Hi folks, I'm Bob Schrupp physical therapist, Brad Heineck physical therapist
Together we are the most famous physical therapists on the internet in our opinion, of course, probably the most unorganized therapists
On the Internet too wouldn't you say Brad? Yeah, but we still get 'er done
Yeah, today, we're gonna talk about three never to do treatments for sciatica
And we're also going to show you how to fix it the right way, right
So these are I know I see people sometimes and they get thoughts in their mind about
Well, I'm getting pain all the way down my legs
So this is what I should do in a treatment to treat it, right
It ends up being the exact opposite of what you should be doing
Precisely as a matter of fact, I was just working with someone, well I wasn't working with them I was at a track meet
This guy said he had this pain down my leg and he says I better stretch it out
So does the way the number one thing. Should we wait or invite our guests? We gotta keep them hanging for a second
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Oh good
There are nice people. All right. So what is the number one thing that you should never do? People think
Well, we got to stretch things out, got to stretch your back and go stretch the legs. Yep. Stretch it out stretch when
particularly, if your sciatica which often times is a result of a disc problem a bulging disc or herniated you do that and
More than likely you're gonna exacerbate the problem make it worse. Absolutely
And if you won't even make it worse yet bend and kind of twist to one side
You know how they do sometimes they grab one leg like that, you want to stretch that hamstring
Because the pain's going down, but the pain is not from the muscle
It's from the nerve, which is coming from the back, right
I mean, you know, it's just trust us on this one. You are making things much worse, right
You know, there are certain cases where it might be that but we're talking about the majority
Yeah if there's like an adhesion on
The nerve. But you need to have a therapist diagnosis. Believe me if I'm a betting man
I'm betting that you go the other way most cases. Sure. Okay. That's number one. What's the second one?
The second one Brad is the hurdler stretch, right, you always show this well, Brad
Well, there's different ways to do the hurdle stretch. One is actually like this, I don't to this one
But and then like this it does a really nice job of stretching the hamstring but it doesn't do a good job of
Your back putting pressure on the back again putting pressure on the disc again
And this is even worse this even flexes the lumbar spine more
it doesn't stretch the hamstring as well either so you've been doing this and
Bending forward would be worse too, right? I'm pretty tight myself here. All right. I work on my hamstrings a lot
But I mean I get up to 90, so you seem like you doubt my voracity
No, I don't doubt anything you say Bob. All right, the third one Brad
Massaging the leg if the leg hurts and you said especially numbness tingling all those
Sensations very clearly a nerve problem
right and if you massage it
Is it gonna make the source better. I wouldn't say that
This is one that makes it worse but it's not going to help, right
And generally the rule of thumb with massages to me
anyway is if you're like pushing down the leg and there's no pain there, you know what I mean
It's not tender from pushing then the muscle's not involved
Then the massage isn't gonna help I mean again even up here
sometimes people get referral pain into the upper trap and
I'll push on you and they'll say no, there's no pain there, but they feel pain there from the nerve
So the massage isn't gonna help, and this can get a little tricky, it can
So as therapists it's more clear to us than the layperson
So we've got other videos that if this doesn't make sense go to the other ones that show, they go into greater detail, right
You bet, but we want to start off with the three things
You should never do and now we'll
Kind of give you some things and show you why you want to not do those and go into the opposite direction basically, right
You want me to start one Brad?
Yeah cuz that doesn't agree with my body. So
You're gonna start off with extensions and this is a lot of times even just regular old back pain
sometimes a lot of people want to start off with this way but
especially with a sciatica problem
Some people actually have to start, they can't even lay in this position they have to lay with a pillow underneath them
You want to give me one Brad?
Now one pillow maybe even two pillows I'll start off with and you start off with this and this is the treatment it's easy, isn't it, you just lay
Now if you lay like this you put a pillow under there and things start to feel better in the leg already
Which I've had happen many times
You're heading up the right pathway, you want to explain that a little more Brad, what they're supposed to feel.
What's the end goal here? You've got sciatica, pain is running down the leg to the ankle you lay on your stomach and
It still hurts
But you put a pillow under here and it makes it feel
Then it becomes comfortable and you lay there for a minute or two and all of a sudden
The pain and the leg starts to dissipate particularly down here and I've had this happen many times
I'm sure you have too Bob where
You know and I'll just talk to the patient a little bit about you know
What their kids are up to or whatever for about a minute and I say how is the pain in your leg now?
And they say well I only feel from the knee up
I don't feel it my foot anymore boy, then you know, you're doing the right thing
Then you can start some press-ups or you can actually you might start off then going to the point of
Taking the pillow out or you might put up on the elbows here without no prop. You just continue to monitor
and you know
This is one of the things that you kind of vary and it varies a little bit from person to person
But if you can take the pillow out and go to this position and the leg starts feeling better yet, boy
You know things are really going in the right direction. You have a really good prognosis for improvement
now if you go up in this position and the
Leg pain comes back, then you have to go back down again, right and maybe try that for a day
Eventually, you want to get up to the point where you're starting to do press ups
So you got your hands underneath your shoulders
And you're pressing up like this, same thing
you're looking for you're looking for the pain to be
traveling up the legs in a sense, it's going out of the leg and it's going into the buttock and maybe even into
The back could even be getting a little worse in here
But as long as it's going out of there, that's a great sign, you bet. There's your sign,
Where does that come from Bob? That was that one comedian. He says there's your sign
I heard that. I don't know if I ever saw him
Now if you want to get a book about this you want to get Mackenzie's book, "How to treat your own back"
We have it here normally in our shelf, but I don't because literally one of my patients is using it
He borrowed it out. It's gonna come back
I hope anyways
So this is one for the neck but it goes through this whole treatment so you can follow it, they really explain it well
I mean they do a really good detailed job and it's for the layperson.
So Brad, should we talk about some of the variations you might have to do
Let's say you're trying all this stuff and you're getting here and it's just not going out of the leg
So now one thing you might try is what we call making yourself into the banana
So I'm gonna shift my hips over. This is the painful side
So I'm gonna actually shift my hips to the right and my legs to the left. So I'm forming a banana
So the banana means if you're looking from the top from the ceiling down
He has a curve this direction
so it kind of looks like a little banana and then you keep your body like that while you do a press up
And actually after you do that and I'll have results you do the banana shape and all of a sudden the leg starts to feel better even
Before the press ups. Yeah, because you just put it in that position. You bet so if there's the right leg
I would move my hips to the left, shoulders to the right, legs to the right and the banana's that way
If we had a camera from the ceiling, it'd really be nice Bob. Yeah Lonnie get up on the ceiling. What are you doing there?
Yeah, we don't want any injuries Bob. All right. Now, how about the pillow underneath the
Well, how about the towel underneath the pelvis Brad?
That might be a little thick. Yeah, it is
So you can just take a folded towel
Here, there we go. That's better. You don't have to roll up, but you can just fold one
I just fold one sometimes into like a quarter. We'll fold one up Bob
We'll get it yet, right. This is how I do it
And so I'll put it underneath the side and then I'll try a press up and I've had luck with this before
So it's amazing. You try these little details. You're trying to find what works
Yes, in essence and that's where you go with it then do you want to show them roadkill?
Sure roadkill. Yeah. This is one that as a matter of fact just in the last couple of weeks
I had someone I was having her do the press ups and whatnot
And I said bring your knee up just like Bob did and as soon as she did that it started to feel better
And it's like oh now we're getting somewhere and I've had just a number of times
So now I'm gonna go ahead and try and do press ups that way, another again
You know another third variation you can try, again you're only going to proceed with each of these
Individual ones is if it clearly makes the leg feel better and overall things are getting better clearly
It's not like you're gonna push through a bunch of pain and hope it gets better and we should talk about often they can do this Brad
As long as you have good success with it
It continues to make the leg feel better and the pain
Centralize or go up towards the buttock in the center of the back. You can do it every hour about ten repetitions
You're not gonna do them for 30-40 repetitions, but if you can do it every hour 10 repetitions
And honestly if things are centralizing and going very well
You'll do that for a day or two and you'll
Be able to drop it down because you'll be doing much better
I've actually had people
patients that I've had them bring cardboard with them to put on the floor because they worked on a factory and
They'd lay on the cardboard and do it, you know on their shift every hour. I thought you're
Where did you think I was going with this? I thought you'd say to take the cardboard and go sledding down the hill in the winter
Oh, yeah, that's what I intend to have my patients do, have them go sledding. So
Remember Brad and I can fix just about anything except for a broken heart. We fix broken backs
We fix sciatica, really afraid to go into flexion Bob aren't you. Yeah I am
Thanks for watching