♪ Bob and Brad, the two most famous physical therapists ♪
♪ On the internet ♪
(clapping)
- 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.
- Pumped up, Brad. - Pumped up.
- Okay, how to treat sciatica and spinal stenosis
or spinalostesis.
- Spinalostesis.
- I always say it wrong.
This was actually a request from a retired French doctor.
- Oh really?
- Yeah, on email and he said he had both
and he was a big fan and he was hoping
we could help him out.
- We have had requests for this on our panel section
over the years, so it's about time we take care of it.
- We tackle this.
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So the first thing, maybe we should talk just a little bit
about sciatica and spinal stenosis, spinalol--, whatever,
however you say it.
With sciatica generally what we're trying to do is avoid
flexion like this, especially flexion movements,
rounded out posture, slumped posture.
Unfortunately, with spinal stenosis that is the posture
that feels better.
- That's a little more comfortable than standing up
or particularly back a little bit.
- You might have even heard of shopping cart syndrome,
like when you have spinal stenosis or spondy,
you tend to want to lean on the cart
because it feels a lot better.
- Yesterday I just worked with a gentleman,
shopping cart, he said, I feel so much better
when I go shopping and lean on my cart.
I can walk as far as I want.
How does this stuff just fall into place, Bob?
- I don't know, but you know the thing is I had one lady,
the problem with that is then over time you get to the point
where you can't even straighten up anymore.
So we're gonna recommend, I don't know if you
want to show a spondy or not.
Probably don't need to show it, do you?
- That's all right, we're show how it works later.
- She was to the point where she couldn't straighten up
any more than this.
So the first thing I want you to do is do not play
into the flexed posture.
Even though it feels better I want you to stay
as straight as possible.
We want to keep that spine as straight as possible.
Whenever you do any lifting or bend it all should come
from the hips.
You want the movement here.
This should stay as straight as possible.
If you are already flexed a bit or bend over,
we're gonna start you on pillows here.
Or prone.
- Right, and if you've got sciatica from a disc problem
this is gonna help with that as well.
This can be a little tricky.
This is not a straightforward thing.
So we're gonna go through some detail on us
and there's gonna be options and you'll see what works
best for you.
You'll know what works best because it feels better.
- Pain, we don't want to increase pain
with any of this stuff.
This lady, I had her start on three pillows like this
and she couldn't tolerate less than this.
I mean if we took away any one of the pillows
eventually we were able to get down to two, and then one.
But she never got down to zero.
But this is just a great stretch, you know.
Relax for five to ten minutes.
If you can, you can put your chin up on your fist like this.
But the idea is eventually to re-stretch your back
so that you can get back to straight again.
- Right, we've gotta get, there's a string on your shirt.
We can't have that.
- All right, next we're gonna take out a pillow.
We're gonna work our way down, it's a simple as this.
It might take a couple days,
you might be able to do it day one.
That's gonna be up to the individual.
But you want to get as straight as possible.
If possible, you do want to get down to this.
And maybe even this.
- Now you'll body will let you know.
You'll either have a back pain or if you develop pain
down your leg, numbness or symptoms,
those are big red flags that means you're going
too fast, go back to another pillow and give it
some more time.
- Well Brad has spondy, can you lay like that?
- I can lay flat.
It's not real comfor--,
after a few minutes it's not comfortable.
I don't lay on my stomach very much at all.
- Right and I think it's okay for you to do
for three to five minutes, right?
Or maybe three minutes, whatever it allows you.
But look at Brad, you have good posture, Brad.
You're not crooked, you're not bent over.
- When I got back to here it's a little uncomfortable.
When I go back farther and I repeat that I'm going
to have a back ache the next day.
- But you're keeping as straight as possible,
that's part of your deal.
And you have a grade two?
- Yeah, it's grade two.
- It's fused now.
- I hope so.
I haven't had x-rays for a few years,
but it feels much better so I feel comfortable.
- I think he's a great example of someone who again,
that followed these tenants to keep as straight
as possible despite.
- Right, posture, posture.
- All right, the other thing you can try, number three
is you can actually try some decompression on the spine,
or traction.
Now we're gonna show you a simple way to do it.
It does involve a purchase.
You need to get the hanging handles.
And we're gonna have a link below about where
to purchase them.
Less than 50 bucks, but these are great.
I use them all the time.
I just have them in my office and when I take a break
it's just a great way to decompress the spine
and actually good for the shoulders, too.
- If you had a pull-up bar you could do that.
- You can do a pull-up bar, that would work too.
This is just a great thing because it kind of keeps
your back supported at the same time.
So want to go ahead and show it, Brad?
- So back up against the wall.
- Again obviously these are going to have to be put
into a stud.
It comes with these anchors, too.
It comes with the whole device here.
- Yeah, this is a nice thing.
You're going to have it level so that when you're standing
you can grab here and you're not hanging.
And you're gonna see I'm just gonna slowly go down.
And as you do this, this should not create any pain
and should just feel like a really good stretch.
And if you have sciatica you may even have a point
where as you get the traction on your back
the leg symptoms and pain gets better.
And if that happens it's gold.
Then you're gonna want to hang 20 to 30 seconds
and do that repeatedly as long as the leg pain goes away.
- You can do it in shifts kind of here.
And what's nice about this is you can do it every hour,
or every 20 minutes, whatever you want to do.
I even try this, Brad, sometimes.
I even do it this way and do some hanging.
I also have done it where I hang.
Of course, I'm taller, but you actually pick your feet up.
But you can actually just do gentle rotation
if it feels better.
If it doesn't feel better you don't do it.
- Right, all these are with caution.
- These are great for the shoulders, by the way, too.
We had whole videos on that how we can help decrease
shoulder pain, too.
- Those impingement problems.
I'm gonna hang a little bit more, Bob.
I'm just gonna hang out.
- All right, we'll go to the next one, number four.
Okay, the fourth thing we want you to do
is some nerve flossing.
And this is for the sciatica, basically.
It can help desensitize the nerve if you're getting pain
down your leg.
Basically we're trying to pull the nerve from one end
while releasing it from the other.
Now warning, this can make your pain worse.
If it does, I mean we're gonna have you try it once,
do a set of 10, wait a day and see how it did.
If it got worse you're gonna wait another week
before you try it again.
- Sure.
- If it was the same or better, then you can keep
doing it every day at least once or twice a day
for 10 reps.
- Sure.
- So let's go ahead.
You need a high table or a bench where you can swing
your legs a little bit.
They can swing underneath.
- Like here, this gets in the way so that's not good.
But I can go out a little bit.
- Yeah, it's not bad.
Same with mine, I'm kind of hitting this bar right here.
- I could go past it when I make an adjustment
on the table.
You probably can do some kind of adjustment.
You'll see once we do the exercise.
- So you're gonna straighten the side the leg pain is on,
I can get it out, Brad.
And at the same time you're gonna extend your neck.
Wanna make sure you completely extend your neck.
Don't just move your head like this, move your entire
neck like that.
So straighten the leg, extend the neck,
and bring the toe toward you.
Then go down, we're gonna show it slow right now
and then we'll pick it up at the speed.
Go down, flex the neck, flex the knee,
and put the toe down towards the floor.
We're going up, straighten the leg, extend the neck,
toe towards me.
Going down, flex the knee, flex the neck,
toe goes down to the floor.
Okay, we'll pick up the speed here a little bit, Brad.
See if I can talk fast, too.
Okay, extend the neck, extend the knee, toe towards me.
Going down, flex the knee, flex the neck, toe goes down.
Extend the neck, extend the knee, toe goes towards me.
Flex the neck, flex the knee, toe goes down to the floor.
We get the idea, Brad?
- Yes, be careful with it.
If it's not comfortable, you get some pain with it
or the leg pain gets worse, maybe if you've got sciatica
or a disc problem that's so bad that this isn't tolerated,
stop doing it.
It should feel reasonably comfortable.
And like Bob says, wait 24 hours, see how it responds to it.
- Yeah, you can try it again in a week
and if it's still stinging you you've gotta forget it.
You've gotta do these other things if you can't do that one.
All right, number five, stabilization exercises.
These are always great to strengthen the core,
but you want to strengthen the core without really
bending the core of extending the core.
- Trying to keep that neutral posture.
- I'll show the first one here, Brad.
This is a great one for you want to strengthen the front,
sides, and back of the core.
So we're gonna show you a real simple one.
You can put your hands underneath your back,
underneath your spine to give it support like this.
And you're gonna lift your elbows and you're just
gonna raise your head towards the ceiling,
right towards the ceiling.
- You see how when Bob comes up I can just get my fingers
under his shoulder blades.
And then you know you're abdominals are working well.
- And you can start off, I don't know, you can start off
with a set of 10 or 20.
Do whatever you tolerate.
This should not increase your pain at all.
- [Brad] If you have never done sit-ups before,
10 is going to be probably enough.
- Probably plenty, right.
So then we want to get the sides.
You want to show a beginner side?
This is just a side plank.
- So you're just gonna bring your feet out about two feet
from the wall.
Keep them together, keep your body straight.
Don't let it sink in like this.
And tighten up that stomach.
The leaning against the side will activate the side muscles.
So you get the side of the muscles engaged.
And you can stay here for 30 seconds or so.
Probably best to do both sides so you get even.
- Now if that's too easy for you, you can go ahead and try
on the floor.
So all you're gonna do is bend your knees like this,
your elbows like this and you're just extending your butt.
I mean you're extending your legs here.
- Getting in line, tighten up everything.
Make sure you breathe while you do this.
- What I do is I do sets of 10, Brad.
I count to 10 seconds, relax, then do another 10 seconds.
I do like a set of four.
I just don't do that many, but that seems to be enough.
The final one, I'm gonna show this one real quick, too Brad.
Is the pointer dog.
You're going to be in this position here
and you're going to slide your leg back
while raising the opposite arm.
Now if this is too hard for you to start off,
you might just want to start with the leg,
or you might just start with the arm.
But I'm trying to keep the back real straight
while I'm doing these.
How am I doing, Brad?
- Good, good, you've really got nice posture Bob,
I'm impressed.
Wow, you've been practicing.
- It takes a lot to impress Brad.
All right, so that'll give you some stabilization exercise.
We go into greater detail on some of these things
on our other videos.
But this is basically what you want to try
and hopefully that will help decrease your pain level.
- Sure.
- Thanks for watching.