♪ 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 therapists
on the internet.
- In our opinion, of course, Bob.
- Today's video is on how to stand and lean forward
pain free with back pain or sciatica.
Now, this comes up quite often during the day,
and the typical day it does for Brad and I for sure,
and we want to make sure you're doing it correctly
because it's another time where you can irritate your back,
irritate the sciatica, and make it harder again to heal.
- A good example, I'll have a back pain patient come in
and I'll say, well when does it bother you?
And they say when I'm brushing my teeth, when I'm vacuuming,
or making the bed.
And it's things where they're
leaning forward, not a lot, their not lifting anything,
you're just, from this posture to this posture can put
a tremendous amount of stress on the low back
particularly when it's injured.
- Particularly if you do it wrong.
So if you're leaning forward on the bed or over the sink,
and you're rounding out your low back like this,
which is what people typically do,
you may not even realize you're doing it.
You almost may need to have somebody watch you or film you
because you may be surprised how poorly
your back looks when you're doing this.
Now I feel it quite often while we work with patients in bed
and I feel it quite often when I lean over the bed,
and I do work on doing the things we'll talk about today.
But, the first thing is
you want to try to keep the back in a locked in position.
We've mentioned this locked in position on other videos.
What that means is you're gonna really,
I always do the wrong side.
Did I get it right this time Brad?
- Bob is using the stick
so he can see that neutral position,
the locked in position,
so that the low back is where it should be with less stress.
- Yeah, mention the three points of contact again Brad,
I know we've mentioned it a million times but.
- Yep, it's here right below the belt line on the sacrum,
right between the shoulder blades, and then the head.
And if those three places have contact with this stick,
we have a good neutral, locked in posture.
- Locked in spine, and what you'll see here,
what I want is when you're bending forward,
really all of the movement is coming from the hips,
the back is locked in.
The back is not moving, the back is not bending,
the hips are moving.
- So if one of those three points becomes without contact
usually it's the head or the low back
and here you can see the stick is rocking.
Then, you know you've got a lot more stress on the low back.
- Right, and this is something you may want to practice.
I practice it with squats.
I do squats and it really carries over to my life.
But, sometimes just visualizing this
will help you lean forward correctly.
- And if you're a weightlifter, they call that hip hinging.
So keeping that.
And yoga I think they try to stress that too.
But, a lot of people just aren't aware of it
because it's not natural.
- It's like you want to think your back is being in a cast
and you can't break the cast.
The hip can move but the back can't.
Now, another thing you might try though
is you might try varying.
If you're having a lot of pain in the back
even still when you're locking the hip or the back in place,
you might try varying how much arch is in your back.
Sometimes putting a little more arch
or putting a little less arch.
And this is sometimes difficult for people to do.
But, it can change how much pain you're having.
- Right, and that's done with the pelvis
and your abdominal muscles.
Where, if you look at my hands, I can change my pelvis.
They call it the anterior and posterior tilt.
By tightening your stomach,
I know with me personally if I tighten my stomach up
and I get into a position I can,
while my back isn't irritated with spondylolisthesis,
it's a chronic thing I have.
But, I've learned to adjust
and make it feel good just by doing that.
- And you alluded to the other thing you can try.
You can actually, when you're leaning forward,
you want to tighten your abdominals.
And you can tell that their tightened just by
poking your fingers in there
and are they tightened up or not.
If their not, you know, if you're the Pillsbury Dough Boy.
Remember that guy?
You can poke in obviously it's not tightened up there.
- So yeah, it's a lot of awareness.
The other thing is the height of, for example, the sink.
We have two bathrooms in our house.
One sink has a newer one,
it's for inches taller than the older one.
And it's amazing what a difference it makes.
It makes me from standing here,
and on the lower sink I'm here
And even if I don't have back pain, I feel it.
I'm pretty aware of my body
because that's what I do for a living and with exercise.
But, four inches can make a big difference.
- Also, what you can do if you're doing dishes
on a regular basis in the sink.
We used to recommend this when I worked at Mayo.
You take two tubs and you put one tub upside down
in the sink and you put another tub on top of it
so that it raises up the sink in essence.
- So then you just use your water in the taller sink.
- Now you can also get closer to the job by doing what Brad?
By opening the cabinet.
You looked at me like you didn't know
what I was talking about.
- So this would be the sink here,
open up the vanity door,
and then you can get closer.
You can even put one foot up in here.
Sometimes that will help take stress off of your back.
But, yeah, getting closer to your workspace.
- Now, it also helps to like,
if you're working with the bed
sometimes to put the knee up there.
You can get a little bit closer.
The other thing that really helps whenever possible
is to take some weight off the back
by putting one hand down.
This does an incredible job.
And you can even do that if you're bending forward
is put a hand on a thigh and lean forward
and work like this.
Makes a big difference.
Really takes a lot of stress off the back
because even if you're keeping it straight
your back tends to not have that much endurance
and just gives it a rest
by taking some of the stress off so.
Anything else you want to add Brad?
- No, I think we've covered a lot of it.
Again it's that locked in back,
keep things close, the higher the better.
- There we go, watch our next video in the series.
- Thank you.