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We Answer Your Physical Therapy Questions!
- chelsie462
- 4 hours ago
- 12 min read
This article is a transcribed, edited summary of a video Bob and Brad recorded in October 2024. For the original video, go to https://youtu.be/HCdO37IWGV8
Mike: Today, we are taking your physical therapy questions and answering some of them.
Brad: That's right. Well, let's just get right to it, Mike, first question.
Mike: So this username is really hard to say, but @lainiesmajovits says, "Hi guys, I suffer from osteoarthritis in my fingers. Sometimes it's so painful that it wakes me up at night. Can you help me with some exercises to relieve the pain?"
Brad: We would absolutely love to. Actually, we're going to do what we call the Mayo Clinic six pack. This came right from Bob. It's got nothing to do with a six-pack of beer. I'm from Wisconsin. That came to my mind. But here it is. There are six specific exercises, and it's going to start with your hand. You can do this with both hands at the same time. We'll just do one, now, put your fingers straight up. Get it as straight as you can. If your fingers are hooked from the arthritis, you can try and straighten them a little bit with the other hand. Get a little stretch on there. And then we go to the hook. Simply like this, there will be a gap between your fingers. So we're just trying to get those joints and the fingers moving so you can go back and forth if they're stiff.
Mike: What if I want to call this the claw?
Brad: Yeah, well, you call it whatever you'd like, Mike. Let's get onto the next one. Now we're going to go to the flat fist. This is where you bring your fingers down, and you actually flatten out. So you can see your fingernails, like Mike's got an excellent position of that. And you can repeat that, if they're not going down, you can give a little help with the other hand and straighten them.
Brad: Spend about 10 to 15 seconds on them if they're tight, okay? And then we go to the regular fist where you curl the fingers underneath, curl the thumb around, and you're making an actual fist, a full fist. And work that sometimes the other hand can go over and stretch them just to get a little more stretch with that.
Brad: And then the tabletop is simply like this, a flat tabletop. Do what you can to get it straight as you need.
Brad: And then touch thumb, first finger, thumb to second finger, finger tip or thumb tip to fingertip. And do that one or two times. And do that with each hand or again, both at the same time. It's a wonderful way to get a complete range of motion throughout your fingers.
Mike: Now, when you're done, clap. That's more finger exercises.
Brad: There you go. Alright, let's go to the next one.
Mike: So our next question comes from @blueeyedsoulman, and the question is, "How about traction, and can traction be administered to someone with moderate to severe scoliosis?"
Brad: The answer is yes. However, if you have severe scoliosis and pain associated with it, particularly, you need to see your doctor and get it okayed. If you just scoliosis with no pain, but you have it, you can do this as long as it does not create pain. We're going to show you three options for traction. The first one is a simple one on a firm chair with good, firm armrests. You're going to relax your core muscles around your stomach, and you have to have strong arms for this. If you don't, it will not work. We'll go to the second option. Here you simply push up, and then I'm going to bring my legs out, and right now my core muscles are very loose, and I can feel my back actually getting a little bit of gravity traction. Again, I'm gonna hold it. Your arms will probably get tired, so maybe for five to 10 seconds, so you get arm strengthening and traction. If this doesn't work for you, fine, let's go to the second option.
Mike: Now, for this, you're going to need something to hang onto, a pull-up bar. You can technically do this on an open door, but it's a little bit different. So what you're going to do is grab on and slowly sit your butt down and just kind of hang like this. I am relaxing my stomach muscles. And that way it's going to let that traction apply to your spine. Now, if you're doing this and you have a full pull-up bar where you can actually dangle your legs, that is fine. You just don't want your core engaged holding up like this because it's not going to allow the spine to separate like you need it to.
Brad: And again, no pain should be experienced with this. It should feel good. If it's painful, you scratch it off. It's not an option.
Mike: You can just start with like 15, 30 seconds if it feels good. If you have the tolerance, you can go for longer durations, like a minute if you want to. As long as it's feeling good. Now there are some other traction options available, but we don't want to spend a lot of time on this. You can watch the video, "Top 3 Ways to Apply Traction (Decompression) to Spine (Back Pain/Sciatica) With Equipment." This one involves actual traction units. Some of them are Saunders units, and some of them are inversion tables. So click that video link if you are interested in that. The next question comes from @christywells-reece, and they say, "I wish you guys would do a video on the exercises we could do for sciatica pain in the behind, (thinking they mean buttocks). Until it happened to me, I didn't know it was even a thing."
Brad: Okay, this is kind of a difficult one to deal with, Christy. So we're going to give you two simple exercises. There could be a lot more, but you could try these if they offer immediate relief, and after you're done, they continue to feel good, do them. If they don't, if they do not feel good and the pain does not improve, scratch both of them. It's one of those things you'll need to see a therapist directly.
Mike: If these stretches don't help, we do have tons of videos on sciatica pain. It's the same exercise as if it's in your butt or down your leg or just in your back. So just a heads up. To do the first stretch. We're going to show it's the same stretch, just done differently, if you're specifically having one-sided pain. So typically, that's what it is with sciatica. Say it's my left side. What I'm going to do is do a stretch to try to open up the spine and decompress it. So I'm going to grab the top of the doorframe. You can certainly use a pull-up bar, whatever you have. I'm going to relax, bend my knees, and I'm going to lean into it. Leaning into it like this is going to separate those vertebrae, give that disc some room to breathe, and possibly take pressure off that sciatic nerve that is irritated right now. So you're going to hold this for roughly 15, 30 seconds. Make sure to relax and breathe, and do it a couple of times a day.
Brad: And if that's not an option because you're too short or the door is not solid, you can simply take a stick four to five feet long, you can use a Booyah Stik. It has to be solid, rigid. Put it on a chair next to you so it doesn't slide. If it does slide, you take your shoe off and put that right there. Reach up, grab here. If it's my right side, the right-sided pain, then you're gonna lean without letting your hand slide, and it's going to stretch this side. Again, I'm going to repeat this.
Brad: When you do this, it should make that sciatic pain you're experiencing get better while you're doing it, as well as when you're done holding it for like he said, 15 to 30 seconds. Walk around; it should continue to feel better. If it does not feel better while or after, scratch it; you do not want to continue that exercise.
Mike: I'd like to mention your door does not have to be on wheels or stairs like that. Alright, question four comes from @ConnyGermangirl. "Do you have any stretches for people with arthritis in the lower back? Hugs from Texas."
Brad: Well, you're in luck, Conny. We have some excellent stretches to get that arthritis loosened up. You can do it in bed before you get out of bed or lie down on a carpeted floor throughout the day. The first one, Mike, is going to actually show a modified version of what I'm doing in a chair. A firm chair works best with an armrest. Bring your knees up while you're lying down, and we're simply going to relax. Keep your hips still with your hands at your hips, and just let your knees go back and forth. I always tell my patients you're doing like a windshield wiper in a car, and you can let one knee separate a little bit, and I cannot feel my lower back actually loosen it up a little bit. So nice stretch. Do it 10 to 15 repetitions. If any of these create pain, you do not do them. How are you doing, Mike?
Mike: I'm doing just fine.
Brad: Let's go to the next one, then.
Mike: So the next one you're going to do, single knee to chest to begin with. Now, if you're in a chair, just grab one leg, bring it up as far as you comfortably can. If you're limited, just a small motion, that's fine. You're just going to kind of hold it there for a few seconds. You can either hold this for 15 to 30 seconds in one spot if that feels good. Or you can kind of do some repetitions. Just bring it up and back down. Make sure to do this on both legs.
Mike: If this is easy, you can do both knees to the chest, which is a little awkward in the chair. So we would recommend this one lying down, like Brad is showing.
Brad: There you go. Yep, it's as simple as that. Relax, again, they should feel good. Get those joints in the vertebra nice and moving and relaxed. Let's go to the next one.
Mike: So the last one is the prayer stretch. Now Brad is going to show it in bed, and you can do this in a chair. So what I'm going to do in a chair is just sit up, arch my back, lift my arms above my head, and stretch this way. And then you can even come back down and go to what is comfortable. Notice I'm having a nice straight back. I'm not rounding like this. Just go down to what you feel is comfortable, just getting that spine moving.
Mike: Obviously, the version Brad is showing is quite a bit different. Do you want to explain how to do that one?
Brad: Sure, so on your knees, hands out, and you just let your bottom go back to your heels, and feel the stretch right across your back there. If you want to get one side more than the other, simply place one hand over the other, or this way, and do it as many repetitions as you feel comfortable. Typically five, maybe up to 10 maximum.
Mike: Now, one other thing we kind of talked about with the other two, with back issues or sciatica, is you can certainly try hanging if that's an option for you personally. Again, you're going to need something sturdy, like a pull-up bar or hanging handles, to hang onto.
Mike: Again, just distract, and they'll get more traction in there, where the other ones are working on rotation and flexion, and extension patterns.
Brad: Again, good luck with these. Only do them if they feel good while you're doing them, as well as afterwards. Good. Let's go to the next one, Mike.
Mike: Okay, our last question comes from @placeboreality, hopefully this isn't a placebo. Anyway, "Can you please do a video on pelvic tilt? Is it a myth or true? And some stretches we can do to help if you have an anterior tilted pelvis." So, for those of you who aren't aware, this is your pelvis and your spine, and anterior tilt means you are arched forward like this. I'm obviously exaggerating on this model, and your butt sticks up.
Mike: This can cause a lot of low back pain issues, hip issues, and anything related to the hip or pelvis in this region. Typically, what is common with this is that people have tight hip flexors. Your hip flexors are located in the front of the pelvis. If they are tied from sitting too much and not standing up or stretching, they can cause this pattern. So it is true, this can be a problem. And in order to fix it, most of the time we need to stretch the hip flexors.
Brad: Now, the hip flexor stretch is a very well-known stretch, but there's only one way to do it to get the rectus femoris, which happens to be the muscle that gets neglected most of the time. So we got this from Rick Olderman. He has had extreme success with it, written books, and taught therapists about it. Can you show how to do the Thomas? Well, we call it the Thomas test, but it's actually the Rick Olderman hip flexor stretch, to be complete.
Mike: So what you're going to want to do is sit on the edge of a firm surface like I am here. If you happen to have stairs, this is the top, and your stairs go down, you could try it there. We've met some people who have done that. You could also do it on a tabletop, whatever you have. Hopefully, your mattress is firm enough, and you can try it there as well. Anyway, what you're going to do is lie down, and you're going to bring both knees to your chest to begin with. Now, if I'm doing my left side, I'm simply going to drop it down. Once I'm here to get that rectus femoris, I'm going to bend my knee, and it's important to pull the opposite knee up towards my chest. So you can see when I do that, my hip wants to go up a bit. Try to keep it down. Hold this for 30 seconds, and also make sure your leg is staying in a nice straight line.
Mike: Don't let it wander out to the side like this or drift in too far. You should feel a stretch. If you are stuck way up here. Your hip flexors are tight.
Mike: If you can get to the mattress or down a little bit, you're probably okay, and it's not causing too much discomfort. But again, try to hold this stretch, and check it on both sides. Most people are going to notice a difference from one leg to the other. It may not be super noticeable, but you will definitely feel it when you are stretching.
Brad: There you go, nice work, Mike. Alright, so those are the end of our questions and our answers. Good luck with them.
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