♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- 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, Bob.
- How to overcome cervical pinched nerve and radiculopathy.
No worries, that's what you're claiming,
we won't need any worries, right?
- Well, yeah, people get these symptoms
that we're talking about,
and they can be very worrisome,
'cause you're really not sure what's going on.
- Yeah, when you start getting pain, and numbness,
and tingling all the way down the arm, that's scary.
- And into the hand, yeah.
So we're gonna explain to you, first of all,
the terms, too, where do they come from
when a doctor says you got radiculopathy,
you're wondering, "Oh my gosh."
- That's ridiculous.
- Yeah, but it's really not, once you understand it.
So a pinched nerve, let's talk about that first.
- Sure.
- A pinched nerve, as far as if you're having pain symptoms
down the arm to the hand, oftentimes, excuse me, Sam.
- We got Sam, the super skeleton here.
- Yep.
Oftentimes the pinch is actually around the spine area.
Okay? It could be down this nerve,
goes in the brachial plexus,
and it travels down past the first rib
and under the clavicle,
and there's some areas in there
that I could get pinched.
- Yeah, it could get pinched anywhere
along the pathway really-
- Right.
but the most common area probably
is up in the cervical spine.
- Right.
And if the diagnosis is radiculopathy,
that is referring-
- to the neck.
- To the neck, to the spine.
- If your doctor says you have a radiculopathy,
yeah, it's neck.
- Right, well, that's what they think it is.
(Brad laughs)
- That's what they think it is, right.
- So anyways, it's important to have that
cleared away so you just understand the term,
what they're talking about,
make you feel better at least that way,
you know it's just not just large term
that's getting you nervous.
- So we have the radiculopathy,
we're gonna be doing things to the neck
to try to take the pain out of the arm.
- Right, precisely.
- By the way, Brad,
in case you are new to our channel-
- please take a second-
- Wow.
to subscribe to us.
We provide videos, how to stay healthy, fit, pain free,
and we upload every day.
Also go over to...
- Over there.
- No, over there, Facebook.
- Oh, the sign, yeah.
- Yeah, and make sure you like us
because Brad and I all this week again,
we're having the same sale.
If you like us some angel is gonna get their wings.
- Oh yeah, that's right.
And we gotta get more wings out there because well,
that's it's a good thing.
- It's a heavenly thing.
- So not only this time we're gonna show you
some treatments that we've shown in the past,
but we're gonna go one step further,
and show you how to actually
in a systematic way like therapists do-
- Sure.
- how to treat your neck so your
success rate becomes much better.
- Well, the first thing to do is document.
- Right.
- You know, what your symptoms are
because this happens to Brad and I all the time,
we document it, and then somebody will come in saying,
"No, it's not getting any better."
I go, "Do you still have numbness down here?"
"Well, no, that went away."
"Well, do you still get pain in the hand?"
"Well, no, that went away."
"So you did get better?"
You wanna make sure that you're seeing things are improving.
Do you wanna show that for 'em?
- Sure.
- So one thing, what Bob was referring to
is something we call centralization.
- Right.
- If you've got pain and symptoms
down into the arm and the hand,
and they start to improve what we call distally,
or further down here,
let's say there's no more pain below the elbow,
but you still have it up here.
That's a really good sign.
- Yes it is.
- You're making progress.
- That's what we're looking for is the pain
to start travel back up and into the neck
where it'll eventually go away.
- So what we want you to do is get a piece of paper.
We're gonna show you a Mackenzie form that we use,
but you could just take a piece of paper
and draw out a really rough sketch of a body with arms.
You don't have to go down below the waist.
How we doing here, Lonnie, can you see this?
We focused in?
This is my best side, by the way.
(Brad laughs)
- There's no best side, Brad, sorry to tell you.
- Okay, so if you have pain,
or numbness, or tingling,
and it starts in the shoulder and you feel it,
and I want you to be specific,
if you feel it in your bicep
make sure you draw it on the front,
or if it's in the tricep you'll draw it on the side,
and make sure you get the right arm or the left arm.
And then if it goes to specific fingers,
it's nice to draw which fingers you feel it in,
'cause you may not remember that a week later.
Okay. So it may look
like a solid blue thing all the way down
but it may be only in your pinky ring
or half your ring finger and middle finger.
And then you have some information of where it was.
- And I would rank it too from 0 to 10.
- Right, so you know how severe it was.
- Zero, meaning no pain, and 10 meaning
you'd have to go to the hospital, it's so bad.
- And then you set that off to the side,
'cause you're not gonna remember
this information a week from now.
And like we said, people forget about how bad it was.
And then they say,
"Oh, that's right, my fingers were numb,
my hand, my arm, my forearm."
- Right.
- So do that first and then set that aside.
And then the very next step is check your range
of motion of your neck, okay?
The first thing that usually isn't too bad, we'll ask,
"Can you bend forward?"
And then we'll ask,
"Can you do a chin tuck?"
which is kind of a strange move where you
bring your head like someone's gonna take a pie
and put it in your face, and chin tuck in.
So it's not in and down, it's in and back.
Okay?
If you have pain with that, you'll note it.
And then the location of the pain
if it feel it in the shoulder.
Sometimes I'll have people do a chin tuck and say,
"Oh it hurts right here", where it doesn't make sense.
But that does make sense when it comes to radiculopathy.
- And that's when it's really verifying
that it's coming from the neck.
- Right.
- If any of your neck movements start
changing the pain down on the arm,
it's a good sign that, that's where it's coming from.
- It's a true radiculopathy, correct.
And then you're also gonna check extension.
If you can go all the way back like this,
then that's normal.
If you go back halfway, and it's like,
"Oh, this is no good."
- And Brad and I are gonna say very commonly
that's where we find the lack of movement is going back.
- Right, it's either going back or if you do a side bend,
which you're gonna go to the right,
I always tell people,
"Bring your right ear to your right shoulder,
but don't rotate your head."
- Do it with good posture.
- Yeah, shoulders back.
And typically this is done in a chair.
I'm standing now, but we'll do it in a chair,
you know, like Bob's sitting there.
You're gonna check both directions.
You may find one direction is normal,
the other direction is not near as good, and it's painful.
Make sure you write it down, side bend, right or left.
And then of course rotation,
looking over your right shoulder
without moving your shoulder.
- Right, you don't want to be turning
your body along with it.
- Sometimes that will have a significant change.
Then each direction you're gonna make a note,
and you can do that on the same paper
you have your diagram with the pain location,
and then you have that set aside.
And that's another indication of a week later.
- Yeah, things are getting better if it's moving better,
or hurting less in that direction.
Well, let's start some exercises.
- Right. Okay!
- La di da di da.
- We're both getting the chair.
- La di da di da?
- Okay, you know another thing
that can be really helpful if you want to
take care of your radiculopathy and pain,
and you want to do it yourself
and have some really good documentation and information,
is the McKenzie Treat Your Own Neck book.
- I'll put a link down below,
because it's really a good book.
It'll cover everything we're saying today in better detail.
- Right, yeah.
He's a little better than we are at explaining things.
And it's cheap, it's about $10, but it's-
- Well worth it.
- Well worth it, it's written for the layperson.
- Yeah.
- The first thing we're gonna try is chin tucks.
Now we're gonna look for with all the exercises,
got about six of them,
we're gonna go through each one,
and you're gonna know which one centralizes the pain.
- Which one starts taking the pain out of the arm
and bringing it more up into the neck.
- Right.
- So, like this one, Bob, I think you have the
same experience with patients as I,
will do the chin tuck, and oftentimes they'll say,
"Oh, it hurts back up in here."
And then I'll say,
"Well, let's do it some more, and then I want you to
not pay attention up there,
but what's going on down here in the arm."
And after they do three or four of them, they'll say,
"Well, yeah, my fingers are starting to feel better,
but it hurts more up here."
That's a good sign.
- That's a good sign.
Or maybe nothing's gonna happen.
Quite often for me nothing happens on in the chin tuck.
- And then we're gonna go to,
you're gonna do a slight chin tuck
and then we're gonna try to extend the neck,
but we really find it's best to do with a towel roll
and you support the neck with a towel-
- Generally to start.
A lot of times you want to have a chair,
that, kind of a higher back chair like here
so you can kinda lean back on the chair itself.
- Right.
You're not really doing like this.
You're leaning back in the chair and going back.
It makes a big difference.
- If you go back like this and it's uncomfortable,
if you do put a thicker towel roll there
you'll find oftentimes it's more comfortable.
And then again, see if the arm is starting
to improve that centralization.
Now you're not gonna do 20 or 30 of these, 20 or 30.
You're just gonna do a few of them.
And after about three or four
it should start to show some signs of centralization.
If it does start to feel better in your arm,
usually we go up to 10 on the first time.
- Right.
- Not more than that.
And then come back to it later.
- You're gonna be doing these quite often, actually.
I mean, we recommend at least five to six times a day,
but you can do it every hour if you want.
- Sure, okay, now if you do both of these and this,
and it's things aren't working, aren't well, it's painful,
there's nothing going on in the arm, don't worry.
We've got more options.
And this is exactly how we approach it.
- Lot's of tricks to try.
- You bet.
So the next one, I did wanna mention this little trick.
And this is a thing about being a therapist,
you learn little tricks that sometimes work.
You can lay down.
Bob, I'm gonna have to...
- Yep.
Lay down, preferably on a carpeted floor.
It's a little bit firm.
And you can do try your chin tuck laying down,
and sometimes dips the-
- Taking the weight off the neck, it helps a lot.
So if it just didn't get better sitting,
You can go to try it laying down instead,
and doing it that way.
- And it's a little easier.
Now you can take a towel roll and put it be under your head.
And it gives you a little more room for the chin tuck,
be gentle with it, be patient.
If it doesn't start to work after a few repetitions,
go to the next one.
- Sure. Now we're doing a little traction, Brad?
- Yep. Little traction.
And you can do self traction, take a towel.
This towel's gonna work better.
- I was gonna say you probably
want a longer towel don't you?
- Yep. Yep.
- You're gonna grab the towel with the arm
that feels better.
- Right.
- Yeah. If you can or have someone help you.
- Right.
I've done this to a patient.
And then I say
you got a family member at home that can help.
And sometimes they say, yeah
and sometimes they say I got a family member
but they're not gonna help.
(Bob laughs)
You gotta watch out.
So we don't have any family arguments
over treatment.
- That's right.
- So I like to spin it up
like you do one of those.
Oh, sorry, Bob.
- Yeah.
- Snaps.
And then we're gonna go like this
and this, again
back into the chair.
Good posture.
Bring your head up in good posture.
And you're gonna go up and you're gonna be
pulling up towards the ceiling.
Bob, can you show-
- Probably a little bit of an angle, right?
- Yep. It, it hooks really well against,
I hope you can hear me,
against the back of your neck-
- So you go on this, this direction here.
Now again, you might grab with one arm, Brad.
- Yep.
- If you have a painful arm-
- If this one's the painful one, I'll grab here.
- Right. Now, it would be nice
if you had someone here that would give you a little pull.
- Right.
- Now if traction works
you're gonna feel relief right away.
As soon as you start putting pressure on the
the pain is gonna drop down
it's gonna say, oh, that feels good.
And then hopefully after that
you can start to do the chin tucks.
- Yeah, the idea is that eventually you're still
gonna get back to that extension.
- Right.
- Cause that's where the magic happens
generally is the farther you go back,
the more the pain tends to go down.
- Right.
More centralization.
- Right, now you might be one
of those cases where that doesn't work at all.
I'm one of those cases where actually you
try side bending toward the pain.
- Right.
- What you do first is you do a chin tuck.
Do you wanna show 'em?
- Yep.
- Chin tuck
and then you side bend towards the pain
and you repeat that.
Chin tuck, side bend towards the pain.
Now, if that starts to relieve the pain,
I had a dentist that this worked beautifully for-
- Sure.
We tried to extension just didn't work.
He would do this and it would just take the pain
and eventually took the pain all the way outta the arm
and outta the shoulder.
- Sure. Yep.
- And he's back torturing people again.
- So once again-
(Bob laughs)
- He doesn't use novocaine?
No, no, he's just, old fashion style.
- So once again you got
radiculopathy in the neck.
No worries.
Take the system.
Work with it.
Be patient, get the Mackenzie book.
It's another great tool to, to use at home.
Yep. You can gift it.
You know, after your neck pain's gone
you can gift it at Christmas to
you know, your sister, your brother, whatever.
- It's a wonderful thing.
(Brad laughs)
It's a wonderful life.
Thanks for watching.