♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪On the internet ♪
- Well, hi there 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, Bob.
- So neck pain, should you wear a neck brace?
Well, if so, you should do this
and this is we're going to get right into it Brad.
So neck braces are cervical collars
or C-collars, cervical being neck.
They support the neck,
they often support and protect the spinal cord
that runs through the neck.
That's very serious if it's good centered
- Yep.
- And it all supports your neck
and it limits motion of the neck.
- Sure.
- So it's really good after
like for short term recovery, after like surgery
injury or if you like like, a traumatic event
like a motor vehicle accident or a sporting injury
and you'll see people, on the TV shows
where someone gets hurt and they right away
they put them on the board and they...
- And that's a very different situation
then compared to like them seeing us
after the fact after the injury.
- I often... when I see a lot of them too
is what people had whiplash.
- Sure.
- After them being in a motor vehicle accident.
Now, it's less often used with a pinched nerve of the neck
or with neck arthritis
or just general neck pain or stiffness.
In fact, I would say, I hope I'm not speaking for you here,
Brad, but I never really used a neck brace in that instance.
- You personally, or with your patients?
- No with my patients.
- I'm thinking the same thing as very rare,
the exception is wearing neck plexi or neck braces
after surgery, or specifically ordered by the doctor.
- Right.
- I've never suggested
that a patient wear neck brace with the exception of-
- I've had a whiplash person that was bad.
Like I said, Oh, maybe you do want to talk to your doctor
about using a brace because she couldn't sleep.
- Sure, yeah but generally not.
And actually the exception I was thinking of with dizziness.
- Oh right and vertigo!
You wear it one night or two nights.
- Yeah and it's not because of your neck.
- Yeah we do that all the time actually.
- Yeah, so in whiplash
one study showed that actually the braces
may not be any good, that early movement is better.
But again, as I already said, or alluded to the fact that
if you're not getting sleep and you're in so much pain
the brace gives you some relief, go ahead and use it.
And then of course following studies that were
the other way around.
- So whiplash, 'cause I think some people may not know,
you're in a car or in a seat and you get hit from behind
and you can do this and your head really goes this big...
and then it come forward, you know?
So your head's going like whip.
And there are a lot of force going to the spine.
- You actually tear the muscles quite often.
And that's what I have found.
Like, I've had people with a whiplash
like they felt like they, they can't even hold their head up
on their necks because the muscles weren't working.
And we're going to show you some things to try for that.
Especially whiplash.
- Yeah. I'm not near so common now
because they have the headrest, you know
for many years now, that's why they put that.
- They can hit that, right, exactly.
Good point Brad.
But in most cases, the doctor makes the decision
whether or not, like you said, in trauma or surgery
they have hard collars and soft collars.
The hard collars are made out of like plastic or plexiglass
and they often have a chin support
and they're better at limiting motion,
but they're not as comfortable.
- Yeah.
- So the soft collars are more comfortable
or felt foam or rubber, but they conform better
but they don't prevent motion as well.
- So it's much easier to put on and take off.
- Much easier
but if you're having like trying to protect after surgery
most of them you find, is in a hard collar.
- Yeah.
- So, if you use a collar, you know, again
we recommend trying to get out of them as soon as possible
but quite often, your doctors are going to determine that
after you get out, there's often increased stiffness
and also strength, decreased strength.
So we're going to show you just the range of motion
exercises you should do after you come out,
if it's okay with your doctor
and the strengthening exercises.
So let's start with range of motion.
The first thing you want to do is always doing that...
If you want to do it from that angle, Brad.
- So if the doctor says, go ahead and do it.
Any range of motion that's tolerated,
that means that does not create any pain
maybe a little stretch pain, but no sharp pain.
- Right. So usually you start with chin tucks
and that's where we're kind of just working
the upper cervical spine or upper neck.
And you're going back, you're backing your head up
and you're not going down, you're not going up.
You're just going straight back.
There might not be much motion there to start off with.
And then you progressed to neck extension.
I think I'm gonna have you show, Brad,
probably cause you gotta...
I usually like to use a towel
just because it gives them support to start of with.
- Yeah it's more cushy.
One thing that we have to mention
is before you do any neck range of motion exercises
you need to be in good posture.
If you start out slouched-
- It's not going to work.
- Yeah. It could cause problems.
So here we are sitting good.
We're going to put this around the neck and you know
a towel roll to start out with can work out well
as you get more flexible, something less bulky
like maybe a belt or a strap.
- Yeah, we got the Bob and Brad stretch out strap here.
This one will settle really well
because you can get right onto specific levels.
- And if you have hand problems, arthritis,
the beauty of that is you don't like here,
you have to grab and hold.
And some people have problems with that
especially if you're older.
- Now we have our head down to or hands up.
- Yep.
And that depends on, you know, what's more comfortable
in your shoulders as well.
Some people have a hard time doing that,
if you're older particularly.
- This is the motion that quite often gets limited
when you're in a brace, is going back like this.
And it's important that you re-establish that.
You eventually want to do it to the point
where you don't have the towel or the straps.
- Sure.
- And you can just get good posture
and then work on going back.
- You might put your hand, put your hands there.
- A good point Brad,
- Lean back into the chair and use that.
It needs to be relaxed, again pain-free
just gentle stretching
or gentle stretch pain at the most.
I just worked with someone over the weekend
and she said, "I was taught
you're never supposed to look back
'cause its hard on your neck."
The farthest thing from the truth
you gotta follow the rules, no pain gentle,
and your neck is made to look up.
- Now, that's not to say that if you look up for hours
you might have pain.
Like if you're painting, you know
you could jam the joints if you're painting for a long time.
- And obviously after an injury, whatever
you're listening to your body or the doctor.
- Neck rotations, you want to get those rotations back.
So you're going to work on turning
into the right and turn left.
Again very good posture when you're doing these
you can do a little bit of stretch, gentle.
You can put one hand behind the head
and one like this and give it a little counter stress.
- I always emphasize to my patients, fingertips only.
You're not going to get your whole hand and crank on it.
- If you've got the fingertips
it's pretty hard to put too much pressure on there.
And if it increases pain, you don't do it, right?
- Exactly. Right.
- If your one direction works better than the other
work on that one direction for a while
and then check the other direction.
The final rotation one or range of motion one,
is neck side bending.
So chin tuck again, kind of side bend to the right
trying to put that ear on the shoulder.
Don't lift the shoulder up to it, though.
You leave it down.
And Brad's fingertip rule also applies here.
You can take your hand with the fingertips
on the same side that you're bending to
and just gently bend to the side.
- The most common mistake with this one, is I have patients,
they look down like this
but you want to keep looking straight ahead
and ear to the shoulder, ear to that shoulder,
as my verbal cue.
- So this is the beginning strengthening exercises
for the neck, works really good with whiplash.
I don't know if you remember this, Brad?
- Isometrics?
- Isometrics.
- We did a video on this back in 19...
(both giggling) - 32!
- It was quite a while ago.
- But yeah, I know they've done many studies on this
and that isometric strengthening
is probably one of the best things you can do for whiplash.
So you're going to go on all the directions here.
Let's first do flexion, Brad.
So you can just put your hand on your forehead here
and prevent yourself from going forward like this
and by doing that, you're going to strengthen the muscles
in the front that flex the neck.
- And if it hurts, if you push really hard,
don't push really hard,
start-off, it should all be pain-free.
- Five second holds.
- Yep.
- And do you do 10.
Then you're going to do extentions.
So going back, put your hand behind your head.
And one, two, three, four, five.
- I think you could, if you wanted to be a little lazy
put your chair up against the wall and use the wall.
- There you go.
- Just an option.
- Sure.
You could do rotations,
so you can just put your... oop!
Okay, I just hit my mic.
Put your hand on the side of your face
and you're stopping yourself from rotating to the left.
- Most people don't wear mics.
- So yeah, that should not be a problem.
And then the last one, Brad is side bending.
Put your hand on the side of the head
and prevent yourself from putting your ear on the shoulder.
Five second holds on all these, times 10.
And you'd be surprised, it makes difference
because you usually don't do strengthened to your neck.
And so it doesn't take much to get into some gains.
- The collar is one of those things
that it's going to take a lot of strength,
plus the injury and the pain muscles relax
and they fatigue and relax and weaken very quickly.
- Yeah, you may have tore some of those muscles
and they're repairing and it helps when you strengthen them
as they're trying to repair themselves.
- Right. Exactly.
- Alright.
- We done already?
- Yep. - Wow.
- Remember Brad and I can fix just about anything...
- Except for...
- A broken heart.
- But a broke...
Yeah, the neck is...
we're on that.
- Yeah. Thanks for watching.
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