♪ Bob and Brad, the two most famous physical therapists ♪
♪ on the internet. ♪
(clapping)
- Hi folks, I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- And we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- So we're going to show you today
how to use TENS unit with neck pain,
specifically we're going to show you correct pad placement.
At the end of the video, we're going to show you
an exercise, a bonus.
This is kind of a, one of the most common exercises
we do with neck pain, so we're going to add that in.
- Little complement to the TENS.
- Yeah, it's always good to get movement
along with the use of the TENS unit.
Now Brad and I have tried dozens and dozens of TENS units,
we've said this on other videos.
All were good, all were powerful.
Some of them didn't have very good instructions.
- Yeah.
And because of that,
we decided we're going to endorse iReliev.
We've done videos on three of their units.
We're going to show you step by step how to use their units.
We have the 1313, which one do you have there, Brad?
- This is the 8080.
- 8080, that's probably my favorite.
- Yeah, it's kind of the most common one probably purchased.
- Yeah.
- We like it the best anyways.
- Right, I think that actually the 5050 is the wireless,
and that's been selling really well, too.
- Right.
- And that has no wires,
but I just like the simplicity of this one.
I'm an old person, so.
(laughing)
So anyway, we're going to show you a step by step,
if you go to bobandbrad.com, go to our Programs,
this is by the way, this is all free.
- Right.
- We don't need anything, not even an e-mail.
Go to our Programs under Bob and Brad,
go to TENS under the Programs,
and then you can look for the specific videos
on 1313, 5050, or 8080.
- And there's PDF print-outs,
which even makes it more convenient for you.
This is really a deal.
- Yeah.
- You just can't find this anywhere...
- That's right, for free.
Yeah, so if you have a different TENS unit,
which is good, which is fine,
just use their instructions.
'Cause we can't give instructions
for every TENS unit out there.
- But the pad placement can be used, that,
what we're talking about today will be used
with any TENS unit, it's the same.
- Yeah, so with the pad placement,
the first thing I just want to say
as a general overall rule,
there's a big precaution there.
We don't want you putting pads over the carotid arteries.
- Right.
- That can mess up your sinus rhythm, and...
- Your heart rate.
- And your heart rate.
- It's not a desirable thing.
- Right, so now what we're going to do,
we're going to show how to put pads on one-sided,
on the back of the neck, and then also two-sided.
And then Mike is gonna come up.
Mike's part of our camera crew,
but he's also part of the Bob and Bad, Bob and Brad Crew.
Try to say that, Bob and Brad Crew.
Which is, they have their own channel,
which is really cool.
We'll have to have a link down below with that,
so make sure you check them out.
- Great, absolutely, check it out.
- So all right, well I'll check the,
change places with Mike now.
You won't hear Mike, because Mike is a mute.
No, Mike doesn't have a mic on, yeah.
- One thing I do want to mention right off the bat,
particularly with neck, like right now,
because of this Covid-19 I haven't been to get my hair cut
for a few weeks now.
And I've got hair that grows down your neck,
along with a, goes along with your hair.
You need to shave. - Yes, very good point.
- Because if it's too hairy,
these will not make good contact, it's just,
they don't last very long, and you just, you have to have,
and Mike is nice and clean-shaven.
You cut your hair at home, right?
- [Bob] Yeah, and even beyond that,
you may want to put soap and water on the area first,
because the oils from your skin can break down the pads.
Wash it up good, dry it good,
makes the pads last much longer.
Mike, do you want to face the wall a little bit more?
(chuckling)
There we go.
- You got a time-out Bob.
- [Bob] There you go, yeah.
- Mike, I mean.
All right, so, you know, we would imagine we're using this,
we're just going to start out,
there's always two channels on all their units,
two wires, which go to, each one has two leads,
call 'em pigtails.
So each channel is one color, here.
So we got Channel One, there's two pads there, Channel Two.
We're just going to use one channel
for this first demonstration.
The pads always come on a nice, this plastic,
clear plastic material to keep 'em clean,
so you always keep 'em there, if you're not using 'em.
- [Bob] And we colored those pads,
the pads are normally black, or normally white.
We put colors on 'em just so that you know
what Channel One is and what Channel Two is.
And right now Brad's gonna start with Channel One.
- Yep.
- [Bob] And he's gonna show one-sided pain, neck pain.
- Right, and typically, you know, the neck pain,
we find probably mostly we're looking down
in the upper traps area.
Are you okay?
My fingers are a little cold, Mike.
He's not jumping, so that's good, today he's not.
I'm just gonna pull this down a little bit.
Let's say the pain is right there where my finger is.
I'll just, we got a little white spot.
We're gonna start with the first.
There's a number of different things,
we're just starting with the first option,
it doesn't have to be what you want to start with.
But we're gonna put the pad right over the pain, okay.
Now one thing you do not want to do,
is put one pad close, or touching, that would be too close.
Plus you don't want to put it directly over the spine.
So those are two "no's."
There's a lot of options,
but those are two things you cannot do.
I mean, we could...
- [Bob] Go on one side?
- Go on one side over to here.
Now going up, we could do this here,
but again, if there's, we're in his hairline,
which is gonna cause problems.
It doesn't stick as well,
and it can be uncomfortable, just, you'll feel it.
Instead of having a comfortable pins and needles feeling,
it kind of can zing you a little bit,
so up in the hairline you want to stay away from.
- [Bob] There really is not a lot of room
on that neck, is there?
- Yeah, right.
- [Bob] So you almost maybe are going
to want to go with the...
- Yeah, unless you've got a nice bald head,
you know, shave it off, that's an option.
We can go down here, or we could go over the shoulder area.
What makes this a little easier,
if this again is the painful spot,
maybe you got a trigger point there,
we could go and, I'm going to say, bridge it, if you will.
Go one pad on one side of it.
Again we want to avoid the spine,
so we would have to jump to the other side.
That's getting kind of far apart,
I think that's acceptable,
but that's probably about as far as you would want to go.
I always tell my patients,
if you put your hand between there, and it fits it's okay,
but once it starts getting wider than that, it's too far.
- [Bob] So you certainly can go one above the pain,
and one below the pain.
- Good, yep.
- [Bob] That might be the best option on the neck area.
- Yep, there, there.
- Bob] Well, Brad I did say is that
this is always an experiment, basically.
You're gonna find out what works for you.
If it, you know, takes away your pain,
and it's not giving you any problems, great.
That's what you should try, and keep using.
You know, you don't have to change this up
from time to time.
- [Brad] Exactly.
- [Bob] Once you find one that works for you,
just go with that.
- [Brad] So again, we're not going to go over below the ear,
that's by that carotid sinus Bob was talking about.
We need to stay away from that.
You know, this is where TENS, you don't get to that area.
- [Bob] And TENS really are not recommended
for headaches, too.
So you're not supposed to put 'em on your head.
I remember years ago
when they were just coming out with these,
they were trying that.
- [Brad] Sure, sure.
- [Bob] Why don't you show, Brad, what you're going to do
if let's say you have pain over your whole neck,
kind of global, and you're going to use four pads.
There's really almost only one option, isn't there?
- Right, that's exactly what I was thinking.
I'm gonna, thanks, Mike.
We're going to put one here.
Now this is where the colors really come in handy
for instruction use.
I'm not gonna, let's say the pain is
over the central low neck here.
It's kind of global.
I'm not gonna put this one here,
but I'm gonna put it up here, and then you'll see...
- [Bob] Yeah, you'll see in a minute
why he wants to do that.
Now you'll go with Channel Two.
- This is gonna go here. - [Bob] That's the green pads.
- And this distance here is probably
about as close as you'd want to get.
- [Bob] Sure.
And here, now I'm stretching, Mike.
Is this one of your good shirts, Mike?
I'm stretching...
- It's super nice!
- [Bob] Uh-oh.
- I'm gonna have to buy him a new shirt.
- [Bob] It's one of his best shirts.
(laughs)
- So, now, just so you understand
the principles of a TENS unit.
Technically, the current, the electrical current goes
from the yellow to the yellow.
It doesn't cross channels, it stays with the same channel.
Channel One to Channel One, goes through here,
and then Channel Two goes through here.
And it actually makes a cross,
and that's going to be the most effective
for pain managing.
As opposed to doing this.
- [Bob] Yeah, that wouldn't work at all.
- It doesn't, it separates,
to where you don't get that mass volume
of area being treated.
So keep it like that.
So really, like Bob says, that's the only way you can do it,
'cause you don't want to go over the spine with either one.
You know, I mean, I could spread it out a little bit more,
especially the lower one, I have a little bit of leeway.
But then we're getting too far apart.
- [Bob] You could go down a little bit maybe more
of almost getting into the upper back there.
So, depending on what the neck pain is doing.
- Yeah, so again, the neck is probably the area
that you have to be...
- [Bob] You're kind of limited.
- Yeah, you're a little limited,
and you have to remember these precautions,
so that you don't have a problem.
- [Bob] All right,
why don't we show the exercise, Brad, now?
- Oh, sure.
- [Bob] We'll get Mike outta there.
- Oh, sorry Mike.
- [Bob] And put him back to work.
- Nice work, though, appreciate it.
- [Bob] I don't think Mike wants to leave.
He's waiting for pads.
- He's happy, life is good.
- Mike just said, does he have a future in neck modeling?
I would say...
- I would imagine you'll get some e-mails...
- I would say yes.
- From some of the...
- The big fans?
- Yep, the big fans and some of the big companies,
and we'll have to find a new cameraman.
- This is kind of a McKenzie technique
that we're working on here for the one exercise.
You'll basically, you start with a chin tuck.
Everything starts with a chin tuck.
- With good posture, though.
- With good posture.
- Shoulders back.
- A chin tuck means that you're tucking your chin back,
you're not going down like this,
you're not going up like this,
you're going just straight back.
Now once you do that chin tuck,
now you're gonna start working back like this.
Now for a lot of you,
you can actually lean up against a chair, really helps.
- Right.
- But for a lot of you, this is uncomfortable.
This doesn't feel quite right.
And so we recommend using a towel.
- Yep, I'll be right back, Bob.
- And so, yeah, we have a towel here
that's wrapped up, we actually have some tape on it,
just so that it keeps in place.
Yeah, you have a better chair, don't you Brad?
- Well, I'm gonna show,
this chair's actually too high for me.
- Oh, is it?
- So that they can see the wrong, you know,
'cause when I do this, actually this,
it's getting a little high,
but if you have chair where your head hits here,
you need to get a shorter back rest.
This just makes it for me.
- Sure.
- I'd rather go back to the chair I had, actually.
- Well, Brad and I have found with most of our patients,
the first couple days, maybe the first week,
they need to use a towel to do this.
They put a towel, they wrap around,
and they pull down like this.
I'm pulling down toward my knees, and I work back like this.
And again, I could lean back against the chair.
And I just gradually do some small oscillations
to start out with.
And eventually you want to go further and further.
Let it go as far as it will let you go.
You can go up a little bit, down a little bit.
Sometimes people even go like this,
and go along with their eyes, or just one arm.
There's variations of it.
- Now if this creates pain, you need to stop.
Don't push through the pain.
This should be gentle,
and if it does start to become painful,
you stop and go forward.
Gently bump into the pain.
You know, maybe ten repetitions,
and if you find after repetitions you're going back
a little farther, a little farther with less pain,
you're doing the right thing.
If the pain gets worse with repetition,
there's another problem we have to solve.
- Now the key to this, by the way,
is to do this like every hour.
This isn't an exercise you do once a day
and then you're done, you want to do it quite often,
maybe five to six times a day.
And you'll find you'll gain more and more.
Eventually you can probably get rid of the towel,
and you start going back without it.
- Sometimes I'll have patients just put their hands,
and use their hands as a transition
between the towel and without,
assuming you have the range of motion to reach back there.
- Very good.
All right, we hope all of this helps you,
and if you haven't already, please subscribe to us.
- Yes.
(musical chord)