- ♪ Bob and Brad ♪
♪ the two most famous physical therapists on the internet. ♪
- 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, Bob.
- All right.
Well, we're really happy about it, but today, Brad
we're gonna talk about, can, can you return
to running slash walking after low back pain or sciatica?
This is basically not a yes or no question, is it?
- Right. There's so many different degrees
of how severe it was or how things have healed
or what your history is, or, you know, so we're gonna talk
about this and, and Bob and I are gonna go back and forth.
And if you listen closely, I think we are gonna find
out what's gonna fit your particular needs.
- Right. It's it's gonna be so individualized
that you're gonna have to adjust it
to how you're your pain is reacting --
- Exactly.
- --when you do stuff, so.
- And that's all part of therapy.
When a patient comes into us, we're,
we're customizing exercises to fit our patients
all the time.
We just don't go
into the book and say, oh, back pain with running--
- Right.
- --These are the 10 that you're gonna use.
- There's no cookie cutter.
There's it's always adjustment.
- Exactly.
- So by the way, if you are new to our channel
please take a second to subscribe to us.
We provide videos on how stay healthy, fit, pain free
and we upload every day. Subscription button here or here.
- Wow.
- And by the way, Brad
- By the way
- Please get some people to like us.
- Yeah. We will.
- Like us on Facebook.
- We want to be liked.
- And the reason you'll wanna do that
by the way we give you a reason is
that we do give away a lot of free stuff.
And, and right now we are giving away
we're gonna have a contest over next week.
We're gonna give away three of these, the Naipo memory foam.
I got a picture of it up.
You should be seeing it right now.
- Oh, good.
- Lumbar support pillow slash cushion.
It's for low back pain relief for home office and car use.
- Right?
- Naipo.
- I'm kind of excited
about to get used this one in my car.
Because as you know, if you watch our channel, my back is a
a constant thing I need to deal with.
So with spondylolisthesis so yeah, I can't wait to use this.
- Well, give it a shot.
- All right.
Fine. Brad, what do you wanna start talking about the spine?
- Well, Bob, I want, oh yeah.
Back to the shot.
I wanna talk about the spine.
Here we go.
We got a, a spine right here and we're talking
about the low spine and what I wanted to do, we're talking
about running, which is considered a high-impact activity.
So let's go into, what do they mean by high impact?
You know?
- Sure.
- You think about impact.
You think about taking a hammer and hitting it on a table.
Well, we're not really talking about that kind of impact,
but in a sense we are.
So we're gonna look at the spine.
Maybe I should, should I go up there?
- Yeah walk on up there.
- Yeah.
- Let's pull the pointer pen.
We have the official pointer pen here.
And if we look, let's say, for example
this red disc represents the source of your back pain.
It may be herniated.
You may have some problem
with the facet joints, but that's the area.
Yep. What's going on with that disc when we walk
and when we run and what kind of stresses are being put on?
- Yeah. These bones are coming together and they're
they're putting additional stress on the disc.
- Right? So if you're talking about walking
there is really not, it's not considered a high-impact
activity. You have heel strike and the, that you have
more forces going through your joints in your back
as your heel strike goes through, but it's not terrific
as compared to when you jog or run.
And if you're a heel striker
and you land right on that heel, that puts a--
- Yeah. Those forces are going all the way
up through the leg, into the back.
- Exactly. Plus you're on one leg.
So you got a, a force that's going through your pelvis all
on one side, which can kind of put it
at an angle and, and cause some other problems
particularly if your core's not strong yet
- Can I just say, as a rule, a thumb, Brad.
- You can.
- Basically, you know, with a lot of our back patients
we try to get them walking like from day one.
- Sure. Yeah.
- And again, it's going by their symptoms.
If it makes their symptoms worse, we we're gonna have you
stop. Right.
But if you can walk, if you can walk 20 minutes, do it
you know, obviously don't go out 10 minutes and then find
out you can't make it back.
Cause you're gonna be stuck out there.
- Yeah, exactly.
- But the other thing with, with sciatica often
helps take shorter strides.
- Sure.
- So you're putting less stress on the, the nerve.
- Less heel impact.
- Right.
- Exactly.
- So short strides definitely want
try to get to walking as soon as possible.
- Okay. Now let's look at that disc
in this high impact when we start to jogging or running
because that's what I have a lot of people commenting.
Can I get back to running after I have sciatica?
This green ball has got gel
in it and it's got a tough outside layer
just like a disc and I'm gonna put it in there.
And that represents a disc.
Can you zoom right in on that Lonnie?
All right.
So normally there's a little shock absorbed
from like this and that's, that's one of the jobs
of the disc is to take a little shock away
and you've got, you know, five discs in your lumbar spine
but every time you heal strikes, it's gonna, boom.
It's gonna pound in there.
And then if you look back here
if your disc is not fully healed every time it pops, it
it could eventually lead to that again, that herniated disc
because we got that impact.
And it's not just one or two times
but if you're gonna run a mile, you're gonna have hundreds
of those little impacts occurring.
- Right. And the other thing is posture is still
so important with walking and running.
I see runners that do not have good posture running.
- Sure.
- I mean, they're flexed
and that's gonna put that disc more likely to scoot
out the back.
- Right. With poor posture,
that bulge is more likely to reoccur.
- Right.
- You know, 'cause most bulges do come
out the back as possible.
That it's one that doesn't
but we're talking about the majority here.
- So with walking and with running
you really wanna work on really good posture.
- Exactly.
- Get that, that spine as straight as possible.
- Okay. So this is what I'm gonna
this is how I'm gonna suggest if you've got
you've been a weak, this is a pretty conservative approach.
- Sure.
- But it's gonna be a safe approach
and it's gonna give you your best odds
for having minimal chance of reoccurrence.
So be patient with this, no symptoms down your leg
on your back for a week.
You're feeling pretty good.
- Can we talk about what, what you should do
before you even walk Brad?
Oh, maybe do a couple of the back exercises.
- Sure. Right.
- So do you want me to show?
- Yeah, go ahead and show.
Now Bob's gonna show a common exercises that
that works good for a herniated disc or sciatica.
- So you're putting your hands underneath your shoulders.
You're keeping your pelvis down and you're pressing
up like this.
- Right.
- And now again, this will often work for work for a lot
of different types of back pain too.
- Just sure.
- Normal. Yep.
80% of the people that have back pain.
This is gonna work for sure.
It's not gonna work for you, Brad.
'Cause you have "spondy."
- Right.
- And it's not gonna work for spinal stenosis, but--
- Right.
- --It's gonna work for a lot of people and you can do just
to have press up here, but these are good to
do right before you do the walking or running.
- Right. Right.
- And you can also, you want just show a standing one, Brad?
- Sure. Oh why don't you do it Bob. I don't like doing them.
- Again. You can go ahead.
Lonnie doesn't like me standing up tall.
- Yeah. We're looking at him back anyways.
- So anyway, we're you're gonna grab
you can put some pressure on the belt line here
or you can put hands like that
and you're just gonna bend back and do a couple press.
- Right.
- Press-ups, press backs I guess you'd call it
huh?
- Yep. I just call ''''em back bends.
- Bends. Yep.
Prior to doing the exercise.
- Now if you have,
if you got some modified exercises like this
that you know, work for you stick with the ones that
that you know, you've had good success with.
So after you've had no, no problems for a week
you're doing your exercises.
You started walking.
Walking's not a problem.
You're walking up to a half mile, perhaps a mile
without any problems.
- Sure.
- Then you can start jogging.
We're not gonna go into running.
- Right.
- We're gonna go into jogging and I'm gonna suggest you
do a walk run protocol where you you're gonna run
or jog, I'm sorry, for 400 meters.
If you don't know how far 400 meters in is, you know
like a block.
- Right.
- Okay? You're gonna, well, block would be less than that.
But if you're a runner, you know it 400 meters
- Once around the track.
- Yep, exactly.
- Outdoor track.
- Then you're gonna walk.
Okay. You can walk before you start the run
and then you're gonna walk after you run.
And I'm gonna say do that for three days.
And if you have no symptoms
this is a little conservative, but it's gonna be safe.
Then you can bump up to 800 meters.
- And with both of these,
I would really keep a short stride.
- Sure.
- A lot more foot strikes rather than trying to stride out.
- Yep.
- 'Cause you're gonna put less stress
on the sciatic nerve that way.
- So exactly. Just remember the, the
the model we had with the disc earlier.
Just think about every time you hit.
So you're gonna try and run smoothly.
And you know, I have a friend every
I can hear him run right next to me 'cause he goes, clap
clap, clap, clap.
- Brad and I both had a discussion about this.
Well, we had
both changed our running style to be more four foot runners.
- Right.
- As opposed to heel strike runners.
- Right.
- And it really has lessened, I think our injury risk.
- Oh sure. And that's another video, but--
- Right.
- --You know, that's an option you can look into.
So after you get you're running eight,
800 meters or half mile, and then you're gonna walk.
And after you do that, walk, run your 800 meters.
Walk again, do that three days in a row.
And if there's no symptoms, things are feeling good
and you're itching right now to get back to your running.
I'm gonna say, put the brakes on.
Then I want you to go
to a protocol of walking your five minutes
or so, running 800 meters, walking, run another 800
meters, walking, run a third 800 meters.
So you got three sets of walking and
800 meters and then do that for three days.
And then, and if that is clear, then I want you to jump
into running the distance of, you know, up to 1600 meters
or that mild distance and always doing the jogging.
And not until you get to that mild distance
you can have zero symptoms for a week.
Then you can start going
into your higher speeds and longer distances.
- And in all cases, by the way, Brad, which you
you wanted to allude to is that when you get done running
you wanna avoid doing stuff like this.
- These are things you don't even think about.
- Yeah. You're trying to get yourself, you know
some accessory muscles here
over your chest that help your help your breathing.
But this is really not good for your back.
You know, if you want anything
you wanna do a few of these.
- Right. So yeah.
You know, Bob's talking about when you get done running
you're tired.
This is just becomes a habit.
'Cause if, especially if you're, you know, when
you're healthy, you're sprinting, if you're doing
some high impact or high-intensity workout, I mean
this is just a normal resting or you sit down and a chair
- And you sit and you slouch
- And then you slouch while
- You 'cause you're, you're tired.
- Yeah. And, and, and Mackenzie, by the way
the ones that we think is probably one
of the greatest developer of exercises for the spine
sciatica he, he said one of the things that he thinks causes
pain more than the exercise themselves is how people act
after the exercise.
They sit and they slouch 'cause they're tired.
Because they're fatigued and, and the body goes
- The body's really warmed up.
So it really bends.
- Exactly.
- So it's not a good thing for it.
- And, and then the other thing, just like we had
mentioned here, you get your workout in or whatever
no matter where you're at, look at your seated posture.
I think this gets for forgotten about a lot.
Your running might feel good and everything's the running
or the walking's helping it perhaps.
- Right.
- But then, then you go in your car and you sit
and drive for two or three hours.
- Right.
- And if your car does not have a good lumber of support
and then you get outta your car and it's hard to get
out and it's hard to straighten
up, you need to change your seated posture.
- Yeah. It wasn't the running.
That was a problem or the walking
that was a problem.
It was what you did after.
- Right.
- So always make sure you keep aware of that.
- So, so good seated posture, good goodbye to mechanics
and build things up and get that back strong again.
We didn't get into core exercises on this too
but that would be another yeah.
Benefit to keep that core strong
around your, your abdomen and stomach, back.
- And remember Brad, we can fix just about anything.
- Exactly.
- But except For a broken heart
- You say that now, but what do you really mean?
- But we're working on it.
That's what I mean.
(laughing)
- I've always wanted to say that
- You always wanted to say a lot of things.