♪ Bob and Brad, the two most famous ♪
♪ physical therapists on the internet. ♪
- Howdy folks.
I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- And we're the most famous
physical therapists on the internet
- In our opinion, of course, Bob.
- Degenerative disc disease
or sciatica of the low back.
We're gonna show you 10 best exercises you can do for this.
- Right, so the question is, are we talking
about DDD or degenerative disc disease
or sciatica or low back pain?
- Could be all the same, right?
- Right, right, you could have all three in one
or it could be separate.
But I do wanna kind of hit on this degenerative disc disease
and I've had people, viewers comment on it.
And I think it's one of those terms.
I really feel pretty confident
that it's overused and it's a misnomer.
- It sounds terrible.
- Right.
- I mean, I got a disease.
- Right, exactly.
- And it really isn't a disease.
It's more degeneration.
It's aging, right, Brad? In most cases?
- So, why listen to a couple therapists?
So I went and did some research on it.
I found a nice article by Dr. Peter Ullrich.
And he came up with these exact same
or very similar
- Thoughts.
- Thoughts, exactly.
That it's a misnomer, not a disease.
It's a, it's pain from a lesion,
or in other words, a problem with the disc.
And it may be that the disc is shrinking.
In over age, all of our discs do shrink.
You know, when you get it, they lose
- They lose water,
they lose water and they get smaller
- Right.
- and they compress down.
- Right. That's simplifying it.
But basically that's what happens, simplifying it.
- Right, it is simplifying it.
- And the thing is about it,
we'll show you one right here as a matter of fact,
this, this model, how does that look line?
You got it? Is it clear?
- [Bob] You want me to hold it, Brad?
- [Brad] Sure. So you don't have, if you have a
a disease disc, it's not red like this,
it's just this model.
So you can, it's easy for instructional educational purpose.
There's a disc
but you can see the thickness of this disc,
this and all these are thick and this one...
- [Bob] Good healthy discs.
- [Brad] Right. This one's much thinner.
This one could be considered to have
degenerative disc disease and also
has a herniation as well.
And that may be part of the problem that all works together.
And then because of this, you get sciatica.
So you can kind of see how everything can work together.
- [Bob] Oh also, could you see how if these two bones
come together, that this hole gets smaller.
- [Brad] Right.
- [Bob] Where the nerve, the spinal nerve comes out.
- [Brad] Right that, that's called the foramen.
Another, foramen just means a hole.
And yeah, if that hole gets too small,
you pinch the nerve, sciatica occurs.
- [Bob] It's easier to pinch the nerve too.
You know, not necessarily is it gonna pinch it all the time
but there's not a lot of room in there.
So if there gets some inflammation in there
it narrows up that hole.
- [Brad] Exactly. Exactly.
I'm gonna show you another,
actually a x-ray of the same disc.
- Level?
Yep. And yeah, we're looking at it from this angle.
If we look at some x-rays.
Okay, these are real live x-rays taken.
- [Bob] So it'd be like this.
- [Brad] Yep. There you go.
- [Bob] This angle.
- [Brad] Yep.
So here's L2, which we're at here.
Then L3 and L4.
Now, look at here between L4 and L5.
There is literally no disc between these two discs.
And actually this particular back has something
called spondylolisthesis,
and this has a shifted forward and we have no disc.
And actually this disc down here is changed shape
it's pie shaped, and it should not be that way.
It should like this.
So we got two discs here with this.
- [Bob] With problems.
- [Brad] Right. Exactly.
Now the other thing that Dr. Ullrich brought up
was the fact that oftentimes,
with time, the disc can degenerate worse,
but the pain can improve.
- [Bob] Right.
- [Brad] Which is good news.
And actually this one has done that exact same thing.
And because this is my spine
this is my x-rays taken in 2000...
- [Bob] The big reveal.
- [Brad] Yeah. 2013.
And here four years later, my back is improving.
Although I am treating it properly, usually.
Doing exercises.
But let's go through some exercises that you can also do.
- [Bob] I think the point here that we, Brad and I,
try to make quite often is
the body has a great capacity for healing.
- [Brad] Right.
- [Bob] If you allow it
and you do things to make it not worse.
- Yep.
- I mean it, it over time will try
to solve the problems.
- Exactly.
- In most cases.
By the way, if you're new to our channel,
please take a second to subscribe to us.
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And we upload every day.
- Excellent. Bob.
- All right.
Start off with some exercises.
- Okay. So the whole concept, Bob,
is we're talking about the core.
Okay, to support the muscles around the back
that are having the problem.
And not only that, but learn your back
so that you know where the neutral position is.
So if, if I arch my back this way,
that's one end range, we call it.
And if I,
- So the belt is kinda slanted down
- Yep.
- On that one.
- And then if I go this way, I'm rounding my back.
That's the opposite direction.
We'd like to find kind of the midpoint in there.
And that's where we want to strengthen our muscles.
And so we keep that back in that mid-range.
- Keep your pelvis in the neutral zone, yeah.
- Exactly. Exactly.
Okay.
- Do you want...
- Well, let's start out with...
- You're gonna lay down or?
- You, you wanna do?
- Whatever you wanna then.
- No, I tell you what.
- You're gonna go.
- No. You do the first ones because I wanna,
I'm gonna do the ones with the ball.
- Okay.
And besides I wanted to take a,
I wanted to sit down, roll around on my stool a little bit.
There you go.
Get a pillow laying down.
These do work better on a carpeted floor.
You can do 'em on your bed.
If it's a firm bed, that's better.
If you're unable to get down to the floor
for falling purposes, go on to bed.
But firm bed is best.
Okay. First thing, double knees to chest, Bob.
- Would you start probably with single, Brad?
- Yeah. We could maybe...
- Just, maybe just stretch a little bit like this.
- But then we're gonna have 11 exercises and we said 10.
- All right, well count this as one.
- We'll add a bonus. A bonus.
- So I'm stretching just a little bit.
Pressure on, pressure off, pressure on, pressure off.
- Yep.
- And then I'll bring 'em both up.
- There you go, it is a good idea.
- And pressure on.
- These should feel good on your back.
- Pressure off.
- Now we we've got - Pressure on.
- 10 or 11 exercises here - Pressure off
- as Bob is exercising.
You're probably gonna find
two or three of 'em that feel good.
And those are the ones who are gonna focus on.
If any of 'em hurt, you just stop.
- Yeah, we always try to make that suggestion.
Find the movement that you can do.
That's gonna be pain free or make your pain better.
- Right.
- And that's the one you keep repeating.
- Exactly.
- So it's always an experiment, isn't it Brad?
- Exactly.
- Next one, Brad?
- Let's go to hook lying rotation.
- Okay. So you're gonna bring your legs up
and then you're just gonna go roll back and forth like this.
- Right.
- And again, you might find one direction that feels better.
- Yep.
- Well work that one.
If it feels better just going to the right,
just go to the right.
- Right.
- And over time, you know if it goes better to the left,
go left and you can maybe even go way over like this.
- Yeah. Notice how Bob's shoulders are flat.
- Yeah, staying down.
- He's not rolling the whole trunk.
So that way we get some range of motion
and rotation in the low back.
- You could even venture way out here, Brad, if you want.
- If that feels good, you do it.
- Yep.
Okay. And...
- Do you wanna do extension in lying then?
- Well, yes. Actually good, good idea.
Yep. Let's do the prone.
- This is, this is one that might make it worse, but you...
- I would try it.
- Yep. I would too.
- Oh, Bob, look at your shirt, it's not tucked in anymore.
How are we gonna
- I'll get it.
What are they gonna say?
The people are gonna start talking.
- Slobby.
- Okay, here we go.
- Instead of Bobby.
Okay. Now what you want me to go up
on the elbow maybe a little bit first.
- Yep. You could try this
- To get it a little acclimated.
- a static stretch, in other words he's not moving.
If it feels good, hang out there for a while.
- Prone prop.
- If it hurts right away,
you might try it for 5 or 10 seconds.
If it keeps hurting, go back down.
- Yeah.
- And then go to the pushup position, Bob.
- And then I'm gonna go probably halfway up
to first start these and see.
Again, is it making my pain better?
Is it making it worse?
Is it spreading the pain out?
If it's spreading the pain out, it's getting worse.
- Right.
- So you wanna see the pain
get a little more localized.
- Right.
If you have pain across your belt line
and maybe down in your buttock, you want
usually it'll come closer to the center of the back.
If that's the case, you're doing the right thing.
- I think most people know right away, Brad,
if this is, this is good.
- Right.
- I mean, they go, oh, this feels really good.
Or no, it doesn't feel really good.
- Right. Especially in this case. Yep.
- And if it feels good you, I mean,
you can work your way all the way up.
- Right.
- I mean, and, and try to get to the point
where the pelvis is down, the arm is straight.
Don't go like this, where you're pulling the pelvis up.
You're not doing anything then.
- Right. You're, you're doing some core work.
- You're doing some core workout.
That's that's about it.
Yep.
- Yep.
- Okay. Brad, what's next.
- Now I just wanted to mention, if you happen to
are watching this video and you have pain, numbness,
tingling all the way down your leg
then I'd work with that one a little bit
and see if the symptoms come outta your leg.
That would be a good thing.
If you just have back pain with this
then we do it exactly how we mentioned it.
The next one.
- A pelvic tilt?
- Right.
Yeah. Back on your back again.
This one, oftentimes I, we start out with
because it's a basic range of motion.
This is gonna work good with your mic on here.
'Cause we can watch that thing tilt.
- Okay.
- So there we go.
See, so he's pushing his back down because
- Yeah. So if, if Brad had his hand in there
I would actually squish his hand.
- Ouch. I'm just kidding.
But I can feel it squish my fingers.
- So I'm moving the pelvis like this.
- Right.
Oftentimes this direction is what people are
gonna need to do.
It also helps those core muscles strengthen in your stomach.
- Yeah.
- If you've never done any core exercises
this is a great place to start.
- Keep breathing though.
- Yeah.
- Don't be holding your breath while you're doing this.
This is a good one to wake up in bed and
and do a few of these, Brad.
- Yep.
- I mean, you know,
and same with the rotations.
It's a good one to start off with.
- People are gonna ask about how many, Bob.
I'm gonna say 10 is a good place to start.
- Yep.
- And you can go up to 15 and kinda get a feel.
Once you zero down on the exercises you like
then that number can increase as long as it feels good
and it gives you good results.
- Right.
- All right.
- Where are we at next?
- We wanna do the pointer dog.
- Oh, okay.
You don't wanna do supine crunches?
- Well, yeah.
- Oh, you'll do that with the ball or with a...
- Well, I'll tell you what Bob let's do this.
I wanna do this one, 'cause I,
- Okay.
- I want to use the ball and
- Okay.
- This is the way we work sometimes
we have to think about our exercises.
Okay. So supine crunches.
I don't care for the pillow.
I like to do them like this, cross like that.
Get your tie organized.
Actually we don't do these at home with our tie on.
Okay. And we're just thinking about getting our head
and shoulders off the table.
It's not like this, but it's like this.
So you don't stress that neck.
There we go.
And you don't have to do this thing
where you go all the way up like that.
That's actually hard on your low back.
Okay. We wanna just work it up to here.
Well, when I do these
I get my upper back to crack and feel good.
It's a wonderful feeling.
- [Bob] Oh really?
- Oh yeah, it's wonderful.
Now the other thing you can do.
Can I have that ball, Bob?
- [Bob] Sure can.
- Put that right under my legs.
If you happen to have a ball,
use it for core exercises because it is one of
the best things, in my opinion, for, for core exercises.
You can do the same thing with your feet on the ball.
And then if that's, if you're getting stronger,
you lift them both up at the same time.
Ball comes up, elbows to the knees and they,
you know, they can touch it doesn't matter.
And the nice thing about doing this
on a firm surface on the floor, Bob,
is it forces your back to stay in that neutral position.
- [Bob] Sure.
- You're, I'm flattening my back.
Just like we talked about before
and I'm doing a nice job of strengthening that muscle.
This is a bonus too.
If you wanna roll back and forth
it's kinda like the hook lying rotation.
Okay, good.
Now the last two I want to cover is, hold that please, Bob.
- Sure.
- The infamous pointer dog, you arch your back
bring it up and then go halfway in between.
Tighten up your stomach muscles.
I'm really doing some good core strengthening here.
- [Bob] I do these every day, Brad.
- Can I have the ball?
- [Bob] Yeah.
= If you have a ball, I encourage you to do it like this
because if that hurts your back, there's a good chance
that this is gonna make your back feel better
with the same exercise.
You can hear my voice.
Now I can talk freely.
- [Bob] I started with it, with this way.
And then I, I progressed to the, without the ball.
- Sure, yeah.
- [Bob] 'Cause it was harder.
- And, and you can bounce on the ball.
It's kind of fun.
(ball bouncing)
- Oh darn, I thought it was gonna stay...
- [Bob] Brad, in Brad's world.
Oh, he's gonna knock all stuff over.
- Yeah. We're gonna tear the whole department apart here.
- Wow. Brad, we're not just pretty.
- We're pretty ugly.
- No, we're pretty helpful.
- Oh, that's right. Helpful.
Yeah we're, we do good job helping some people a lot there.
- All right, thanks a lot.