♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the internet ♪
(Bob claps)
- Hi folks, I'm Bob Shrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today, we're gonna talk about three best stretches
to quickly remedy lumbar spinal stenosis and avoid surgery.
- That's right, Bob.
- So who do we know, Brad, that's having trouble with this?
Well, Bob, this truly happens too.
By the way, this is not uncommon,
particularly with people past 50 years old.
And we'll get into that a little bit.
- By the way, if you're new to our channel,
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Go to bobandbrad.com. Go to the giveaway section.
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- That's right.
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The most comfortable mattress. Brad, you can attest to this.
- I certainly can.
- You got back pain, and you love it.
- We both do.
- Oh, yeah.
- I mean, separate beds, of course.
- Yeah. (both laugh)
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- Watch this.
(cardboard plops)
All right, so spinal stenosis...
In this case, lumbar.
So, you can have stenosis throughout
your whole spine. - Yeah, you can have
in your cervicals, in the neck.
- And stenosis, technically, if you look at it,
it just means a narrowing.
- Right.
- A hole.
- The hole was like this. Now it's like this.
- So you can have stenosis of your arteries
or your veins. - Sure, yeah.
- So we're talking about...
We'll, look at this.
I don't have my little pointer here.
But here, if we look at the spine,
and we're talking about lumbar stenosis.
We're talking about the low back.
And if you look at spinal stenosis,
there's two areas of stenosis
that can cause pain in your back
and going down into one or both of your legs.
And we look right here.
Can you zoom in on this, Tanner?
With this nerve...
Here we got a nerve coming up,
peripheral nerve we'll call that,
which does go down into your leg.
Now, the gap right here is called the foramen.
That actually starts to close up.
It may be because your disc,
as aging process is deteriorating,
which pretty much happens in everyone,
or it could be some bony-
- [Bob] Overgrowth.
- [Brad] Overgrowth.
- Arthritis getting started. - [Brad] Calcification going.
One way or another,
but the nerve gets pinched
because the hole that it goes through becomes smaller
or stenotic.
That can also happen with the spinal cord.
It's hard to show in here,
but if you look at the-
- [Bob] Yeah, in the spinal canal, you can-
- [Brad} There you go, Bob, that's right.
- [Bob] Right here, Brad, you can kind of show it.
- [Brad] There you go. Yep, in here.
But it happens
more often lower. - Oh, lower, right.
- [Brad] When that happens,
oftentimes, the pain or the symptoms will go down
both legs. - Both legs, yes.
- One way or another, there is, worst case scenario,
surgery, that typically typically can help it out.
However, I found out after doing a little research
that most of the time, vast majority of time-
- Right, vast majority.
- you don't need surgery.
- Right.
- So that's good news.
- Because it can get inflamed.
And once the inflammation calms down,
it has enough room then.
- Yeah.
- But with the inflammation, there is not.
- Right.
- And also certain movements can be done.
- Right, and that's what we're gonna do is
show you exercises that increase that gap
and make it even more,
a less chance yet of having surgery.
So we gotta get rid of the spine here.
I'm back now.
So let's go into...
There's a five question self-test-
- Oh, yeah, that's right.
- that can take for this.
It's not a definitive test,
but it'll help give you...
If four of these answers are yes out of the five,
there's a pretty good chance you have stenosis.
- Spinal stenosis, right?
- Right.
So the first one,
if you have bilateral
or pain or symptoms down both of your legs,
if that's a yes, then you've just put a yes down.
- Right. You're definitely...
- Well, there could be other things, but yeah.
And as again, as all these combine.
Number two, if more leg pain than back pain.
So if you got...
And sometimes its leg pain
because it feels like a toothache,
a numbness, a tingling, all those symptoms.
If you have more down the leg,
one leg or both legs and not so much up here, that's a yes.
If that's the case, you'd check that one off.
Number three, if pain gets better, when you sit down.
- Yes.
- And I've had lots of patients, including myself,
boy, you sit down and within...
not hours, but within a minute or so,
it's like, "Oh." - Yeah.
Sometimes right away. - Yeah, it's a big relief.
- Yeah. Number four-
- You missed number three, Brad.
Pain with standing or walking.
- Oh, yeah. How could I miss that one?
Very typical, people find when-
- Standing straight.
- Yep, standing up straight.
Or like if you're walking- - Walking straight.
- if you were shopping, you hold onto the grocery cart,
and you find that leaning forward
onto the cart feels better.
- That's a dead ringer there.
I'll tell you...
Well, they call it shopping cart syndrome actually,
because you actually feel better when you're walking
with the shopping cart.
- And then if you are older than 48...
Now we've had, Bob, that's something older than 55.
Whatever, if you get up into your fifties or older,
there's a more chance
that it's gonna happen. - Yeah, I saw
if you're older then 55, and if you did this,
you go up like this, and that would increase your pain?
- Sure.
- That was spinal stenosis
because you're closing up the gaps there.
- So there's different information out there,
but of those five questions,
if four of them are positive or yes,
there's a fairly good chance you have stenosis.
So the other thing is if you're having leg symptoms
on one or both legs, and it sounded like stenosis,
and you're having problems with your balance,
or you've had a history of falls,
you need to go see a doctor.
Don't go through this and try and fix it.
You need to see a...
If you're falling, figure out what's going on;
and you have these symptoms, get it checked out.
And then maybe see a therapist directly.
Cause that's getting more serious.
- Right?
- So if you're having these symptoms,
but you feel functional,
and you sit down, and it feels better,
here's one of the stretches.
We've got three stretches to do.
These are relatively easy.
Particularly, this first set.
You can do these in your bed before you get out of bed.
If you can lay down on a floor, carpeted floor,
that's a good option as well.
The first one is just start with a single knee to the chest.
Oftentimes, if it's the right leg
that feels the pain going down just one leg,
that leg going up by itself may feel better.
In my case right now, oh, yeah, that feels better.
Make sure you do both legs.
And it may take both.
And we do suggest do both knees coming up
cause that helps open those gaps up on both sides.
You got anything more about this, Bob?
- No, that looks good to me.
- You can hold this 15 to 30 seconds
depending on how it feels.
If it feels better to get motion
and go pressure on, pressure off,
10 repetitions is probably good.
- Again, this should feel good, though.
If this is causing increased pain, you're stopping.
- Right. There's something else-
- Or even increased pain afterwards.
- Right, you do 10, and it feels okay,
or a little bit better,
but then you get up-
- And it's actually worse.
- And you're getting worse,
and over the next half following,
you've flared it up.
- Yeah.
- So yeah, be really aware of how things respond
after the exercise.
So if those help, and they stay good afterwards,
you can do those three times a day, I'd recommend.
- Sure.
- Or possibly more, as long as it continues to feel good.
The next one, the six inch roll.
Now, this one I learned taking a continuing ed class.
- He's got a foam roller.
- Yep. So this one you need to do on a floor.
You're not gonna do it in your bed, for sure.
- Yeah, you need a firm surface.
- Yeah, carpeted floor.
I would not try it on a smooth floor.
You could do a rolled up towel that was rolled up tight.
- Really? Yeah.
- But these work a lot better.
Now, what you're gonna do with a foam roller...
It works better if it's a little bit softer.
They have a lower density,
but even a hard one that's usually...
They're black and color,
they're a little more firm.
That'll work. This is a little more comfortable.
You put it down below your belt line under the sacrum,
the lower part of the sacrum.
Not down in here where it feels like it's gonna fall off.
- So the sacrum is a triangle right about here.
- Yep.
- So that can kind of give you
a little bit of a hint of where the location is.
- So you'll go like this,
and you'll know it's in the right spot
cause it's gonna feel good for one thing.
And if it feels like it's falling off like that,
you need to bring it in a little bit closer,
not much, a half inch or so.
And this...
Though, what happens is a roll kind of helps gap
those facets or those foramen.
- Sure.
- And if you push a little bit like this and roll it,
and actually, what I do is...
I'm gonna expose a little bit of myself here.
I'm gonna go right on my skin
cause it grabs a hold of the skin,
and that actually feels good.
It kind of gaps.
- Sure.
- It pulls the foramen apart.
- Almost like a little traction there.
- Yep, exactly. Right, Bob, yep.
And you're gonna do that...
Like right now, this is feeling really good,
and I could do this for about 30 seconds easily
until I get tired.
You're gonna work with that for a few minutes.
Do that a few times a day.
Now, this next exercise, number three,
it's gonna take a little bit of...
Not special equipment, but a pull up bar.
We're gonna use the hanging handles,
but pull a bar that...
And you're gonna actually put some traction
through your back by hanging.
This is no new science or anything.
It's been around for a long time.
There's one thing I've found.
I haven't seen this anywhere.
- I haven't really seen it, Brad.
- But I know it works for me, so.
- I thought this was a cool idea.
- So first of all, if you have a pull up bar, grab that.
If you have hanging handles, it works better yet.
It works good to be up against the wall.
- Up against the wall.
And plus if you have the hanging handles,
you can keep your feet on the ground.
- Yep. Yeah, you don't wanna have something
you have to jump up to get.
- Yeah.
- So here and then you slowly go down.
- And you still can have some weight
through the feet if you want.
- Yep.
- And then if you want,
you can progress to no weight.
- Yeah. And assuming your shoulders tolerate this.
Typically, it's good for your shoulders
if you got reasonably...
- Right.
- And that's a whole another topic we've got videos on,
but I can actually do this.
But the key part about this is you have to be able
to relax your core muscles
because they're gonna allow the spine
to get that traction and open up those foramen.
- Yeah, if they're tightening up,
you're not actually getting any traction.
- Right. If you're going
( Brad grunts)
and you're all tight,
it's not gonna work.
You need to relax. Let everything relax.
Now, what I found is if I put my feet right here
and that actually lets me relax better,
and it flexes the spine just like the previous exercise.
- See, what happens if you're hanging,
and you're having to lift the legs,
those muscles are tightening up and pulling on the spine.
- Yep, exactly.
- So this is relaxing the muscles of the legs.
- Mm hmm, yeah.
- And relaxing the stomach and abdomen,
and you can just let it hang.
- Yep.
- It's a brilliant idea, Brad.
- And I can do a little of this.
Or I can go up to this level.
At home, I've done it.
I don't have a stool like this.
- Just make sure you got enough strength to hold on to it
because you don't wanna end up falling.
- Yeah, absolutely. - And landing on your butt.
- This is not one to do
if you're concerned about that at all.
You need to feel confident in hanging.
- In hanging, right.
- Yep.
So I typically only hang 20 to 30 seconds at the most.
When my fingers are starting to become tired,
I don't even try to push it.
- So what do you call it, the Heineck hanging method?
- Yeah, the Heineck maneuver.
- The Heineck maneuver. (chuckles)
- Not to be confused with
the Heimlich maneuver. - Not the Heimlich.
The Heineck maneuver.
- Right.
- There we go.
- I do feel...
It feels good now.
I've got spinal stenosis, by the way,
so that's why I have at this young age,
well, I guess, I'm 68 now.
(Bob laughs)
But I had this when I was younger.
- Young age?
- Well, you know, I'm trying to be optimistic, Bob.
- You're trying to find some dirt that says older viewer.
(Brad laughs)
- Why, Bob? Why?
- By the way, if you're new to our channel,
you've gotta...
Will we do that part yet?
I was gonna say-
- Talk about age.
- we could fix just about everything.
- Except for-
- A broken heart.
- That's right, Bob.
The hanging isn't gonna do anything
for it. - All right.
(both laugh)
Thanks.
- Be careful.