♪ 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 are the most famous
physical therapist on the internet.
- In our opinion, of course, Bob.
- All right, today, we're gonna talk about five test, tests.
- Tests, plural.
- To stop back pain in sitting, standing, lifting
and in while you're in bed.
And the thing is, what's good about this,
you can perform these tests yourself.
- Exactly.
We're really teaching people to be their own therapist,
pseudo therapists. - Right, self therapist.
The idea is that, we're trying to figure out,
what causes your pain.
If you can figure out what causes it,
what specific movements,
you can maybe figure out what to stop the pain.
- Say no more Bob, that's the key.
But, before we go any further.
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- That's right, Bob. - These are awesome.
These are a great exercise tool,
especially if you're gonna have knee replacement.
- Absolutely.
- Or any type of lower extremity surgery.
- Or if you've got a lot of arthritis in your knees
and walking is painful.
- Yeah, all right, you can also find
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If you want a 60 second version of our program.
- Absolutely, Bob, before we go any further,
I wonder if people have noticed a little difference?
- Oh, yeah, we're starting to add stuff here.
We're in a new set and we're starting to add
a little bit of decorating.
- Right and now because the memory thing,
all I have to do is look back before I forget our names.
- I'm the top one.
All right, today, let's start off with number one.
So we're looking for pain triggers.
What starts your pain?
These are five tests you could do.
Let's start in bed Brad,
'cause you wake up in the morning.
Sometimes people go,
I wake up and the pain's right there, right away.
- Exactly, let's start there.
It really is the best place
to get this thing going.
- I put a pillow on there, you don't want it?
- Well, Bob, I don't know.
- Go ahead. - I just threw it off.
It's just part of my routine, throwing a pillow off.
- So visualize this.
Brad wakes up in the morning
and Brad does have spondylolisthesis.
So a lot of times it may be hurting in the morning.
- Actually, I am typically a little more stiff in bed.
- Sure, so the first thing what people do
if they're lying on their back,
is they're gonna turn.
And sometimes what they'll do
is they'll turn their body first then turn their back.
So first thing I wanna see,
does any of these directions bother you?
- Actually, this is not fun for me in the morning.
- This turn?
- If I rotate, yeah.
- Okay and the same with this way,
one may be be fine, one may not be fine.
- As a matter of fact,
I've had patients who had to change
from one side of the bed
to get on the other side of the bed
'cause it was much easier.
- They can turn one way
but they can't turn the other way.
- Precisely.
- Exactly okay, so let's say we,
Brad finds out it does hurt to go like this.
So now he knows that in order to get out of bed,
he has to turn his whole body and roll like a log.
See that keeps the back protected.
- It does feel better, Bob.
- Now, the next step is he brings the legs off here
but now let's say you're gonna bend up wrong Brad.
See how he's curling his spine?
He's curling it and twisting it.
Yeah, let's say that hurts.
So now he has performed another test,
of the bed tests and he's gonna figure out,
he needs to get up like a column.
- Like my whole trunk is in a cast.
So I'm gonna tighten up my core muscles
and put that cast on internally.
And I'm gonna take my time and go up like this
and keep that spine neutral.
Yeah, that's better.
- What he did is he, like you said, he tightened it up.
So 'cause you could do that without tightening up
and it might still hurt.
(Brad groaning)
This is bracing you're back, getting it ready.
It's quite a useful thing to do by the way.
We'll show it later on with lifting too.
All right Brad, let's move on to sitting.
You wanna grab the chair?
All right, a lot of people sit all day long for a living.
- Oh you wanted me to put it down?
- Yeah (laughing).
Grab the chair and put it down.
Okay Brad, why don't you sit down?
- How is this Liz in her new digs?
- Okay, so first when you're gonna sit,
I want you to sit slumped,
to see if that bothers your back, all right?
Now it may not bother it right away
'cause sometimes it takes awhile
but we'll accelerate this a little bit.
Then I want you to sit straight.
You sit at the test, sit straight up, yep
and see if the back feels better that way.
You may use a roll towel between lower,
in the lower back to hold it.
- Yep, lumbar support.
- Now but here comes the real test.
I'm gonna have you do a slumped again, Brad.
But this time I'm gonna have you
grab the bottom of the chair and pull out,
which is gonna put some compressions through the spine.
- So I'm trying to push my shoulders into my hips.
- Yeah, so and if that hurts,
now I'm gonna have you try it the same way.
It's completely straight.
- Okay, so back to good posture.
- And now he's gonna pull up through the chair.
- Oh yeah.
- And so if you find out you can pull up through the chair,
with your back straight, no pain,
that shows you there, pretty convincingly that,
I'm sorry, I think I just spit on your Brad.
Convincingly, that you need to keep that back
straight throughout the day
and maybe you can need a lumbar support
or a rolled towel to help you.
- And virtually a vast majority of people,
you need good posture, it's very critical.
Unless you have stenosis.
- Stenosis might actually feel better
to be a little bloated out.
All right, standing Brad,
how about we look at standing.
So it's the same thing.
He's gonna slouch a little bit with standing, feel that,
then you can just try straightening up, compare the two.
Now this is one where you can actually slouch
and he's gonna lift his heels up and drop them on the floor.
- Little compression.
- Yep, so there's a shock up through the spine.
- [Brad] Don't do that too harder the first time
'cause if you've got back pain and you do it hurriedly.
- [Bob] It might really give you a shock.
- [Brad] Yeah so just start gently.
- But we wanna see again,
does it help to straighten the back
and now go ahead and drop the heel.
Does it feel better?
And if it does again,
this is teaching you the right way to,
why it's important to have that back straight
and put the spine in good position.
All right, with lifting,
you're gonna lift something with a rounded back.
I'll go ahead and do this one Brad.
- Oh, sure.
- Okay and feel it then I want you
to go ahead and straighten your back.
And a lot of times I'll use the Booyah Stik.
I suppose we don't want to have it right here.
- Oh, absolutely right there.
And with this, you don't even necessarily
have to lift an object.
I think just doing it.
- Yeah, bending over and you don't need a Booyah Stik
but this is how I want you to visualize this.
- Switch the hands once, Bob.
It just helps a little better for the camera I think.
- So you're gonna imagine
that you are maintaining three points of contact.
Brad's gonna point out.
- Head, between the shoulder blades
and right below the belt line.
- So when I bend down, now I'm keeping everything straight,
the spine's straight, it can handle a lot more load.
So you can compare those two.
Compare lifting with a rounded back,
compare to lifting with a straight back and then finally,
you can also compare to actually tightening the abdomen
when you're lifting.
I found this odd back when I was shoveling last year.
I was like, I wasn't tightening my abdomen at all
and I was like, boy, my back is getting pretty sore.
And I started tightening
and I was like, wow, that really made a difference.
- That's the natural.
- Yeah, it's a natural brace.
- Brace, yeah so it's just a habit
and things you need to be aware of
so that's why we're here.
- All right, walking, same thing.
You're gonna walk with your shoulders rounded.
And then I want you to go ahead and take your arms
and straight back like this and do a chin tuck.
This is a way to straighten your posture.
Sometimes we have people walk a little bit
and pulling their arms back just to make sure
and then they let go like this and they're in good position.
Compare walking to slump to walking straight.
See where there's any pain.
Compare, you also might look at long strides
versus short strides.
There may be a little bit less
force coming up through your legs
if you're doing short strides.
- So yeah you striding out long
and you can feel that heel impact.
- Yeah, pounding.
So and you also might compare walking faster to slower.
- Right.
- Believe it or not and I've seen this on many patients,
when they walk faster at a higher pace,
there's a little bit less stress on the spine.
And when they're really ambling along slowly,
they're really putting a lot of stress on the spine.
- Which people might find a little confusing
'cause we just said if you walk harder,
it's kind of how you walk.
- It's a pace.
- Do you impact or do you walk smoothly?
It's kinda like the running technique
or getting off track a little bit.
- You can take short strides and still go fast.
- Right.
- Is what we're saying.
- So just pay attention how you walk
and I think you'll find,
if you walk uphill versus downhill
and not even a steep angle,
you may find a difference.
Uphill may increased pain or vice versa so pay attention.
- So we're trying to prove to here
is that many of you can take control of your life,
your back pain.
You can maybe make it turn on
and you can maybe make a turn off,
just by what positions you're in.
- Right, so avoid the thing that turned it on,
the pain makers, get rid of those
and do the things, you want activity and movement
but they should not irritate that back.
- And remember Brad and I can fix just about anything.
- Except for.
- A broken heart.
- You fell right into that, Bob, it was smooth.
- Yeah, bromance. We're getting better at this.
Yep.
- Adios.