♪ 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
(laughing) on the internet.
- In our opinion of course Bob.
- Today we're gonna talk about the herniated disc.
We're gonna clearly explain it
and we're gonna show how to easily fix it too.
- That's right, Bob, this video, I'm excited too.
We got some really good information, puts you at ease.
- You'll understand how it works.
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- Right, then this is the cover cutaway.
- Yep and you got 700 individual mattresses.
- 700 tiny mattress. - And it's got air channels.
And what this does is really provides you
with a lot of pain relief. - Right.
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I love it, I sleep all night.
- I'll get rid of this. - Carry on, we got work to do
with the herniated disc Bob. - All right.
- Okay, so we wanna talk about herniated disc.
If you got one you've been in MRI
or however it may come to you,
you're pretty nervous about it.
- Right. - You're thinking...
A lot of people right away, they think about surgery
but you need to know all the facts about it first,
and that's what we're gonna show you.
There's a lot of good news out there, Bob.
And first of all, let's talk about a herniated disc.
First-- - Where does it happen
most commonly Brad? - Good point.
And there's research shows 95% happen between L4
and L5, L5 and S1. - We'll show that on here.
- Which is right about the belt line.
- Right, and it makes sense
because that's where the stress first comes
when you bend forward. - Right.
I mean, it makes sense to therapists.
- Yeah, it makes sense to therapists
- But you have to trust us.
So if we look at the spine,
the belt line would be right about here
and so we're looking...
Actually this red disc
represents a herniated or a bulging disc between L4 and L5.
And then the next disc down would be the next one.
That is very common.
So we're looking at this.
Could you zoom in on this, Mike?
Okay, you can see the red disc and the bulge,
and this nerve right here, L4-L5 nerve
is getting pinched and that's gonna send signal
or pain, numbness, tingling, all these weird--
- Burning-- - Uncomfortable symptoms
down the leg all the way to the foot.
- It can. - Yes, it can.
Not always, but it's not uncommon, that's for sure.
So all we...
What we need to do is get rid of that bulge
one way or another.
Surgery can be an option, but hold on.
There's a lot of other things that can happen before that.
- Right there's...
And I wanna show one thing-- - Oh, sure!
- The thing that causes it to bulge or herniate
is if you bend the back forward like this.
Can you see how that--
We'll show in a minute why that works out.
But as I start bending here,
the bending firstly occurs here, then there, then there.
So that's why the bending almost always occurs
at the lower back.
- Especially with poor body mechanics,
which happens to be very common,
as well as poor posture
with sitting. - With sitting.
- When you slump--
- Especially you slump all the way.
- That puts a lot of pressure on that herniation
to actually get worse.
So that's a key part of this is straining up your posture,
use lumbar support in your chair, so you maintain good--
- Don't be lifting like this. - Yes.
- You should be lifting like this.
- Yep, and if you've got a herniated disc
you're just gonna stop lifting.
You really gotta use--
- Yeah, you won't even be able to do it because it hurts.
- Yeah, take a break from that.
And you'll find someone else to do--
- Should we show the cups, Brad?
- Now, if we look at the herniation,
now this will make it a little more clear.
Let's...
Oh, we can throw that, yeah, that one retired.
We're gonna use a red ball because it matches the red disc.
- Oh, there we go.
- Yep, so this is L5.
Remember L5, L4-L5 herniate.
The most are 95%
- That's the disc, the red ball represents the disc.
- Yep, now this is the backside of the disc,
so the spinal cord goes through here
and your spinal nerve that gets pinched
comes right out here, so a healthy disc has some fluidity
and it has give like this.
So when you walk, it bounces, it's like a shock absorber.
When you bend forward, things flex.
When you bend backwards and rotate,
the disc must be flexible, must be pliable
for a healthy back.
But what happens is when you sit with poor posture,
you bend with poor body mechanics year after year,
the disc can start to bulge and look at that.
You got this ball just as exaggerated.
It's not exactly, but it gives you the concept.
We need to get this bulge now pinching the nerve,
we've got to give it some room and an exercise
to allow it to go back in, eliminating the problem.
- So the repetitive flexing, repetitive bending,
wears out the back of the disc, and is what you have.
And you can actually get it to herniate
till where the inner substance of it,
the fluid actually comes out of the disc.
- Yeah, and that's what we wanna avoid so...
But there's good news about that.
So you need to understand that.
Understand posture, particularly the seated posture
and body mechanics of bending is a critical aspect.
- Do you wanna talk about statistics now, Brad?
- Oh absolutely, Bob, this is important.
So 19 to 27%, I think a fourth of people
with herniated disc have no symptoms.
- Right. - And they don't even know it.
And they live like that, and it's okay.
- So both Brad and I most like...
It's possible we have a bulging disc
and certainly we might have a herniated disc
and we don't even know it because we're not having any pain.
And that's very common
- And that's okay.
The body is adjusted to it. - Right.
- It's not pushing into the nerve and it's okay.
And they've done that because they've taken MRI studies
of healthy people to find this specific information out.
- It's funny, I just had a neighbor who went in for a scan.
I said, they're gonna find it, they're gonna find something,
'cause it's part of aging.
The older you get,
the more likely you are gonna get a herniated disc.
- Which brings us to the next point.
Them people that mostly have herniated discs
are between the ages of 30 and 50.
Once you get closer to 60 and older,
the disc, the annulus--
- Yeah, doesn't end up fluid. - Yeah, it starts to gel up.
- Nucleus pulposus is in the center.
- The fluid in the middle of that
becomes more like crab meat.
That's what the instructor told me
in one of my back courses.
So older people don't have herniated discs
near as often as between 30-- - Symptomatic herniated disc.
- Yeah, between 30 and 50.
So that's a little tidbit to remember.
Now, if you're a male versus a female
there's two males that have a herniated disc
versus every female,
so you're twice as likely if you're a male.
Now this next one is really important
because 90% of patients diagnosed with a herniated disc
has been treated after six weeks,
90% of them are not candidates
for surgery, why? - They got better.
- Because they've gotten better.
And they resolved the disc, it went back in
and life is good again.
- So you have very good odds of not having to need surgery,
if you follow a program.
- Right and you know, some people just get better
without seeing a therapist at all
because they avoid things that occur to them naturally.
But if you get information like we just talked about,
with the bending, posture and we got some exercises.
Now, Bob should we tell them about--
- Sure, actually if you want a complete program on this
you go to bobandbrad.com, go to the program section.
This is completely free, we don't even ask for an email.
It's just, we have like what, 50 something videos
on sciatica. - It's a lot.
But don't get excited about that.
You don't have to...
You only watch the ones that pertain to you.
- Right, so like if you--
- There might be three or four only.
- Yeah, if you're already having trouble
with sitting in a car, we have a video on that.
We have the whole exercise program,
the complete exercise program you need to do in that series.
- Right, and the great part about it is each...
And they're usually about 10 minutes long.
They come with a PDF printout,
so you can print out the exercises
so you don't have to go back and look at our faces anymore.
- That's right.
- You can say, "What exercise is safe?"
You look at it on paper. - You actually could print
it out and not even watch the video (indistinct)
- Oh Bob, you cannot do that.
- These are really instructive, demonstrative that can be--
- I mean you could but-- - Demonstrative.
(laughing) There we go.
- Anyways, it's a really good service that we're offering.
- Should we give them a sample
of some of the stuff you do in there, Brad?
- Good idea, Bob, let's do it.
Some of the more common exercises--
- One of the staples of this, and it is from...
Robin McKenzie developed this.
Really quite groundbreaking when it came out,
to be honest with you,
is you start by lying on your stomach
and then you get up onto your elbows.
Can you see how I'm actually turning,
bending the back the opposite direction now?
- Yep. - And this is meant to help
try to push that disc in.
Now sometimes even just lying here, Brad can help gravity.
- Yep. - We'll push that in.
But eventually you move
to put your hands beneath your shoulders,
do some micro press-ups, mini press-ups like this.
And I'm trying to push that disc in even further.
And I was always taught by my McKenzie instructor
that the magic happens
when you start getting up really high.
And what you don't wanna do
is you don't want the pelvis to come off the bed.
- Sure, sure.
- Yep, that means you're not doing anything anyway then.
It's just staying straight.
So you gotta work on getting the bend here.
- Shall we show them one of the little tricks?
If that doesn't work, we can show them
what we call the banana. - Sure.
- So with the banana, if we could get the camera
to look straight down that's where you see the banana shape.
- I'll say the pain is down the left leg.
- Yep, closer to the camera.
- So I'm trying to close this side down.
So what I'm gonna do is I'm gonna put these legs out here,
and I'ma bring these shoulders over that direction too.
So in that fact I've created a banana shape.
- If you're looking from the top down.
- Yeah, and now once I'm in that banana shape
you can try to do a few press-ups here.
These are not as easy to do once you're in that shape.
- You're only gonna do this if it works.
If it makes the leg feel better, you continue.
If not, you might go to the next one.
- The next one is the roadkill
where you actually take your...
On the same side again, the painful side,
you take your foot
and put it on your knee, up the opposite leg,
and again, sometimes just getting in this position
feels good.
- I've had a number of patients say,
"Oh my leg feels a little better already."
Then I know we're on target.
- Yep, and what we're looking for is that your symptoms
going down the leg are improving.
We're not looking for improving the back pain right away.
We're looking for the symptoms.
Generally further down,
the more we expect the symptoms to get better.
So like all the way down to the foot
we'd like to see the numbness
or tingling or the pain get better so--
- Now we're moving up. - Moving up, yep.
So again, I can do some press-ups in this position
but again, we explain it with better clarity in the program
'cause we take more time and we're more demonstrative.
- Wow, Bob, you've been looking things up.
But yeah, the programs, it's just such a easy way
to have a whole plethora of videos
at your disposal very simply.
- We wanna mention too, that walking is a good idea.
Always with sciatica, try to do some walking
with maybe short strides
and work on it, we're running out of time, Brad.
- Oh yeah. (laughing)
- Let's say goodbye to everybody.
- Take care and good luck.
(bright upbeat music)