♪ Bob and Brad, the two most famous ♪ ♪ Physical therapists on the internet ♪ – Hi folks, I'm BobSchrupp, physical therapist.
– Brad Heineck, physical therapist.
– Together we are the most famous physical therapists on the internet.
– In our opinion, of course, Bob.
– Keeping our distancein our secret bunker.
Today, we're going to talk aboutfive pain-free, you say it.
– Spondylolisthesiscore exercises at home.
Improve daily activity ifyou do these exercises.
– Say no more, Bob.
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Take it away with Brad-itude! – Bob, we do get a regularbarrage of comments for people with spondylolisthesis.
If you're not familiar withit, it's a big long term, it means in your spine, typically, we're going to talkabout the lumbar spine, I'm going to say spondy tomake it a little shorter.
That's where it's most commonly occurs, and I'm very familiar withit because I have spondy and, as a matter of fact, Ihave x-rays so you can see what they look like.
And now, if someone says you have spondy and they don't have x-rays to back it up, you've got to get x-rays because it's very, very clear on x-rays.
And I'll show you here, these, Mike, can you tell mewhen we get right there.
– [Bob] Mike, I've gotto move out of the way, – So this is the side viewfor me, lateral x-rays.
Here's my hip, here's my sacrum.
– [Bob] Show them the vertebrae, Brad.
So basically we're talking about bones that stack up like that.
– Right, well here we've got L5 and L4 and you can see I've gotthem outlined in black.
Now, they should be all in a line, but this L4 is movedforward or anteriorly, about two centimeters, and L5 and S1 doesn't look likea real healthy deal either, but these were taken in 2013.
At that point, my backpain was fairly consistent, walking more than three fourths of a mile, I'd get numbness down my leg because I was getting a pinched nerve because there was a componentof stenosis in there.
At this point, I was considering going to see a neurosurgeon and seeing if they could do some surgeryto get rid of the stenosis, but I start doing the exercisesthat I'm going to show you.
– Bravo to you, Brad.
You did a really good job.
I say this many times, I kid with Brad, but I think the average personwould've gone to the surgery and they would probably befairly disabled right now, when Brad, he's as active as can be.
He still does triathlonsand he's still sassy.
– Well, let's go oversome of the symptoms, typical symptoms if you have spondy.
Now this is what I have in people I've worked with with spondy.
It's very typical if you're standing in one spot, statically standing, this happens to me whenI'm shopping with my wife and she's going through clothes and I'm – How convenient.
– patiently waiting- It starts to hurt that.
– Oh, my back will start to hurt.
If I sit down, it goes away, it feels so much better.
Very typical of spondy.
If you do overhead work, I was painting my wife's bathroom this weekend, gave me a sore back.
– Your wife's bathroom? Don't you have one too? – Well, I use the one downstairs.
– Oh, okay (laughs).
Actually, I joke, we do the same thing.
I have a separate bathroom.
– Well, you know, it just works out better.
– Yeah, it works out better.
– Yeah, and now, soanyways, overhead activities give you a back ache.
And I've got to admit, now when I do them compared to six yearsago or seven years ago, they're not as severe anymore.
Also, once again– – Prolonged walking.
– Yeah, prolonged walking, like I mentioned, with meit was very consistent.
Three fourths of a mile, back pain, numbness down my right leg.
– And you couldn't run either, right Brad? – I could very limitedly.
I could jog kind of, and now I'm up to three to five miles consistentlywithout any problem.
– And the other thing is, we should point out that spinal stenosis wouldhave similar symptoms.
– So, just because you'rehaving these symptoms doesn't mean you have spondy, you could also have spinalstenosis, but these same– – You treat the same way.
– Yeah, you treat the same way.
Exactly the same.
– You could do the same exercises.
Maybe we should haveput that on the title.
Oh, anyways, one thingI do want to mention, in my car, if I would sitfor any length of time, half hour drive to work, getting out of my car wasa back ache every day.
That went on for a few years and I used some supports andwhatnot, lumbar supports, and I finally found this one, the Kebado.
I don't know if I'm pronouncing it right, but it's memory foam.
I put that in my car, it has changed my life.
– Now, we don't even know ifthat ones available anymore, but there are ones thatare similar to that, that are memory foam andabout a similar shape.
So if you can find one of those.
Now, I don't like that one.
So, I don't have spinalstenosis or spondy, and so it's a very personal thing.
– It is.
You may have spondy andit may not work for you, I can't guarantee.
Your shift may be different than mine and almost certainly is, and it might be at a differentlevel which may change it.
This is something you have to deal with.
– I liked that in my office chair.
– You do.
– I don't like it in my car.
– This video's about me, Bob.
– All right, it's all about Brad (laughs).
All right, Brad, do some work now.
– Yeah, let's go to the exercises.
– Get some exercises in.
– The only thing I've found that works, and you do have to get a ball.
You cannot do it withoutthe ball, at least I can't.
I can, but this makes it work.
So if you get a ball, you don't sit on it, but just to get the rightsized ball, if you sit on it, and this is pretty forgiving, your thigh should be aboutparallel to the floor.
I'm a little low here.
– [Bob] Little low.
– It works just fine.
So I guess in a ball part, just don't get a little one, – [Bob] Little one or the real big one, right?- or the very big one.
So, and these are quite simple luckily.
And this supports your back.
All I do is I grab the ball.
If you do it with your shoes one, or I'll do it with myshorts on, so my skin.
– [Bob] Nice socks, Brad.
– Those are cool, I like them.
And I can squeeze the ball andI can hook it with my feet, and what we're going to do is just simply lift the ball up in the air to here, and every time I do these, my back feels better.
If I've got a sore back, Ido these, it feels better.
If it doesn't, if it's not sore, it feels fine, I'm just exercising.
– [Bob] He's gettingtwo benefits from this, if I might point this out, Brad.
One, he's getting thelittle bit of back movement, although it's mostly from the hips, but he's getting core strengthening, – (smacking stomach)- [Bob] that's the key.
He's strengthening that core, which is going to help protect the spine and allow you to go throughlife without increased pain.
It acts like your personal back brace.
How many do you do with this, Brad? – I do 50 of each, there are four of these.
– [Bob] You're not going to be able to start by doing 50.
You're probably start bydoing 10 if you're lucky.
– I do these three days a week, Monday, Wednesday, and Friday every week.
And so I do 50 of those.
And then my next one is I keepmy feet on, they're relaxed, and I put my arms here, then I work my upper core.
Like Bob said, we'restrengthening abdominal muscles, and when I was doing this one, that actually gaps the facets, which, if you've got stenosis, isgoing to help your stenosis.
– [Bob] Now this too, he'skeeping the back straight, flat to the ground, the low back, that's not coming up, and he's, a lot of times you're almost moving the head up towards the ceiling, curling it forward, really.
– Not this.
– [Bob] Not that, movingit up towards the ceiling.
Yep, and that's gettingthe rectus abdominis, that's getting the musclesin the front of the abdomen, and that's going to helpstrengthen that part of the core.
– So you may start with 10 of these.
And, like I said, I do 50.
Now, my next one I call the double crunch.
The knees go up and the ball goes up and my elbows go toward the knees, and then I work this.
– [Bob] Same thing, notcurling too much with the head, as much as you can.
Kind of go straight up.
– Yep, not (grunts).
– [Bob] Again, workingthe entire core there with this exercise.
– And then the last oneto get some obliques, I do this, I take rightelbow to the left knee in the same posture I wasin on the previous exercise, and then I just do this.
– [Bob] But again, he's keeping the back flat against the floor.
He's just rotating up by the shoulders, but he's not curling the back.
It's really important theykeep the back straight.
– (slaps stomach) That's a good workout.
– [Bob] Do you do 50 of those too? – Yeah, so it's 200 altogether, but it took me a while to get there and you've got to dosomething for the abs anyways.
Now, the other the Ido add, we mentioned– – [Bob] I'll just say, I always liked this one that you do, Brad.
– We don't want to extend our back overly, but we don't want to losethat motion of what we have.
So, on the ball, and this really needs to be done with a ball.
I thought about sayingyou could do the option of using a pillow on the floor, but it's not going to work.
– [Bob] No, no.
This is probably oneof the better exercises for keeping you straight when you're trying to dealwith spondylolisthesis.
I mean, because, you'regoing to want to creep to that positioning of being bent over.
So I just do hipextensions, 10 on each leg, feeling these muscles work, and then I put the hands on the ball, this is not an exercise to getyour muscles big and bulky, this is strictly therapeutic, and I extend up whatever is pain-free.
If I go back up here, it hurts, if I go to here, it doesn't hurt.
And so I'm going to do itin the pain-free range.
I do 10 of those.
Then I go back to 10 on thisleg, and then 10 on this leg, and then my next one, I extend and rotate in a pain-free range.
And I go this way, fivetimes on each side.
The last spondy patient I had, I was teaching him the exact same program, he could go to the right but he could not go to the left without pain.
So, his job was to go straight up to the center and only to the right.
And as time goes on, test to the left, and with any luck at all, he's going to begin to start going to the left and to the right without pain.
– [Bob] Yeah, these are golden.
These are, I think, someof the key exercises you should be doing, Brad, for them out there, because you're strengtheningthe back muscles a little bit, but you're keeping that back from causing you to be bent over.
– Eventually, you don'twant to have this happening.
We want to stay with good posture.
– And I've seen it, I've absolutely, in fact, one of my lastpatients that had this, Brad, she has spinal stenosis, butshe was walking like this, and it took, we were workingon trying to get her straighter and we were having a tough time.
– It works better for you here because you're in the camera better.
But no, seriously, that is a posture you absolutely want to avoid if possible.
– Right, because you're goingto end up with other issues.
You're now going tohave other back problems because you're bent over.
– Right, so I think we've got to call it end, Bob.
– (Bob drowned out by Brad).
– We're going to call end.
That's all folks.