♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Keeping our distance in our secret bunker.
Today, we're going to talk about five pain-free, you say it.
- Spondylolisthesis.
- Spondylolisthesis core exercises at home.
Improve daily activity if you do these exercises.
- Say no more, Bob.
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- Bob, we do get a regular barrage of comments
for people with spondylolisthesis.
If you're not familiar with it, it's a big long term,
it means in your spine, typically,
we're going to talk about the lumbar spine,
I'm going to say spondy to make it a little shorter.
That's where it's most commonly occurs,
and I'm very familiar with it because I have spondy
and, as a matter of fact, I have x-rays so you can see
what they look like.
And now, if someone says you have spondy
and they don't have x-rays to back it up,
you've got to get x-rays because
it's very, very clear on x-rays.
And I'll show you here, these,
Mike, can you tell me when we get right there.
- [Bob] Mike, I've got to move out of the way,
- So this is the side view for me, lateral x-rays.
Here's my hip, here's my sacrum.
- [Bob] Show them the vertebrae, Brad.
So basically we're talking about bones
that stack up like that.
- Right, well here we've got L5 and L4
and you can see I've got them outlined in black.
Now, they should be all in a line,
but this L4 is moved forward or anteriorly,
about two centimeters,
and L5 and S1 doesn't look like a real healthy deal either,
but these were taken in 2013.
At that point, my back pain was fairly consistent,
walking more than three fourths of a mile,
I'd get numbness down my leg
because I was getting a pinched nerve
because there was a component of stenosis in there.
At this point, I was considering
going to see a neurosurgeon and seeing if
they could do some surgery to get rid of the stenosis,
but I start doing the exercises that I'm going to show you.
- Bravo to you, Brad.
You did a really good job.
I say this many times, I kid with Brad,
but I think the average person would've gone to the surgery
and they would probably be fairly disabled right now,
when Brad, he's as active as can be.
He still does triathlons and he's still sassy.
- Well, let's go over some of the symptoms,
typical symptoms if you have spondy.
Now this is what I have in people
I've worked with with spondy.
It's very typical if you're standing
in one spot, statically standing,
this happens to me when I'm shopping with my wife
and she's going through clothes and I'm
- How convenient.
- patiently waiting - It starts to hurt that.
- Oh, my back will start to hurt.
If I sit down, it goes away, it feels so much better.
Very typical of spondy.
If you do overhead work, I was painting
my wife's bathroom this weekend,
gave me a sore back.
- Your wife's bathroom?
Don't you have one too?
- Well, I use the one downstairs.
- Oh, okay (laughs).
Actually, I joke, we do the same thing.
I have a separate bathroom. - Well, you know,
it just works out better.
- Yeah, it works out better.
- Yeah, and now, so anyways, overhead activities
give you a back ache.
And I've got to admit, now when I do them
compared to six years ago or seven years ago,
they're not as severe anymore.
Also, once again--
- Prolonged walking.
- Yeah, prolonged walking,
like I mentioned, with me it was very consistent.
Three fourths of a mile, back pain,
numbness down my right leg.
- And you couldn't run either, right Brad?
- I could very limitedly.
I could jog kind of, and now I'm up to
three to five miles consistently without any problem.
- And the other thing is, we should point out that
spinal stenosis would have similar symptoms.
- Yes.
- So, just because you're having these symptoms
doesn't mean you have spondy,
you could also have spinal stenosis, but these same--
- You treat the same way.
- Yeah, you treat the same way.
Exactly the same. - You could do
the same exercises.
Maybe we should have put that on the title.
Oh, anyways, one thing I do want to mention,
in my car, if I would sit for any length of time,
half hour drive to work,
getting out of my car was a back ache every day.
That went on for a few years
and I used some supports and whatnot, lumbar supports,
and I finally found this one, the Kebado.
I don't know if I'm pronouncing it right,
but it's memory foam.
I put that in my car, it has changed my life.
- Now, we don't even know if that ones available anymore,
but there are ones that are similar to that,
that are memory foam and about a similar shape.
So if you can find one of those.
Now, I don't like that one.
So, I don't have spinal stenosis or spondy,
and so it's a very personal thing.
- It is.
You may have spondy and it may not work for you,
I can't guarantee.
Your shift may be different than mine
and almost certainly is,
and it might be at a different level which may change it.
This is something you have to deal with.
- I liked that in my office chair.
- You do.
- I don't like it in my car.
- This video's about me, Bob.
- All right, it's all about Brad (laughs).
All right, Brad, do some work now.
- Yeah, let's go to the exercises.
- Get some exercises in.
- The only thing I've found that works,
and you do have to get a ball.
You cannot do it without the ball, at least I can't.
I can, but this makes it work.
So if you get a ball, you don't sit on it,
but just to get the right sized ball, if you sit on it,
and this is pretty forgiving,
your thigh should be about parallel to the floor.
I'm a little low here. - [Bob] Little low.
- It works just fine.
So I guess in a ball part, just don't get a little one,
- [Bob] Little one or the
real big one, right? - or the very big one.
So, and these are quite simple luckily.
And this supports your back.
All I do is I grab the ball.
If you do it with your shoes one,
or I'll do it with my shorts on, so my skin...
- [Bob] Nice socks, Brad.
- Those are cool, I like them.
And I can squeeze the ball and I can hook it with my feet,
and what we're going to do is just simply
lift the ball up in the air to here,
and every time I do these, my back feels better.
If I've got a sore back, I do these, it feels better.
If it doesn't, if it's not sore,
it feels fine, I'm just exercising.
- [Bob] He's getting two benefits from this,
if I might point this out, Brad.
One, he's getting the little bit of back movement,
although it's mostly from the hips,
but he's getting core strengthening,
- (smacking stomach) - [Bob] that's the key.
He's strengthening that core,
which is going to help protect the spine
and allow you to go through life without increased pain.
It acts like your personal back brace.
How many do you do with this, Brad?
- I do 50 of each,
there are four of these. - [Bob] You're not going
to be able to start by doing 50.
You're probably start by doing 10 if you're lucky.
- I do these three days a week,
Monday, Wednesday, and Friday every week.
And so I do 50 of those.
And then my next one is I keep my feet on, they're relaxed,
and I put my arms here, then I work my upper core.
Like Bob said, we're strengthening abdominal muscles,
and when I was doing this one,
that actually gaps the facets, which,
if you've got stenosis, is going to help your stenosis.
- [Bob] Now this too, he's keeping the back straight,
flat to the ground, the low back,
that's not coming up, and he's,
a lot of times you're almost moving
the head up towards the ceiling, curling it forward, really.
- Not this.
- [Bob] Not that, moving it up towards the ceiling.
Yep, and that's getting the rectus abdominis,
that's getting the muscles in the front of the abdomen,
and that's going to help strengthen that part of the core.
- So you may start with 10 of these.
And, like I said, I do 50.
Now, my next one I call the double crunch.
The knees go up and the ball goes up
and my elbows go toward the knees,
and then I work this.
- [Bob] Same thing, not curling too much with the head,
as much as you can.
Kind of go straight up.
- Yep, not (grunts).
- [Bob] Again, working the entire core there
with this exercise.
- And then the last one to get some obliques,
I do this, I take right elbow to the left knee
in the same posture I was in on the previous exercise,
and then I just do this.
- [Bob] But again, he's keeping the back
flat against the floor.
He's just rotating up by the shoulders,
but he's not curling the back.
It's really important they keep the back straight.
- (slaps stomach) That's a good workout.
- [Bob] Do you do 50 of those too?
- Yeah, so it's 200 altogether,
but it took me a while to get there
and you've got to do something for the abs anyways.
Now, the other the I do add, we mentioned--
- [Bob] I'll just say, I always liked this one
that you do, Brad.
- We don't want to extend our back overly,
but we don't want to lose that motion of what we have.
So, on the ball, and this really needs
to be done with a ball.
I thought about saying you could do the option
of using a pillow on the floor,
but it's not going to work. - [Bob] No, no.
This is probably one of the better exercises
for keeping you straight when
you're trying to deal with spondylolisthesis.
I mean, because, you're going to want to creep
to that positioning of being bent over.
- Right.
So I just do hip extensions, 10 on each leg,
feeling these muscles work,
and then I put the hands on the ball,
this is not an exercise to get your muscles big and bulky,
this is strictly therapeutic,
and I extend up whatever is pain-free.
If I go back up here, it hurts,
if I go to here, it doesn't hurt.
And so I'm going to do it in the pain-free range.
I do 10 of those.
Then I go back to 10 on this leg, and then 10 on this leg,
and then my next one, I extend and rotate
in a pain-free range.
And I go this way, five times on each side.
The last spondy patient I had,
I was teaching him the exact same program,
he could go to the right but
he could not go to the left without pain.
So, his job was to go straight up
to the center and only to the right.
And as time goes on, test to the left,
and with any luck at all, he's going to
begin to start going to the left
and to the right without pain.
- [Bob] Yeah, these are golden.
These are, I think, some of the key exercises
you should be doing, Brad, for them out there,
because you're strengthening the back muscles a little bit,
but you're keeping that back
from causing you to be bent over.
- Eventually, you don't want to have this happening.
We want to stay with good posture.
- And I've seen it, I've absolutely,
in fact, one of my last patients that had this, Brad,
she has spinal stenosis, but she was walking like this,
and it took, we were working on trying to get her straighter
and we were having a tough time.
- It works better for you here
because you're in the camera better.
But no, seriously, that is a posture
you absolutely want to avoid if possible.
- Right, because you're going to end up with other issues.
You're now going to have other back problems
because you're bent over.
- Right, so I think we've got to
call it end, Bob. - (Bob drowned out by Brad).
- We're going to call end.
That's all folks.
(electronic tone)