- ♪Bob and Brad ♪
♪the two most famous physical therapists on the internet. ♪
- Hi folks.
I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist.
- Yeah. We are the most famous
physical therapists on internet. What is that?
- I think that's kind of funny in our opinion, of course Bob
- Single most important core exercise to perform.
When you have back pain
Brad's gonna take it away on this one.
But before we do that, even should, should I go ahead?
- Yeah, let's, let's get that out.
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because it's such a tragic tale.
Like I, I got a little tear
in my eye when I didn't even say this, Brad
Brad and I were picked on as children.
And we're trying to turn everything around.
We're trying to get people to like us now.
- So yeah, like away, like away, like away, Bob I've had a
you know, in the comments, there's a number of them, even
though we don't have the time to answer, we're reading them.
People talk about, can I do core exercises?
If I got back pain, what can I do?
So I wanted to give that a good answer for that.
- Sure.
- So here we go.
This is it.
Now, if you're in the throes of acute back pain
in other words, it's really, you just hurt your back
and you're, everything is really sore.
You, you may not be able to do that.
- Its probably too soon
- Right. So, but I'll give you a little answer for that.
- Brad, where are you going?
- Oh, I'm gone, Rob.
You know, this is one of the nicest
- The pillow too
- devices that you can use for acute back pain.
I use it on my patients a lot
and puts a lot of smiles on their face
because this position takes pressure off that low back.
And it really can help get through that and put a cold pack
under here and get that pain under control.
- Yeah. And generally, especially if the pain
if the back pain is acute, meaning that it just occurred.
You're definitely gonna wanna use ice first 24 to 48 hours.
- Precisely Bob.
- After that, you could go heat.
- Sure. You bet.
- Or, or thermotex.
- Yeah. Well you have deep heat.
Yeah. Get some deep heat.
- By the way, Brad
just going off topic a little bit.
That that position is also good for hips.
- Oh sure.
- I just had a lady who had bad hips.
Right. And it, it took the pressure off her hip
because it puts the hips in a neutral position too.
- Right? Yeah.
It really has a magical little device.
- Yeah. Inexpensive.
- Yeah. So it's just one
of those tips that we like to share, cuz it really works.
But if we wanna get these muscles to relax, Bob
and that's a, that can be a big key to
to get your back pain to, you know
resolve a little bit is get the muscles to relax.
- Cuz a lot of people say my, my back feels really
tight
- Spasms that, yeah.
- Might be spasm, but just even tight.
- Sure.
- And some of 'em don't even have pain.
They have tightness there.
- Right? So, and they may want to continue
with their core exercises.
So how are we gonna do that?
Well, as far as these muscles to get 'em loose
the core exercise can be an answer.
And it's something that therapists in school
we learned this it's a term called reciprocal inhibition.
So you're wondering, well
what does that get to do with anything?
So what happens with the body is there's always two sets
of muscles the agonists and the antagonists.
When one muscle's working the opposite muscle, relax.
- It has to relax.
Otherwise the other muscle couldn't work.
- Right? So example, bicep here.
If I'm gonna lift something with this hand
my bicep is working to lift something.
The tricep does the opposite direction.
So when I'm lifting here
the tricep will automatically relax maximally
so that the bicep can continue with its work.
- So, so if we carry that over to the back?
- Right, if we want these muscles to relax in the back
we need to exercise,
- Activate these muscles.
- Perfect. Perfect.
So, so how we gonna do that?
- Well, there's a, a couple different ways we can do that
but it's the single most important thing we need to do.
- Right? You, you're not gonna do it
in a standing position because you have the weight
of your body going through your back and your spine.
And that puts stress on it.
- Right? We want you're activating the spine already.
- Right?
- I mean, there's no way around it.
You can't get it to the yeah.
- That's how you're, that's how you don't.
That's why you don't tip over.
Cause all these muscles are working to keep you up.
So we want to get that stress off of it.
So we're gonna lay down on your back.
You're gonna go on a carpeted floor is gonna be
the best you could do it on a firm bed.
We're gonna do it on this table here.
So Lonnie can see us.
But typically most people it's a carpeted floor
- And being instructors as we are Brad
why don't you show the proper way to get into bed?
Oh, just actually two, two ways.
Isn't that?
- Yes. Yeah.
If you're got, if you got back pain
you're gonna imagine there's a
- Brace around or
- cast cast around your back.
So you can't move it and you're gonna go in and
if you've had back pain, you know exactly what I'm doing
you know why we're doing this and then I'm gonna go this way
as opposed to rolling in like that.
We're gonna go this way.
Keep that back straight.
See how I'm bringing this leg up.
This one's up one at a time here, work my way down.
And once you get here, we log roll.
Everything stays in position.
And then we roll over.
Now, if your back isn't that sore and you can get, you know
you don't have to go that slow.
That's fine.
If there's no pain
- At the end I'll show you another way to do it.
The one that I actually had to do when I had back pain.
- Oh sure.
- When you we'll wait for the end.
- Okay.
- All right.
So how we gonna exercise these muscles?
We're gonna lay down like this and there's
there's a little bit of a progression here depending
on how severe your pain is
and how strong your stomach muscles are and you know
your history of core exercises.
But to start out with
we're gonna talk just a simple posterior pelvic tilt.
So my muscles here
the ones we want to tighten I'm tightening.
And can you show him that?
- Yeah. Well the other thing is, you know
if I put this underneath here, he's squishing this.
- Yep.
So if I put my hand underneath there
he'd be squishing my hand.
- Right?
- You're you're moving the pelvis
like this you're flattening the pelvis all there.
Like that.
- It's kinda like a dance Bob,
but so there we're doing that.
And that itself is,
I'm experiencing that reciprocal inhibition.
My stomach muscles are working my back muscles
have to relax.
- So we got the spine here.
The pelvis is turning like this.
- You're doing it on this side so they can see that.
So this is happening
- And see how the back flattens out.
The, the erectus abdominus has to be working to do that.
And therefore you're firing that muscle
and hopefully relaxing the muscles of the back.
- Oh yeah.
That feels good, Bob.
- All right.
What's the next progression.
- The next one is, you're gonna flatten in the back.
Now let you know how to do that.
You get that experience and you're gonna hold it flat
and you're gonna bring one knee up at a time.
- Yeah. This might be plenty for
for some people who are just starting off with this.
- Right. And we're gonna do 10 to 20 reps.
If you can do 20 reps like this without any problems
then you're probably ready to flatten the back again and
- Do doubles,
- Do double knees up while you keep it flat.
And that's really working the core that erectus.
- Now again, if this fires up your back
this isn't something you're gonna do right now.
You, I mean your back, pain's gotta be getting
better or feeling better when you're doing this.
- Now the option to this, this particularly when go down
I have patients say, oh, that hurts.
When I go down, then you might want to go to
this and this will work the upper abs.
And we're still getting that same.
- So again, he flatten, you flatten your pelvis, right?
Brad?
- Yep.
Flatten it down.
Good point.
- And he is just bringing up his shoulders
and his, his head.
- Right.
- Basically.
- I'm not doing this.
- He's not curling.
- I'm just kind of going straight up.
- Aren't ya Brad?
- `Yeah. Straight up.
And you're only about an inch.
Your just to get these shoulder blades off the
of the carpet
- Now, do you wanna do one with the ball?
- Yeah, I do.
So. And if you have a ball
I really like the ball because
- This one?
- Which one? Lonnie. Red or the blue caught her off guard.
She wasn't paying attention.
- Lonnie fell asleep back there all right.
- So you go like this with a ball.
Now the thing about this is you don't really have to think
about flattening your back.
Cause the ball kind of at all
- The ball does it yeah.
- And then you get a hold of that ball with your legs.
My heels I'm gonna curl in right there.
Or you can squeeze it this way
like a clam shell and you just go like this.
- I just started these based on Brad's recommendation.
And these are difficult for me.
I mean, I mean, I do 'em and I
I can do actually 40 of them, but it's, it's more work
than the ones I, I just haven't adapted to it yet.
Cause I've adapted to some of the other.
- Yeah. You know, if you've never done this, you know
you may have to practice.
I find that, do it with my shorts on.
So my skin goes on the ball in shoes where they have heels
the skin doesn't slip on the ball.
I just had a patient experience this.
And she, she said, yeah
it was much easier when she had her shorts on for me.
- I, I have, for me, I have to grab it down further.
- Well, you got those, those long legs.
- Long legs, yeah.
So, so I'm, I'm more on the side of it to, to do those so.
- And with these 10 to 20 of them
now I do these all the time.
Cuz I do it with my spondylosyndesis and I usually do 50
but I've been doing 'em for years and with the ball.
- So he had to outshine me basically.
I said 40.
So what does he say?
I do 50.
- Well, if you would've said 50, I would've said 60.
- I know you would've.
So now you're doing doubles here.
Aren't you?
- Well, actually now I'm just doing my shoulders.
Okay. But if you really are advanced
and you want to continue, you could do this
but you gotta be careful.
You don't curl up too much.
- That'd be a tough one. Huh?
- Now I wouldn't do obliques.
- No,
- Cuz you, you gotta sore back.
You don't wanna be twisting your back.
We just wanna be working it.
So be within reason it should feel good.
It shouldn't be irritating your back.
And this actually does feel really good on, on my back.
- All right, Brad, do you want me to show them now
the way to get that outta bed?
- Yeah. So again,
- All right, Brad.
Luckily had shown me this technique right
before I had a, like a one, two day episode of back pain.
And I literally, I was
like this and I could not get into bed.
- You were locked up.
- I could, I could not get in it.
I mean, it hurt so bad.
So what I did is I, oh my God, I
you go to the bed and you support yourself
and you just bring your leg up like this
and that way you're keeping the back straight
the whole time right here.
And then you come down like this
and then you bring the other one
up and then you can roll over.
- There you go.
- Yep. And then getting out, it's the exact opposite.
You just go ahead
and bring the leg off the edge and come up.
Like this really works out.
Well, you know, one thing you want to keep in mind
you're back all night long
the discs are filling up with fluid,
- Right.
- So you're actually taller in the mornings than you are
at night, you know where you're squished the fluid out.
- Right.
- But your back is more vulnerable
in the mornings to disc injuries.
- Sure.
- So it's good
for you not to try to get outta bed, you know
with like this don't be curling
up like this and then getting outta bed.
Cuz you're putting a lot of stress on the back.
You wanna roll onto your side
and get up like the technique Brad.
- Sure. So there there's quite a,
quite a science to the back
and it's things that if you haven't, if you had back pain
you say, oh, I wish I would've done that then.
- Right.
- You know?
- Right.
- So, all right, Bob, what do you say?
- Remember Brad and I can fix just
about anything except for that broken heart.
- Is it coming out Bob right here?
- Yeah, it should.
- So see what happens.
- Yeah. Thanks for watching.