(upbeat music) ♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the Internet ♪
- Well hi there folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous
physical therapists on the Internet.
- In our opinion
of course, Bob. - Humble opinion.
Today we're gonna talk about how a pelvic tilt
can stop your back pain
and we're gonna show you how to do it.
- I'm convinced that the majority of people,
if they could get their body awareness of their pelvis,
can really change their back pain or
if they're gonna get back pain.
- Right, it's basically posture for the back.
You gotta get this right. - Exactly.
- We'll show you how to do it.
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'cause we're always giving something away.
Right now we're giving away the ProPoint,
these are like mild fashion release,
what would you call them Bob?
- Massagers. - Massagers, yeah.
- It's for your trigger points
on your back it works well.
On the bottom of your feet you can put it on the floor,
work your back, lay on it, your feet.
- It'll also stick to walls if the wall's very smooth.
- There you go. - Or a column.
- It's got a suction cup.
- Yeah I think a refrigerator would maybe work.
- Well yeah, you could do that before you get your
ice cream. - Your spoon.
(laughing) There you go.
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- There you go. - All right, so,
we're gonna look, oh, it fell down Brad.
(laughing) - Oh my goodness.
- We're gonna start by looking at the pelvis here,
so what we're trying to actually do.
So this is orientated, do you mind getting oriented
just like this is, Brad?
- Well you have to turn it around.
- Oh, you wanna do it that way.
- Well I got the red tape for our visual effect.
- So if you are in what we call a posterior tilt,
the pelvis here is actually gonna be posteriorly rotate,
or rotate back and what that does, in effect,
it rounds out the low back.
And that puts stress on the ligaments
that'll hold bone to bone,
they can actually stretch out
and become instable, or unstable.
- The disc as well. - And the disc as well.
We're gonna show you how that can affect the discs
just by having this rotated back.
So what we wanna do is actually rotated it forward a bit
and get a little more into the anterior neutral position.
- So I'm posterior all the way,
is that showing up on that tape?
And if I go all the way to the anterior,
we wanna go about halfway in between
and get that neutral position,
still a little arch in the back,
but still we're using our core muscles.
- And to be honest when you're
sitting or when you're lifting,
it's hard to go into too much of an anterior tilt
to be honest with you.
You wanna tilt it as much as you can
and you're gonna be lucky if you hit neutral then.
- Right, and then you're gonna use those core muscles
to help support and--
- We'll show you more of that as we get into the sitting.
I just wanna show it with the scale here,
with the discs and-- - Models, yeah.
So this represents your lumbar vertebrae,
L5. - L5.
- Right, they're the lowest one.
And then the green ball represents the disc
which the disc has--
- And this would be L4. - Yep.
There's fluid in the discs, nucleus pulposus,
and the disc is flexible so if you do
posterior pelvic tilt like we first talked about,
it can put pressure on and then in particular if you do that
and do some bending or lifting,
that can lead into this, you got that?
- Over time, especially. - Over time.
- You know if you do it repeatedly day after day,
go into the posterior pelvic tilt,
you can eventually wear out the back of the disc
and it can cause problems
like they're causing a bulging or hernia disc.
So you really wanna keep your back
in what we call the locked-in position
where you're nice and straight,
it's designed to be the strongest
when it's in this direction.
- When he says, well, we're kind of contradicting,
'cause there should be a little arch in there,
but if you think straight for the lay-person
that usually works out well.
- It's a little confusing because, yeah,
you're trying to get a little bit of an arch
in the low back and I consider that to be straight.
Somewhat. - Yeah, there we go.
- So we're gonna start off showing you
how to do a pelvic tilt,
we're gonna do it on the mat here.
I'm gonna grab a pillow,
you mind moving your sign there Bradley?
- Oh yes, we'll get the sign out of there.
- So the best way to start this
is to train on the bed first
'cause most people really have a lot of difficulty
knowing how to do this, Brad.
They have poor body awareness
of where their pelvis is at,
can you see okay?
- Yeah we've got the red tape on our belt lines
so that it's easier to see the movement of the pelvis.
- Now I've found usually it helps to bend the knees,
have you found the same to be true Brad?
- Yep, I agree.
- And a lot of times we'll tell you to even,
as a feedback, put your hand in your low back.
And what you're trying to do is tilt the pelvis,
which in effect causes you to squeeze against the hand.
The back should be flattening up against the hand.
- So you put your hand above the belt line,
in that, we call it the lumbar area.
- Now that's a posterior pelvic tilt,
that's the tilt we don't want you doing, actually.
But I'm trying to just teach you the feeling
for what the pelvis is doing.
So here I'm going posterior, or back,
now I'm going anterior.
And this is the one you're gonna wanna learn how to do,
is the anterior.
And this, you're taking stress off the hand,
and you're moving the pelvis,
you're tilting it this way.
So do this, you know, do this 10-20 times
so you're learning body awareness,
you're learning where you pelvis is at in space.
- So here Bob is, his skeleton is doing this,
and then doing this.
And, you know, it's amazing what movement you have
in the pelvis and the low back that you are not aware of,
so this helps teach that.
- So the next thing you might wanna try to progress
to a seated posture, I'm gonna just do this
right off the edge here.
You mind moving down a little bit Brad?
- Oh, I don't mind.
- So this would be the next area
where you're now trying to learn.
- We gotta get your shirt up so they can see.
- And again, if you slouch,
that almost naturally puts you in
kind of the posterior tilt, the bad tilt.
And so we want you to straighten up,
and also tilt your pelvis a bit.
- You see that extra motion,
that really changes your posture overall.
- Now I'm really not anteriorly rotated
or rotated forward too much here
because when you're sitting it's hard to get too much.
- It is, it's just the mechanics of the hip.
- Yeah so you can almost go as far as it'll allow you,
and then you can, sometimes we actually have you put
support in your, yeah.
- There, you can see that, there you go.
Go back and forth, Bob.
- All right, hold on just a second.
- Get some pelvic motion. - Okay, ready?
- There we go, so we want it there,
and kind of, there and hold it in.
- And sometimes you can actually use a back support
to help hold you in position,
like when you're in the chair.
- What we talk about, just start out using just a towel roll
and put it there and that's gonna help
maintain that pelvic position.
- And that's why it's so important
to use something like that
in your vehicle, especially when you drive a lot,
or when you're at your desk all day.
Now if you are a person with larger curves,
you're gonna probably need a larger towel,
a little more, and if you're a smaller, a slight person,
which I consider myself, I need just a thin little,
piece of foam is what I use.
- And it depends on the cushion of your chair,
or your vehicle seat, if it's softer,
or it might be wore out, if it's wore out,
even if you're a thinner person
you might need a thicker one.
- And some people have the built in lumbar support.
They have the little spin the wheel, right?
- I advanced now, I got a button,
you push a button, it goes, (mimicking whirring), it's fun.
- It makes that noise, huh?
- Well, in my head it does, it's electric.
- And after a while, you try a towel first
to figure out kind of what thickness you like,
then after a while you go online
and you can purchase, McKenzie makes a nice--
- They make a nice cushion and they have different sizes
and different intensities and densities.
- Densities, right.
All right now you're learned
to do it in the seated position,
maybe with the help of a support to get there.
Now you're also gonna wanna learn to do it standing
because when you're standing you really wanna learn
how to do it when you're lifting.
So I'm gonna tilt my pelvis anteriorly a little bit,
and now I can reach down and, again,
as I get down here it's really hard to keep the back
anteriorly rotated so I rotate as far as it'll let me go,
because it will probably put me just in neutral,
is what happens at that point.
- But maintaining that nice straight back
and hip hinging, there's a lot of mechanics
with lifting going on here.
- Yep, so I'm trying to keep this arched,
keep the pelvic tilt while I'm lifting,
and all the movement is coming from my hips,
I'm keeping this like it's in a cast
and there's really no movement there,
it's just staying in an arched position.
That back is in a really safe position
when you're doing this.
I mean you can lift this way,
you can shovel this way,
you can carry things this way,
and you know there's not that much stress on your back.
- Yeah, much much better for the back.
Are we gonna do the next one? - Yeah.
Now the final thing here is that,
I've been finding this out lately, Brad,
Brad and I invented the hanging handles.
So what it comes with is you got two wall anchors basically,
we have more here for other uses,
the wall anchors are nice 'cause you can also attach
bands to them and do exercises.
- It's multi-purpose.
- But these actually come off too,
right off of here.
You know, they come off so you could just
have this up there and you could go up
every so often and just flip it on there
and, what's nice about it is,
you can have it in your office even.
But the big thing about it,
it's good for your shoulders and your posture
but it's really good for doing decompression on your back.
And what I like to do is actually hang
and actually do some pelvic tilts
when I'm in this position.
- Yep so I'm getting shoulder, back, and,
now when I hang, and I think you do the same thing,
I do a posterior pelvic tilt
and it really is comfortable, feels good.
- Yep it's just getting some movement
in that back while it's being stretched.
- And it's a little easier I think for most people,
I know it is for me, while you're hanging
to actually feel your pelvic motion.
So it's a good way for feedback,
you can feel your back, I can feel my back touch the wall,
now with a posterior and I can feel the arch,
it's just easier I think than actually laying down.
Plus again, the shoulder.
I just, I got a pair of these for one of my patients,
and he's a carpenter, and he's gonna mount them
in his work trailer to go to work site, to work site.
- Oh, no kidding. - 'Cause he's starting to get
posture forward, so they're just incredible.
- Well I use them just religiously
when I do work in the office.
Because I'll, like every 20-30 minutes,
I'll get up and I hang.
And my back almost always cavitas,
or pops a little bit because I've been sitting,
even though I'm trying to sit in good posture,
it doesn't always happen.
- Well you get involved with your work,
and it's a lifelong, you know, effort.
- Yeah believe me, my wife came by
and irritated me again recently--
- Again?! - Yeah she said--
- Oh, Bob. - She came over,
and I'm just sitting, sit down Brad,
she goes, you know, you need to be sitting up like this,
like a therapist wants to be told he has bad posture.
- Yeah, well, you know, - I just tell her,
I'm really into something right now,
I can't talk about it.
- You've got a good wife there, Bob,
she cares about you. - Yeah.
Remember, red eye can fix just about anything--
- Except for-- - A broken heart.
But we can affect--
- Yeah this is a part of the--
- Pelvis, you could fix your pelvis.
- Right, which is all a part,
it all works together.
- It's just, we could fix your pelvis.
- I know but, I was being optimistic.
- All right. - Thanks for watching.
(upbeat music)