(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. - In our opinion.
- Wanna talk, Brad?
- Well yeah, I like to talk, but what?
Oh, yeah, we're gonna talk about this subject.
I wanted to talk about my socks.
Zoom in on this once, Nancy.
Look at this, FAT tire, Chequamegon.
Now, if you're into mountain bike racing,
you know this FAT tire race
is one of the largest mountain bike races
in the United States in Wisconsin.
- That's fascinating.
- Hayward, yeah. - All right.
- 1600 bikes, Bob.
- All right, let's-
- You wanna talk about compression fractions, Bob?
- Yeah, let's talk about compression fractures now.
- All right. - All right.
This is kind of a serious business.
And which reminds me, this is something
that generally happens in the elderly
or as you get older, 50, 60, 70.
- Sure.
- And if you're of that age,
you're gonna wanna subscribe to our YouTube site,
Physical Therapy Video, Physical Therapy Video,
because that's the topic that we tend to discuss
is health and fitness for the person who's 50 and over.
- Right. As a matter of fact, just today I saw-
- Even if you're 40, you can do it.
- 40, 50. (laughing)
- Okay, I'm sorry, go ahead.
- This morning on TV, I was, actually, I was exercising.
I got a TV on the wall now
and they had a whole section on diagnosing people
and scanning people for bone density.
- Oh, very good.
- And I just thought about that this morning.
- And that fits right with this
because the person who has less dense bones,
so let's say as an osteo, osteopenia or osteoporosis,
you're gonna be at much more risk for this.
In fact, quite often, I've seen people who
have not really done anything seriously wrong,
no falls or anything like that,
but they still ended up getting their compression fracture
and we're gonna show you how this happens.
- Sure.
- So why don't we start off with the spine?
All right.
Wow, what a throw.
We got a couple students here today.
From University of La Crosse, Wisconsin
Physical Therapy Department, Doctorate program.
- [Bob] Yeah, Sam and Brittany.
- Come on in, come on in.
- [Bob] So, just say hi.
- [Students] Hi.
- Okay, get out of here.
(Brad laughing)
We might use you later.
We might use you to show you up.
Okay, this is the spine and first off,
let's just show you what a compression fracture
looks like on this diagram here.
Can you zoom in on that, Nancy?
All right.
These are obviously two normal vertebrae
and you can see the normal height on them,
even height all the way along here.
This is a compression
and compression fracture is just like it sounds.
It got compressed down.
So the front end is actually smaller than the back end here.
- [Brad] And you can see the,
if you can see that line right there,
that represents the fracture right here.
- So we're gonna demonstrate how this happens
and generally the mechanism of how it happens.
Do you wanna zoom back out?
- Bob could, as far as this picture here,
where is that on the spine itself, on the model here?
- It would be one, this looks like...
Well, oh, that looks like it is a lumbar vertebrae.
- So it'd be lower down, - Lower down here.
To be honest, I think they more often happen
in the thoracic vertebrae.
- Right, in the mid part of the back.
- In the mid back, right.
And I'll show you why in just a second here.
This again, yeah, we have a normal spine here.
This is where your head would be.
This is your pelvis, these are the legs.
Now what puts pressure on the mid back here
is this position right here,
this rounded out, slouched, slumped position.
And in fact, I read in the literature,
a friend of mine who's actually
quite well-versed in this area,
they call this a hinging effect.
It's like, there's a hinge right here
and there's pressure from here
and there's pressure, 'cause this is fixed down here.
And so the, the pressure tends to happen
right in that mid thoracic, mid back area.
So this is the area, just by putting your back
in this position can put you at risk
for compression fracture when you have osteoporosis
or osteopenia, which tends to happen after menopause.
- Right. - In women.
- Females have a higher risk of it.
- Females have a higher risk.
We see many more females with this.
- So this is that posture.
Can you see this, Nance?
Where this rounded posture
and if you pay attention, you'll see that.
They call it kyphosis, thoracic kyphosis.
- And that's where you see the little old ladies
and old men that are, you know, humped over like this
and once they have a compression fracture
they're even more humped over.
The thing is, if you have your back in that position
like this, and then you pick something up
now you've added increased stress on that back
and that's where, I've had people just from doing that,
they'd picked up something and...
- And very light objects.
- Even very light objects and that was enough
to put 'em over the edge
and let me tell you, this is not a fun thing.
This is a very painful situation
and the only way really to treat it,
although they do have some surgical procedures now
where they do vertebroplasty and stuff like that.
But usually they try non-surgically first to treat it.
And basically it's allowing it heal
and staying out of this position.
- Right, they have braces made to put on.
The turtle brace they call it.
- Yep, the turtle. - To keep you up.
It's just another confirmation of how important posture is,
good posture throughout your life.
- Keeping things aligned.
We're gonna show you, give you a demonstration here
of how this compression fracture actually works.
Good throw, nice throw, Sam.
All right.
- Did you play ball?
- Yeah. - Yeah, she did.
- She played ball, all right.
So here we got a couple vertebrae, all right.
Here's one, here's another,
and this is gonna represent a vertebrae.
This is just a piece of foam.
I wanted to do it with a marshmallow.
I thought a marshmallow would be really cool.
You know?
That's what I tell people,
it's like squeezing down a marshmallow.
- Yeah, yeah.
I never do that one.
That's a good idea though, marshmallow.
- So anyway again, you got the lower end
that's kind of fixated because you know, you got your legs.
And the upper end is bending forward like this.
So it's just very simple.
You bend forward like this and what happens?
The pressure squeezes down and if you have
a normal, healthy vertebrae, that's not gonna happen.
It'll maintain its height.
But if you have one that is maybe a little bit less dense
and has lost some bone mass.
- Yeah, the integrity has broke down,
you know, as a result of...
- It can just crush right down like this.
- So this would be, if you wanna look at on the spine,
you might be looking at this vertebra,
this one and this one and the middle one here
as a result of bending forward,
you know, poor posture, poor biomechanics,
increases that compression stress
on there causing the fracture.
- And you can't get away from this.
I mean, you can't, as you get older,
I mean, there's no way you get away
with this position like this.
You're always gonna be at risk
if you put your back in that position.
So, you're really gonna wanna work
on keeping your your posture
and even working it the other way a little bit.
- Right, so what can we do to prevent this, Bob?
- Stay outta this position, Brad.
(both laughing)
- But I mean other things, as far as diet.
I know they talk about,
you can talk to your doctor about that.
As therapists, I don't get into the diet much,
but I know they-
- Not really my area.
A doctor can- - You can talk to your doctor,
or a dietician.
There are ways that your diet
can also supplement the integrity of the bones.
So it's posture, integrity to bones.
Exercise too as far as
weight lifting, mm hmm. - Weight lifting.
Keeps the bones strong.
- That's something you gotta talk
to someone that knows how to lift
and just don't go grab some weights and start lifting
to try and help your bone density.
- Sounds good.