♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi, folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we're the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Today, we're gonna talk about
how to use a TENS unit with low back pain.
Basically, we're gonna show you correct pad placement.
As a bonus, at the end of this video,
we're gonna show you a treatment
that you can do along with the pain--
- Two of 'em, right?
- Along with the TENS, yeah, two different treatments
that work with a lot of back patients.
And you can sometimes, by using the TENS,
it calms down the pain enough
that you can do the treatments successfully.
- So yeah, there are two exercises.
- So what we're doing here is,
we're not really showing you how to use a TENS unit.
We're not trying to be deceptive here.
- We do show it on other videos though.
- We show it on other videos.
Brad and I have tried dozens and dozens of TENS unit.
They all worked.
They all work great.
A lot of them are really powerful.
A lot of them work out fantastic.
Some of them have really poor instructions.
So we decided after a while,
after we reviewed quite a few of that,
we're gonna endorse just one brand.
And we endorse the iReliev
because it's FDA-approved, it's compact,
it's powerful, it has it all.
It has good instructions.
- Yeah, they work well.
We're happy with them.
- In addition to their instructions,
we've actually done a step-by-step video
on how to use three of their different models,
the 1313, the 8080, and the 5050.
And that varies from their low-priced one
up to their highest-priced one, which is a wireless one.
So if you wanna see those, go to bobandbrad.com,
go to our program section, and look for the TENS program.
And under TENS program, you'll find a video that says
"1313 Step-by-Step" or "8080 Step-by-Step".
- And along with that, as well as these,
there's PDF print-outs for each video.
- Thanks for reminding me, Brad.
We didn't mention it on the last video.
- Yes, I forgot too.
But that makes it very convenient.
Watch the video, get the print-out,
and that way, you don't have to refer back to the video.
You can look back at the print-out,
and it'll remind you of what we talked about.
- Yeah, if you find this video on our website,
there'll be a print-out of what we talked about today
so you know where to place the pads.
And that's what we're gonna talk about next.
So we're low back pain.
We're gonna show you one-sided, with one channel.
And then we're gonna show you low back pain,
let's say you have a more larger area.
So we'll show two-sided, with two channels.
Now, all of you have told us
that you don't wanna see us with our shirts off.
So we're gonna have our camera man Mike come out,
and I'm gonna be the camera person.
- Oh, you are?
- Yeah, you can handle it, can't you?
- Well, I'll give it a go, Bob.
- I can comment still behind the camera too.
All right, Mike's gonna come on out.
Everybody take note of his Spongebod...
Spongebod (laughs) Spongebob shirt.
That's his pride and joy.
Luckily, Mike is not mic'ed up, so we can't hear him.
Mike, if you wanna go ahead and...
- [Mike] I know the camera can hear me.
- Faintly.
- [Bob] All right, there we go.
So Brad's gonna start off with the low back.
Again, one-sided, that means one channel.
- Okay, so we're gonna start one channel.
We have our pads here.
Typically, all these will come with four pads,
two pads per channel.
We colored 'em yellow and green, each channel,
just so it's easier to see.
They'll come black.
Sometimes they're white.
But they're not colored when you pull 'em out of the box.
It's just for instructional purposes.
Each channel gets one wire,
Which actually has two wires.
- [Bob] Yeah, leads, they're also called.
- Yep.
Leads, pigtails, you'll hear different terminology for that.
So you're gonna take a pad.
Let's say, Mike... My fingers are cold, Mike.
So he might jump.
On the right side, let's see,
belt-line pain right there.
If the pain is right there, it's kind of a focal point,
one option is to put one pad right over the painful spot.
And then take the second pad,
and you could go above.
Now, the big thing you do not wanna do is go too close.
They should never be touching.
You wanna keep the width of one pad,
that's about there, that much distance between.
Or you can go a little farther,
but you're not gonna go way up here.
So you're gonna be that one to two inches there.
And then, Mike could take this and turn it on
and increase the intensity and see how it responds.
- [Bob] Yeah, so it's always an experiment.
There's really no specific right or wrong.
Mike's gonna give it a try.
If it feels good, yeah.
- Yep, leave 'em there.
If he doesn't like the way it's feeling,
it's not managing the pain or reducing the pain,
you could try over here, you could try over here.
I'm not gonna have him pull his pants down,
but we could go below.
We're not gonna obviously go over the cloth.
And one thing I didn't mention yet is,
make sure you clean the skin very well with soap and water.
Dry it well.
Keep the pads clean.
Always keep these plastic keepers,
I'm gonna call it, available.
You always put 'em back on there when you're done
and pull 'em off here.
- [Bob] You can take off the oils of the skin
with soap and water 'cause that would also affect the pads.
- Right, didn't I mention that?
- [Bob] Oh, did you?
- That's all right.
It's really important.
- [Bob] And if Mike has gorilla back with hair on it,
you're gonna have to shave it.
But he looks pretty smooth.
- Exactly, if you do have a hairy back,
you really need to shave it 'cause
that will interfere with the conduction of the current
and the effects of it,
as well as keeping the pads to last longer.
Bob, should we go to four?
- [Bob] No, how 'bout the other option of,
let's say you surround the pain.
Let's say you only have two pads,
but one... Point to where the pain is.
- The pain is still the same location,
but we're gonna go on both sides of it.
So we're gonna cross.
So the current actually goes from one pad to the other.
So just imagine that's where it's going.
We can go there.
You could go here, and then below the pain.
I'm gonna go there, pretend the pain is up higher
so that I can go on the skin.
Or you can, you know, you can go criss-crosses.
It really doesn't matter where you put it,
but you wanna cross the pain.
If the pain is a global area on this side, you could...
are we gonna go four channels on one side?
- [Bob] Yeah, I would also say, Brad, right from the start,
I probably wouldn't put it right on the spine,
right on the boney spine.
I would stay off that area.
I would stick more into the soft tissues.
- Sure, like that, and then over here.
Let's say, if it is,
we're gonna go way up to here.
Let's say it's kind of a global area.
Then, you take both channels,
which works fine to use 'em both at the same time.
- [Bob] Yeah, now he's using all four pads.
- And I'm gonna take channel one and place 'em as such.
Channel two, we're gonna go here.
Oops.
- [Bob] And again, on the PDF,
it's got actually pictures of this
so you can get that reinforced
as to where you might try it.
But you wanna show how the current
travels between the two, Brad?
- Yep, so it's gonna go yellow to yellow,
channel one to channel one,
channel two to channel two, so it criss-crosses,
and that way, you get a more broad area for pain management
and to decrease that pain.
Again, I can get these a little farther apart
without any problem.
I'm certainly not gonna go this far apart.
That's too far.
You know, you can cover one side of the back.
And actually, we're gonna show both sides of the back.
- [Bob] Yeah, if you go both sides of the back,
you could put one on one side and one on the other side.
Yep, just like that.
- And this works nice if it's more central,
but a larger area.
- [Bob] If you're feeling it on the spine,
but we don't wanna put pads on there, there we go.
We got a criss-cross going on.
- Now, I just wanna repeat this again.
I've had a lot of patients where
the pain is at the belt-line.
So then obviously, you gotta drop the pants down.
And you'll have the pads actually on
one buttock, on each side, on each cheek,
and these will drop down.
Then you just pull the pants up over the top.
And that works good 'cause that actually
holds the pads in place a little bit.
- [Bob] Yeah, see what works for you.
- Exactly.
- [Bob] It's nice, you can hook up the pads,
and then you just put the unit in your pocket,
and you've got some relief for a couple hours.
Luckily, with TENS,
sometimes you get some relief afterwards,
even after you stop using it.
- Yeah, that's very common report.
So these would be all hooked up accordingly.
This would go in his pocket
and set it up.
- [Bob] Mike, why don't you come on back?
Brad, you wanna take those off?
- Oh!
- [Bob] And then we'll show the exercise next.
- Okay, so I'm gonna take 'em off.
Like I mentioned before, we'll put 'em
back on the holding plastic, their home, to stay clean.
- [Bob] Thank you, Mike.
- Good work, Mike, putting up with my ice-cold hands.
- He does have cold hands.
All right, Brad, if you wanna stand up,
if you don't mind for a second.
I'm gonna go ahead and jump right into this.
- Yep, go ahead.
- Now, a common exercise for just the average person,
let's say you're not too old.
When you get into your 50s and 60s,
a lot of you are gonna have spinal stenosis
and some arthritis, and this may not feel good.
This is probably maybe for a little bit younger person.
But this is one that you should always try,
is trunk extension.
So what you're gonna do is lay flat on your stomach,
hopefully not crush your tie.
Put your hands right underneath your shoulders,
and you're gonna press up.
And we start off with mini-press-ups, Brad calls 'em.
- [Brad] Notice he keeps his waistline at the belt there.
- Yeah, I'm not lifting up like this.
I'm getting movement in the spine.
And it's kind of the opposite
of what you typically put stress on the back during the day.
You're doing a lot of bending forward during the day.
This helps counteract that,
helps it stretch in the other direction.
And then eventually, you wanna see
if you can get all the way up like this
without lifting your pelvis off.
If you get up to here, then your pelvis starts coming off,
you have to keep working this area here.
- [Brad] Keep in mind, if this irritates,
or if this causes pain, particularly pain down the leg,
then you're not gonna wanna do it.
You should just do this gently.
It should feel good while you do it and after you get done.
- Yeah, people often say, "It hurts so good."
It feels like the right kind of pain.
Now, one that almost everybody can do
would be the gentle, what we call trunk rotations.
So you lie down in the hook line position.
Your feet are on the bed or on the floor.
And you're just gonna keep your knees together.
You call it the windshield wipers, don't you, Brad?
- [Brad] Well, that's what I instruct it to my patients.
If you look at it from your view,
you're going back and forth like windshield wipers.
- So it's like windshield wipers.
And like you said, it's a way of remembering
visually what's going on.
And if this bothers you, going in one direction,
don't go in that direction.
Go in the other direction for a while,
and then try it again.
But this can really loosen up the back.
It's a great one to do in the morning
before you get out of bed.
It gets the back warmed up prior to starting the day.
And this is, both of these exercises,
something you could do not just once a day.
You could actually do it every hour
as a way to keep the back moving and relaxing
and just start combating pain.
How'd we end up so long on this video, Brad?
- I don't know, Bob.
We were just... We'll blame it on Mike.
- Okay, yeah, it's Mike's fault
with that Spongebob shirt.
Thanks for watching.