- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- Well, in our opinion, of course, Bob.
- Brad, today, we're gonna talk about top three exercises
for ankylosing spondylitis. This is-
- That's a mouthful, Bob.
- It is, but I'm assuming that since you've come to this
you know, this video, you probably know what it is.
It's, you know, a type of a arthritis,
inflammatory arthritis that can affect your spine
your shoulders, your rib cage.
And it tightens you up.
And like Brad and I were talking,
the people we've seen, they've ended up like this.
You know, everything's tightened down on 'them.
It gets to the point where they have difficulty breathing.
So this is where we want to, you know,
from the the time that you discover
that you have this, you're gonna be kind of
in a battle to keep your range of motion
and breathing ability, so.
- Right, so we gotta loosen up that trunk, expand,
work on that posture is really
what it boils down to. - Yeah one thing they actually
- Recommend, even, is that you measure yourself every month
to make sure you're not shrinking, pulling over.
And even measure your chest expansion.
So you measure it with you at rest and then measure,
take a deep breath as you can, and you'd like to see
a good inch and a half to three inch expansion.
- Right, So just use a tape measure just like you do
if you're fitting yourself for a overcoat.
- Yep, all right, let's show you the exercises.
There's a lot of 'them, and obviously you don't need to do
all of 'them, but you know,
we're just gonna throw a whole bunch of 'them out there
and you can see what you can do.
All right, the first one of the three is chest expansions,
Basically what we're trying to do.
And you can do this seated or laying down.
You're gonna put your hands behind your head like this.
So you get a little shoulder range of motion, too.
Just take the deep breath,
(they inhale)
expand, pull the elbows back
(they exhale) and then you go like that.
(they inhale and exhale)
Now you can do that laying on your back, too.
- Right, you might find if you're,
the gentleman I last worked with this,
he was so far into it,
he wasn't able - He couldn't even do that one
to get his hands back.
So that would not be for that person.
- Right, and some of these people,
you're gonna be too far along.
Another one, rolled towel,
Brad put some of his famous duct tape there.
- You better believe it
- Handy man.
Lay flat on your back.
And by the way, you want to use as little pillow as you can,
When you're sleeping at night.
You wanna try to adapt to the point
where you actually use very little pillow at all.
- And the reason for that is,
if you do this cause it feels more comfortable,
it just promotes that poor posture.
- And tightening up of the spine.
So again, I got a rolled towel between my shoulder blades,
and now, the same thing, you can do this.
And again, if you can do it without a pillow
go ahead and do it without a pillow.
And you're gonna go ahead, breathe in.
(Bob inhales and exhales)
(Bob inhales and exhales again)
- Good. So he's breathing in as he comes up,
exhales as the arms go down.
And Bob, can you just roll over this way?
Cause I don't know if everyone knows.
Here's where that towel roll is,
right between the shoulder blades, right on the spine.
And you'll know it's in the middle
cause it's very sensitive to tell.
- Very good. Okay, now the other thing you wanna do
is keep these muscles stretched out.
So Brad's gonna show a wall stretch or a,
well, you can do it in a corner
or you can do it in a doorway. - So if you're in a doorway
you gotta make sure it's about the right width.
And you may start with your hands here
and depending how your shoulder flexibility is,
and you're simply gonna lean in gently and get that stretch.
You should not create any sharp pain, but a nice stretch.
And typically you're gonna feel that across here.
And you can your arms up, If you tolerate it.
Whatever you feel good.
You're gonna hold that for 15 to 20 seconds,
up to 30 seconds If you can.
Okay, and you're gonna do that three times.
You can go to the corner of a wall
if you don't have a door, a corner works good.
This would be a wall here.
But if you get the idea, your face goes
towards the corner and your arms are out on the wall.
- [Bob] Cause yeah, most houses don't have doors.
So, we gotta make sure
we gotta account for that. (Brad laughs)
Okay. The next one we're gonna do is actual,
the second exercise is really more for strengthening.
Cause you wanna strengthen the back muscles
to help hold you straight.
Keeping the spine as straight as possible, that's our goal.
So Brad's gonna go ahead and lay down.
Why don't you lay flat on the pillow, Brad,
with the pillow underneath here.
you want the pillow kind of right over here, in the abdomen.
- So here, - Right there, yeah.
- and simply lay on it.
- So we can start off by just doing arm exercises, too.
- Where's that towel roll gone?
- Oh yeah, the towel for the forehead works out really good,
Doesn't it, Brad?
- Yeah.
- So he can put his head, his forehead on the towel.
Now you can start off by even just raising both arms
like this,
and you can see how that's strengthening
the upper back there,
and starting to help keep that spine straight,
by having the muscles strengthen the core
and the upper back.
Now a little more difficult is to start, maybe
why don't you raise one leg, Brad?
Good.
And the same thing, that's now strengthening
the lower back and some of the upper back too.
And then you can even do alternating, right, Brad?
One leg, one arm.
There you go.
- This is pretty advanced. - This is advanced.
- This is not easy.
- Brad's making it look easy, it's not that easy to do.
Very good.
Now you can hold them for five seconds
and let 'them down, you know.
- Do some isometric kinda.
- You can do a good 20 of these, if you'd like.
it's a good core strengthening exercise.
All right, Brad, why don't you flip right over
onto your back
and we'll show some of the range of motion exercises too,
that you wanna do.
- I thought maybe I could take a nap.
All right.
- All right, the hips tend to get
a little bit tight on these too,
so you can actually pull one knee to your chest, Brad.
Like that, pull it, and do the other one.
Good.
Then you can even do both together.
Good.
The other one that I like to see done, actually,
cause that's actually stretching the hips
and the back a little bit,
is actually just do some rotations.
This is a great one for when you wake up in the morning
just to get things moving in your back.
It's moving all the joints of the back,
especially the low back. - and through here.
- Yep, all the way in through there.
- Typically repetitions are always 10 to 15.
Relaxed and comfortably, getting that stretch.
You'll feel it.
- Okay then why don't you sit up, Brad.
Another good thing to have, Brad, is maybe just have
like a pull up bar or a bar, somewhere in your house.
that you can grab onto and just give yourself a stretch.
Cause that that's gonna help stretch
the back out a little bit
and it's also gonna help stretch the shoulders.
You're gonna probably wanna do even some
neck range of motion.
The typical rotations.
Side bending.
- Might get some chin tucks.
- Chin tucks, extension.
I know we're throwing a lot at you,
but the whole idea is you're trying to get
all the joints moving and you're trying to keep
as straight as possible when you're doing this
and working on your breathing.
- And there may be half of these that you're not able to do.
So just do what you can,
and pick up the ones that work for you.
- That sounds good.
All right, if you have any questions or comments
put 'them down below.
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- All right, thanks a lot.