♪ Bob and Brad ♪
♪ The two most famous ♪
♪ physical therapists ♪
♪ on the internet ♪
- Hi folks I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous
physical therapists on the internet.
- In our opinion of course Bob.
- Today we're gonna be talking about top five exercises
for chronic low back pain.
This is the pain that just doesn't seem to go away.
And we get one that did get some different components
for the exercises and we're gonna include them all.
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- And those are done very well by the way.
- Yeah we make a nice synopsis.
All right the first thing you wanna do
when you have chronic low back pain,
you wanna make sure you're on a walking program.
- Sure.
- That walking is gonna act like nature's natural bomb.
It's gonna help calm things down,
it's gonna get more blood flowing and if you find out
that you have trouble walking,
try walking faster, believe it or not that reduces
the pressure on your spine.
- Right.
- So just take what I say at what it's worth
and give it a shot and see what happens.
- Just make sure you walk on a flat surface you know,
not on a side of a road where it's got a camber or
up and down hills or uneven surfaces.
A nice flat sidewalk or something of that nature.
You know, in the mall.
That's a good place to walk. - Yeah, malls are good.
- They still have malls?
- Oh yeah that's all they're good for is for walking now.
- All right.
Okay the second thing you can try is traction.
And there's a number of ways you can do this
but we're gonna show you
one of the more inexpensive ways to do it.
And we've actually just developed this.
The reason you wanna do traction is,
you actually it's really helpful quite often
to actually pull the bones apart.
To actually pull the vertebrae apart.
It takes pressure off,
let's say you have pressure on the disk.
It takes pressure off that.
If you have pressure on a joint like the facets,
it takes pressure off that.
If you have pressure on the foramen here.
You know, if there's maybe a little bit of bony overgrowth
there you can give yourself some relief.
- Right it can take the impingement off the nerve
if that's what's happening.
Traction's been around for decades.
- Right.
- But they've kind of gotten away with it, away from it,
as much as they used to.
I think it's because they have surgery but,
you know, we wanna avoid surgery
and this is going back to old school but it's,
it still can work.
- It can be very effective first and especially
shorter term relief and help you do things,
take it towards longer term relief.
Anyway what we got here are the hanging handles.
Brad and I developed these.
We actually, these are taking one of our wall anchors,
you gotta put it into a stud.
Believe me, you gotta put it into a stud,
otherwise you can't hang here.
But these handles come with and they can hold what,
275 pounds Brad was it?
- Yeah that's between both you get over 500 pounds
between two handles. - Yeah over 500 pounds.
- So what you can do is you're gonna set it up so you're not
have to reach too high, I like it so that you're actually,
your knees can bend a bit.
And you can you know,
change how much stress you put on your back.
I mean you can actually how much traction
you're putting on your back.
- Right and it's done very easily just through your legs.
- Right I can lift up completely and hang that way
for brief periods of time if I want.
Or I could hang for a minute,
you know if you've got good strength in your hands.
- And I've found with this if I change the position
of my pelvis it stretches my back.
- Oh arch shift?
- Right, yeah and I find when I flatten it,
'cause I've got some stenosis, boy does that feel good
to open those facet joints up.
- And I have found and I do this every like
20 minutes when I'm sitting a lot.
It's just and then my back cracks.
But I like to just do this gentle rotation Brad.
And if you have pain on the right,
I would try rotating your knees to the right.
'Cause that's quite often and I'm just gently,
rocking them back and forth
but it can make a big difference,
it can really take that pain away.
- Yeah this is one of those things that if you find
yourself you know you could go up to a pull up bar
if you don't have one or go somewhere that does have one
and you find that traction hanging from a pull up bar
is helpful, then these would be very beneficial.
The nice addition to these is you go up against the wall
and it keeps your back in really nice straight posture.
- Yeah and you can have it anywhere in the house.
I mean maybe your wife's gonna explain but,
or your spouse but I mean I like again I have it
right near my office so I can right when I'm working
I can just go right over to it and it just wakes me up too.
- So I put my legs like this and I,
you see how I tighten my stomach in and right there
it just feels really good.
- Yeah there's a lot of variations,
we'll have to spend some more time on this another time.
- Exactly.
- Let's go to number three.
All right number three is you have to get some movement
in the spine, it's just gonna make it feel a lot better.
We've got a bunch of 'um you can try here.
You don't need to do all of 'um,
just pick up some of 'um that feel the best
and stick with those.
- Right, they should be moving said are pretty much
pain free or at least part of the motion.
We'll go through that in detail on these.
- And we'd like to make your back actually feels better
after you do it or while you're doing it.
- Right.
- So the first one is cat camel.
Brad's gonna show that.
- So you can do this on your bed,
you know like I'm doing here or down on the carpet
and floor works well too depending on what's easier for you.
But just round the back up and then arch
and go the opposite direction.
Now you might find that once you get so far it's painful.
Then you're gonna stop and don't go into the pain
and go back up to that pain free range.
You only may have half the motion initially
but after doing these for a few days
and things start to improve,
then you can get to that full range of motion.
- Now what Brad's doing with his head,
he's bringing when he humps up this way
he puts his head down and when he arches up the other way
he brings his head up. - Yeah.
Now how does this one feel to you?
Brad has spondylosyndesis and--
- Well you would probably guess, you would know Bob,
'cause you're a therapist, but when I go this way--
- Yup it doesn't have a lot of motion.
- And it's not so fun I don't wanna go--
- Yeah you actually don't like it.
- No.
- So you probably won't even do this one.
All right well how about the next one Brad,
windshield wipers how do those feel to you?
- They're pretty good.
- Okay.
- So we lay down flat with your knees up,
feet on the floor like this it's called hook line,
at least that's what I call it.
And knees together gently and I call it the windshield
wipers because your legs are going back and forth
like windshield wipers on a vehicle.
- [Bob] I think we can attribute this term to Brad.
- You think so?
- [Bob] Yeah I never called it that.
- I don't know I used to always tell my patients
and they seemed you know--
- [Bob] They catch on real quick.
- Yeah so if it hurts going to the right,
then you only go until it starts to hurt,
then you go the other direction and maybe that way
it doesn't hurt and you can go well I'm bumping into this,
you'll have to move the cupboard.
All the way over and you see the hip actually comes up,
my shoulders stay flat and if that's pain free
or just feels like a healthy stretch then you'll do it
and go to the part more painful then bounce back.
- Yeah with all of 'um you don't want pain,
so what Brad is saying you know you can go this far
if it's not painful.
But if it is pain, yeah you can go this far
if it's not painful but if it's painful just go
to the point where it allows you.
Now you can also try moving the feet up a little more.
Or moving the feet down a little more.
That changes the position of the back
and it might feel a lot better in doing those.
- Yeah that's a good point Bob.
I've even had people kind of work it up here.
Particular if they've got stenosis.
- Sure, yeah that's a good point.
Now if you don't have stenosis or you don't have spondyl,
this is a good exercise to try especially if you're younger.
This is the press up so you're gonna put your hands
underneath the shoulders and you're gonna press up
like this while keeping your pelvis
firmly planted on the floor or on the bed.
You don't want the pelvis to be coming up like this.
If you're that tight that it starts to come up,
just go up to that point and then go back down again.
And the pain that rules stand with this also
in that you don't want to do this if it hurts
and if it hurts when you start getting up
a little bit higher don't go up that high.
- [Brad] Right.
- You know basically if it hurts don't do it.
- [Brad] Typically 10 repetitions at one time is good.
- Yeah you could do 'um throughout the day if you'd like.
Especially when you have chronic back pain.
So number four, core strengthening.
So I'm gonna show a couple core strengthening exercises
here, these are the one's I do, I do 'um all the time Brad.
I'm eating my own recipes right.
- You can't go wrong he's field tested.
- So I put my hands underneath my back to support 'um.
And then I lift my elbows up.
- [Brad] So your fingers are out like this?
- Yup, they're touching each other actually.
And I'm gonna lift my head and my shoulders up like this.
So I'm not curling up, my back is still staying straight.
But I'm lifting up like this and I'm going back down again.
Lifting up, going back down again.
- [Brad] Now you'll see a lot of people will promote
what we call the V set up where you go all the way up.
- Like this.
- [Brad] But that puts a fair amount of stress on the back--
- Oh that's terrible for your back.
- [Brad] And yeah so we don't do that.
- The way I actually do these Brad is,
I think I showed you before, I go like this.
I do these and I'll you I have to actually rest
every 10 reps, I do 10 and I go rest for two beats.
Then I do 10 more and then I get up to 50 I am burned.
That's about as far as I can go.
- Yeah it's amazing when you add the legs in with it
how much more it works the abdomen.
- All right then you wanna go right down to your side
and you can start on your knees 'cause it'll be a lot easier
and you're gonna go ahead and just lift up
and you're gonna do some planks like this.
- So his body right now is not in a straight line
and you're doing that on purpose right Bob?
- Am I not straight?
- Well you're flexing the hips a little bit.
- Oh yeah I mean it doesn't matter what the hips are doing,
the back is straight.
- Right no your back is good.
- Yeah if you wanna go ahead and do the full one,
you're gonna put one foot right in front of the other
and lift up like this.
And that's what I do and I just do a count of 10,
I actually just go one, two, three just as a reminder.
And I do 10, then I'll do like four or five sets of those.
- Now this particular one if I try it,
my back is not comfortable in doing it,
but the next day it's pretty darn painful.
- It is.
- And I don't even try these anymore.
And that's with my back condition.
So you know you have to experiment.
- Yeah you have to know and you're obviously gonna do this
on both sides too.
- Right.
- So all right number five.
This has become one of my new favorite exercises
is posture squats.
So, again it just works out so great from muscle memory.
You're gonna strengthen the legs,
I get in a pretty wide position.
I'm trying to keep the knees behind the front of the foot.
Can you maybe show that Brad?
- I think that wide base is so critical
because so many people that I work with,
just instinctively keep their feet close together.
- So by putting the arms up here,
what I'm doing is I'm strengthening all the muscles here.
I'm squatting I'm also strengthening the lower back.
- Now he doesn't want the knee I just got a vertical line
that's all the Booyah Stik is for.
- Now you're gonna see I don't dip down that far.
I don't have that much range,
that's about as far as I can go.
But you know I do 30 of these and I'm working.
- Oh right, right.
- My back is working, my legs are working.
- Right and we do not like to see people go farther
than 90 degrees in the hip or the knees.
I mean so Bob could go down another four inches maybe
but again you work with what you got and Bob is,
what are you, 80, no.
- I'm near it, I feel like 80.
- No but you know there's most people, what are you, 59?
- 59, so.
- 59, have a hard time doing that and that's fine.
- Right and the thing is this really carries over
to whenever I lift something now.
Like whenever I lift something it just my body,
my memory kicks in I'm like and right away my legs are
wide apart, I'm squatting down and everythings firing up
and protecting my back so.
- Yeah when you get to the point you don't have to
think about it anymore, that's huge.
- That's right making it automatic and you don't you know,
that's gonna start knocking your pain levels down.
If you add all these five into your life so.
Remember Brad and I can fix just about anything.
- Except for--
- A broken heart.
- But we're working on it.
- Yeah when are you gonna finish it?
- I think we need to start using some
thread and needle and sew it.
The old fashioned way.