♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ on the internet ♪
- The groove baby.
Hi folks. I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet
- In our opinion, of course.
- It's like riding a bike. Isn't it, Brad?
We're right back into it.
Yeah. Back into saddle again.
- Okay. Chest pain and angina.
How to treat and stop pain.
That's the title of our program today.
We got, you know, there's multiple causes
of chest pain and it always has to be taken very seriously.
- Right. And as therapists, I mean this,
we work with people all the time that are compromised,
as far as in this system.
We have to be aware
and always alert to these symptoms,
and then know what to do with them.
So it's kind of in our background.
- Yeah. I never discount it.
I mean, if someone comes in,
and they're saying they even have a little chest pain,
right away, I have it checked out.
Or I have nursing take a look at it,
because it's just that one time you're wrong,
you're gonna pay, all right.
- (laughs) And that's one thing,
you work with patients for 20, 30 years.
But in my case, I ended up with chest pain,
went to the ER, stayed over in there in the hospital,
had it all assessed.
And then it really hits home, you know?
- Right. When it happens to yourself.
- Right. So yep.
- By the way, Brad.
- Oh yeah, say it.
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- There you go.
So chest pain.
First of all, if you have chest pain
does it mean you're having a heart attack?
- Not necessarily
- Not necessarily.
As a matter of fact,
the statistics on that, I read, it was a while back,
but it was quite high, higher than I thought,
that people that went into the ER with chest pain,
walked out, like myself,
without a heart attack.
- But despite that you have to do that step.
- Yeah, because if it is a heart problem,
your life is literally on the line
and you have to eliminate that possibility.
- Even if you have it one time
and then you have it again,
you have to go in again, right Brad?
- That happened to me.
I had it six months later.
- And you went in again.
- I said, you know, my blood pressure's a little high,
you know, I've got some issues.
And they said, and I said, I went in once already.
I don't want to go in again.
And they said, "no, you're going in."
- Right.
- Cause we're not gonna do anything,
and you go into the ER.
- Yeah.
- So I roll my eyes.
I say there's another thousand dollars.
So I went into the ER and the same thing.
I did not have it, so. (laughs)
- Right.
- So I did feel better.
I felt better.
- You're gonna help a lot of people, Brad,
because just by saying that, you know,
you're probably saving somebody's life right now.
- Sure. Yeah.
You gotta get in there.
So you might be asking,
well if you don't have a heart problem
what other things can cause heart problems,
or heart chest pain, chest pain or angina chest.
Number one, it could be lung related,
because, obviously, your lungs are in your chest,
pleurisy, pneumonia, pulmonary embolism.
- My wife had that one, the pleurisy, one time.
So she was in college and we took her in.
- Oh, at that age then?
- Yeah. - Wow.
I know my dad had it when he was in his sixties.
Very painful.
So there's , you know, a few things with the lung.
The other thing is it could be in the GI,
the GERD. G-E-R-D.
- What? Gastro esophageal reflux disease.
- I like to say GERD. Yeah.
- Or you like to say a heartburn
- Right. Yeah. Precisely.
- Heartburn can definitely simulate
some pretty good chest pains.
Generally, I think people after, you know,
they've been diagnosed with it
and they've had it for a while.
They know what it is, right.
Heartburn. Yep.
- And then the fourth thing.
Oh, there's another one that you hadn't brought up.
- Yeah, panic attacks.
I just had some friends that,
I saw one this weekend,
who had a panic attack at work.
And they took him in.
They treated it very seriously.
He was short of breath
and it was just purely anxiety.
And if you knew his wife, you'd know why.
(both laugh)
- I hope she's not gonna watch it.
- Oh, she's not gonna watch this. I hope.
- I hope.
I know they're waiting to get to the treatment part,
but you really need to go through these things
to separate it out.
So you have, you know, clear understanding
of the options that may be causing this.
The other one,
and this is what the doctor told me
when I was said and done.
I said, "so what is causing my chest pain?"
And they said, "oh, it's musculoskeletal."
- Right.
- And I'm thinking, well, I'm a physical therapist.
Musculoskeletal is right up my alley.
I should know this.
And it's like.
- This is in your wheelhouse.
- Right? It's like, well, I don't know this.
So started doing some homework
and then came up with the answer.
And actually 30, according to Mayo Clinic,
there was a study done at Mayo clinic
of the chest pain, people with chest pain symptoms
that came into the ER, 30% of them were musculoskeletal.
- Wow.
Or, and they got a label for costochondritis.
- Costochondritis. Yep.
And we've seen, I actually have friends have had it.
And Brad, again, is a great example here,
because he's had costochondritis.
- Right. Right.
- We're speaking to a real patient today.
- So should we show them on Sam,
what we're talking about.
Costo refers to the rib.
Chondritis, inflammation.
And so we got the rib
and the sternum
and there is the...
- The cartilage.
- Cartilage that connects the two,
because the ribs expand and contract
every time you breathe,
so there has to be flexibility in this area.
And then, should we go to the back side?
- Sure.
- Along with that, as the ribs expand and you breathe,
the ribs come out, kinda like...
- A bucket handle. Yep.
- This is a little analogy.
Just like this bucket handle shaped kinda like a rib,
connection here, connection here.
- It would be like this, and it comes up like that.
- Yep.
So as you breathe, the rib goes up and it goes down,
it goes up, and of course, all of 'em go together,
and they're not going inches.
They're, you know, it's a smaller amount,
but they go a lot because you breathe, you know,
14 times a minute or whatever you are breathing.
- Yeah. It's a constant thing, so.
- Right.
If back here, there's no cartilage back here,
there's actually a joint
that connects the rib to the vertebrae.
And if those joints,
I think of it as like they get rusted shut
or they get locked up, that puts more stress...
- On this side.
- On this side. - Yep.
- And that can be the result
of inflammation and irritation.
- So you're kind of stuck back here.
The movement has to happen somewhere.
- Right.
- So you get hyper movement over here.
- Right.
- Which irritates it. - Right.
And this was all kind of postulated by Steve August.
- Right.
- He's a New Zealand therapist
and we think he's brilliant. - Yeah.
- Coming up with this.
- Matter of fact, he's got a nice video
explaining all this in even more detail.
- Right. Does a better job than we do.
- He does. Yeah. He's a wonderful guy.
Very intelligent.
- Yeah.
- So anyway, he came up with a product, right Brad?
- Yeah, he did.
And he calls it the Back Pod.
Yep, and what this is for,
is to release the joints that are froze up back here.
And we call it to mobilize the joints.
And this back pod happens to fit very nicely
between the shoulder blade and the spinous process,
or the spine.
You need to get in that muscular area,
which is, you know, you may have an inch of muscle there.
You gotta get through the muscle
and get that joint to break loose.
And once that happens, it takes the stress off the front
and there you go. Success.
- And this product is real solid.
- Yep.
- It's got this rubber,
but it's over this really tough plastic.
And I know he had a, I think,
a video somewhere of a car driving over it.
And I, you know, I can see easily
this thing is really solid.
It's designed really well.
It is a bit pricey.
- Right.
- And, I mentioned this before,
if you go to the reviews on Amazon,
you're gonna see that everybody liked it, though.
And it worked.
- Right.
But they all said it was expensive, but it worked.
And I thought, too,
oh, maybe this could be made out of foam
or, you know, this whole thing,
but no this thing has to be really solid.
- Right.
- And cuz I've been using it
for just plain old, mid back pain.
- Right.
- Just pain between the shoulder blades.
- Yeah.
You can use it to soft tissue mobilization,
just to get those muscles to, you know, relax.
- Well, one thing, Brad, do you mind if I show on you?
- Yeah, go ahead.
- You know, you put it, like you said,
between the spine and the shoulder blade,
but you actually move it up and down
a couple inches everywhere.
And I just, I do this a fair amount now, Brad.
I did it yesterday.
- Yep.
- And now my back feels really good today.
It doesn't always, it felt good right after I did it,
but it feels really good the next day.
- [Brad] Sure.
- So again, you're gonna move it every two inches
for about 30 seconds,
and you wanna show how you do it, Brad?
- Now, at home, to use this.
Oh, there's one other thing I did wanna mention
about symptoms that are consistent with costochondritis.
Oftentimes you're gonna find, along that rib,
that cartilage area you're gonna push
and they'll be sensitive.
- Right.
- Painful.
- That's where, yeah, exactly.
That's pretty, almost the notion that if you push there,
that's almost a good sign that you have costochondritis.
- All right. So here we go.
- So he has you start off with, especially if, you know,
if you're new to this.
- Yeah.
- What you're gonna do is,
you're not gonna be on a soft table like this, in your bed.
You're gonna want to go on the floor.
Carpeted floor is probably ideal.
I'm gonna do it up here just so it's easier to film.
So we're gonna put that down.
And what they recommend is to take a towel or two
and put over that if you haven't done it before,
because it's kind of aggressive.
- [Bob] And then some pillows too.
He mentions a couple pillows, Brad.
- That's under the head, right?
- [Bob] Under the head, yeah.
- To be honest with you, I didn't use the towels,
I went right after it.
- [Bob] I didn't either.
- So you, you may wanna do it that way.
- [Bob] If you've got pretty good mobility,
you can do it without it.
But if your head is up like this,
you need to start with pillows.
- Especially, you know, some people, if they're older,
their necks are not as flexible.
Just as the aging process.
And if they are a little bit tight.
And this is much more comfortable,
but as you get more used to it.
- [Bob] I'm gonna start taking towels away.
- I'm just gonna take 'em right out, and then...
- [Bob] Maybe even take the pillow away eventually.
- Sure.
And like Bob says, I'm between the shoulder blade
and the back right now
and I'm actually gonna do a little bit of movement
and I can feel the muscle.
- [Bob] That's what I did, too.
And you can actually put your arms up over your head,
and take some deep breaths while you're doing this.
But I'm gonna tell you a variation
I've done with this, Brad, now.
- What's that?
- I've discovered.
I actually, if it's too hard on you,
you start on the bed.
- Oh?
- I started on a mattress,
and I laid on it
and it was not as aggressive.
- I see.
- And it worked actually pretty good.
I was like, oh, this would be great,
a starting point for someone,
if they don't wanna use the towel or the pillow,
just put it on your bed and lay on it, right?
- Yeah.
So instead of using the towel,
you taking and putting a soft cushion.
- Right. Yeah.
It worked out good.
- And that's what's going on with this,
because it is soft
- Now.
He says, too, you can also,
you can put it directly on the spine.
both Brad and I didn't like it on the spine, do you?
- No, I like it to get in that muscle.
And actually my back just gravitated a couple times,
in, you know, there.
- You can also, instead of going lengthwise,
you can go across.
He said on some people.
So if you wanna show? Yeah, like that.
So, you know,
you're going across the back, like that, instead of.
So, but again, I haven't used it that way.
It's just worked really well for me
going up and down the spine itself.
- Yeah.
- And Brad, by the way, since he's been using this,
you have not had any episodes of chest pain.
- Symptom free.
As a matter of fact, I was reading, Steve,
the guy who invented it, his history, he had it for years.
And it's no fun, because...
- No it's not.
- You have chest pain
- And you have to take it serious.
- Right. And I've been there.
They'd tell me that it's no problem,
but you still think, well, maybe this is the problem.
- Yeah. Maybe this is the big deal now.
- So it's nice to get rid of it.
- Yeah.
- And it worked for him. He's been pain free for many years.
- I've got a niece
that I'm gonna be having her try out,
cuz they've diagnosed her now her with it, so.
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