♪ Bob and Brad ♪
♪ The two most famous ♪
♪ physical therapists ♪
♪ on the internet ♪
- [Mark] Great to be alive Brad.
- [Brad] Oh.
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Again we are the most famous
physical therapists on the internet.
- In our opinion of course Bob.
- Today we're gonna talk about sciatica, herniated disc.
Should you do cardio exercises for pain relief?
And we're gonna show you exercises to avoid.
- Right there's a lot of people, Bob,
that they want to do cardio,
that's been their exercise of the past
for weight control, cardio vascular and
they just feel better doing it so
you get a herniated disc, sciatica.
Can you do it or can't you?
- What can you do.
We actually got this question from
quite a few people.
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because we are trying to compile them now
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- Sure
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So, here we go, sciatica is referring to
pain, numbness, tingling that runs
down your leg often times past
the knee down into the foot even.
The further down the leg the worse it is.
If your in a flair-up with sciatica
down to the leg then cardio is
probably not going to be an option.
If it's not so bad, yes, and if you
have it on and off...
- Well, I would try it cuz if you're
having pain down below the knee
and you try one of these and it
actually feels better, which it does sometimes
- Right, right.
- then you definitely have the green light.
- Sure, we're going to take it cautiously
at that time.
- Yes, exactly
- But there's one number one rule about
any of these exercises, actually whether
what you do is if the pain in your back
and leg gets worse or goes further
down the leg stop what your doing.
This could be anything from the
exercise or just sitting with poor posture.
- I know that sounds really elementary
but that's really true.
- Right
- It's like the old thing, if you're
hitting your finger with a hammer
and it's hurting, stop hitting it.
Well, its the same case here.
If it's gonna hurt and make it
worse you can't do it.
If it feels better you can do it.
- Right
- Simple as that, and we kinda know which
things tend to make things worse.
- Right, and that's what we're gonna go through.
With sciatica probably the most common
cause of it is from a disc problem.
- Right.
- The disc is bulging or herniated putting
pressure on one of the nerves that
run down into the leg and that's
why the symptoms, and the pain,
numbness happen down the leg.
There are some other possible reasons.
- Could be piriformis, could just be inflammation.
- Right, you may have stenosis
- Stenosis, right
- But we're gonna take what we
see as a general and give you
some information on that.
- And generally the position that's going to
make that disc worse, that herniated disc
worse or bulging disc, is a slouched or
rounded out posture like this.
- Right, they call it lumbar flexion.
- Right so what cardio thing, lets talk about
the first thing to avoid Brad.
Which cardio exercise tends to
put you in this rounded out position?
- Well, I'd say riding a bike.
- There we go, that's exactly right.
- Particularly road bikes where they're
trying to get as aerodynamic as possible cuz
I'm a road biker, I know, I got
aerobars and all that.
- Yeah.
- And it really, unfortunately for you bikers
it's not gonna be good for this problem.
- Right, so we generally, you're going
to want to avoid bicycling even
stationary when you have this.
- Right.
- Now it's possible if you had the seat way up
and your really in good posture its possible.
- I know on my bike I had my bike customed
this winter time to get my handlebars up higher
- Sure
- So I'm not bent over so far, not that I have
serious sciatica but, I'm not going to
gain any more speed but I'm more comfortable.
- That's how my bike is.
I don't bike serious but during the summer
I'll do some biking and people laugh at me
cuz I'm tall and I have it way up like this
so the neighbors literally laugh at me.
- You should get grape hanger handlebars
that go up like this.
(laughter)
- That would be funny.
- Grape hangers.
Anyway, so let's go to some things
that you should do or can try,
often times walking.
Walking on a flat surface.
If you're on a treadmill do not
elevate it like you're going uphill.
- Right
- It needs to be flat.
- If you have a fancy treadmill
that goes downhill you could try
that to a degree but again remember
the rule, how your body responds to it.
- I always remember this Brad actually.
I had a fellow therapist actually,
he was a partner in a different practice
I had at one point and he worked
in a back clinic for years and
all they saw were back patients.
Number one thing they first had
him do was they started him walking.
- On a treadmill?
- If someone came in and they were
really limping around and he'd make
them walk around the room
- Sure.
- Like, just start walking and it's
funny how you get increased blood flow to it.
You're starting to work on better posture.
- Yep.
- You know, it's a good thing to try.
- Now people might want to run and
we were discussing this before the video
and we're kinda up in the air on that.
- Yeah.
- It depends on how you respond.
If your jogging or running..
- You're getting some pounding.
- Right, yeah.
- And if its a disc problem it
could make that disc problem worse.
- Right, so if you're a forefoot runner
where you don't have as much pounding...
- Forefoot, not four foot tall.
(laughter)
You're on the forefoot.
- Right, thank you.
- On the funnier foot.
- I'm glad you clarified that Bob.
- You're a four foot runner
(laugher)
short runner.
- So, don't try it by going out,
if it feels good the first mile
I wouldn't run three miles.
- That's right, I would try that one mile
that day, see how it is for that night.
- For the rest of the day.
- Yeah, that night
- And the next day. - Right
- If it feels good the rest of
the night and the next day that means
you can add on 10%.
- I was telling Brad, when I get
back pain it's not sciatica I always
run the next day and it always feels good.
- Right
- It gets more blood flow.
It's getting things moving.
- It's not sciatica so that's a...
- That's a different, sciatica is a
different story, you gotta really be careful.
- Now elliptical, anything that puts
your back in an upright position
- Yep
- kinda endorses good posture, promotes it.
- It's low impact too.
- Right, but again I'm not going to
tell anyone, if you've got sciatica
you can run your elliptical for
thirty minutes because typically
cardio people like to go thirty minutes
or longer to get the benefits.
- You're experimenting is what you're gonna do.
- Right, exactly.
I know with mine, I was having sciatica.
It wasn't from a disc however,
when I started on the elliptical
very consistently, twenty minutes
I'd start getting the pain.
- You start to feel it, now it's time to stop.
- And that was a few years ago.
Now I can do it as long as I'd like to.
Things have changed with me.
- Sure.
- So this can happen with you as well.
NordicTrack or cross country skiing.
- Like a cross country ski simulator.
- Right.
- With NordicTrack I don't know if
everybody knows the brand name.
- Right, that's kind of a thing
of the past though.
- We're dating ourselves. - Yeah, we are.
- But, where you getting, both hips extend
and so your back extends and when
the back is in that lumbar extension
versus that flexion that we talked about
often times that's going to promote a good
disc position along with the circulation.
- It actually could be helpful.
- Sure.
- It could almost serve as a treatment.
Again, if you go back to rule number one,
if you don't have any increased pain.
- And again, time length. - Right.
- Don't go out and go forever.
You know, an hour long when maybe
you don't want to start at 20 minutes
and see how your body responds.
This next one, swimming, non weight-bearing,
you get to work the muscles.
Again, there are some times where
I've had some people swim including
myself where swimming irritated my back.
- See that's just what I was gonna
ask you Brad, cuz you dealt with
your spondy for many years now.
- Yep.
- Is there a certain thing you can
always do, a certain stroke you can do?
- That's a good question.
Some people if you just take an exercise class
where you're not swimming laps but
you're actually doing exercises...
- In the water?
- Right, you're gonna have to really
pay attention to how your back and leg feel.
Because its no weight-bearing there's
a good chance you're going to tolerate
exercises in the water a lot better.
But not always so just keep the
number one rule in mind.
If you are doing laps typically the crawl,
the normal overhand swimming is gonna be good.
Now if you're twisting your body
I know, cuz if you wanna do it right
you're body's going back and forth like this
that can irritate the back a little bit
because you're puttin' a little twist on there.
- Right.
- The breast stroke, now that's a nice one.
It does arch the back.
- Sure, sure.
- And the back stroke, that one...
- Should be fine
- Should be fine , but you're going
to have to be careful.
One of them I'd probably really
stay away from is the butterfly,
which is probably not a big deal
cuz not very many people do it.
- It's a pretty advanced stroke
and it's very aggressive (chuckles)
- Sure.
- So things to avoid for sure.
I do wanna hit these.
We talked about bicycling.
The next one is the rowing machine.
- Right.
- It's a really good cardio-vascular exercise
but it really is hard on the back,
particularly if you round your back,
which you have a tendency to do.
- Even if you think you're doing it correct
- Right
- If somebody watches you with a
trained eye you're going to probably
find out you're not doing it correct.
- This next one, we've had other videos on it.
Burpees, the full burpees, where
you go down like this and up.
That really puts a lot of stress
on the lower back with sciatica.
Avoid that one.
- Yeah, I'm not a big fan of burpees
to be honest with you, just for the back alone.
I mean, maybe I'll get some
people mad at me again.
- Yeah.
- You don't wanna get the yoga people
mad at me again.
- (laughter) Don't hit that.
- They're still upset at me.
- Yeah, you hit that nerve, wow.
Sorry about that one.
- Well, remember Brad, we can fix just about anything
- Except.
- A broken heart.
- There you go, but we're working on that.
We gotta get to the sciatica first and
then we gotta get through the neck,
but we've got those well under control.
- Broken starts with a B though.
You think we hit that first before...
- No Bob, we're gonna forget about that
alphabetical stuff, chronological, all that.
- Alright, thanks.