- Hi, 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.
- Brad, you have a malady.
You have a problem.
And we're going to show you how to help you
with that thing today.
- Okay. We're talking about spondylolisthesis,
or spondylo- How do you pronounce it, Bob?
- Spondylolysis right.
- However, it's a big, long term.
If you have it, you probably know it.
Although 10%, it's estimated 10%
of the population has some degree of this.
- And, and don't even know it.
- Right. Some of them don't.
Me personally, I do have it.
I definitely know I have it.
You can see it on the x-rays, and I can feel it.
And I have symptoms.
I've learned how to self-treat it.
And that's what I want to teach you how to do.
- Excellent.
- Okay. From personal experience,
as well as some patients I've worked with.
- That's wonderful.
So what is spondylolisthesis?
We're going to look at the back,
and it's usually in the low back.
Okay. So we're talking right about at the belt line.
Mine is between L4 and L5.
It's a common place for it.
- Vertebrae here.
- Right.
We're going to look at those two lumbar vertebrae.
And what happens is, it's kind of interesting.
A fracture occurs, in the back part of the bones.
I'm not going to get into the detail.
- Right.
- But what happens is one vertebra shifts forward,
and it becomes misalignment, misaligned.
And that can cause some problems.
- Or lots of problems.
- Yeah. So if,
- We're going to show them on the cups here.
- Yeah. We're going to use a model.
This virbra cup represents L5.
Why don't you show him where that is on there Bob.
- L5 is right here, and this is L4.
- Right.
- He's going to show those two.
- Now, if you look at your vertebra,
they should be lined up like this.
Between, there's going to be a disc.
Although in mine, the disc has disappeared over time.
So they oftentimes do come together,
and there's a shift forward and an actual misalignment.
- Yeah.
- Okay. There's grade one through grade four.
Okay. We're not going to get into that.
But if you do have this, you have a shift like this.
There's some exercises you can do to help improve this,
and keep it stabilized.
I shouldn't say improve it, but at least,
- Probably keep it, stop it from getting worse. Progressing.
- Right. As well as manage pain. - Right.
- And that's what I've discovered. It works very well.
- Because you're a very active guy, Brad.
And yet, you're getting by with this.
And what is, what, what is your stage or what level?
- I'm in between a one and a two.
- One and a two.
- One and a half to two.
Right. Stage four is the worst.
If you have stage four, you're probably having surgery.
We, I don't even want to think about going there.
- Yeah.
- So if you haven't done any exercises this before,
if you look at the vertebra and they're shifted,
we want to keep, keep them stable by
strengthening the core, primarily abdominal muscles.
We're going to flex things. Okay?
Thank you, Bob.
So the first thing you're going to do is
learn how to do a pelvic anterior tilt.
Or posterior your tilt. I'm sorry.
You get my tilts in gear and that is this.
- So if you watch his belt line here,
which you can't see too well,
but his belt is actually flattening. I mean.
Maybe it be better if I just put my hands in here right?
- Yeah. I'm going to squish.
- Just my hand.
- Yeah. There we go.
I'm tilting my pelvis, this direction.
Tightening those stomach.
And you're going to do 10 to 15 of those.
Some people have a hard time doing this
if you never did this before.
- Yeah. A lot of people have a lot of poor self-awareness.
- Yeah. Put your hand back there,
and think about squishing your fingers into your back.
Okay. Then once you do 10 to 15 of those
and you feel comfortable with doing that,
the next thing you're going to do is
you can cross your hands like this and simply
do a little crunch or a little sit up.
You don't have to go way up like this.
As a matter of fact, I don't want you to do that.
- We don't do that. No.
We want this, this.
- And should your pelvis be pushed down
while you're doing this Brad?
- Yes. Good point, Bob.
I'm going to push down.
- So he's going to, yep.
- Going to round that back up.
- Stabilize that back before he does this.
- Okay. Now we're going to come at.
- How many repetitions Brad?
- 10 to 15.
- Okay.
- If you haven't done this before 10 or 15.
You're going to feel it.
- Right.
And you're going to take a while to get in the shape.
I go, I like to go up to 50.
The goal is to get up to 50.
- Okay.
- Because you want to have a real strong core.
But that may take a month or two, if you haven't done it.
- Sure.
- Then the next thing you're going to just lay here.
- Pelvic tilt.
- Pelvic tilt. Lift one knee up, and then the other one,
and do 10 to 15 of these while you're,
- Keeping the pelvic tilt.
- Pushing your back down into the table.
- That's why it's so important to learn that pelvic tilt.
- Right. And you should do this on
a carpeted floor or a firm table not a bed. Okay?
Then the next thing you're going to do is, if you can,
- This is a little more aggressive.
- Both knees up at the same time.
If you're an athlete already in, in shape,
I'm going to have another video to show you some more
aggressive things you can do
so you can keep your activities up at a good level.
Okay?
- So again, he's doing the pelvic tilt the whole time
while he's, he's doing the leg lifts here..
Right.
- Pretty difficult to do. Brad makes it look,
makes it look easy.
- And the last one. Arms like this, again.
Knees up and you're going to take your right elbow
towards your left knee.
And then, this one's a little difficult at first too.
But once you get used to it, you'll do fine.
Okay?
- Just a gentle, it's a gentle twist, very little.
- Right.
- At all.
- But this helps get the oblique muscles.
It just, it kind of puts a final strap
on the core strength for the.
- We don't want a huge twist,
and we don't want a, you know a huge flexion.
But he's just barely coming up.
- Exactly.
- So once you get going with this,
you'll be able to get through this
in less than five minutes easily.
As you get better at it, you'll add repetitions.
That may take 10 to 15 minutes possibly.
But that's about it.
And there's a couple other things you really
need to absolutely avoid if you have this condition.
And that is overhead work like this.
Like washing the ceiling. Okay?
If you're doing work on the ceiling
where you're extending backwards.
You don't want to do this exercise very much.
You do not want to do,
even though this is a good back exercise for most people.
- That's a bad one for you.
- Right. You don't do this extension exercise.
Okay. We want strength here.
And it's a little unusual in that sense,
but you you'll do fine.
It will definitely help you out.
- So make sure you subscribe if you haven't already.
- Take care.
♪ Bob and Brad, ♪
♪ The two most famous, ♪
♪ Physical therapists, ♪
♪ On the internet. ♪