♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physi- - What are you doing?
- I'm working on my anterior tilt.
Brad Heineck, physical therapist.
- Together we're the famous physical therapist
on the internet.
- In our opinion,
of course, Bob. - So, yes,
that's a title to today's program.
Is an anterior
or posterior pelvic tilt causing your back pain?
How to tell and how to correct it.
- Right? - We're gonna go
into the deep weeds here,
(indistinct), Brad. (Brad laughs)
By the way, if you're new to our channel,
please take a second to subscribe to us.
We provide videos on stay healthy, fit, pain free
and we upload every day.
Also go to bobandbrad.com,
go to the giveaway section
'cause this week we're giving away the Bob and Brad...
(playful music)
You can also go to Facebook,
it'll be pinned to the top of the page.
Go to Twitter, Instagram or TikTok
if you want a 6O second version
of our program where we don't ramble.
(Brad groans) And,
what else do we have, Brad?
- Oh, podcast, Bob.
We do have podcast out now with some excellent interviews.
- So this video was inspired by Stuart McGill.
He wrote the book, "The Back Mechanic" or "Back Mechanic".
And it's a very good book,
I'd recommend it if you have backpack pain.
You're gonna be able to need to do a pelvic tilt
or a hull over
if you wanna find out whether or not an anterior
or posterior pelvic tilt is causing your back pain.
So I'm gonna show that to show that to you
in just a minute.
Let's show on the spine here, Brad,
what an anterior pelvic tilt is.
Can you be, yeah,
be in the same position. - Yup.
- All right, so we're looking at the ileum to here,
the pelvis.
Now, if I bend forward like this, rotate it forward,
you see how I'm doing that?
- [Brad] Yup.
- [Bob] That's gonna arch your back.
- [Brad] So, woop! - [Bob] Yup.
And that's gonna bring all the spines together
and all the joints together and you could compress them
and it could actually cause you some pain.
- [Brad] Right.
- [Bob] Reverse of that would be a posterior pelvic tilt.
So I'm reversing it.
And now I'm putting in kind of a fluxion moment
on the back,
which can cause problems with the disc.
- [Brad] Right.
- That cause a bulging disc, herniated disc
over time.
- Right.
- So, that's what we're trying to do here.
And I want you to be able to do that to yourself
so that you know where the pelvis is in space
and you can correct it.
So-
- This is one of those things that if you're,
that you may have a difficulty at first trying
to make that.
It's like, like being a belly dancer.
You know, you have, - Yup.
- You know, you're gonna...
It's like same thing as doing that
but much, much slower and more,
you've got a lot more time to think about it.
But once you get good at it
and you can actually feel it,
then it'll also become very easy.
- And I'm beginning on the floor, Brad.
So, usually what we teach people,
what we first do is just have them lie down a surface,
usually even hard plans.
But, - [Brad] Yup.
- What did we do is,
I often put my hand in here
and I'll have
to squish my hand. - [Brad] Right.
- That's a posterior pelvic tilt.
You see how I'm-
- [Brad] Yeah, yeah.
'Cause that's very clear
and I've done...
This is the way I almost always do it with a patient.
- Can you see my belt?
- Yeah, so if look at his belt,
go ahead and put your hand, there you go.
So-
- I'm squishing the hand and that's a posterior pelvic tilt.
Posterior means back.
Now, if I go anterior, see what I'm doing there?
This belt is going forward.
It's like, if you're standing,
you're tipping a bucket one way
or the tipping a bucket the other way
and water is spilling out.
- [Brad] And this all has to do with core muscles.
- Right.
So now if you have trouble with it,
this is the Pelvic Rocker and it's made by OPTP.
They sent us one
so we thought we'd give it a try here.
This is really easy, Brad,
to get a feel for it. - [Brad] Sure, yeah.
Yeah, yeah and that's a...
Oh, my goodness,
what's that? - I'll take that.
It's my microphone. (Brad laughs)
- [Brad] Just put it
on your purse. - Yeah.
- Actually, put it on your stomach, Bob.
It'll show,
show right there,
go ahead. - Yeah.
- There.
- All right, I think we've,
done enough- - [Brad] Exhausted that.
- Done enough obscene moves here.
- [Brad] Yeah. (Bob chuckles)
- So, all right,
so, how are you gonna tell
whether or not it's giving you any pain?
And these are by Dr. McGill.
- Sure. - So,
the first one is,
you gonna take a weighted,
a five pound weight.
Where did- - Right behind you
on the floor.
- Okay.
Oh, right behind me.
(Brad laughs)
Brad, I'll give you one.
Now Brad does have spondylolisthesis.
- Right.
So I've got to shift mechanical problem in my back
that's clearly there.
- So you take five pound weight
and you keep it close to you.
And at first, you know,
we're assuming you've learned how to do the pelvic tilt.
What should we do first, Brad?
Should we do anterior,
or posterior. - Yeah, let's do posterior.
- Okay, posterior.
So we're moving the back. - Yup.
- We're flattening
out the back - Yup.
- And you feel how your back feels like that.
- Right.
- Then compare it with the arch
where you put the posterior,
you move the pelvis forward now,
- Yup.
- And compare it to that.
- And we're using the weight just
because it puts a little stress on the back-
- Right. - To make a little more clear.
- Now you can go right in the middle,
find the spot in the middle.
And that's usually where we want you to be.
- Yeah, okay I'm there. - Not forward,
not back, in the middle.
- Yup.
- All right, now, did that bother you at all, Brad?
- Well, yeah, with me,
if I arch my back this way, it's not comfortable.
- Okay.
- There's pressure there.
Not real sharp pain
but it's not comfortable.
When I go the other direction, things feel better.
- So your actually might be one that wouldn't be in neutral.
You might actually be better off having a posterior tilt.
- Yeah, a little more,
yeah. - Yeah,
a little bit anyway.
- And you know that is almost certainly due
to my spondylolisthesis.
- Right.
So, now if you want to make it worse,
(Brad laughs) you can actually put it
out like this.
And then do the same thing, the same test.
'Cause now you're increasing, you know, through physics,
- Yup.
- The beauty of science where you actually...
Well, actually you feel a little stress on my back.
- Yup. - With that.
- So just a longer lever arm puts more stress on it.
- I actually feel more on the extension,
- Yeah.
- But a little, little bit on,
on posterior pelvic tilt too.
So, I put it right in the middle and that is the best.
- So you have,
so then you just need to practice keeping that neutral
or pain-free position
with your exercises and daily activities.
- Now you, another one you can do is, actually,
do the same thing.
I'm gonna get to the posterior
and then I'm actually drop on my heel a little bit.
- So we're dropping
to put some compressive- - Pressure, right.
Force on there.
And the same thing, I'm gonna do an anterior pelvic tilt
and just drop on my heel.
- [Brad] So you compare-
- [Bob] Yeah. - [Brad] Anterior-
- [Bob] Posterior and,
- [Bob and Brad] Neutral,
- Right in the middle - Yeah.
- And compared.
- Yeah. - Well-
- It's definitely better- - Any pump?
- It's better for me when I'm back
than forward. - Sure, sure.
- Not a big painful thing. - All right,
now this next one, I don't want you to do...
If any of these already bothered you,
there's no reason to do this one.
This is maybe for, more for the weightlifter.
And this would be,
I'd like my son to try this one
because he's having trouble with,
I think, anterior pelvic tilt.
So he's going to take a weighted bar,
this bar weighs 45 pounds.
I'm actually gonna put it up on my shoulder
and like this.
And now I'm gonna do a pelvic tilt, Brad.
- Okay.
- So I'm gonna pil, posterior pelvic tilt.
- So he's pulling it this way.
- Now I'm gonna do an anterior pelvic...
I can turn to the side if I don't hit you.
- Yeah, oh, I see.
(Brad laughs)
Thank you, Bob.
- Okay.
- So we're looking,
there we go. - There's a,
anterior pelvic tilt.
- Gonna see.
- And posterior pelvic tilt. - Yup.
- And right in the middle.
- Right in the middle.
- And again, my son,
I think he does way too much of an anterior pelvic tilt
when he's lifting.
- Arching that back. - And he's gotta learn
to find that neutral spot
and lift like that and squat like that.
- I'm assuming that's,
see, I'm not a weightlifter
but I'm assuming those back belts promote that
in neutral position. - Yeah, probably a little bit.
- Yeah. - Yeah, exactly so.
All right, so how do you correct?
One, you've, you already started.
'Cause you, now you found out neutral is
where you wanna be. - Yup, yup.
- A good one to use is the Booyah Stick or a stick.
- Yeah, then you don't have
to have a 45 pound (laughs)- - Right.
- Weight there.
- But, you know, if you arch too much,
you could not feel the pelvis
against it. - Switch hands once, Bob.
It will be much easier to see. - Sure.
- So we're talking about, right here, the gap here.
Go ahead and arch.
- Yeah, see that's too much,
that's too much over arch.
You wanna be- - Whoa!
- Yeah. - It pinched me.
- Yeah, and so,
and plus you wanna make sure you have contact
in three points.
- Here, here- - If I have-
- And here. - Contact on only one point,
I'm too rounded out.
If I have contact on my head, mid back and low back-
- Yeah.
- That's where you want to be.
And now you can do squats
and keep that back straight while you're doing it.
- Those squats aren't gonna make,
you know, it's not a strengthening squat,
it's a postural-
- It's a technique.
- Right, right.
- To learn the proper technique.
Another one Stuart McGill does,
is he actually just has you comp and leaning
against the wall like this.
And you, you find out like you,
you do anterior pelvic tilt, posterior pelvic tilt
and find that middle
and see if it feels okay over there.
And you can actually work on extending
and flexing your hips by keeping your back straight
in that neutral position while you're doing it.
- So you're training yourself to maintain
that neutral position.
- Right, it's almost like a, little bit of a plank.
- Sure, right.
It's halfway between horizontal
and vertical. - All right,
and the final one I'ma show you is,
you're just gonna ahead,
you're gonna get yourself in a outfielders position,
not an infielder, I'm sorry,
infielders position. (Brad chuckles)
You're gonna be like this,
right? - Yup,
athletic stance, some people call it.
- Yeah, athletic stance.
Again, you're gonna find the right tilt
that you want. - Yup.
- This is too much,
this is the other way.
I'm right in the middle.
Now I'm gonna anti-shrug my shoulders
'cause I don't want my shoulders to be up.
- Yup.
- And by doing that,
I'm actually tightening up my lats.
- Okay. - For it to support my back
a little bit.
And now I'm gonna tighten up my stomach too.
- Okay.
- And now I'm in the right position.
I mean, now for lifting,
- Sure. - For carrying,
- Yup. - For,
I mean, that's the position you want to be in
if you have to bend over.
- Sure.
- So, just work on that.
And again, don't forget to tighten the abdomen.
The abdomen is really key- - Yeah.
- For providing bracing around the back.
- Right, they call it intraabdominal forces,
support the spine, that low back.
- So again, I know the word
out on the street is often as it's anterior pelvic tilt
but posterior pelvic tilt is just as bad.
- Sure.
- So, check it out
and find out which one you have.
- Good luck with it.