♪ Bob and Brad, ♪
♪ The two most famous physical therapists ♪
♪ On the internet. ♪
- Hi, 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, Bob.
- All right, Brad,
it's no secret out there.
We're big McKenzie fans.
Aren't we?
- Right.
- Robin McKenzie,
he came up with some treatments for the spine, neck, back,
and he actually does the extremities now, too.
- Exactly.
Arms and legs. - But when we have somebody
with neck pain or with a pinched nerve,
the pinched nerve causing pain down the arm,
this is probably our, it is our,
number one go-to approach.
Wouldn't you agree?
- Yep, I would agree.
- Absolutely.
So today we're gonna go over some of the basics
of the McKenzie approach,
but you know,
we recommend that if you get stuck,
and you're not getting better,
that you may wanna go ahead
and seek out a McKenzie therapist,
and I'll put that video on the end of this one
on how to find one.
- Right.
And they're worldwide.
- Yeah, they're worldwide.
Exactly.
What did we decide?
36, 38 countries, something like that.
- Right, mm hmm.
- So definitely a lot of them in the United States.
- Right.
- So basically, what we're trying to do, Brad,
is we're trying to,
if you're dealing with a pinched nerve or neck pain,
a lot of times you're getting pain
Does that show up, Lonnie?
I know this looks like an alien, but--
- You got really good artwork, Bob.
- Yeah.
- You're getting better.
- Yeah.
- Now, this is the back of the person.
That's why you don't see the face on there.
- Exactly.
- And this is a common pain pattern.
You might have it going down into the shoulder,
down into the back of the arm,
down into the arm itself,
and even into the hand.
And that includes numbness and tingling.
- Yep, that's very common.
- Yep.
And you also might have it in the shoulder blade.
- Exactly.
Matter of fact, we just had a viewer ask about this,
and this would be a good one for him to watch.
- Yeah. So the big thing about this,
with the McKenzie exercise,
what you're trying to do is
to get the pain to, what we call, centralize.
You want it to come out of the extremities
and go into more of the base of the neck.
- Right.
And you wanna go from the distal to the proximal.
We're using some therapy words here.
So the extremity is the arm,
and we want to get it from the farthest point,
would be the fingertips
if it went that far,
and have it come back,
just like a thermometer going backwards.
That's what I always tell my people.
- Good analogy.
But what we really don't wanna see
is that it actually goes away here
and gets worse in the arms and the fingers.
- That's no good.
- Yeah.
So the exercise,
what you're looking for when you do the exercise,
is that this may start to go away in the first, you know--
- Here, let me help you, Bob.
- And then eventually it goes out of the arm.
I know I'm not doing this perfect here.
And then maybe it goes outta the shoulder blade,
and eventually it's stuck right here,
and eventually then it'll go away.
It could even get a little more intense in this area.
Couldn't you say, Brad?
- Right.
But it's usually not that intense where you can't take it.
It's just more intense.
And that's the center right there,
the low part of the neck.
- Right.
- Right about where the collar is.
- All right.
Well, the first thing you need to do, Brad,
is you have to make sure you correct your posture.
If you're working,
and you're like this all day long.
- Yeah.
Working on a computer.
- I don't care how many times you do these exercises,
it's not gonna help
because you're gonna go right back to that.
So you need to make sure you're getting your ears lined up
with the shoulder, shoulders lined up with the hips,
that type of thing.
And this first exercise helps you a little bit with that.
So the first exercise we're doing is neck retractions.
That's exercise number one.
So basically, you're taking your chin
- Your chin tuck.
- Your chin tucks.
So you're going back.
We've showed this one many times.
Talk about like a pie in the face.
- I thought you wanted me to do a high five, Bob.
- Oh no.
- Yeah.
So yeah.
If something's coming at that part,
you just say, "Whoa."
You back up.
You know, an option for this,
if this doesn't work or it makes a little problem,
you can--
- Oh yeah, absolutely.
You can do it laying down.
- As a matter of fact,
I just gave this information to one of our viewers
last night
when I was responding.
And he said it hurt when he was doing the chin tucks
in the seated position.
Well, make sure you try it in a position like this.
So now, the back of your head does sometimes--
- And sometimes, Brad,
I even use a little towel like this.
It makes it easier then, the chin tuck.
- And that position, the change in position,
the weightbearing, changes a mechanics slightly.
And you may have--
- Not so much chin down,
yeah, chin back.
- I like it better like this,
but you could certainly use something in there.
- [Bob] Yeah, it enhances, sometimes.
- Even your hand if you don't have a towel roll.
- [Bob] Yeah.
So if you try the exercise sitting up,
and it's painful,
maybe try laying down.
- Right. - And that's gonna be the same
for exercise number two, Brad, which is--
- An important point, Bob,
the first time or two,
it may not help.
But if by the third time,
if you start to feel some changes,
some things feeling better,
then you're gonna go repetitions up to 10.
So you need some repetitions in there,
but usually not more than 10.
- And that's a good point, Brad,
because actually, it may hurt a little more even at first
for the first couple reps,
but it should start getting back to normal very rapidly,
and then eventually, it should start feeling better.
- Right.
If you get seven or eight, and it's not improving,
and things are actually getting worse in there,
stop.
- Yeah, you need to see a therapist then.
I mean, it is just no way about it.
All right.
Next one we're gonna do is, actually,
we're gonna do extensions,
but again, what's good about the chin tucks is
it's getting you a good posture.
The next one,
I'd like you to find a chair
with a nice solid back like this.
And you're gonna,
a lot of times you do a couple chin tucks
to warm up a little bit,
and then you're gonna go ahead and work on going back.
Now, you can go back
to the point where it starts to really hurt
then back off.
- Right.
- You can work halfway,
go back,
and then eventually you want to,
the key with all these is to really get back
as far as you can.
- As long it's making it better.
- Right.
As long as it's making the symptoms down your arm,
or in your back or in your neck, better
- Right.
Centralization is getting out of there.
- You wanna show the towel, Brad?
- A lot of times I'll have people and my patients,
they'll start doing,
the chin tuck is doing good,
and then they'll get back to here,
and oh, and they can't really do it.
So I'll have them take a towel roll,
put it here.
And with that little bit of support,
not pulling hard,
but just a little bit of support,
and then all of a sudden,
oh yeah, that feels better.
and then they can go back,
and then you can help pull your head up too,
a little bit.
So in the initial phase,
that towel roll can really be helpful.
- I do it a little different. I use the edge of the towel.
- Oh yeah.
- Quite often, I'll use--
- I was taught this way too,
and then I just--
- I like the edge on the towel.
- There's a name for that edge, but I can't remember it.
- Yeah, I think there is.
And I like to bring it up actually
towards the eyes like this.
And then the arms go along with the neck like this.
- Yeah. I learned that, didn't we learn that,
in Mulligan class?
- Could be.
Yeah.
And then you can go different levels.
You can go a little bit lower,
a little bit lower,
and see how it works with that.
Now again, Brad kind of alluded to this,
but with all these,
you're gonna do the exercise 10 times,
and you can do it five to six times a day.
I actually tell my patients to do it every hour.
- Sure.
Yeah.
- And the reason I tell them to do it every hour
is because I know they won't.
I mean, nobody can do everything every hour.
They get busy,
but they end up doing it five to six times a day then.
So that's a good start.
Same thing with this one.
If this is just too tendered, not working,
you can do this off the edge of the bed.
You can go off like this,
and you can take your hand like this,
and you can just lower yourself like that.
- This is the one where I really do like to use the towel,
the whole towel because--
- Oh, that would work too.
- It's a little more control.
- Yeah, more control.
- [Brad] Again, we can't emphasize this enough.
You're only gonna do these if they improve and--
- If they're improving the pain.
- And they're gonna improve it by the 10th one,
you should feel clearly better than the first one.
- Right.
Certainly, not worse.
I mean, maybe it'll stabilize.
Maybe it's gonna take a little bit,
but yeah, you'd like to see something improving in the hand,
or if it doesn't go all the way to the hand,
it's not going into the shoulder as much.
- Yeah.
If you can eliminate the symptoms of tingling and stuff
from here to here,
and this is gone,
well, that's good progress.
- Yeah, 80% of the people get better with this,
80% of the people.
All right.
The third exercise, this is the one that helped me, Brad.
Let's say having pain on the right side.
You're actually gonna do,
first you're gonna get into kind of a good position,
good posture.
And you're actually gonna side bend towards the side
- Towards the side of the symptom.
- Towards the side of the pain, yep.
So chin tuck towards the side of the pain.
- And again, we should say symptoms, technically,
because sometimes it's numbness and tingling.
So we wanna include everything with this.
- Yeah, the numbness and tingling might get better.
I had a dentist that did this one,
worked beautifully.
I mean, this didn't work.
This didn't work.
Went to this, and it went right away,
and he had it all the way into his hands.
- Did you get some free dental work?
- No, I didn't, as you can tell.
- The old barter system didn't go over.
- So that one works out really good.
Again, with all these,
there's a lot of different things
that can be tried by a therapist that works with you
and that's been trained in this.
It's a four day course just for the back,
or five day course for the back.
- There's a four for the lower back,
three, I think, for the neck.
We took it.
It's been a few years.
- Yeah.
So I mean, there's a lot of different things
that can be tried,
so if you're not having any luck,
I would seek a McKenzie therapist.
- Exactly.
- Again, you won't be disappointed.
This is your best chance of getting things resolved
without surgery
or without being heavily medicated all the time.
- Exactly.
The whole concept is learn how to treat yourself.
- So watch the videos at the end.
If you're having trouble with your lower back,
I'll put that one on the end too.
- Over there?
- Well, I don't know.
It'll be somewhere. - Okay.
- All right, thanks.
- Take care.