♪ 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.
- Today we are going to talk about Sciatica back pain.
How to stop pain with posture changes
And how you can test and fix this at home, your own home.
- Right, some tests that we do as therapists
but on these tests there's no reason why
you can't do it yourself so listen closely.
- Very revealing
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- There you go Bob.
Alright so Sciatica back pain often times related
you don't have to have both.
These changes could affect one, both or one or the other
- There helpful either way
- Exactly.
So what we want to do is.
We just talked about this McKenzie Robin McKenzie,
who's a guru and respected worldwide with treatment
of back pain.
He stated that he feels that at least 50% of back pain
can be improved just by posture change
- Just by posture change
- And we've seen that with ourselves in the clinic
- All the time
- The first thing we want to look at is seated posture.
So let's get a chair
You're going to want a firm chair for this.
You don't have to have arm rests.
Actually they get in the way a little bit.
So if you have one without arms its good.
You're going to sit in the chair.
Actually you're going to slump, poor posture.
Which actually a lot of people do, its not uncommon.
And monitor your back pain, or if you have Sciatica
monitor your symptoms down the leg and not only that,
where the location is.
If it goes to the knee, if it goes to the ankle or the toes.
Monitor the location and the intensity.
And then get a timer out and hit the timer.
And sit for 30 seconds and see if the pain gets better,
if it gets worse.
As you sit there and if its getting worse.
Well its pretty clear that this posture is not good.
Then you'll want to, you may want get up
and walk around a little bit and then come back and sit down
Put yourself in good posture.
So think about your chest going out, your back arching
your shoulders going back.
Cause a lot of people aren't aware of there posture.
- No they aren't at all.
They think they actually have better posture than they do.
- So, what you'll want to do is you can have a mirror handy
or you can simply get a straight edge or a stick
or we use the Booyah Stik.
And I'm going to hold this here touching my butt
where the belt line is, my back and I'm going to get my head
Let me go this way, get my head here
And now I know I'm straight.
- So he's got the 3 points of contact
His head, mid back, and low back
If he's only got point of contact, in the mid back
Then you know your rounded out a little bit.
- Bring it up a bit
- Some of you may not be able to get into this position
but get in as close as you can
- Right
- You may have to do some exercises to regain that posture.
- Especially if you have years of poor posture
- Right, right
- So get yourself in a upright posture
And again time it for 30 seconds.
And often times I'll get people into this position
and immediately the pain is down
- Sure
- We have them sit for 30 seconds and see how it responds
Now the next one is the same position
but we are going to add some compression
You're going to sit in the chair.
You're going to do the slouch.
- In other words we're putting some stress through the spine
- Right, downward
- We are going to see how it reacts to that
- Now as a therapist I may put pressure on the shoulders
Stand behind me, Bob
- Sure
- And show that, this is how the therapists
I'll say can you slouch a little bit and then pushes down
So and if it makes it worse particularly pain down the leg
worse with that compression we know
we got to eliminate that.
But you can do this by yourself by simply grabbing the chair
here and then pulling down and that puts compression
I don't know if you can see this little subtle movement
but it does the same type of force through your back
and see how you respond.
Often times its going to hurt, make it worse
and we know that's going to be an issue.
And then change your posture to upright,
put the same amount of pressure down
and see which one is better.
Typically, upright the back is in it's proper position
it's going to feel better this way.
So how you going to fix this?
- So that's teaching you by the way you want to have
proper posture as a goal.
It's also teaching you that, let's say you didn't have
pain this way but you did with additional pressure
- Sure
- That's showing you that when you're lifting loads
and there is more stress on your back
you really want to keep your back straight.
- Right
Or just eliminate lifting until things improve.
- Right, exacty
- So in the seated position its hard to sit
with good posture for long periods of time
but all's you need to do is get a lumbar support
You can use a throw pillow.
You can use a towel roll.
I think I've got it up there Bob.
Or you can purchase a lumbar support
Whatever works best for you.
Usually I have my patients try a towel roll
Once they figure out what size they need, the diameter
then we get, its nice to get a nice boughten one
but you don't need to.
Put it back there and you'll feel it immediately
You'll feel that support
Aww that feels good. Right now that does feel good on me
If you put it back there and it feels like a bump
and its too much you need a smaller diameter one
You find the right support and use that for seated posture
- That's again hopefully help knock your pain levels down.
- We've done wonderful progress
with just changing seated posture with support.
- Especially in a car
- I can speak of that personally myself
Now standing tests.
You're going to stand up, your going to slouch forward
get your timer going for 30 seconds.
See how your back and your leg and Sciatica responds to it
Put a number on it.
Tens the worst ones no pain.
If the number goes up as you stand there
Note that you can write it down or make a mental note
Stand tall with good posture and see how it changes
- Again you can do the Booyah Stik here.
- There you go.
- You can make sure everything is going to line up
- Cause even though I was like this I thought I was lined up
and oh I got 2-3 inches to go with my head
- Get the spine right in a line
- Typically the posture change is going to improve it
and then your going to want to go for walks.
Typically people walk with better posture
then when they stand just because of the mechanics of it
So you may want to walk make sure you walk on a flat surface
avoid hills and uneven surfaces that's going
to irritate your back.
- There are people that walk with bad posture though too
- That's a good point
- You really want to correct it, if your walking like this
I see a lot of runners too that are really poor posture
when there running.
There pounding and putting stress through the spine
- Really can be aggravating is a therapist to watch people
They're always picking things up
Think about your posture when your walking,
that can be helpful
Use a device like a Booyah Stik if you don't have one
Find something at home that is about 5 foot long
and actually put it here, get the 3 points of contact
and practice squats maintaining good body posture
so your doing hip hinging.
Can you show them where my hips are hinged?
- So there is no movement like going on here
All the movement is coming from the hips, its hinging
- You can use this to practice getting out of a chair
- Absolutely
- A lot of people get out of chairs improperly
- They round out and they lean forward
- Here, here, There's 1
- This is a great exercise that you should throw
into your repeatur because if you can learn this movement
pattern your going to knock down your pain levels.
- Right
- It's got one of those pain makers as Brad so famously said
that we want to get rid of
- Right.
So Bob I thought this was going to be easier video
but it turned out to be a little more complicated
then I thought
Watch it again if you need to.
- That's right
- Remember Brad and I can fix just about anything
- Except for
- A broken heart
- There it is.
Can you balance it on that stick?
- Spin it (laughing)
Thanks for watching