♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, Schrupp Bob, physical therapist.
- Brad Heineck, physical therapist.
- We have the most famous physical therapist
on the internet.
- In our opinion, of course.
- Tommy got Brad off guard there.
Today, we're going to talk about...
so you know how to say this, retrolisthesis?
- Right Bob, retrolisthesis.
- Back pain.
Five best exercises and treatments to stop the pain.
Brad and I have received this request quite often.
- Over the years. - Over the years.
So we decided to finally to tackle it
because we listened to our audience.
- Right, and we do a spondylolisthesis
'cause I have spondylitis, so I'm kinda linked in to that.
But retro, I didn't think that many people had it,
but actually there are
because we've got people requesting it.
So we're gonna actually do a pretty detailed video on this.
So be patient.
And if you have it, you'll want all this information.
- By the way, if you're new to our channel,
please take a second and just subscribe to us.
We provide videos on how to stay healthy, be pain-free,
and we upload every day.
Also, you're gonna want to go to our website,
bobandbrad.com.
Go to the giveaway section.
We're doing a great giveaway this week,
the Teeter LT3 FreeStepper Recumbent,
something cross trainer.
It's a great device.
Again, Marcus, if you're listening, show a little bit of it.
- Put a little picture in there.
- Put a picture or something of it.
You can go to Facebook also,
it'll be pinned at the top of the page,
the contest that is, you'll see it there.
You'll see what it looks like.
Go to Twitter or Instagram or tiktok
if you want a 60 second version of our program.
- There you go.
All right, so retrolisthesis,
you can have this in your lumber area,
your thoracic or your neck.
Very, very rare I understand for the thoracic.
Typically it's in the lumbar.
- Yeah. - Lower back.
So that's what I'm gonna focus on.
We're not gonna talk about the neck, unfortunately.
- You wanna show us on this spine?
- Real bad, Bob.
So Bob, why don't you stand up and face this way please?
All right, now bend over.
(Brad laughing) I'm just kidding.
Okay, it's just a joke.
So we're going to look at the spine like here.
So this, if I took Bob spine out, he's facing that way.
Now we're gonna look at...
typically it's gonna be L5, L4 or L3.
Those are the most common areas.
So we're gonna look at L4 and L5.
That's where my spondylolisthesis is.
We're gonna look at retro, is just the opposite.
So here--
- Yeah, so we've got five bones that make up the lower back
and they number them one, two, three, four and five.
- Right.
- And we're looking at number four and number five,
Brad's gonna show--
- Let's say we just chose four and five.
- Out of there, right on there.
- We can't move this cause it's rigid,
that's the way the model is.
But if you have a spondylolisthesis like me,
the top vertebra, L4 shifts forward,
actually towards your stomach.
If you have retro, it goes just the opposite.
It shifts this direction.
Symptoms from...
I've never treated anybody with retro.
- [Bob] I haven't either.
- But after my research on it,
symptoms and treatment are very, very close to the same.
- Sure.
The same as spondy, is what you're saying?
- Right, exactly.
- Which makes sense to me.
Now a lot of times, this can be due to trauma?
- Right, that's possible, yep.
- They don't know. - A lot of times
you just don't know, you take x-rays in a sec.
- There is.
- And it is confirmed by x-rays
and x-rays they need to be taken at a lateral view,
which the doctor-- - From the side basically,
Which makes sense to see that it has shifted.
- And there's four grades, one, two, three, and four.
Four is the farthest slip.
By the time you are at grade four,
you probably need surgery with hardware.
It's very rare.
Typically you don't need surgery.
Your best treatment is therapy, so you have to do it.
So the things we recommend,
you'll find out some of the options will be very helpful
and relieve your pain.
Some may not.
So it's gonna be a little different between each person.
- The one thing with Brad having gone through spondy,
deal with spondy,
it was a while before some of these things paid off.
- Right.
- I mean, you gotta be patient here and you gotta do 'em.
- Exactly.
- But you'll find out over time,
you can go from what was probably a surgery,
where you probably would have required surgery,
to the point now Brad's very active running triathlons.
And--
- But I'm still limited. - Still limited, right?
- Comparative if I didn't have it.
I still have pain.
Like I ran three and a half miles this morning
up and down the hill,
my back's a little sore, but not bad.
I've done it long enough.
I kinda know if I go too much or whatever.
So it's taken a while.
- But you are almost 100 years old to us.
- Why Bob?
Let's get on, these people are waiting.
- All right, number one.
- Avoid postures or activities that irritate your back.
- Yeah, that seems real simple.
Like, well of course I'm gonna do that.
No, a lot of people don't.
They think, "Well, my back hurts.
"It's gonna hurt."
It's like, no, you're doing something
that's causing it to hurt.
- Right.
- So you wanna analyze it and change the posture.
If you're sitting, do you wanna show us anyway around it?
- Right, well, a lot of times a static posture,
you'll find that standing in a certain way,
maybe on one foot, irritates it.
So don't do that anymore.
And a lot of times people aren't aware of it.
If you think about it, it's like,
"Oh yeah, I didn't know I stood with all my weight
"on one foot."
- Yeah you kinda shift to one side.
- And that kinks your back,
and that can put pressure on that area that's injured
or shifted. - So you wanna make sure
you just go ahead and level out
when you're standing
and maybe put a little bend in your knee.
But right now we'll surely see the position here.
- You know if standing for a long time is irritating,
you can't stand.
If sitting for a long time is irritating
you can't sit for a long time.
You may have to do
a sit-stand option. - Stop right
go back and forth. - And that's common.
Now lumbar supports can be very helpful.
You're probably not gonna get one like this
because this is probably too specific on the area.
This lumbar support literally changed my life
unlike my car.
- It spreads the forces out
as opposed to hitting one specific part of the spine.
- Right.
Yup, and it's made of a memory foam
which adapts to any shape back.
So it doesn't matter where your shift is.
If it's L4 or 5, or L3.
This is the key battle.
- Kubota.
- Kubota, I'm not sure how we pronounce it.
But I just know I have three of these.
I use one in my car, at home in my recliner
and in my riding lawnmower, wouldn't go without them.
And it really feels good. - what's interesting
is now with me, I don't have back pain.
I don't like this one.
So they are very specific to people.
But my guess is, if I were to put a guess forward,
that yeah, this would be the one for spondy and for retro.
- Right, something even if it's not this brand,
something that spreads out,
and I just think the memory foam
is very helpful. - Okay.
- Yep.
- All right, we were gonna mention a few things
just for pain control too, right Brad?
- Oh, sure.
- So one thing Brad likes to do
is he likes to get his feet up on, like a wedge like this.
You can put your feet up on pillows too,
but he likes to use an ice pack
when things are flared up.
- Yep, so if I do something silly, my back will really sore.
It's like, "Oh, why did I do that?
"It's gonna hurt for two days."
I will take a leg wedge.
You don't have to have one of these,
but they really work well.
And they're not that expensive.
You can use pillows that works, but not quite as well.
A cold pack, a nice gel, one about this size.
- We even have recipe how to make your own cold pack,
so you can put Bob and Brad ice pack,
if you wanna make your own.
- Yeah, it's just rubbing alcohol and water.
- You're laying on the floor,
you can put your feet up on an Ottoman or a up on a chair.
- Exactly.
- [Bob] There's ways around this,
you don't have to buy anything.
- I've done that, exactly.
Good point, Bob.
But whether you have your feet up here,
something about raising your feet, your legs,
either here, or if you want up on a sofa, it feels good.
And 20 minutes on here
and I've had my back pain go from a six over 10
down to a one.
And then I get up and this much better.
- Now, if instead you wanna try to get more blood flow
to the area, a regular heating pad does not really work
because regular heating pad only penetrates...
we've got actually a visualization here
on the yard stick here,
it only penetrates just surface.
So this represents how deep
that regular heat pad goes. - Basically skin deep.
- [Bob] This is why we like to use
the far infrared heating system.
That penetrates 2.36 inches.
- Right, 2.36.
So that's gonna get down into the muscle
and into the joints.
And when your bone slip and you have that thesis there,
you want those bones like on mine,
the disc actually, desegregated over a matter of years.
- And fused. - And it can be the same way
you want that to fuse.
So if you can get more blood supply there,
it's gonna heal better and faster.
These don't heal over a period of a couple of weeks.
It takes months.
- So I actually use this too.
At night you just put it in your chair,
and sit and watch TV,
and you have it on for an hour or whatever,
how long you watch TV.
- So it becomes part of your lumbar support.
- Right, right.
- Yeah, and they are expensive.
So, you don't have to get one,
but if you respond well to heat, things feel good.
It's gonna last for years.
- Yeah, and you can use it
on all sorts of your parts of your body.
From a Texas one great company from Canada.
- All right.
- All right, moving on, Brad.
What's the next thing?
- Body mechanics.
- Sure.
We should hire someone to fix our back, a mechanic?
- There you go.
And hire someone to do everything for you.
- Probably do our jokes.
- Yeah.
You wanna stay active, but you wanna be active
with really good mechanics.
The best way I think, to teach someone
how to bend over or pick something up properly,
so it don't irritate your back is we use the ballistic,
but you can just take a five foot long piece of Dowling
or a broomstick works well.
And you put it behind your back.
And Bob's gonna show where the contacts are.
- So it's three points of contact you wanna have.
I probably think you're a little bit better like this, Brad.
So you wanna have the head touching,
the mid back touching and like the lower pelvis,
the pelvis itself, this the lower part of the spine.
That shows you that you're in good posture.
If you're not in good posture.
Yup, you like this. - That's not good.
- Only one point of contact.
So this is a great training device
and you necessarily don't have stick around every time.
But initially do a few bends like this, squats like this.
And then, you know, with my wife, I was trying to...
she was having some trouble with her back
and I said, "Just picture the stick like this."
And she said, it was really easy then for her
to apply that to real life.
Do you know what I mean, when she picks something up,
she just pictured the stick there
and she was able to lift correctly then.
- So what you can do,
and this is what I have my patients do,
I say, "Take your stick, whatever you're using,
"and do 10 squats."
And do that two or three times a day.
It takes you about 15 seconds.
And it's gonna give you muscle memory
so that you remember just like Linda,
Bob's wife was talking about.
And you know, that becomes a habit that way.
- Yep, absolutely.
It becomes part of your daily routine then.
So, next one, some core strengthening, Brad.
- Great, should we go down on the floor for this?
Can we lose.
These exercises, I think are the best exercises
that help keep your back protected.
And these are exactly what I do.
I absolutely love them.
They really have helped my back a lot.
- Who picked on your socks?
- Aren't they nice?
And there's the thing to come,
everyone's gonna start wearing this.
So anyways, I thought that would draw some attention.
So you need a ball.
You're gonna have to invest in a ball.
There's no way around it to protect your back.
- [Bob] They're like only $15.
- Yeah, you can get them online at $15, sometimes 20.
You don't need to buy the one that has the video with it.
And I do simply this.
And your back is stabilized by the floor.
It protects it.
And you're strengthening your core muscles here.
Now, I'll do 50 of these,
but you know, when you start out do 10 or 15,
whatever's comfortable and then build up.
And then I actually jumped to the more advanced one
where I do the double crunch.
Same one, except for elbows and shoulder blades come off.
I'm not bringing my head forward.
- He's not carrying his head forward.
He's not, yeah, he's almost bringing it up.
You know, just yeah, there you go.
- Get your stomach burn with that.
Another 10 or 15 or whatever it takes.
Now this is what I don't do,
but this is one they strongly recommended.
And it makes a lot of sense to me for retro
as just to do a bridging.
So you get those. - Gotcha.
- Well, (mumbles) muscles, which surround that area.
- [Bob] And you're also doing the glutes a little bit,
which the glutes are attached by fascia, lower backs.
- Now when you do these, if they irritate your back,
there's something wrong, you don't do 'em.
- Right, anything we say today,
if it hurts your back, if it makes it worse,
sorry, it's not feeling right, don't do it.
It's always, let pain be your guide.
- And now this one, hopefully it doesn't turn my mic off
cause I'm on the box.
This is a really good advantage with the ball.
And you'll go like this and you can put your forearms down.
And then you're working these back muscles here
as well as your hip.
And I'll do one leg at a time, 10,
and then I'll do the other, 10.
- Yeah, again the back is nice and supported
while you're doing this
and you can get some good strength.
And then it goes the other way on the opposite side.
- [Bob] And again, all pain-free,
but you'll feel the ball really supports that involved area
of your back.
So again,
I really think the ball is something that you'll wanna do.
It'd be a good investment.
- When I was going
to the point where I was gonna have surgery,
I started to do my ball exercises very consistently.
And I really feel between that and this was the key.
- You become a big fan.
- All right, now.
- We'll go over here, Brad.
- Yeah, so final thing, sorry to take so long,
is the transverse muscles
and the oblique muscles of the core,
which get missed by those exercises.
And I do think functionally,
this is really makes a difference
on getting you functionally throughout the day,
doing daily activities without pain.
So you're gonna need something with handles and the band
and some way to anchor it to a wall.
You can go to a door.
They make things that go on a door when you buy these.
We use the wall here cause they just work so much better.
But the exercise is like this.
So you just get athletic position.
And then we're gonna stir the band, Bob.
We go like this, in circles.
But you get out, so there's enough tension.
You'll feel your core tighten.
Right now I feel it.
And I'm just a worker and I'll go 10 times this way.
I'll go 10 times this way.
I'm not right now, but that's what I'll do.
- It's interesting when you do these
they don't look that hard but I know from experience
these are quite challenging.
- And you do them with that good posture.
You don't do when slumped.
Everything you do is maintain.
And then, the other one I really like to do
is you need to get a different angle.
So I'm gonna go up to here.
And it works the obliques really well.
And I'm gonna get that good posture.
And I just bring my arm down here like that.
I wanna make it a little tighter.
It works better like this.
I can really, and I'll palpate with my fingers.
I will feel my stomach muscles right there.
Boy, they're really working hard,
right in that area when I'm trying to keep.
So when my hand goes to the opposite knee.
And those old bleaks are really working,
I'll do both sides and this feels good.
My back is completely pain-free.
And if that's the situation,
boy, your goal, that's the exercise you wanna work with.
- But again, don't expect
that this is gonna help even in a week.
- No.
- Like these type of exercises, like core strengthening,
this is an investment of time.
Pick out the ones that you feel comfortable with
and that you're gonna do for a while.
Maybe it's just the ball.
- Right, I would, for sure, you need to avoid the postures
and the activities that irritated.
I would start with the ball,
cold pack or hot pack, whatever makes that feel better.
And then these exercises over here.
- These are bonus ones.
- That's when you're getting better
and you're getting more active and you're feeling better.
- All right, remember Brad and I
can fix the back of everything.
- Except for.
- Anything I mean.
Except for a broken heart.
We're working on it.
- This stuff is a good help for that.
- Yeah. (both laughing)