♪ - Bob and Brad, the two most famous ♪
♪ physical therapists on the internet. ♪
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together, we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Alright, Brad, you may be having leg pain
and maybe coming from two, it may be coming from your back.
- Right.
- But there's, you know, lots of possibilities,
but let's go over two main ones that could be causing it.
- Sure.
- One could be stenosis.
- Right.
- And the other one could be a herniated disc.
- Right. And I think everyone knows about a herniated disc
or you know, have heard of it.
Stenosis. You may have heard of, it's not quite as common
but they're actually two very different reasons
why the, why you get pain down the leg.
- And, and you're gonna treat 'em very differently.
- Exactly. And they present differently,
- Sure, right.
- and we, we can tell that kind of pretty easily.
- Yeah.
- So let's talk about a herniated disc.
- Alright.
- Symptoms of a herniated disc.
Typically, not always, but oftentimes, sitting down,
for any length of time,
- It's gonna make it worse.
- Right. Get that pain down the leg going.
- Yep. Once you stand up up.
- Can I show-?
Yep. - Yep.
- We have a demonstration of where the pain often may go.
- Oftentimes it'll, it'll start here or here.
And it goes down, oftentimes down the back, the leg,
sometimes it'll wrap around to the front
but it will go down in a pattern similar to this.
- Yep.
- Okay.
So sitting down prolonged, typically makes that worse.
- Right.
- Also, getting up from a seated position, oh, it hurts,
and everything hurts, and once you get moving-
- Yeah, anytime you're bending that back forward, you know,
even carrying things or bending forward like this,
you're gonna have increased pain with sciatica.
- Exactly.
- So.
- If you're walking, oftentimes,
if it's not serious, it will improve it.
- Right. If it's not really, really bad.
- Right.
- Often, that's one sign we look for,
people say, it actually feels a little better
after I walk a little bit.
- Right.
- Some say it feels better after they walk a little bit
and then it gets worse again, as they walk really too far.
- Right. Yeah. That's pretty common.
- Yeah.
- Now, if you have stenosis,
that's actually a different problem
where the, it's getting pinched from a different reason.
- Right.
- And with stenosis, people say,
standing oftentimes makes it hurt after-
- Almost consistently makes it worse,
- Right.
- where sitting almost consistently makes it better.
So, it's the exact opposite.
- Exactly. Walking usually makes it worse.
Standing makes it worse.
Oh, pain, pain, pain.
You sit down, relief very quickly.
- It's often called shopping cart syndrome
because if they get up and you bend forward
and hold onto a shopping cart,
it actually feels better
- Right.
- when you're walking with stenosis. But, if you don't-
- But, the pain pattern, it can be very similar.
- Yep. It can be very similar.
So, you have one where sitting makes it worse,
which is sciatica.
- Right.
- And one where sitting makes it better, that's stenosis.
- Right.
- Walking makes stenosis worse, it makes sciatica better.
(Brad laughs)
Got it all.
- Yeah. So, treatment.
- So, so what are we gonna do? Yeah.
- How do you treat it?
Okay. If the walking makes it better,
the sitting makes it worse and you it's the sciatica.
- Right.
- Then we're gonna do-
- Press ups.
- And we just did a video on this
and we've done videos on this, but you know
we can link a few of these, but basically,
you're gonna be putting your hands beneath your shoulders.
- Just wait Bob, turn around and do this one.
- Turn around which way?
- Yeah. Stand up, turn around.
- Okay. Oh, you wanna see the, you wanna see the leg pain?
- Yeah. Go away.
- Okay. - Okay.
So, so-
- You see it?
- Yeah.
- Can you see the-
- Okay, so we got the leg pain going down here.
You're gonna lay down. Do, let's do some press-ups Bob,
and Bob's gonna do 10 of 'em.
And as he is doing 'em, I have literally seen this
in the clinic oftentimes.
- So have I, many times.
- The pain starts going away from the leg,
from the foot, going up towards the butt
and then it ends up, up here.
And if you do ten press-ups and that happens, boy,
you know you're doing the right exercise.
- Yeah. It's getting better.
- Right. Now, in the other case,
if walking and standing consistently irritate it
and sitting makes the pain go away,
you're gonna lay on your back like this,
and then you're gonna do double knees to chest.
- Yeah. You bring up one, you might even stretch one first.
- Right.
- And you might even stretch the other one first,
bring it forward and then bring both up.
- Right.
- And then-
- And you'll do about ten repetitions of these as well.
- Yeah.
Pressure on, pressure off, pressure on, pressure off.
- Sure.
- And you can just hold it too.
- Yeah. I mean, and these should be pain free,
it should feel like a good stretch.
- Yeah. Again, that's gonna feel better. I mean, so that's,
- Sure, exactly.
- the opposite treatment, that's for stenosis.
The other one was for sciatica.
- Right.
- So.
- So, as far as repetitions, usually ten to fifteen,
three times a day. You could do more if,
if it's responded well, you can do it more.
- Exactly.
- Only if it responds well. So, what do you say Bob,
stenosis or herniated disc or sciatica?
- I don't know which, what should I say?
Which we covered both, so thanks for watching.