♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck physical therapist.
- And we're the most famous physical therapist
on the internet.
- In our opinion of course Bob.
- Today we're gonna talk about home self cervical traction.
Two best options,
you're almost gonna show three best options, Brad.
- Well that's a good point
but they'll have to see, really two categories.
- Two main ones, right.
- Hmm hmm.
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- All right Bob, self cervical traction,
sometimes it's known as decompression.
- Or neck traction.
- People don't know what cervical is.
- Exactly.
The reason it's done mostly is if you have neck pain
or you have a pinched nerve in your neck
and you'll have pain, numbness, tingling
into the shoulder and down into the arm,
all the way to the hand possibly.
- Yeah it could be ridiculopathy, as we call it.
- Exactly, and this can be a real effective way
to treat that as well.
So what we want to --
- You want to show it on here? Yeah maybe we should.
Let me get my glasses on Bob, so I can see what's going on.
- Boy this guy has a severed cord.
- Whoa.
- Did you know that?
- Yeah that's a problem, I don't think,
too much traction perhaps.
So here we've got the neck,
here, this would be the back of the spine.
And so like this, we'd be looking that direction.
If you look right ...
Can you zoom in on this Mike?
- (Bob) So the first seven bones make up
the cervical spine in the neck.
- Right, and if you look at it
there's a fair amount of motion that goes on
between each vertebrae.
I mean it's not like a joint, like an elbow joint
but there's, they call them dendrites.
So there's seven on this side, seven on this side.
And they slide against each other with rotation,
as well as when you look and look forward.
And then these yellow little like spaghetti coming out,
those are your nerves and those nerves
actually go down and into your arm, you shoulder.
- [Bob] Yeah they're cut off here,
they actually extend into your extremities.
- So when I mentioned before if you have a pinched nerve
and the traction can help it,
what's happening here is the nerve here
is being pinched and it could be from a disc bulging,
it could be stenosis, or some bone spurs.
Or arthritis can cause that.
- [Bob] Yeah that hole that that the nerve's coming out,
it actually can be narrowed because of arthritis.
So that's where the traction can help too.
- Right, so when you pull it actually opens things up.
I don't know if we can see that.
- [Bob] I bet you if you go to this angle
you can see that.
- The movement is subtle.
If we look here and I see it right here.
And on your neck it is pretty darn subtle.
- [Bob] Yeah it is subtle.
- You're not gonna come out two inches taller
because of this, by any means. - Right.
But that's the whole concept.
And when it works, it works right now.
You don't do traction unless you have obvious improvement.
If traction hurts or creates pain, you stop right now
and you're done with it.
It's gotta be very clear.
- Are you gonna show the test, Brad, first,
that you do on a patient?
- [Brad] Well that's a good point Bob.
- Well I think you should.
- Yep, Bob why don't you pretend to be the patient.
- Sure, how about if I sit?
You wanna do the one where you just pull up?
- Yep, right, exactly.
You know, why don't we sit in --
- Yeah I was gonna say, I might could use that.
- It's a lot easier for me to--
- Are you okay Mike if I come over here?
- [Mike] Yeah.
- We might also show this is done in the clinic.
So someone's complaining of neck pain
and maybe down into the arm.
One of the things I will do is I will have the patient
sit up nice and tall.
- In good posture right now.
- Good posture first and I take my hand right here
and here and gently push down.
And I'm gonna ask, is there any change in your neck pain?
- Yeah it's making it worse. - It's making it worse.
So compression makes it worse.
So I'm not gonna bear down on it,
just using some gentle pressure.
And then I'm gonna take my hand and go like this
and this hand to go like this
and I'm not gonna choke Bob.
- He's thinking about it.
- (laughing) Yeah, thinking about it.
I'm gonna go under the jaw here,
so I'm on the mandible, the jawbone,
and on the back, the occiput.
And I'm just gonna go gently pressure.
- I'm gonna show from this side.
- Yeah, that's a good point. Get the profile.
There we go.
My hands are cold Bob.
- Yeah I know that already.
- But I don't care, not with you, it's okay.
In the clinic I wash with warm water.
You go here, here and I'm gonna go straight up
but not a lot of pressure.
Gentle, and then I'm gonna say does that change anything?
Does it make it better or worse?
Better or worse?
- Better.
- Oh okay, I didn't know --
- Thumbs up.
- I didn't know a thumbs up was worse pain,
you know what I mean.
- Oh (laughing).
- So you have to be clear you know.
- Sure.
- And this is something, obviously, you can't do to yourself
- And you were probably putting what
10, 20 pounds of pressure?
- At the most, yeah between 10 and 15.
Somewhere in there. - Sure.
- And if there's someone to help,
then the option is to use a towel roll.
And that's what we're gonna get to next.
If this works, then we go to the next section anyways,
the next step, which is --
- The towel. Do you want to do it in the chair?
- Yeah, yeah, let's do it.
- So here I've got a towel rolled.
The red tape, you know it's just some red tape.
- It's just to hold it in place.
- Yeah, just so it doesn't fall apart.
And this, you can do by yourself.
The only limitation particularly is the strength
of your arms, and then they also fatigue.
So you'll get good posture, you're gonna go around,
I'm gonna mess up my mic a little here
so you might here some noises.
Here and --
- So he's hooked underneath, again,
the occiput as we call it and he's gonna pull straight up.
- Yeah.
- Now you can, what you can do,
let's say your having pain down your right arm,
you could put both, yeah both towels,
ends of the towel together and pull up with just one.
And that often feels better because the right arm
is irritated already, the nerve.
So this is a way to do it without further irritating it.
- Can you hear me Mike?
It's like my mic is in my nose.
(both laughing)
And don't wear your mic when you do this at home.
- Right.
- So, again, you're gonna be limited by,
as long as it feels good, it takes pressure off,
it makes the pain feel better,
particularly if it makes your arm feel better.
You know your goal, you want to continue to do this
but you're limited, again, by your arms getting tired
or especially one arm.
- You can even do repetitions.
- Yep.
- You can pull and then relax.
Pull and then relax.
You can do it throughout the day.
This is something you can have the towel nearby you
when you're at your chair.
- Sure.
- And you can do it every hour.
And sometimes it gets you through the day that way
and sometimes the neck improves overall
because you're stretching some things out
that maybe won't put as much pressure on the nerve anymore.
- And also likely, posture is a very big component of this.
And this actually helps you promote good posture.
- Now we do have a more expensive version.
- Well I got another one.
- Oh you do?
- Yeah if you have someone at home
and I've done this many times with patients.
- Oh sure, we're gonna have Mike come out for this one,
aren't we?
- Yeah, yeah.
So Mike is gonna be our patient 'cause he doesn't,
we're not gonna --
We're not gonna put a microphone on Mike.
- Mike's our camera man.
- Mike's our camera man, he's also part of the
Bob and Brad crew.
- There you go.
- And check out their videos,
he's pretty funny.
He thinks he's funny anyway.
(laughing)
Thanks Mike, the man in black.
- All right so Mike why don't you lay down.
If Mike already knows that --
- If you lie down Brad.
- Lie down, I'm sorry.
He's done the traction and it helps
but it's like he can't hold it long enough.
If you could hold it for a couple, three minutes
but wow would that make things better.
Then he's gonna get somebody at home.
And I've done this many times with either
the spouse or a family member that has,
you know, good judgment, adult person.
You take the towel roll underneath the head here.
And usually just above the ears
and then put the towel --
- [Bob] Not above the ears, below the ears.
- Below the ears, I'm sorry. I'm looking upside down.
And you have to communicate with the person.
Okay Mike I'm just gonna pull gently as,
if it feels good you have to let me know.
How does that feel?
Good?
No pain?
- [Bob] So how much pressure Brad are you putting on.
- I'm just leaning gently.
This is nothing that you're gonna --
- [Bob] Yeah you really want to start out
very slow on this.
- If you're a large person, muscular,
and you're doing a smaller person, really any size,
it's not, it's not like your maxing out by any means.
It's gentle and the person, Mike, would say
it's starting to hurt.
The hand, the arm, especially if the arm is getting worse,
you gotta stop right away.
Only continue if it feels better.
- [Bob] Yeah I often have my patients
signal with their finger.
I say raise the one finger if it hurts and we'll stop.
So you know, if they get to the point where it hurts,
raise the finger.
- Sure.
- [Bob] And not the middle finger (laughing)
Just the, a finger.
- Why don't you just have him talk?
- [Bob] Well because sometimes,
I guess I'm thinking about two when I --
- Right I know what you mean.
There's one where you go like this
and then you're holding their jaw shut.
- [Bob] Yeah and they can't talk.
- We're not showing that one.
That's kind of more for therapists.
Okay and typically when I do this
I'll hold it as long as it feels good
and they're saying boy it feels good
just keep doing it, I'll hold til I get tired.
And that's usually a couple, three minutes
and then go I need to take a break,
my back's a little tired, my arms are tired.
And you'll do that a couple times
and then if you can do that throughout the day.
Now if this is all working good
and you're helper is getting tired
or they're not around enough,
there is an option and I've had patients use this
and that's cervical traction unit you can buy.
And you can do this completely by yourself
once you learn how to use it. - [Bob] That's a nice unit.
- It is, this is the Saunders Cervical Traction.
It's a little spendy but if it keeps you
from having any surgery on your neck,
it's well worth the money obviously.
About three to 400 dollars last time I looked.
Mike, can you scoot down a little bit?
- [Bob] By the way, if you pop Mike's head off,
you can just put it right back on right?
- Oh yeah (laughing)
- [Bob] But it's interesting Brad
that I actually worked at Saunders clinic
when I was going through school.
- In the Twin Cities area.
- [Bob] In the Twin Cities area.
Dwayne Saunders invented this whole traction genre
and he had a clinic at that time.
So I worked there for it was about three months.
- He was, or is he still alive?
- [Bob] He's still alive.
He's retired.
- You want to lay down Mike?
He's a physical therapist as well.
- [Bob] Physical therapist, he's kinda like you Brad,
he's a big inventor.
He was very good with mechanical things.
- Me?
- No like Brad, not like you Mike.
- You won't be able to hear Mike without a mic on.
So you adjust this so it's comfortable on the occiput there.
This gently goes over the head.
- [Bob] This is something you can do yourself.
- Yep, yep.
- [Bob] You can set yourself up rather easy,
to be honest with you.
- There's a pneumatic cylinder,
a little pressure cylinder that you control
with this pump right here.
It says pump here.
We've got another video called Saunders Traction
by Bob and Brad, cervical traction.
Now Mike you're gonna tell me when there's
some pressure on this and you feel like
your neck is becoming pulled.
- [Bob] See Brad's pumping right now
and that's causing the traction to occur.
- So this is moving that way, his shoulders
are being stabilized by this pad down here.
- [Bob] And again, normally Mike would do this.
- Yeah, yeah. I'm just doing it now just to demonstrate.
- [Bob] Facilitate.
- This gives you an indication of how much pressure.
So right now we're at 13 pounds.
Now if Mike is feeling like oh this feels good,
we're gonna keep it going.
We may, and I usually have the patient do it.
Mike you want to pump that,
but only if it feels good.
When it feels like it's enough pressure then you stop.
If it creates pain in any manner
or makes anything worse, you stop immediately.
You do not continue whatsoever.
How you doing Mike?
Okay so then what I'll do the first day
with a person, I'll have them on this traction,
I'll note how many pounds.
How many pounds are on there Mike?
- 15.
- 15, I'll write down 15 pounds, I'll hit a timer
and then I'll go for five minutes
as long as it continues to feel good.
Once the five minutes is done,
we take the pressure off, we stand up, move around,
move the neck --
- [Bob] How's the pressure taking off Brad?
There's a little twist on the dial.
- Yeah right there, good point.
So there's a hold button and then a relief, yeah.
I can hear, you won't be able to hear
but the, you can hear the air release,
this goes down.
And then you get up and walk around
and it should continue to feel good during traction
as well as afterwards, for the rest of the day.
If response is good after one treatment of five minutes,
then we'll go up to 10 minutes.
See how it goes and then the next day maybe 15.
20 minutes is the most I've ever gone,
but usually 10 to 15.
And you can do this throughout the day,
two to three times.
I've had patients so happy with it
they buy them because it works,
eliminating the need for surgery.
- [Bob] That's a neat little unit.
- It is.
- [Bob] I was very impressed with it.
There are very inexpensive units over the door,
hanging ones.
And they're fine too.
We have no problem with whatever you want to try.
Or you can try the ones that don't cost anything at all.
Use the towel.
- Right, exactly.
And again, I would never purchase one of these
if laying down and a towel roll's traction
like we previously demonstrated,
if that doesn't work ...
You only do that if that works really good
and you know the traction is successful.
- [Bob] Sounds good.
- All right wow.
- Brad and I can fix about anything --
- Except for --
- [Bob] A broken heart. - There you go, good luck.
- [Bob] Yeah but we're working on it.
- Be careful.