♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We're the most famous physical therapists on the internet.
- In our opinion of course, Bob.
- Today we're gonna show you how to self-mobilize
your sacroiliac joint, also known as the S-I joint.
At home, you can stop pain in minutes.
- Bob, well put.
- Yes.
- Are we gonna continue on with our--
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- Ohh.
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- Oh, yeah.
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- But it doesn't just vibrate, it rotates,
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Let's get started, Brad.
- All right, Bob.
Sacroiliac, you know, I remember hearing this
when I was a youngster, my mom would talk about it.
I don't think she knew what it was.
I know she didn't.
- Everybody associates it with back.
- Right.
And actually, it's associated with the hip.
The hip and the sacrum.
The sacroiliac joint, S-I joint, is right here.
It's the joint from the sacrum to the ilium,
or the pelvis bone.
- [Bob] Yeah, its more associated with the pelvis,
not the hip so much.
- Yeah, you're right, you're exactly right.
So right there.
So there's one thing about pain from the S-I joint,
it can often time be misdiagnosed--
- Very easily so.
- Or confused with low back pain,
or from the hip possibly.
- Yes, yes.
- So that's why, if you continue to watch us,
it'll help, you'll be able to figure that out,
because we have our ways to explain this.
- That's right.
- So, typical location of pain.
People that come in and complain
of S-I joint pain, there's typically on one side,
okay, typically not across.
I say typically, because these can be tricky.
- Yeah.
- Down the leg, referral down the leg
but usually not past the knee.
It can wrap around a little bit.
Oftentimes it's provoked with weight-bearing activities.
For example, I have an S-I joint issue,
and this morning I went running
and I can feel it's irritated right now a little bit.
- Yeah, 'cause if you think about it
once he's pounding through that pelvis
- Right.
- And so like, stairs, uneven ground,
- Yep.
- It can also be brought on by sitting uneven, Brad.
- Sure.
- Like if the pelvis, if you're one of those people that
tend to sit like this all the time--
- Sitting on that big fat wallet with 1000s of dollars.
- That would do it.
- Another thing, if you step off a curb unexpectedly,
and you come down hard,
that could push that S-I joint out of place.
- Or if you have one leg that's longer than the other one.
- There ya go, yep.
- Very typical, very common with that also.
- Right, jumping off the back of a pickup truck.
- Sure.
- Something that's higher than you expected.
All those things can provoke and cause S-I joint problems.
So oftentimes like I said, weight-bearing,
typically when you sit down,
assuming you sit down properly on a good seat.
- And level.
- Level.
It feels better.
Or if you lay down.
Pain typically goes away.
So how do we treat it?
Okay, I've got four options.
Two of them work very consistently for me personally.
I've had other ones work well with patients.
So then the first option is,
Bob, you want to concur?
- Yeah, I concur, I just, do you have the Backpod here?
- That's a good point.
- Why don't you go ahead and start, I'll go find it.
- There ya go. - All right.
- Okay. - I'll be back.
- Okay, you know, we'll show some options.
If there's a softball, we could show an option using that.
First of all, laying down,
let's say my right S-I joint is suspect of
being the culprit of the back pain
and the hip pain and the leg pain.
I'm gonna take that right knee and bring it
up like this, and then I'm gonna pull,
I'm gonna let this leg down.
I'm not gonna let it come up, keep it flat.
And now I'm going to pull this knee this way.
Now at this point,
my S-I joint is feeling better already.
So this is what I do.
I do like this, and now the next thing's I put a
what we call a muscle energy technique.
This is a typical physical therapist's term.
I'm gonna hold my knee very solid with my right arm,
lock it in, and now I'm gonna push my knee this way
and it's an isometric basically.
I'm pushing right now as hard as I can,
and it feels better.
And now it feels better,
I know I'm doing the right stretch.
Gonna hold that for about five to 10 seconds.
Give a little break,
and you can just go like this if you want.
Push.
- [Bob] Now, would you agree, Brad,
that if, you might, that might make it worse.
And it might feel better to do it on the other side.
- That's right, if you do it here,
like mine, it clearly feels better.
I know I'm doing the right thing,
but if it hurts, makes it worse,
then you go to other side,
- [Bob] Try it, even if your pain's on the other side.
- Yep.
- [Bob] Try both ways.
- Right, so let symptoms be your guide.
It should make it feel better.
If it doesn't, makes it worse, you stop.
Don't go with the no pain, no gain rule.
- [Bob] Right.
- It's not gonna get you better.
The next one is simply slide,
and sometimes if this one here makes it worse,
Bob mentioned the option of doing the other one,
- Right.
- The third option is just slide your body
close to the edge of the bed,
and let that right hip, right leg, drop down.
- [Bob] Now you can keep the shoulders well onto the mat.
- Yes.
- [Bob] Or onto the bed.
- My whole trunk is securely on the bed or the mat.
- [Bob] Don't want anybody falling off the bed here.
- Now when this goes down,
now we're rotating that pelvis
the other direction, if this starts to feel good
then you may want to add this and do that,
and if it feels like, oh that's a really good stretch,
you're gonna continue to do it.
You may hold it 15 seconds or so,
and then you're gonna need to take a break.
- [Bob] You can even try a little oscillating.
- You bet.
- Yep, if that feels better.
You were doing a little bit of that, Brad.
I dunno if you realize that.
- Yeah, I was, because I wanted to, see it,
now this feels okay for me, but not as good.
- [Bob] It's not the winner winner huh?
- Nope.
- [Bob] Chicken dinner?
- Not this one.
- [Bob] All right.
- Okay, now the next one is, you can use
- The Backpod?
- The Backpod.
- All right.
- Now if you don't happen to have a Backpod
'cause you probably don't if you,
you could try a tennis ball,
or you could use a baseball or a softball.
But they're a little bit,
tennis balls are a little bit small,
softball can be a little aggressive.
This has got a soft rubber coating
and then it's firm underneath, like that,
and it pops right in nicely.
- A tennis ball works if you put a towel over it.
- Yeah.
- A thicker towel.
- Well, a tennis ball is a little softer.
I would think a softball might need a--
- Sure. - A towel.
Why don't ya throw me a tennis ball, Bob.
There's one right over there.
'Cause a lot of people won't have this.
- [Bob] Well see, what I'm trying to say, Brad,
is by, when you put the towel over it like this,
you know, it makes it a little thicker and
makes it a little more--
- Right, right.
- Have a little more density.
- Yeah, whatever--
- [Bob] It doesn't make it softer.
- Whatever you're using, if it's too aggressive,
it feels like it's too hard,
then cushion it with a towel.
Where'd you get this tiger's call?
Don't you have any regular towels?
- [Bob] Leopard.
- It's leopard!
- [Bob] Tiger? Tiger's stripes.
- Your wife wearing that or something?
- [Bob] What are you talking about?
(laughing)
- Okay, I'll go back to the shoes.
So we're going to put that right on that S-I joint.
- [Bob] Now that's gonna be on the floor, right Brad?
- Yeah, you're not gonna do this on the bed.
You're gonna do it on maybe a carpeted floor, is the best.
But I'm not gonna climb down there for that,
because you can get the adjust.
Now, when I do this, I'm gonna take this out
because I always use the Backpod at home,
because it really works better.
- [Bob] You're putting it right...
- I put it not on the sacrum,
not on the joint but just to the side.
But you're gonna put it wherever it feels good.
- [Bob] Okay.
- So again, same rule, now I'm rolling
all of my body weight, well, not all of it.
My trunk is supported by my shoulders
and my feet here on the ground.
So I can very easily adjust how much pressure
by letting my butt down onto that and
you're gonna know, you're only gonna do this
if it clearly feels better.
If it hurts, you stop.
That's the red, red flag, the red light, stop.
And go to the next option.
With me, it typically feels real good,
and what I'll do is, I'll go like this on there
and I'll do a double knees to chest.
And that all feels good.
But again, with me, this works
but not near as well as this one.
This is my go-to exercise.
Or I have one other one in standing,
which I wanna go to right now.
- [Bob] You wanna show on the spine just real quick
where you were placing that, Brad?
- Yeah, so here's the sacrum.
You don't wanna put it right over the bone here.
But typically over to the side.
- [Bob] So you're on the ilium a little bit.
You're on that flare out.
- Yep.
And so all we're trying to do,
could you zoom in on this, Mike?
Is, there's not a lot of movement in the S-I joint.
It's very little.
- [Bob] Yeah, a lot of ligaments holding it.
- Yeah, and that's why I can't really,
you won't be able to see it, but we're just getting
subtle movements in here, and you want to get
it subtly movement to the right direction,
which will decrease the pain.
- Now I just want to say, Brad,
we're big fans of the Backpod,
but it's expensive.
- Right.
- And a lot of people think, like,
oh my God, why are they asking so much money for it?
But we, again, as therapists and inventors ourselves,
we know how much it costs to make a mold.
It's become one of our favorite devices.
I mean, I use it every morning up on my upper back.
- Yeah, I use it not only there, and I use it
in my back so it's a tool that is widely used with me.
We'll do some more videos on that
in the future. - Yeah, we will.
- Now, oh, I need the stool, Bob.
- Okay.
- Oh, we can't, we gotta take the clock off.
- Can you, oh you wanted that stool, okay.
- Yeah, I have to have this.
- All right, let's go to work.
That stool.
- Yeah.
- So a high stool.
- So my right S-I joint is a problem,
and if I do this and I do this
and what we're doing is rotational force on it,
and I put weight through there and stretch
right now, I can feel that,
it just feels good.
Clearly, it's clearly feels like a good stretch.
- And once again, it's possible that even though
we have the pain in the right,
it might feel better if you put the left leg up.
- Yep.
- It's depending on which way
you're trying to rotate the pelvis.
- Now this feels like a nice stretch,
but it doesn't relieve that pain that I was getting
so I'm still gonna do this leg, but on this one,
I'll do it, and actually if I really drop into it
it just feels better and better
the more pressure I put on it.
And I'll do that for five to 10 seconds,
two to three reps.
- How much carry over do you have from that?
I mean, like, does it feel better for an hour?
Does it feel better--
- No, it's good.
- For the day, kinda it helps?
- Or I can do it.
Again I don't have a severe case.
I can just tell
it's lurking.
- It's right on the edge there.
- So, I'll do these for maintenance
and I can manage it, very nicely.
- All right, remember,
Brad and I can fix just about anything.
- Except for--
- A broken heart.
- Yeah, you know, I just had a friend,
he had a heart attack, and you know what they use?
They use stents.
(Bob laughing)
And it worked good, I dunno.
Maybe we should consider that.
- All right, we'll look into that as an option.
Thanks for watching.
(low-tech electronic musical flourish)