- Hi, I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- And together, we are the most famous
Physical Therapists on the internet.
- In our opinion, of course.
- Brad, the title today is:
"Top Three Exercises for a Herniated Disc."
What we're gonna do is
we're gonna go right into the exercises,
'cause we know people are impatient,
and at the end we're gonna show
what a herniated disc is and why those exercises work.
- We got an excellent model to really show you.
- Yeah, really visually cool.
Right now we need pillows.
- Oh, pillows.
We got one.
Go ahead, throw it, Nancy.
- All right, we'll start off with number one.
What we're trying to do is,
we're trying to get the back bending this way.
- Right.
- So, to start into that direction,
you're gonna start by just laying on your stomach.
Now if you can't do this...
What we're looking for is,
normally you get pain down your leg
with a herniated disc.
- Sure.
- What we're looking for is that pain comes out of the leg
and goes into the back.
- We call it centralizing.
- Centralizing, exactly.
So if you go like this,
and it starts making the pain in your leg worse,
maybe you want to start
with the pillow underneath you, like this.
- Right.
- And just lay like this for a while.
- Right.
- Watch TV, read a book, I don't care what you do.
- Probably about five minutes or so.
- About five minutes, yup.
Now, if you can tolerate this,
right away you can tolerate getting up on your elbows,
go ahead and do it this way.
- Again, it should make you feel better.
That pain should be coming out of your leg,
going towards the back.
- And you see how I'm starting
to bend my back the other way?
It's bending into extension.
If that is too much,
alternative would be just to lay on a pillow like this.
- Right.
- I'm still getting a little bit of back bend,
and I'm starting work in the right direction.
- Right. So the goal is to kind of
reverse that arch in the back to come up,
which will help reduce or eliminate that herniated disc.
Bit too much too soon is not going to work,
and your body's gonna tell you.
It's gonna be uncomfortable,
and make pain down your leg worse.
Red flag, stop doing that.
- Okay, so the next day,
or even the same day, if that worked out pretty good,
now we're gonna start doing what we call prone extensions.
- Yup.
- So what you're gonna start with
is your hands underneath your shoulders here,
like you're going to do a push up.
We call it a press up. - Yup.
- And you're gonna press your body up,
keeping your pelvis down the whole time.
Brad, what's my pelvis?
Show 'em what my pelvis is.
- I always tell people, my patients,
pretend it's a belt around your waist line,
holding your waist to the floor,
or the table, whatever you're on.
- Right.
- So like, pushing here, stabilizing that.
- What you don't want is this:
You don't want your pelvis coming up like this.
And this is what I have a lot of people do,
if they're very stiff in the back.
So you can start with your hands back here,
if that's too much for you,
and just start going like this.
- Right.
- As you get more advanced,
you can put your hands down lower
and really bend your back up, like this.
But this is the exercise.
You're going pressure on,
pressure off.
- How long you gonna hold it up there, Bob?
- You can go give seconds if you want to.
- Yeah?
- Otherwise you can just say, "Pressure on,
"Pressure off."
- And you might start with only going up this high.
- Yeah, you may only go up this high.
- And as you get better,
as the herniation improves,
then your height will go up, typically.
- You're looking for the same things on this, though.
You're looking for the pain to go out of the leg,
into the back.
- Right, up this way.
- Even if it shortens up in the leg.
Let's say it was going the entire leg,
and now it's just going up to the thigh.
That's a good sign. - Right, absolutely.
- We're trying to get it out of the leg first.
If this makes the pain worse in the leg,
then you may have to try something else.
- [Brad] Right.
- All right, what's the last one, Brad?
The third exercise?
- This one is standing.
Hands here at the belt line/waist line.
I usually put my thumbs in there,
you can go like this.
Then you're just gonna extend backwards gently.
- Basically a back bend.
- Right.
Usually this one doesn't come until you can do this one.
- Right.
- And then you're gonna extend backwards,
but don't hang out there like this for five minutes.
It's just back, hold for half a second.
- Pressure on, pressure off. - Yeah.
- Now, this is a great one,
because you can do this almost any time.
- Yeah.
- You can do this at work.
And that's why it's great, when you can get to this point.
Like I had a guy the other day who,
he could do this right away, and he loved this one.
- Yeah.
- And he was a truck driver.
He'd get out of his truck and he'd do that one.
I mean, it's a great one to do.
- Probably had him do it
before he got in the truck, too, right?
- Yup.
- This is a variation.
Just take a towel or a belt or something,
you can go around here,
and you put some pressure there,
and then use that for support.
- And then you can work up and down the spine.
- Yeah. Yup, yup.
I think we have that in another video.
- That's a good one to do.
I always forget about that one.
- Feels good, too.
- 'Cause what I do, I got flexibility,
I just take my fists and I put 'em up like this,
and I even do it up higher.
- Yup. You ever get it to crack?
- Oh, it just cracked right there.
- That's fun!
- So yeah.
All right, we're gonna show,
if you could throw us the spine now,
we're gonna show why we're trying to do this.
- And you that most herniated discs
are people that're 40 and over.
Which is a good point,
because you're gonna want to subscribe to us right here.
- You're going to want to subscribe to us
if you're 40/50 or older,
because we are gonna provide you information
on how to stay healthy and fit and pain-free.
- Right.
- To get pain free if you're hurtin'.
- Stay moving.
- All right, Nancy can you bring us some coffee?
- Oh, we need a coffee table.
- Yeah, we need a coffee table.
Actually this isn't...
We're not gonna drink coffee right now.
What these are, these are mugs
that are shaped like vertebrae.
So, Brad, you're pretty good at explaining this, usually,
but you want to start off?
- [Brad] Okay, so we're looking at a herniated disc.
The disc are between the vertebrae.
Here's level four, level five, and level four.
Here's the disc between them,
this red one represents the injured disc.
This bulge right here, can you see that? Get zoomed.
That's the herniation, it's a bulge in a disc.
The disc has fluid, not necessarily fluid, but like a...
- [Bob] A viscous, like toothpaste almost.
- [Brad] Right. Material inside.
The outside is a tough material, it's called the annulus.
And the bulge is if you're leaning forward too much,
it's usually from sitting, from poor posture,
bending too much, lifting too much.
Then you get a bulge coming out
that's like that toothpaste material
trying to get out of there.
And this is a really...
- A herniation is a beyond the bulge.
And the reason it becomes a problem,
you see this yellow thing right here?
Those are nerves.
They're cut off here,
those nerves go all the way down into your legs,
and that's what can give you pain.
Let's show on the model, Brad.
Can you turn it the other way so it's the same direction?
- [Brad] Sure, you got it.
Okay, this is L5 vertebrae, this is L4.
And this represents the disc.
- [Bob] And the disc is a shock absorber,
as you can see.
Watch how it bounces along.
- [Brad] So when you're ready to walk,
and you get a little shock absorbing,
and that's why you can bend and twist.
- [Bob] It gives you a little height,
and it's good for,
well it's filled with, like you said, a fluid.
- [Brad] Right. It allows mobility in the spine,
otherwise your back would be like a 2x4.
- [Bob] And this is a healthy disc, right now.
And when you bend forward on a healthy disc,
there's no problem.
But when you bend forward...
So again, this would be going like,
I'm bending like this.
- [Brad] Yep. Right. - [Bob] That's what this is.
Okay?
- Now, if you bend forward too much,
and you have a problem, a lesion they call it,
in your disc, this is what can happen.
It can start to bulge.
Zoom right in on that, Nancy.
And that bulge happens to be pushing right into the nerve
Bob was talking about, and that's gonna create pain.
Now, a herniation is a real bad bulge like this.
And we've got to get that to come back
and get back in where it belongs.
And you're gonna do that by doing the exercises.
- [Brad] Right. So when I bend forward,
that causes the bulge to go out,
or the herniation to go out.
When I go back the other way,
the idea is you're trying to push that right back in.
- Right.
Not always as easy as it sounds.
- No.
- Sometimes it works really good, that's really fun.
Other times you gotta work with it.
- Yup. And a lot of times, if you can't do it on your own,
you may want to get a therapist
that's been trained in the McKenzie method.
- Right.
- M, C, K, E, N, Z, I, E.
- Yeah, we talked about McKenzie.
- Yeah, Robin McKenzie.
He's the one that came up with this technique.
So, good luck. - All right.
- If you have any comments below, we'll try to answer 'em.
- Yeah, absolutely.