♪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 are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Today, we're gonna talk about,
is an anterior pelvic tilt causing your back pain.
We're going to show you how to tell,
- Mm hmm.
- But we're also gonna show how to treat it.
- That's right.
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- So my son has a anterior pelvic tilt.
- Sure how old is he?
- He is gonna be 26.
- Oh wow he's getting older too.
- That's my youngest believe it or not.
And anyway he kind of revealed to me that,
this past weekend that he's had pain
for years doing certain things.
- Mm hmm.
- It's like you didn't tell me?
I mean, you know he-
- Well you probably would've said, you said tough it out.
(laughs)
- Yeah like give him a massage gun
and say go away
- Go home.
(laughs)
So anyway I started noticing when I would golf with my son,
that he had a lot of anterior pelvic tilt
that he really was extended like this.
- So we got this pink here,
it's not Bob's belt,
it's so you can see it so-
- He's supposed to be like this.
- Yeah so we're looking at the bones,
we're looking this motion
versus into that neutral position.
- Right so if you want to line this up with me Brad.
- Yeah, yeah, yeah.
- If you're have a normal spine lined up,
a way the therapist will tell is you actually feel
for the anterior superior iliac spine.
ASIS - ASIS yeah this bump.
- And the PSIS
- There's a bump there and a bump there.
- Yeah and those should be about level.
- Mm hmm.
- And that's what I was checking on my son,
and he was like a inch higher in the back than the front.
- Yep.
- So you can see he's extended.
- Puts a lot of stress on the lumbar spine-
- Yes on the joints.
- Yes yes.
- And that's what he's finding,
like there's some days he can't even lift weights.
Cause if he stands with the extension,
- Yeah.
- it actually causes increased pain.
So what we did with him for the test,
very simple tests you can take like a 10 pound weight.
He actually took a 30 pound weight
just like this one Brad.
- Well of course.
- And he stood,
he's kind of a beefy-er kid.
and I had him stand with the weight close to him like this,
holding onto it like this.
- Yep.
- And you first keep your pelvis kind of aligned correctly.
Does that look about level Brad?
- I think so,
yep looks level.
- Okay then you could actually flex.
- Go the other way so you tighten your stomach muscles.
- Yep and you're going into flexion.
- Yep.
- And that was no pain for him.
Then he went like this.
- Tilted it this way.
- Then he felt a little bit of pain.
- So it may be those facet joints,
- Jammin together.
- Coming together yes.
- Then,
- Whoa!
(chuckles)
- Had him actually hold the weight out like this.
- Yeah.
- And had him go flexion,
- Yep.
- and extension.
This hurt his back.
That he felt right away so. - That was, yep.
If you woulda dropped that on your
toe you woulda felt that too.
- Right so what I would like him to do,
and we talked about this already.
- Mm hmm.
- One we wanna strengthen,
not strengthen stretch the muscles
on the front of the thigh here
that are actually could be pulling the pelvis forward.
And he is tight there so.
- Yeah the rectus femoris actually connects to the ASIS,
so if that's tight that's gonna pull down.
So we wanna loosen that up pretty particular.
- Right and rectus I damn near,
what is it wrecked em I damn near killed em
or something like that? (laughs)
- I think you can't apply that to this anatomy.
- Right so the stretch I really like
is the couch stretch or Brad's
gonna show it against the wall.
But I go up to a couch like this,
and I actually bring my leg up like this,
oh I'm getting a cramp!
- Oh that feels good!
- There we go.
- You can do it on your bed too can't ya?
- Yeah bed and you actually lean back like this,
and this is a great stretch.
I love the way this feels Brad.
- You know I'm gonna take and put a pillow
down because it feels better on my knee.
My patella digs in the,
there so this the same thing?
- Yeah you're actually stretching the foot too.
You know this one's not stretching the foot as much.
- Sure so I'm getting the little plantar flexion right here,
which you know nothing wrong with that.
Whoa yes oh!
- Really and I think a lot of peoples tight,
and a lotta people if you have a anterior pelvic tilt
it is one of the reasons.
- Yep.
- It's pulling you forward.
All right then I want you to start,
Matt I want you to start getting a sense
of what it is like to change your pelvic tilt.
- Matt's his son.
- Yeah.
(laughs)
Wonder why I'm yelling at him
(laughs)
Okay Brad I need that pillow.
- Oh you don't want to massage it.
- Yep so we're gonna go ahead
and take a throw pillow,
and this is gonna make it,
I'll show you in a second why take a throw pillow.
Take a throw pillow and kinda
put it towards the end of your spine right?
Towards the sacroiliac probably joint.
- Yeah or down by the tail bone.
- Top of the tail bone yeah.
- Yep, mm hmm.
- So watch me with this in position,
now it's very simple to do pelvic tilts.
- It creates a little gap in here,
allows you some freedom. - You see how this is tilting?
- Yep.
- Now if I take this out it's a lot harder to do.
I just can't get the travel or motion that you would with-
- You don't have that freedom of movement.
- Well make it a lot easier,
you know basically I'm trying to flatten my back,
- Yep.
- And I'm tightening my stomach,
the abdomen while I'm doing it.
- So you could do this on your bed or on the floor,
probably better on the floor,
a carpet or floor's preferred. - Right, right.
And that'll start giving you a sense
of where your pelvis is at and how to move it.
- Yeah.
- So finally I wanna translate that to functional positions.
So we're gonna start in the quadruped position first.
- Hands and knees.
- Yep so move this out of the way,
and Brad do you wanna take a look again?
- Sure.
- So if I go like this that's making it worse.
- The anterior pelvic tilt.
- So arching the back I don't wanna do that,
I wanna go the other way like I'm doing,
I don't know have we decided-
- I think this is the camel I don't know.
- All right the camel.
So you can start just doing camels.
Go to neutral and camel over and over
so you start getting the feeling what that is like.
Then you're gonna go up to a surface like this Brad.
- Yes?
- And you're gonna grab on
to the end of a bed or a couch or a countertop so-
- Ideally it'd be like this,
I know you're trying to show in the camera.
- Same thing I'm trying to arch.
- You know me with my spondy,
this is so clear cause when I do this
it feels so good. - You oughta do this,
it feels better.
- Oh yeah.
- And then finally you're gonna stand up,
and you're gonna know how to do this step.
You're gonna be able to translate it to the real world.
- I don't know if this is not part of your script
but one thing that works really well for me
is when I hang up against the wall,
- Oh.
- and then my back I can feel it
and you can arch,
oh and it feels so good. - Oh sure.
- But if I go this way oh if you can
see what's on right here. - I can see it yeah.
Move that out of the way Brad.
- There we go.
And you don't even have to have,
you could just do this up against the wall,
and it's the same thing as what you're doing laying down
but you're in a vertical position.
- Yeah it's easier to do.
- Yeah and you know you could do
this anywhere there's a wall.
- So again you don't need to do this
unless you have pain with an anterior pelvic tilt
- Right.
- Then you would wanna do these,
and when you're lifting you wanna go ahead
and do the pelvic tilt,
- Yep.
- back and put your back in the correct position
so you could lift without putting stress on the facets.
- Which are by the way,
if you happen to have stenosis,
lumbar stenosis or you know somebody that does,
similar exercises-
- Well spondy too.
- Exactly spondylolisthesis.
- Yep.
- So yeah I don't mind just doing this
while you talk it feels so good.
Go on!
- I hope you're happy.
(laughs)
Well by the way Brad and I can fix just about anything.
- Except for,
- A broken heart.
- And we're not getting to far on it
but we continue to persevere.
- Darn we gotta make some advancements on that.
- I know it I'm thinking about it.
Last night I thought about it for about-
- You did not!
- Before I went to sleep 2 seconds.
- Alright thanks for watching. - Be careful.
(upbeat tone)