- All right, this is a video of Rick Olderman.
He is easily one of the best therapists,
physical therapists we know.
He's a real master clinician
- Right, he's been treating patients for about 25 years away
if I do the math right.
- Right.
- And he teaches patients to- patients to take care
of themselves.
- How, how to-
- The root problem.
- Yeah. It- it's just, it's what people are looking
for when it regards to-
- So, yeah, I-I'm sorry Ben.
- Don't worry about it.
- In this video he's working with a real patient
who's low back pain is caused by spinal stenosis.
- Right, which is pretty common.
- So he gives her six exercises that help give her
some immediate relief.
- All right, we better let Rick take over.
- Yeah, take over Rick.
♪ Bob And Brad ♪
♪ The two most famous physical therapist on the internet ♪
- Katherine, why don't you tell me a little bit
about your back pain?
- So it's- it starts in my lumbar spine at- at,
you know, at the bottom there,
and then it just- it's a pain that shoots equally down
both legs and- and it goes all the way down
to my ankles, and it just kind of feels
like I stepped on a, you know, live wire.
- Oh, okay, and when does this happen?
- It happens- it happens in the morning when I get up.
That's only predictable time it happens.
It'll happen at odd times during the day,
but like when I get up from sitting
and get up from bed, I know it's, I can be prepared,
but then sometimes it just does it on its own.
- Am I right, did you- did you have an MRI
or x-ray of your back recently?
Did it- was there something that showed up there?
Stenosis or something?
- Yes, that's right, that's right, I did,
cause I sent you the- oh, sorry, I sent you the report
and- and yes, it shows a- a narrowing.
I guess you call it stenosis.
- Uh huh. And- and do you remember the level?
I think it was- was it L4 L5 or?
- Oh, I know it was L3, L4.
- Okay, all right.
- Being compromised.
- Yeah, yeah. So, you know, diagnoses of stenosis,
there's varying degrees of stenosis,
it doesn't worry me, we help people even
with severe stenosis.
- Oh, that's good to know.
- So, what really matters is the stresses that are acting
on that stenosis, so that's what we're gonna be
- Yeah.
- Hopefully solving today.
- Yeah.
- All right, so the first thing that we're gonna be doing,
Catherine, one of the things with especially stenosis,
but most back pain is that we get spasm in the back
and the muscles just get really irritated
and stuck in contraction.
- Oh, okay.
- So what I'm gonna just have you do is
I want you to arch those- your back
and you'll feel those muscles contract.
- Yeah.
- And then I want you to learn how to relax your back
and round into like a slumped position,
and you can rest your weight on your hands if you want
to. Good, and feel that-
and this should feel really good just to slump like that,
it should feel like a nice stretch.
- [Catherine] It does, it feels very stretch.
- Good, good, okay, then we're gonna do it again,
we're gonna inhale and arch your back
and go as deep as you want to, and then exhale
and flatten your back and rest on your hands.
All right, and then we're gonna come back up
and this time when you sit up tall,
we're not gonna arch the back quite as much.
So we're gonna keep it out of that excessive contraction.
- Okay.
- How does that feel?
Does that feel like a good thing to do?
- Yeah, it does, it does.
- Great, It's an- it's an easy thing
that you can do throughout the day.
Anytime your back starts to feel
like it's starting to seize up
or get contracted, just go into that.
You're gonna release that reflexive contraction
and then relax them again.
- Oh, okay.
- So the first exercise we're gonna do
is just have you get up on the table,
and I'm gonna lower this down a little bit for ya.
Good, so all we're gonna do is I'm gonna have
you just kind of lean forward into that
and you'll feel a little bit of a hamstring stretch.
- I do.
- Now, if you want to, you can pull the toes back
and you'll feel more stretch in your calf too.
- Indeed, I really do.
- Okay, so we wanna be gentle with this one
because you've got sciatic nerve symptoms running
down your leg, that's what all that lightning bolt kind
of action is, and we don't wanna irritate it,
so we just wanna gently move- stretch that nerve
a little bit and the muscles surrounding it
by doing this one, and we'll just hold here
for a few seconds and breathe.
- Oh, this is it?
- This is it. Yeah, it's this simple.
- Oh, wow.
- Yeah. So you're just gonna breathe
through that little gentle stretch,
and then we're gonna go ahead
and turn around and stretch your other leg too.
- Okay.
- Oh, that's interesting, I feel way more
on one side than the other.
- Yes, and that's why I was asking you
about whether you felt it in both legs the same,
because often there's an asymmetry
to how we're using our body
- Uh huh.
- that causes one side to be tighter than the other,
and that lends itself to creating these types of problems.
- Okay.
- So- and we often start feeling that asymmetry
once we start addressing
- Yeah, interesting,
- the system.
- Okay.
- All right.
- All right, Catherine, what we're gonna do now
is a little hip strengthening exercise.
- Okay.
- So, often when the hips get weak
they create asymmetry in the pelvis and the back,
- Uh huh.
- and we wanna make everything nice
and symmetrical for you, okay?
- Yes, yes.
- And especially if you like hiking and-
and walking outdoors, hip strength is really critical.
- Okay.
- All you're gonna do is you're gonna move that other leg
out and in 15 times. Pretty interesting, isn't it?
- [Catherine] Yeah, it's very interesting.
- [Rick] Yeah. Until- so these little asymmetries sneak
into our body and we're not aware of them.
- [Catherine] Yeah.
- [Rick] You're a pretty fit person,
and you're unaware of these things happening.
- [Catherine] Yeah.
- [Rick] And so, this lends itself to one side
of the body being used a little bit more
than the other, undergoing a little bit more stress
than the other,
- [Catherine] Good, okay.
- [Rick] you know, all that kind of stuff.
What we're looking for is maybe a little fatigue
in the hips here. Do you feel any fatigue from doing that?
- [Catherine] I do, I do.
- [Rick] Okay, okay. Great.
- [Catherine] Yeah.
- [Rick] All right, great, so we'll move on to the next one.
You can stay right there.
- [Catherine] Okay.
- Okay, so we're gonna lie on your back
with your knees toward your chest.
Now this should feel really good for your low back.
- Yeah, it does.
- Okay. Do you ever do this
on your own just to relieve your pain?
- Yes, this is what I do.
- Okay, so that's your body telling you,
hey, I want more of this, right?
And so one of the reasons this isn't happening is
because of the tightness in the front of your thighs here,
so we're gonna stretch those out a little bit.
- Okay.
- [Rick] And by the way when you do this stretch
you'll notice that if I take this pillow
away from your head,
- Yeah.
- [Rick] your back wants to arch more.
- Yes it does.
- [Rick] And when we lift up the head- the head,
- Yeah.
- [Rick] it makes it flatten more.
- Yeah, yeah.
- [Rick] So this is a good thing to do at home.
- Okay, okay.
- [Rick] Okay, so all you're gonna do is- let's hold
onto your left knee first.
- Okay, like this?
- [Rick] Yep, and then you're gonna lower
that other leg down,
- Okay.
- [Rick] and you wanna keep this knee bent at 90 degrees,
- 90- Oh.
- [Rick] and you'll feel that stretch right here.
- I do.
- [Rick] Good. That's all we're doing is stretching it,
so no magic here, and then yes,
pull back on this knee to keep your back nice and flat.
- Yes.
- [Rick] This knee will want to tend to travel forward,
- Yes.
- [Rick] and then your back will start to arch,
and if that happens you'll get up from the stretch
with some back pain, we don't want that.
- Okay.
- [Rick] We're trying to go the other direction, right?
- Okay, okay.
- [Rick] So, if you can't bend your knee at 90 degrees
you can bend it wherever you want, all right?
- Okay.
- Whatever's comfortable for you,
but 90 degrees is where we want.
- And am I at 90 degrees?
- Yes, you're-
- Okay.
- you're pretty close there,
and then also we want this leg ultimately to be able to rest
on the table, but if it's off the table in the beginning,
that's perfectly fine,
- Yeah, yeah, you know it's off the table right now.
- just- just take your time.
- (indistinct) something to work.
- Exactly, all right? So generally about a- a minute here,
is this feeling okay?
- Uh huh!
- This should not increase any pain while you're doing this,
in fact it should feel good.
- Yeah, it does feel good.
- Okay, great.
Okay, So this next one Catherine, we're gonna have
you just- we'll pretend like this is
your kitchen countertop,
- Okay.
- and we're just gonna lean on it
and we're gonna lift one leg with the knee bent,
and you're gonna lift that up,
and you'll feel your butt engage here at the top here,
and I just want you to do a nice little pulse
at the top there
- Oh.
- and feel that the butt is contracting to do that.
- Should my standing leg be straight?
- I would like it to be a slightly bent,
- Okay, okay.
- if you can do that.
- Yeah, cause that- that feels a lot better.
- Good, so ultimately the arching of your back is
what's causing your back pain.
- Uh huh.
- The more you bend the stance knee,
the less arching your back will go through.
- Very good.
- All right?
- Okay, that makes sense.
- So we're gonna do about 30 of those,
and then we're gonna hit the other leg,
so let's go ahead and switch.
- Okay.
- And so what is this actually doing?
- Well, a lot of back pain is caused from hip dysfunction.
- Oh.
- All right? And so what we're doing is correcting the-
the most likely cause of your hip dysfunction
- Okay.
- with this exercise,
- Okay.
- which then is contributing to strain in the back.
- Okay.
- All right?
- 30 times. Each side.
- 30 times, yep.
- Okay.
- Okay, and then you can stand up.
- Okay.
- All right.
- Everything just feels a little more loose.
- Yeah, I love how you just figured that out.
- Yeah.
- You know, you just listen to your body
and that's what it's really all about.
- Yeah, yeah.
- I love that, that's exactly what you should be doing.
- Okay.
- All right, so what we're doing is just turning
on some key muscles, turning off some others,
- Oh, good.
- and taking stress off of that stenosis in your back
and the other areas that are under-
- Oh, thank you.
- under siege.
- Thank you, thank you so much.
- All right, so how does that feel?
- Yeah, so it just, I mean, it-
it feels like, it feels so refreshing
that I can't wait to do what- go, you know, I'm- I'm, it-
it encourages me to wanna continue
- Yeah.
- to do these exercises.
- Good. It's really that simple.
- Yeah!
- It's- it's not hard.
- I'm surprised. I thought it was gonna be-
- It's just, yeah.
- I thought it was gonna be hard.
- Yeah, it's- it's not aggressive, it's gentle,
you- hopefully you don't feel winded or strained in any way.
- No. No, no.
- Great, great, and that's the key.
- Oh, I'm pleased. Thank you.
- Great. Oh, my pleasure, thanks for coming.
(Catherine laughs)
All right.
(Upbeat music)