♪ Bob and Brad, ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ on the internet. ♪
- [Bob] Well hi there 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 going to show you the first three things
everyone with back pain should try.
This is physical therapists' advice.
And we can say that because we're physical therapists.
- Say no more Bob.
- By the way if you're new to our channel,
please take a second to subscribe to us.
We provide videos on how to stay healthy, fit, pain free
upload everyday. If you go to bobandbrad.com,
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- Bonus.
- Right.
So, also, bring this back, Brad, if you don't mind.
- Oh, yes, yes, yes, yes, absolutely.
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Let's get started Brad. So the first piece
of advice we're going to give you is
that you try to do some walking.
And the reason is that by walking,
you're getting all the joints of the back moving.
It acts kind of like as a lubricant for the back.
- Sure
- Plus it's a good time to start working on your posture.
Now, some of you are gonna say,
when I walk it actually hurts.
- Mhm.
Try walking at a increased speed.
I've tried this for a number of patients, it's been amazing.
They came in really limping away and I said,
"walk a little faster and get your arms moving."
And you could see the look on their face like,
"Oh my God, it actually feels better."
Because there's less weight on the spine
as you pick up the speed.
You know, there's less of the back settling in.
- Even things are, just and
also make sure you walk on an even surface.
- Right.
- No hills or uneven surfaces in the yard,
you know, a nice smooth area is the best.
- And what you can do every so often,
I want you to swing the arms if possible,
but every so often you can also just take your arms
and lock them behind you like this
and just to make sure your posture is pretty good.
- Sure.
- It's a good posture check.
Number 2, you want to make sure
the spine is in the correct position, no matter
whether you're sitting, standing, lifting, lying down.
And what is the correct position Brad?
- Well, Bob, We call it the S Position.
Right.
- I never know if this is making the S
or is it the other way that makes the S?
- Well, whatever, you're--
- This one?
Yeah.
- He doesn't even know what an S is.
- He doesn't even know what an S is. Right.
- (laughing)
- So we have a curve, a slight curve in at the neck,
slight curve out at the mid back,
a slight curve in at the mid back.
You're basically standing up straight
is what you're trying to do.
If you got your shoulders back and chin slightly tucked in,
you'll have that proper position.
- Now, yeah, the key to this though is
that you maintain that position even when
you're doing such things as bending over or lifting up.
So, If I'm gonna go ahead and I'm going to pick up
something from the floor, look at me
I got my back nice and straight,
my movement doesn't come from the back,
my movement comes from the legs.
So, an easy way to do that is just to do a lunge.
- Sure. I go down like this and you see
how my back stays straight the entire time.
I find with lot of people, Brad, when they have back pain,
they initially keep the back straight
because it hurts when they're bend it.
- Right.
- So, Yeah.
- Taking their time which is good.
- So if it's hurting, you're probably not
keeping it in the correct position.
It's very possible.
- But even as it gets better, continue to
monitor that so it stays better.
- Right. That's what you want to do
for the rest of your life. You want to keep the back --
Brad, do you want to show how
you can actually keep your back straighter
using chair with a little bit of help?
- Well first of all, it's nice to get a nice firm chair
that's gonna, you know, offer a good posture.
And of course, we're not gonna to sit like this.
We're gonna get your bottom back.
And it's nice to get a support in the lumbar spine.
- We have lots of different types of supports.
These are all McKenzie type ones.
- Yeah, and you can start out with a towel roll.
Roll up and put it in there and that works fine.
These will be a little more comfortable
and the thing is you need to find out
what size you need with the towel roll
by changing the size of the towel roll.
This is obviously thicker, this one's a rounder shape
and this one is kind of a flatter shape
and it's air-filled, yeah (grunts).
- So the thing is if you have kind of a larger buttock,
you know, you're going to need a larger support,
because you're gonna have a bigger arch.
If you're a slight person, I guess I'd be considered a
smaller person, right Brad?
A thinner person.
- Well, you're tall though.
- Right. I would, I need less support.
I have one that's very flat in my vehicle that I use.
- And it does depend on your chair
or the seat that you're sitting in.
A soft one, typically, you need a thicker one
to make up for the soft squishy--
- Right, very good point Brad, like if you're on a couch,
you're probably going to need like a throw pillow
or something behind you to give you support.
So, now, if you're lying down in the bed,
if you're not having pain,
I don't know that you need to correct it.
But if you are having pain issues, you may even wanna use,
you could take a sheet and roll around, roll it up
and then tie it around you.
And this helps maintain the arch in your back,
while you're, am I doing this wrong?
There we go.
Maintain the arch in your back when I'm laying on my back.
So if I'm on my back now, now it's not sagging down
in a rounded out position.
What's nice about this, if I lie on my side,
it also fills in that little gap there.
So I'm not getting that arch in my back.
So just, it's a way to keep your back straight
while you're in bed.
Number three, the third thing,
piece of advice that Brad and I, and most therapists
will tell somebody, we're gonna try
to get your back moving, but we're basically
gonna pick a directional exercise.
- Sure.
- So for some of you, I would say the majority of you,
the first thing I would try is back extension,
which is press ups.
- Right, on your stomach.
- All right Brad, yeah, I'll give that to you.
So, because, the reason for this is what a lot of times,
the way you hurt your back is bending forward like this.
- Sure.
So we actually find by extending in the opposite direction,
sometimes the movement and the direction
actually makes it feel better.
- Right.
- So you're gonna start off with,
some of you are gonna be down like this
and maybe just even start like this.
Eventually you move up onto your elbows,
what we call it the elbow prop.
And then eventually, you can put your hands underneath
your shoulders like this and start doing
micro press-ups or mini press-ups.
- And notice he allows, or keeps, his waistline right
on the mat, or you could do these,
they're probably best be done on a carpeted floor.
You can do them on a bed, but a carpeted floor is the best.
- Yeah, you don't want to be doing this.
And if your back is really tight that's how you might start.
I mean, you might feel like you can't get your pelvis down.
- Sure.
But eventually, you want to keep working at it,
working at it, working at it, stretch to the point
where you got your arms straight and your pelvis down.
- Sure.
So that's the exercise.
Now, this is one that I
would not try with spondylolisthesis.
Did I say it right?
- Or spondylolisthesis.
- I don't know, I think we say it the same way.
- (laughing)
- And also spinal stenosis. It's probably
not going to help those.
The one that we find that almost everybody can do it
for the first time is trunk rotation.
Do you want to show that one Brad?
- Oh, sure.
Yeah this is a nice, even if your back pain
is pretty severe you can start with this.
And you can do this, you know, before you get out of bed,
but you're in hook lying position and your back relaxed,
bring your knees up to about this position,
knees together gently, feet together gently
and just back and forth.
I always tell my patients it's like a windshield wiper
going back and forth on your car.
I'll only go in a pain free range.
If you can go this far to the right it's pain-free,
and you go to the left and you only go a short direction,
don't push into the pain, just bump to the pain
and then go back and eventually, you know,
this may take, over period of a few days,
that direction that was painful should start to loosen up
and then you can become equal on both sides.
That's the goal.
- I don't know if I've found anybody
that can't do this one Brad.
- Oh, yeah.
I mean, almost anyone, when they're in pretty severe pain,
they were able to do some of these.
- Right, but it's pretty common
that one direction may be painful.
- Right, Exactly.
Or they maybe couldn't do really wide swatches.
All right, this one's a little more complicated,
this would be for someone who has spinal stenosis
or spondylolisthesis, I can't say it.
- That's pretty close and maybe you're right, Bob.
I don't know.
- So, what I do is I actually have them,
this works well on a staircase,
especially if they have a railing on the staircase.
They put their foot up, may be a couple of steps like this,
and they're gonna stretch forward
and they're gonna stretch the hip flexors here
which tends to pull on the pelvis,
which tends to pull on the back.
- Can you put your other leg up?
- Yeah, that would be better idea.
- That'll be easier for everyone to see.
- So I'm stretching the hip flexors here
and while I'm in this position,
I'm gonna try a little bit of a couple of rotations here.
I'm keeping my back really straight,
but I'm getting a little bit of back movement
while I'm stretching the hip flexor.
This is just, I've found this one works with people
with spinal stenosis and I would think it
would be okay with spondy too, right Brad?
- Again, if it creates pain, you're not gonna do it.
If it's just a stretch, then you could do it.
- So you're gonna wanna do both sides.
You're gonna go ahead and stretch this side.
- There you go.
- Stay nice and straight and work on rotations, too.
- It's really nice to do it on stairwell that has a handrail
you can hold for balance.
- Yeah, exactly.
It does work with a chair, but it's a little more iffy.
- We didn't want to build a staircase in the studio today.
- I was willing to, you were the one that backed out.
- Well, Bob, I didn't bring my drill.
- (laughing) All right.
Well anyway, those are three possibilities.
We usually, I usually start people
that way off the first session.
Give them one thing to work on.
I found out, Brad, that
if you give people too many exercises to start off with,
they don't do any of them.
- (laughing)
- So I say, "we're making a deal here.
I'm giving you one exercise, but you gotta say
that you're gonna do it."
- Right
- So, and, if I can, I make them sign a contract.
- Wow, you're pretty tough on your patients.
- I am tough.
- Well, sometimes we gotta be.
- Yeah, you wanna get them better, you gotta be tough.
- That's right.
- Thanks for watching.