, one thing
that we should clear up, Bob,
is what is the job of this muscle?
This muscle's, a hip flexor.
- [Bob] Right. It pulls.
So you can see, if this is attached here and holds on,
it's gonna actually lift up the hip here.
- [Brad] So if you're marching in place,
those muscles are responsible for majority of that.
- But can you see if this, if we fix it here, Brad,
you know what it's gonna do here?
It's gonna side bend you.
- Okay. - It's gonna bend you
off to the side, and that's gonna be important later.
I'll show you why.
- Okay. - But right now,
mainly think of it as a hip flexor.
There is another muscle right here that attaches into here.
It's called the iliacus, and they come together
actually, Brad. - Sure.
- [Bob] And a lot of times they call it the iliopsoas,
both together. - Right.
Kind of a combination muscle.
- [Bob] There are a couple other couple muscles
that help with hip flexion,
and we'll have to talk about them too.
- You bet. - But right now,
that's probably good enough for a start.
So again, picture this on both sides, big, strong muscle.
If it's tight, it's gonna compress all the discs together
and could give you some back issues.
- Sure. - So you do wanna
stretch it if it's tight.
So let's talk about that first.
How do you tell if it's tight?
Well, one thing Brad, a simple way
is if, when you're standing, and if you tend to stand
with that anterior pelvic tilt
and you can't flatten your back
while you're standing. - Let's move this arm forward.
So we're looking at this part of the low back.
Yeah, pull that shirt there, Bob.
- You know, it might look good
to look at my belt line, Brad.
There you go. - If you can't
flatten your back, see how my belt line
is moving forward here?
Now it's moving back.
If you can't flatten your back while you're standing,
you might have a tight
psoas muscle. - Right.
But we'll show you a better way
to test that. - Right, there could
be some other things causing that too,
but that's one of the- - One of the tests.
- Right. - Okay, the better way
to test it is to actually go off
the edge of the bed here. - Sure. Yep.
Let's try and isolate it. - Yep.
So you're gonna have your knees kinda,
maybe six inches or so off the edge of the bed here.
And then I'm gonna lay back,
and I'm gonna pull this leg up.
Now, my leg actually does
come up a little bit. - Yeah.
- But believe it or not, it's not my psoas that's tight.
It's my rectus femoris or my tensor fasciae latae.
- Sure. - And I know we're probably
confusing people here, but let's say you do this,
and the leg really comes up. - Right.
- Okay? - Right.
So if this happens and you're relaxed and there's
a gap like this here. - Yep.
- There's a good chance that
this muscle's responsible. - It might be tight,
but you have to do one more thing, Brad.
- Okay. - You have to have someone
straighten the leg for you,
and then see if the leg will go down.
- Yeah, then if it drops down real easy.
- Then it's definitely, if it doesn't drop down,
it is that muscle.
- Right. - Okay?
If it stays up, even when you straighten the leg,
then it is the iliopsoas or the psoas muscle.
- Sure, yep. Yep. - Okay.
Is that clear as mud? - Yeah. (chuckles)
So again, pull up, goes up.
Straighten it, still stays up, it's tight.
- Curb. You got it. - Okay.
All right, so if it's tight, how are you gonna stretch it?
There's a lot of different ways we can stretch it.
Probably the most simple way is one way we can do it,
is just the way we were doing it, Brad.
- Yeah, yeah. - Just put it
off the edge like this, and actually it's best
if you keep it a little bit straight,
otherwise you're stretching the the tensor fasciae latae.
So when he says off the edge,
he's coming this direction towards the camera.
- Don't fall off the bed. - Right.
'Cause you need to have room for the hamstring area
right here, to drop down. - Yep.
- And then, if I was doing this to a patient,
and I wanted to get more aggressive,
this is what I would do, gently.
Gravity's usually more than enough.
- Right. Exactly.
So you can stretch both sides that way.
You'd flip around and do the other side.
- Right. Otherwise you walk in circles.
- Yeah. (Brad chuckling)
Brad loves that joke. He's told that joke.
Okay, pillow, please. - Pillow.
Yeah, we gotta get on with the stretches.
Sorry about that, Bob.
This might be the better way, even, to stretch, Brad.
This is the way I do it.
So you're gonna go ahead and lean forward
like this, good posture. - Yep.
- Remember that we don't want to go in like this.
- Right. That's critical.
That's your upright. - Okay.
But there's a little twist here, Brad.
- Okay. - Remember this muscle
is a side bender.
So in order to add a little more stretch to it,
you can actually bend to the side
- Sure. - away from it.
- Right. - And that's gonna really
isolate on that psoas muscle.
- One thing I tell my patients, I say,
"Imagine there's a rope right around your belt line,
and it's gonna pull your hip forward that way",
and that's really gonna help,
and then like you said, a little side bend
- Yep. - To the opposite
direction, and yeah, you'll feel it.
- And I do. - Both legs on that one too,
right? - Yep.
Both legs on that one,
or what will happen, Brad?
- I'm not gonna go there.
(Bob chuckling)
- All right. - So another way
would be, Brad, to actually
this is really quite a stretch, isn't it?
- Oh, yeah.
It looks like you are having fun, Bob, but it is.
So you gotta have a firm, a bed may work,
but you need a firm table. - Right.
- A firm mattress. - This really
stretches it, Brad. - Oh yeah.
- You know, and the leg's straight.
So I mean, it is focused on the psoas muscle.
- Right, and again, you're up as high as you can get
right there, as far as your shoulders, arching back.
- Yep. Oh yeah.
Yeah, I can go up a little bit higher.
- The further you go, the more aggressive the stretch.
- Let me go right into the next one, Brad,
which actually is you can do, press-ups like this.
This is gonna stretch your back,
but this is also gonna stretch the iliopsoas,
or the psoas and the psoas muscles.
- Exactly, so the idea is keep the belt line
glued to the table. - Right.
- Show 'em the wrong way to do that, Bob.
Yeah, that's not - Yep.
- gonna do anything.
- If you can only go up this high,
only go up this high. - Right.
- If you can only go up a little ways,
work your way up into it.
- Right. - And eventually get to it.
I think one more way, Brad, would be to,
I gotta watch out for my mic here.
- Yeah, be careful with that, Bob.
- Is, you can't sit down, Brad.
I gotta do something. - Oh, sorry.
- Would be to lay on your side,
and you could stretch it like this.
Now again, this is gonna get the rectus femoris too,
and everything. - He's talking about a muscle
that goes from your hip, down to your knee,
and you'll definitely feel that.
- Yeah, but you're gonna get the psoas too.
- Yeah. - I mean, you're gonna
get both. - It's a double header.
- Yep, that's one way to work on both.
All right, Brad, how do we tell if it's weak?
Pretty simple, isn't it? - We test it.
- Yep. - We just test it.
- So you sit in a chair. - Yep.
- You're gonna have to have somebody that helps you.
You lift it up, and they're gonna push down on that leg.
- Hold it strong. Hold it, hold it.
- Okay. That one was fairly strong.
How about this one? - Okay.
- Now I may have faked that.
- Now any healthy person that's an adult,
go ahead and lift it up, normally it's,
you can put a lot of weight.
- Right. - It's gonna
hold like a rock.
And it's good, you got two legs,
test one or the other. - You can test
one or the other, - Yeah.
- and you can see.
If they're both weak, if it just drops right down,
you may need some strengthening.
And one way to start with strengthening, Brad,
is to just do it in the chair.
What you can do, put some weights on.
We got some weights over there?
- [Brad] You want some weights, Bob, don't you?
- Yep. - We lost them.
- Oh, there they are, right there.
- [Brad] You want some ankle weights?
- Yeah. - Sure.
- You can get some ankle weights
at any of the big box stores.
- So you're simply gonna do some marching?
Is that correct? - Yep, exactly.
- Yeah. - So very simply.
- We'll just do one leg. - Yeah.
You're gonna work on slowly bringing it up,
and doing some repetitions that way.
- And I think it is important that,
you probably are gonna get into this,
that you also do it in
a standing position. - Yeah.
That's exactly where I was going next, Brad,
is to start doing it working in the standing position.
' Cause you're getting a good range then, aren't you?
- I always put my hand up and from, I say,
"Get your knee up to my hand as best that you can",
and the higher you can get it, the more range of motion.
- [Bob] And you can probably alternate,
have 'em on the other. - A lot of times,
people that are doing this, may be weak
if they're after a surgery, or older or whatever,
then a walker or something to hold on to
is good to have. - Sure, to provide balance.
- Brad, do you wanna show it on the ball?
- Oh yeah. This is one of my favorites.
This is for a higher level person.
Can you get down to the floor, Lonnie?
Okay, if you're, you know,
pretty strong, fairly agile and athletic,
this is a really good way to work it.
And you're gonna have to move, Bob.
- I'm sorry. - I don't wanna bump
my head into your.
Okay, so you get out about to here.
Is that okay, Lonnie?
And you simply keep your back strong right here.
Can you point to that, Bob?
- Sure. - Right there.
- Right here. Keep this thing strong.
- Yeah, don't let it arch,
keep a nice, neutral position,
and simply bring the knees to the chest,
and that works those hip flexors,
and if this gets too easy,
you can do 10 or 15 of these, simply go to one leg,
and that helps quite a bit to make it more.
- [Bob] Well, I'm glad I had you do this one, Brad.
I don't know if I could do one leg.
- This is the one I always like to do this, Bob,
just for fun, but you don't have to do this for hip flexors,
but it's a good balance one.
Sorry, Bob. - It actually is working
the hip flexor a little bit
when you do that. - Little bit, it is.
- All right, the other thing you can do, Brad,
come on over here, Lonnie, now,
you can buy these furniture sliders.
- This is one of those simple, little things.
- Yeah, these are very inexpensive.
You can get them like 10, 15 bucks at the most,
and there's a whole bunch of exercises you can do with 'em,
but you can actually put your feet on 'em,
and you can do what they call
mountain climbers. - Yeah.
- You're getting some hamstring with this too,
and hip extension, but you're working the hip flexors too.
- [Brad] Oh yeah, this is a great overall workout.
- Yeah. - You just keep going, Bob.
- Yeah. - Those furniture gliders
are things that you put on the bottom,
if you're not familiar,
you put on furniture. - Furniture sliders.
- Sliders. - Yep, you gotta
call 'em slider 'cause otherwise,
you'll get you the wrong thing,
you gotta watch it on Amazon. - And they work good
for sliding furniture as well as the exercise.
- That's exactly right. That's what my wife used it for.
Thanks, everybody, for watching.
- All right.