(upbeat music)
- Welcome my friends,
to the Bob and Brad Podcast
produced by Bob and Brad,
the two most famous physical therapists on the internet.
In our opinion.
My name is Bob.
I am exactly one half of the Bob and Brad team.
And I'm joined by Mike Kenitz,
who is part of the Bob and Brad crew
and has a channel in their own right,
which covers Bob and Brad products
and other products
- Yep. - for review.
So it is our extreme pleasure today to be,
this is really gonna be part of our expert series
- Yeah.
- where we're interviewing people
that are experts in their field.
And today it is a great pleasure to have
Dr. Deb or Deborah Riczaw,
did I say that correct?
Riczo?
- It's Riczo, like Ritz cracker.
- Oh, Ritz, oh Riczo, okay.
Dr. Deb. (chuckling)
- Dr. Deb.
- Yeah, Dr. Deb, if you'd maybe give
just a little bit of your background
so people can know who you are,
in case they aren't familiar with you.
- Sure.
I am a physical therapist
and I've been a practicing physical therapist for,
I hate to say this
- I know. (chuckling)
- for decades.
So, I worked for over 30 years
at Metro Health Hospital, which is a county hospital,
and got incredible amount of breadth of experience
working in there
and focused in the last decade on orthopedics
and developed a method that is
kind of the thrust of what my work is now,
helping women with pelvic girdle and with iliac issues.
So that's kind of, plus, oh plus,
in the nineties and the eighties,
when people really weren't doing it,
I had a business with teaching prenatal and postpartum
exercise classes in the community
and I partnered with a couple other therapists.
And so that was really fun.
And I got to do a lot of program development
and actually teaching the exercise classes.
So, I have a long history
of being involved with women's health,
specifically the prenatal and postpartum population,
but women's health in general.
- Awesome, awesome.
And yeah, I'm gonna just mention you have two books.
Do you have more than that?
Or, do I?
I'm familiar-
- No, I don't.
I started writing when I retired.
That's why I retired when I did
so that I could actually, you know, continue my journey.
- I've read both of them, believe it or not.
And they are excellent books
that are really written for the lay person.
Although the professional will get something out of it too,
believe me. - Yeah.
- And the first one is called, "Sacroiliac Pain."
That was your first book that, and,
"Understanding the Pelvic Girdle Musculoskeletal Method."
And the second one is,
"Back and Pelvic Girdle Pain in Pregnancy and Postpartum,
Find Relief Using the Pelvic Girdle Musculoskeletal Method."
Now these are both on Amazon, correct?
And OPTP, and?
- Yes.
- Would it be okay if we talk about
the pelvic girdle pain a little?
- Sure, sure. - Sure.
Okay, so I saw from your book that this is really common.
You want me to give the stats or?
- Sure.
- So during pregnancy, up to 56 to 72% of the women
can feel pelvic girdle pain.
And I thought what was more distressing
was that seven to 25% can have continued pain afterwards.
So that is a large part of the population
that have that. - Yes, yes.
And then that affects, you know,
it affects their quality of life.
- Oh, absolutely.
- And it affects their relationships.
It affects what they can do with their children.
And with her husband, it affects their livelihoods.
Sometimes they go on disability.
Anxiety and depression
have been widely associated with chronic pain.
So there's all kinds of really not good sequelae
for not having a good treatment and kind of,
that's why I do what I'm doing.
- Sure.
- Is so that I can try to help
as many people as possible, specifically women,
because most of the research has been done on women
prenatally and postpartum for pelvic girdle pain,
because that's the population that it affects the most.
And I know that when I am treating a woman in menopause,
often she has, she'll tell me
her first time when she had pain
was during her prenatal or postpartum period.
And then it may go away, but then it comes back,
and it just really never goes away.
- Oh, good lord.
- Because they haven't addressed all the pieces and parts
as far as their flexibility and their strength
and their function and how they're moving
to have it, you know, to really be gone.
- Sure.
So, I know our recommendation
would be to check out this book.
Well, I'd say this one,
actually. - Oh, that one, yeah.
- 'cause these are for back and pelvic girdle pain
in pregnancy and postpartum.
Now, I think this is a great starting point.
Some people will probably alleviate their pain
just by doing the self treatments in here.
But where would they find a PT, a physical therapist,
that is expert in this area?
- The American Physical Therapy Association
has a section called Pelvic Health.
And so, those are the therapists that are really specialized
in working with areas of the pelvis
and any type of pelvic pain,
pelvic girdle pain, and pelvic pain.
So,
- If you go to their website are you able to-
- You can go to their website, is APTA
- Dot org or dot com? - pelvichealth.org
and they have a find a PT,
- Oh, awesome. - tab.
I am also going to be rolling out,
'cause I just launched my new website yesterday,
but I'm going to be rolling out a PT section
for therapists that have taken my course.
- Oh, fantastic.
- You know, I have a one-day course.
I used to actually teach a two-day course,
but now it's a one-day course and it's virtual.
So, I'm gonna be rolling out that section
and I'm gonna contact people
that have taken my course over the years
and see if they want to be on that list,
so that there will be reference for people, literally.
Now that it's virtual,
it'll be for people literally all over.
So that's coming.
I haven't done that yet.
- Okay, so yeah, and you can see her website
was listed behind her, over her right shoulder.
or left shoulder, depends on how you're looking at her.
But okay,
so - I went like this. (laughing)
- Do you mind if I ask,
what kind of success rate have you had
with SI and pelvic girdle pain?
I mean, do you have a sense of, of what?
I mean, obviously you were doing quite well
because people,
whenever people start finding the guru
and start sending people to them,
there's a reason.
I mean, people are getting better.
So, but-
- Yes, I mean, I really, as long as people are compliant,
that was the big, you know, the biggest thing.
Because sometimes - It always is, isn't it?
people, so here's the thing,
sometimes people feel better
and then they don't do the whole
- They stop. - package, you know?
So I don't have a hard number for you
'cause I haven't actually taken statistics,
but the vast majority respond to this treatment.
I mean, I even had, there's reviews on Amazon
that people that have had pain,
that I don't know and I've never touched,
- Sure, read the book alone. - But people that have been
through practitioners
or have had pain for a number of years,
and they are getting relief.
So to me, that's why I keep going,
because I know that this technique, this approach,
it's an approach, which is a holistic approach.
Like, you cannot not get that mind-body connection,
connect with your breathing, and do all that work,
and just do the exercises
and then be real tensed up when you're doing 'em.
And like, "Oh, these don't work."
You know, it's a huge, it's a package.
And then being aware of what you're doing during the day.
How you're sitting, how you're carrying things,
it's really, the whole method is all those things.
And the specific exercises too.
- Yeah, and it's very comprehensive.
I mean, it goes through
- Yeah. - the pregnancy
and also afterwards and a lot of stretches.
And I think you emphasize,
with some of the stretches towards the end of the book,
you don't necessarily have to do every one.
You certainly don't even have to do it on both sides.
If you find one side is tight,
you might wanna focus on that side and vice versa, so.
- Right.
And so, the other thing I wanted to mention, Bob,
is that these exercises are meant,
they're meant to be simple, they're meant to be,
I call them remedial.
So they're the first stepping stone
to kind of get you going.
- [Bob] Sure.
- So they're not meant for that,
you need to do these for the rest of your life.
They're meant that these are
to get you where you wanna go, where you wanna be.
If you want to get back to a sport that you were doing,
or if you wanted to, you know, go hiking for your exercise,
that's where you wanna go.
You wanna do things that you enjoy,
but you wanna have, this is,
these are stepping stones.
- Gotcha.
Can you talk about the importance
of strengthening the pelvic floor?
You know, it's interesting,
'cause I'd read a book with the Kegels and stuff like that,
and in their approach,
they were really trying to have you focus
on the pelvic floor alone and not the muscles around it.
And it seems to be on your approach
that you're wanting to engage them at the same time.
Am I wrong?
Am I miss-
- No, that's a very good observation.
So, there is a place
for just doing the pelvic floor contraction.
There is a place for that.
And that is when women are having more specific issues
with incontinence, pelvic organ prolapse,
which is a common condition after pregnancy,
and painful sex.
So, when you're having some of these issues,
that's where the pelvic health therapist will come in
and they will actually evaluate the pelvic floor
and then work on you getting a control back.
'Cause see, those systems work automatically.
- Mm hmm.
- And so if that automatic piece isn't working great,
that's when they need to kind of work with that
to try to get that system working properly.
I incorporate the pelvic floor in the exercises
because they normally would come in when you exhale.
So, it's just kind of bringing an awareness there.
But if, when you are exhaling
and you pull your pelvic floor in,
when you're breathing back in,
that pelvic floor should relax down.
- Gotcha.
- So it should be doing this.
And if it's only doing this,
then we have a problem, Houston.
- Right, if it's tightened all the time.
- Yeah. - Hypertone.
Yeah, and that's exactly what you said.
It was the case where they were,
it was for people that were having trouble
with, you know, bladder problems or, and such.
It wasn't other issues.
It wasn't pain, except like you said, maybe it was sex.
But, thank you for clarifying that.
When do you recommend the use of compression?
This is a Facebook question.
Was it yours?
- No, it's mine. (laughing)
- [Bob] Your question?
- [Mike] Those are all my questions.
- Oh, when would you recommend compression pants
or maybe even the maternity support?
- I think that maternity supports
will probably make most women feel more comfortable
in that last trimester.
Specifically, if someone's walking around
and they're always holding their belly.
I don't know if you've been around many pregnant women.
- [Bob] Yeah, I've seen that.
- A lot of women hold their belly.
They, for sure. (laughing)
That's a sign.
Because the abdominals are so stretched,
they can only stretch so much,
and just that little bit of support helps.
So, in that last trimester,
I think a lot of women would benefit.
You know, financially it's an issue
because they're not, you know,
it would just be it's something else to do.
But if you find that you're holding yourself like that,
you're holding your belly a lot,
you would benefit from a maternity support.
And I know that some women would also benefit
from the sacroiliac belt
just because the joints are just getting looser.
And that compression.
Now, I didn't say this before,
so I'm glad I had this opportunity
'cause I kind of, anyway.
So, if you put on a sacroiliac belt
and it makes you feel worse,
it's a very good chance that you need to do
the pelvic balancing exercises that I prescribe
and get that balanced, and then put it back on.
And then, that works nine outta 10 times.
I haven't really seen that not work.
- That makes complete sense.
Is there a time when compression pants are appropriate, or?
- Oh yeah.
A lot of women find a lot of support postpartum as well,
to having a compression pant.
There is a compression pant out there
that has a sacroiliac,
reinforced area around the sacroiliac.
And that is Supacore,
and they're based out of Australia.
And the reason I know
is because they had contacted me to work with them
and then the pandemic hit.
So, they are looking to come into the United States
and have a distributor and things like that.
But they are advertising on Facebook and social media.
I've seen their ads.
But the product would actually be shipped from Australia.
- Gotcha, gotcha. - Called Supacore, yeah.
- Is this your?
Is this probably too?
- They're all mine. (laughing)
- All right
How important is diet when it comes to pain management?
- Well, you know that
what we eat can influence inflammation.
- [Bob] Right.
- There is actually called an anti-inflammatory diet.
And you can find information on this diet
on the arthritis foundation website.
It's also known as the Mediterranean diet.
So if we're eating a diet that causes more inflammation,
then we're setting ourselves up
for having more inflammation.
- [Bob] Right.
- And that's why you take medication,
some people take medication
is for that anti-inflammatory effect.
And so if you can, you know, diet's important.
- Gotcha, yep. - To answer your question.
- Really anti-inflammatory type diet.
- That is, yes, yes.
- Lotta plant based, quite often, Mike.
- Well, Mike doesn't cause inflammation. (laughing)
- Yeah, okay, all right.
Well, anyway, again, we just kinda
got the tip of the iceberg there,
maybe, on pelvic girdle pain.
And you're gonna do a lot better if you check out the book.
- Yeah. - Again,
"Back and Pelvic Girdle Pain in Pregnancy and Postpartum"
by Dr. Deb, Debra Riczaw, Riczaw.
- Riczo. - Riczo, Riczo,
yeah, there we go.
- You also did a write-up on our blog.
- Oh yeah, thank you very much for doing that, by the way.
- If people just wanna see a little short excerpt
of a lot of these things, it's on there, too,
before they buy the book.
Like, they could check that out as well.
- Yeah, we'll put a link for that.
- And I should have mentioned earlier
that OPTP is running a 20% discount on the book
- Oh, great.
- to help me celebrate my new website.
So you just would go to my website,
and there'll be a banner at the top saying 20% off.
And then you'll get a code.
I'll send you a code and they,
you can get it for 20% off through the end of March.
And then the sale goes away.
And it's not an expensive book,
it really isn't. - No, it's not.
In fact, I don't know if you knew this, Deb, Dr. Deb,
the way I found out about you is,
you know, we have some products through OPTP, too,
and their president had told me, or CEO, had told me
that she put your,
they did an email blast of your first book, the SI book.
That it was the best response they've ever had to a book.
- [Deb] Really?
- Yeah, she maybe didn't tell you that, huh?
- No. (laughing)
- Well, it was, oh, I want that book, then.
That's when they sent it to me.
- These are nice for your average consumer too, I'd say.
'Cause I mean, this book is 36 pages.
I mean, it's not like a heavy, dense textbook.
I mean, your pregnancy, one's more,
it's like a hundred pages. - It's more comprehensive,
yeah. - A little more comprehensive,
but I mean, it's very easy reading
and there's lots of diagrams
of how to do everything properly, so.
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