- ♪ 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, is someone faking back pain?
- That's the big question you're asking me?
- I don't know.
The thing is this is not a definitive test,
but it does help you start pointing in that
direction to determine, whether or not they are faking.
And we'll talk about this more,
but it it's called Waddell's,
or, it was invented by Gordon Waddell.
He's an orthopedic doctor from Scotland.
- Oh
- I dunno if he's still alive or not,
but anyway, he came up with these tests,
and there's not, you know,
it does not mean if they're, if they're positive,
and we usually do five of them, and if three
or four of 'em are positive, then you start thinking
is the person faking?
or is there an emotional component that's really
enhancing their responses to
- Right.
- Your tests.
- They had a real bad experience.
And they're just so anxious
that it's gonna flare up or get that stabbing pain.
It's it's like that,
And this is usually done by a physical therapist,
a physical therapist assistant you, you know,
you can do it if you're not a therapist,
but we're the ones that normally use this thing.
- Right. We're the ones that see a lot of patients,
so we start seeing when something seems a little abnormal,
cause I don't do these on everybody by any means.
I'll start to do these,
if I start seeing something a little weird, right.
You know, and I have two,
I'm gonna give it just two examples, real quickly.
One, definitely, person was faking,
and I've only probably had one or two people
in my lifetime that were faking clearly.
Yeah, clearly.
And the other person, no, it wasn't emotional component.
She was abused as a child and she just, you know,
her pain scale was always 20 from zero to 10.
I mean just one
of these people you could tell emotionally, not stable.
- Right.
- So, all right.
The first test that we like to do is called,
why don't you go ahead and stand up Brad,
and we're gonna go ahead and just put, all I do
to the person is I put some gentle pressure on the head.
Now this is for back pain,
so this, you know, I'm seeing Brad for back pain.
He's been acting a little strange.
So I go ahead and I push down on his head really lightly.
There's no way,
there's no way that even put pressure on his neck
to be honest with you,
and, and yeah.
Your reaction, Brad.
Yeah. Oh, oh, it hurt my back.
All right,
so the second test that's similar to that is
you're gonna put your hands on your
sides down on your legs,
and you're gonna wanna kind of twist from the knees.
And as you see from this,
there's actually no stress on the back whatsoever,
because the back's moving like a log or rotation.
- The arms are acting like two splints.
- Right, so that's, yeah,
so it's... all my motions for my ankles and my knees.
- So there's no stress on the back at all.
And if this increases their pain, again,
it's a possible sign.
So we're gonna go distracted now, Brad.
So everybody knows like, go ahead
and lay down flat on your back, Brad.
a lot of people know that this is the test for
back pain, for a sciatic nerve.
You bring your leg up and then you bring the foot forward,
and they'll have increased pain with that.
So that's not, that's fine if you know, Brad has that.
Ow, ow, ow, it hurts.
- Right, pain here.
- Yeah, going down my leg.
But then later on when I'm treating him,
I'll have Brad sit up,
and I'll do it in the seated position.
Not even saying anything to him
I'll just bring the leg up like this,
- No problem.
- Yeah, he has no pain.
- Yeah, scratch my foot a little bit.
- Yeah.
- Yep.
- And if he had it laying down,
he should also have it seated now.
Otherwise that's inconsistent.
And again, there's an issue going on here.
If, if the patient is telling me that they have like a
a sensory loss or numbness
or tingling throughout the entire leg,
- Right.
- You know, not, not front
not back cuz usually it's in the back.
- Right. And, and all the therapists,
we know the dermatomes right.
Where the pattern of the nerve typically responds.
- Right.
- You know, so if they have numbness
throughout the entire leg, there's your sign.
Yeah, so.
- And is that it?
- No the other one is that kind of falls
in that same category,
if we're testing their muscle strength
and this is one that,
it takes a little bit of experience to know,
but when you push, and something's weak,
it just kind of gradually gives away like this.
- Yep.
- But if someone goes like this
and all of a sudden they just give, like that,
that's not normal.
- Right.
- That's not how muscle strength usually gives way.
The last sign is, is, Brad.
If they're just over exaggerating everything,
like go and I just touch and, oh, oh, oh, oh,
you know, they're just, I mean. So again,
those are five signs you can look at.
And again, does not mean that they're faking for sure,
- Right.
- But if it does, you know, if I'm a surgeon
I'm not gonna do surgery on a person like this,
you know I'm not gonna jump into surgery
'cause, this person's gonna come
out and probably still have pain.
- Right.
- Cause it's an emotional component.
So that emotional component may need to be treated
along with the back pain.
- Right, exactly.
So, it's like,
if you have three out of the five are positive,
but if it's five out of five,
something is going on.
I had someone that had five out of five, and like I said
one was a faker and she ended up settling with
an insurance company, with the insurance company,
and the other one, like I said was an emotional component.
So alright thanks for watching.
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