♪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.
- Today, we're going to talk about neck pain, pinched nerve,
how to know if you're doing the right
neck exercises or stretches.
- Sure.
- This is very important because if you're doing
the wrong one, it can make it worse.
- Absolutely, set you on the wrong direction quick.
- So, the common causes of a pinched nerve
in the neck are... you could have a disc problem.
- Mm-hmm.
- You could have degeneration of the bones
to the point where they make the hole smaller
where the nerves come out.
- Sure.
- Um, you could have thoracic outlet syndrome,
and that's where you're getting pinching
between the collarbone and the first rib.
- Right.
- So, and you can also just have compression
from muscles in your neck, so..
- Right. So there's more, but...
- There's more, yeah.
- We don't need to bore you.
- That's right. So..
(laughs)
- Neck pain can vary in, uh, in location, intensity,
depends on your diagnosis and your age and your posture.
But the common locations are, and I got, we got them kinda..
- We mapped them out.
- We mapped them out. This is for a pinched nerve,
but it's very common to have neck pain, of course,
up in the neck itself, um, but then you can also,
Brad, do you want to show them?
- Sure. So, we have, a lot of people may not
be aware of this, but oftentimes there's something called
referral pain, uh, their pain refers
down to the shoulder blade area.
That's very common. I can come over this way
onto the shoulder as the blue tape shows.
Uh, and then if it's a nerve and it's pinched pretty bad,
it's very common that it's going to go down the arm.
Now it may be in the front of the arm,
not always in the back like we have it here,
but down the arm and down all the way to the wrist,
and actually up into the fingers.
Uh, and that's where our neck problems and carpal tunnel
can cross over symptoms.
So, that's something we have to be careful of.
- And it can also be, say,
between the shoulder blades, too, Brad?
- Yeah. I don't have,
we don't have a piece of tape for that, but yeah,
it could radiate down into, or refer down, between as well.
- Sure.
- So those are the common areas, uh,
and if your pain is getting worse,
it's going to go further down.
- Right. Right.
- It's pretty much a rule of thumb that can be relied on.
- Pretty universal.
- Yeah. Um, so like, if you just have shoulder pain,
and it keeps referring down the arm,
that shoulder pain is getting worse.
- Right.
- If you have, uh, just regular neck pain,
not even a pinched nerve,
but the pain is going further down the arm.
- Mm-hmm.
- It's, it's getting worse, so...
- Yep. Yeah, so if you're stretching your neck,
and maybe the neck feels better but the arm
starts to feel worse or it goes down the arm,
that's a big red flag.
- That's a bad sign, so.
- You need to stop that.
- What we're looking for is that your symptoms
are going to improve the farthest away.
- Right.
- Where you're feeling. So like,
if I'm getting symptoms all the way down here into the hand
what I want to see is the hand gets better first.
- Yep.
- Now that could be numbness or tingling
or burning or whatever, but, you know
if you do the exercise, you go
ah, there's a little bit less burning there.
- Yep.
- Just a little bit, I can feel it now.
- Right, you really have to be, uh, aware
of it before you start your stretch.
I always have patients put a number for intensity
on the pain and numbness in your hand and fingers right now,
they'll say a six and we'll do some exercises,
and sometimes they have to think about it.
- Yeah.
- Oh, that's down to a three now.
So, or if it's getting worse from a six to a eight?
Well then, we're going to stop that exercise.
- That's a good point, Brad, because people forget.
- Yeah.
- And it may even, you know, not happen the first day.
They might do the exercise for a couple
of days and then they go, yeah, I can't remember
if it's better or not, but if they go, it was a six
and now it's only a three, I mean, so.
- A good thing is sometimes it's like, oh yeah
I forgot I even had it, where it goes back to normal.
Your mind kind of forgets where it was.
Uh, so writing it down on a calendar
or a piece of paper is a really good idea.
- This is a time, yeah, it's really good to chart.
- Yeah.
- So as it gets better, you're going to see the pain
hopefully get, improve as you move up the arm.
We actually have this tape so Brad
can show improvement here.
- Yep. Yeah, so Bob has these symptoms
and he starts to stretch his neck in a certain way,
and this is what happens the next day.
The pain, the blue represents where the pain
or the symptoms, numbness, tingling are.
Let's say it gets this much better, all of a sudden.
Oh, this part's gone but it still hurts here,
and maybe even a little worse up here.
That's actually a good sign 'cause it's getting better
they call it distally or farther away from the neck.
- Yeah. And, you know the thing is
this could happen the same day even.
- Oh, I've had it happen in the treatment room.
- Yeah. So it might be a couple of days,
it might be the same day.
- Right.
- Either way, you don't want it to get worse.
- Yeah. We don't want it to come back.
Let's say it gets better, but then the next day it returns.
- Or the next day you do an exercise
and it causes pain down here.
- Yeah. That's a negative thing. We don't want that.
- Right. So yeah let's say you're, you come in
and you see me and you're like this.
- Yep.
- And we start doing exercises,
and all of a sudden you have pain down here too.
- Yeah.
- That's the worst sign.
- Yeah, then you gotta stop and change exercise,
and that's what the therapist,
that's our job is to get to the right exercise.
It's just not a global thing.
So let's say we do, we get to the right exercise
and all of a sudden, well, oh, the arm pain is gone.
- Yeah, the numbness, the tingling.
- But it hurts a little more up here possibly.
But the arm pain, the numbness, tingling is all gone.
- Very good signs.
- You bet. We're, I'm smiling as a therapist.
- Yeah, now we're happy.
- Yep.
- It doesn't take much to make us, but this makes us happy.
- And that's nice. A lot of people say
"I thought it was a bad sign because of my neck hurts,
but the arm is better," and then you reassure them,
oh, this is good.
People relax and things start improve even more yet.
Uh, do we want to continue?
- Sure, let's continue.
- Yep, you keep doing, a lot of times the same stretch,
sometimes it has to be modified.
Uh, and then the shoulder pain goes away
and we just have a little bit here,
and I'll have patients while they're doing the exercise,
you know, they can feel the pain dissipate.
- Go away.
- Yep, uh, and you know, those are the easier ones,
and out of all, not everything is this easy unfortunately.
- Yeah.
- It's when it, when it does happen, it's nice.
It's kind of like the miracle in the clinic, you know.
- Yeah, it's fun then. The patients think you're God.
(laughs)
- And then we continue, continue,
and you know, when it comes down to it's just pain
in the neck here, boy, and everything else is feeling good.
That's a really good sign, you continue to work it
and eventually
- Boom, it's gone.
- Yeah. Boom. Wow.
You're feeling much better, aren't you buddy?
- I'm feeling great.
You know, it's funny, you brought that story
about they think we're God or whatever, but
(laughs)
you know, obviously we're not, but uh.
(laughs)
I did my first, one of my first rotations as a student.
I got this patient and she's got better really well.
- Yeah.
- Better, and she, so my, my CI,
my instructor, clinical instructor,
said "Oh, your disciple's here."
(laughs)
She just would go on and on about how I made her better.
- Yeah, it was quite a boost as a student.
(laughs)
- Yeah. The other story I have is, real quick,
my mom had to go into a nursing home to get some treatment.
- I know this story.
- You know this story, and she goes,
"You guys are like Jesus,
you take care of the sick and you make people better."
- Yeah. That's going a little far.
- That's going a little far, so.
Uh, this video by the way is a part of a series
of videos on neck pain.
If you want to see the whole series,
hopefully we'll start.
It's gotta be, they have to all be uploaded,
so it's gonna take a while.
- Right.
- But go to bobandbrad.com, go to the program section.
There's other programs there, by the way.
- Yes.
- And you'll see, find the one on neck pain.
Watch the videos that you just want to watch
that pertain to you.
- Right, just go by the title.
- And check it out.
- Oh, the PDF printout is available for each video
shows a review of the video exercises,
a list of highlights we went through.
There's nothing required for you, except for a smile
and good luck with it. No e-mail or anything.
- We got, uh, fu-future videos that are going to
show the exercise that hopefully is going to work for you.
- Sure. Exactly, yeah, we won't cut you off.
- All right, check it out.
(relaxing music)