♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we're the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Right Brad, today we're going to talk about
the four signs that your back is about to go out.
I mean, you know that situation
where you can't even walk or can't get out of a chair.
- Yeah.
- Or can't get out of bed.
- Yeah, we both experienced that.
- Yeah we both experienced it
my father-in-law, it used to happen to him a lot,
he actually had to call the ambulance one time.
He had to crawl out of his bedroom.
I mean, it's bad when it happens.
- Yeah, right.
- And these are the signs it's about ready to happen.
This is severe back pain, about ready to happen.
And a lot of time there's little clues
that are going on.
- Sure.
- So, Brad and I, being therapists,
we notice the first one right away.
And that's, if you're in what we call the "C-Curve"
for a long period of time.
- And he's talking about the spine.
- So, yeah.
So this is the spine, you know,
this is where the head would be.
This is where the pelvis and the legs are gonna be.
And this is a side view.
So I'll go with the same side view
as Brad is right now.
And he's in that slumped position.
- Here. It can be like this,
like if you're in the bleachers
and there's no back rest.
(chair rattles)
- Or if you're at a computer chair.
- A lot of times.
I like it when patients come in
and they have back pain,
and they're sitting like this
telling me about their back pain.
- Yeah, exactly.
(Brad laughs)
- Usually a lot of times what we see
is people are stacking events.
That means they go from one thing
where they've bent their back;
like I had a gentleman that was cutting his lawn
in the morning.
Which he thought, "Well, cutting,
when you're cutting, riding that riding lawn mower,
why is that a problem?"
- Right, just sitting there.
- But he's sitting there in kind of a bent position,
and he's bouncing up and down.
- Right, right.
- And that's the worst thing that could happen.
- Right. So you've got those disks just
(claps hands)
taking a beating.
- Yeah. You're putting pressure on that.
He went from that to a two-hour car ride,
which, again, he had bad posture.
- Right, right.
- And then finally he gets out of the car,
and he's going to take something
out of his trunk.
- Which is the hardest thing to get good body mechanics.
- Right. And he's leaning over his trunk, and BOOM!
His back goes out.
- Right.
- So, no surprise.
So, if you're putting your back
in that rounded-out posture for a long period of time,
you're headed for an incident.
I can guarantee you.
- Right. It sets you up for that.
- Yeah. So, and the problem is,
a lot of people, number two is
a lot of people have bad posture
and they don't know it.
They think they're sitting up straight.
A lot of times they don't notice
until they see themselves on camera.
- Right.
- Or they see themselves on film.
Which you and I kinda noticed
when we first started doing these videos.
(Brad laughs)
Our posture wasn't that good.
- Right, and we're aware of it.
- Yeah we're, we thought we were aware of it.
But your body has this thing
called "position sense," where it;
after a while, this starts to feel normal to it.
And this feels abnormal, sitting up straight.
So you need to have someone look at you.
And we'll have to do one of those videos, Brad,
where we assess posture.
- Yeah, yeah.
- So people know how to do it.
- Exactly.
- The third thing- this is a big one.
Is if you're back starts to feel tired,
or just tight, you hear, people say that all the time.
"My back it feels tight and tired.
It's not really painful."
You're about to have an incident.
That's pre-pain.
- Here's a big one.
If you're sitting, probably in that poor posture,
getting out of a car, off of a chair,
sitting for any length of time,
and you get up and it's hard to straighten up.
- Yes.
- And then, once you get straightened up,
or it feels good, then you walk around, and you're fine.
Then you forget about it.
You are probably right on that gray zone
of getting a back injury.
- The other thing is if you haven't been staying active,
you know, like walking or something like that.
Getting some exercise, getting some blood flow to the back,
that's another thing that's going to contribute
to the back pain.
- Right.
- Occurring.
- And walking is really nice,
because walking typically promotes good posture.
- Right.
- You know, unless you're walking like this.
But most people are more upright when they're walking.
Gets the blood flowing.
- Exactly, walking is a great one.
Even if you hurt your back, if you can walk,
it's a great thing to do for a half-hour, even.
- Right. As long as it doesn't irritate it.
- As long as it doesn't irritate it.
So what to do if you're, you know,
you're seeing some of these four signs.
What should you do?
One, you want to start by doing what we call "press-ups."
- Sure.
- And this is, a vast majority of the people
this is good for.
There's a few cases where it's not.
If this hurts you.
But what you're going to do is gonna go ahead
and lay down flat, like this.
And you're gonna, you can rest just for a little bit
here, just to get the back acclimated.
And then you're gonna put your hands
below your shoulders, here.
And it's like doing a push-up,
except you leave your pelvis down.
- I'm going to use my cain, here, for a pointer.
But right here you can see,
just like there's a belt around his waistline.
- Yeah, what we don't want to see it this:
- Yeah.
- Where you're lifting up the- you know.
Because you're back might be so tight,
that when you start coming up here,
it actually lifts up off the bed.
- Right.
You've got pretty good range of motion.
Why don't you go up as high as you can.
This is, this is normal.
- Yeah.
- Usually, if you're in your 60s or 70s
maybe not so much.
But I've seen people, and so has Bob,
that may only get up.
- Yeah this far.
- You know, and it's like "Whoa!"
- And if you're tight, that should be another sign.
If this is tight, and you can't go up,
you're about to have an incident.
- Sure.
- So, you can do press-ups, you can do.
And with me, actually, it was more my mid-back
that went out that time, Brad.
So I did hallelujah stretches.
- Oh, yeah.
(chair rattles)
- He's not gonna sing the song.
- By the way, if you're standing,
and don't have a place to lay down,
you can even try some of these back bends
you know, for the, for down here.
- Sure.
- You put your hands right on the pelvis
and go back like this.
- Right.
- And do some press, some press-ups that way basically.
- That's like if you're doing a job
where you're standing, bending over,
or like at the kitchen, in the kitchen doing dishes,
and you find yourself bending over,
that's a good time to.
- That's like the pregnant woman, right?
Every time the pregnant woman kinda bends forward
she goes like this, you see them doing this
all the time.
- Yeah.
- All right.
This is for more the mid-back.
If you're having trouble with that
or you're having tightness there.
Then you're going to go ahead,
and what we call the hallelujah stretch.
You're just gonna bend over the back of a chair.
It's nice to find a chair,
maybe a little bit lower than this.
- Yeah, look, turn it this way a little bit, Bob.
Bob, bob, you've got thread on your shirt.
What are people gonna think?
- Do you have that ball, that little ball?
- Yeah.
- Yeah, because actually, if you have a little ball,
this works great.
If you put that behind your back.
Now you can really put it where you need to put it.
And you can bend over that ball.
And it give you a nice little extension.
- That's really a nice invention, Brad,
that you presented to us.
And one thing about that,
if you're going to use that ball,
it should feel good.
- Yes.
- If you do it, and it's like,
"Oh my gosh, that hurts."
Don't think, "Oh, I'm going to push through it,
because they told me to and it's going to get better."
It should feel like a good stretch.
It's relieving the stress, not creating it.
- A good set of 10 for both of these.
You can do a set of 10 of these.
And you can do these quite often, Brad.
You can do these every hour, if you want.
And you ca also put your hands like this and bend back.
- Sure.
- So, this one feels good Brad.
I really like that one.
- Yep. It is.
And if you don't, you know,-
usually we have those bigger balls, those softer ones
that you use for kickball.
- Oh, right, right.
The ones you can buy at Walmart or some big box store.
- I actually like my office chair.
It has a soft back and it only comes up low.
- My office chair, same thing.
I think I chose it for that reason.
- Don't tip over with it, though.
- All right, the third thing you want to do
is if you are feeling some, you know,
those symptoms, is going for a walk does help.
- Sure.
I mean, like we talked about.
Just getting more oxygen to the area.
And getting movement.
All those things can help the back from going out.
- One warning about a walk:
is the surface you're walking on.
I would avoid walking uphill,
because that's gonna create you to lean forward
just to keep your balance.
- Perfect, yeah that's a great point, Brad.
- And if the road is, what do they call that?
Where it's tilting.
- Kinda, cam, camber?
(Brad laughs)
- The road, so the water drains off the road.
- Right.
- It's got that tilt on it.
And then you're gonna be walking
with one leg is gonna be naturally lower.
- And it'll put pressure on one side of the back.
- Yeah, so try and get a flat surface,
sidewalks are a little bit better.
- If you do go down one side of the road,
come down the same side, so you can even it all out.
- Right, even it out.
- All right what happens if your back does go out?
Just real quickly, what we tell people
is to take AIM- A-I-M.
- AIM?
- Yes! You didn't know that, huh Brad?
Okay, the first one is an anti-inflammatory.
- Okay.
- "A" stands for the anti-inflammatory.
Ibuprofen or something.
We actually, maybe I should link that up.
That video on how to take ibuprofen.
- Oh, right.
- I'll link that up.
- That's a good way to take it in this situation.
- Yeah. And the second thing is, you want to use "I,"
which is the ice.
- Yep.
- And you want to show how a good position
to put that in, Brad?
- Yeah.
See the reason I was confused, Bob,
is that I think, you know,
we've talked about the RICE or the PRAISE program.
Pretty similar to this.
- But this is "Taking AIM."
- AIM, yeah. We're not gonna RICE it,
we're gonna AIM it.
- You want to use that chair?
Or this stool, maybe.
- Yeah.
Now, at home, if you've got a nice, carpeted floor,
and you've got a nice-
- Ottoman or couch.
- Or a couch; something you can lay down,
and get your cold pack, right, I got right here.
And typically most people with back pain,
when they're in this position, in a relaxed position,
and they put this, whoo that's cold.
(Brad sighs)
This-
- It's a wonderful position.
- Yep, it should make you smile.
- You might have a little difficulty
getting into that position,
and we'll talk about that.
But this is a good way to start.
- Right. And again, it should feel good.
If for some reason, it's creating pain,
it's not for you.
Most people are going to find it very comfortable.
And stay in that position, Brad,
let's take this out.
Then this goes to the third one, the "M."
By the way, I used to teach a back class,
and a guy, I asked the class,
"What does the 'M' stand for?"
A-I-M. He said, "Morgue?"
(Brad laughs)
And I go, "No, it's movement."
- Oh, sure.
- You want to start getting some movement.
So we do little trunk rotations here.
This is one of the best ones we do.
Just gentle and you can go real small oscillations to start.
- I'll go this way so they can see.
- Yeah, real small.
And this if it gets better, you can start
going to larger ones.
And if it hurts one direction,
just go the other direction.
- The pain-free range.
I call them windshield wipers.
- Sure.
- To my patients.
- Oh yeah.
- So then they, it reminds me of;
you know it's just one of those things, Bob.
- Yeah!
Well while you're in that position, Brad,
while we're at it, why don't you show us real quickly
how to get out of bed when you're in back pain.
Because this is a tough thing for a lot of people to do.
- Okay. So if you're gonna try and get up like this-
- You're gonna hurt.
- Right.
- It won't let you.
- So we do what we call "log-rolling" to start with.
Imagine that your trunk is like a log
and it's very firm and it's not gonna twist,
and everything rolls together like a log, okay?
And then we're gonna go to our stomach slowly.
And then you're sliding off.
Let one let down until the toe touches right there.
Then you know where the floor is.
You're gonna keep twisting.
Then you're gonna walk with your hands up,
and then this foot over here that I'll wiggling
its goal is to touch the floor next
while you're keeping your back straight
like it's in a cast.
And you're gonna walk you up like this,
this, like this, and that's how you do it.
- I've told this story many times,
but Brad showed me this, how to do this.
And, like a few days later, my back went out.
And thank god he did
because I literally could not get in to bed.
Because a lot of times we were taught
just to go down into your side like this.
- Right.
- And then roll over.
I could not get in to bed that way.
I mean, it just hurt like you won't believe.
- So I showed how to get out,
why don't you show them how to get in, the reverse way.
- Well, I mean, it's just the same.
You come right up to it, you bend down like this,
and you'd walk your hands along, like this.
- Right.
- Bring your leg up, like this.
And just slowly bring yourself down
and then you roll over on to your back.
- Yeah, exactly.
- All right. Don't let your back go out.
You've been warned.
We've shown you what to do,
and remember we can fix just about anything.
- Except for that broken heart.
- Yeah, we can fix broken backs, even,
but we can't fix a broken heart.
- We're working on it though.
- Thanks a lot.