♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- You should hear some of the conversations
that go on before we,
and together we are the most
famous physical therapists on the internet.
- In our opinion, of course Bob.
- Okay, Brad, today, we're gonna talk about neck pain.
Will traction help your neck pain?
And there's some simple tests you can do to see if it will.
- Sure.
- So, let's start off with,
oh, first off, before you even do this,
you gotta find out whether or not you even qualify
or that you're, there aren't precautions
that you, would make you not even have.
- Right, right.
- Number one, if you have osteoporosis, especially
severe osteoporosis, that means your bones aren't strong.
- Right.
- You're not gonna be pulling up on your neck.
- Right.
- So, Rheumatoid arthritis,
the arthritis is so bad in that the ligaments
aren't holding things like they should.
It's just not a good idea.
- Yeah, and you'll know you have that
cause the doc, you'll be into to see the doctor already.
After a surgery with hardware and your neck,
If they have screws pinning, any kind of fusion in there.
- Yeah, you can't be messing around with it then, so.
- Exactly.
- Or if you've had a fracture, I mean.
A tumor, you don't wanna be messing around.
If you've had some issues with your vertebral arteries
or some blockages, not good to be,
you know, messing out with that.
- Yeah, any of these things that we're gonna do
if you have any symptoms of nauseous
or dizziness at all, you stop.
- Right, yeah, very good point.
- This should be pain free, complete.
- These are, yeah.
These are some of the tests you can do when,
you wanna face first Brad, that way.
- Oh, this is my, the better side though Bob.
- Well there's no good side Brad.
Okay, what we're gonna start off with here is called
Spurling's test.
And what we do is, it's just very simple.
You just bend the, the neck over this way
and then you just push down on the head like this
and if it increases his symptoms,
So, let's say, Brad, I do that.
And you start getting pain down here
or down the arm, like tingling, numbness.
That's a sign that by compressing the spine together,
things are worse.
So, hopefully by distracting the spine,
it's gonna be better.
- Right, so, when you're pushing that pressure down
it is not a great deal of pressure.
- No, it's a light pressure.
I'm just pushing lightly.
- Yep.
- And the same, you know, you check both sides.
You're a little tighter to the left, Brad, aren't you?
- Well, yes.
Now, if, if they get symptoms,
they're gonna happen like when you press,
it's not like you're gonna wait for it.
It'll happen right away.
And you just do it a couple times and you're done, move on.
- Okay, why don't you turn this way, Brad,
this is how I do it.
This is, you're actually gonna do some traction
to the neck, manual traction.
You don't again, you're not pulling really hard.
'cause traction a lot of times is only what
seven, eight, nine, 10 pounds of pressure.
- Well, to start with, yeah.
- Yeah, so I mean, what you're gonna do is, again,
if he's getting symptoms,
let's say he is getting symptoms down this arm,
I'm just gonna grab underneath the chin
and underneath the occiput here
and I'm just pulling straight up.
- And make sure the person is not sitting like this,
- He's in a good posture,
very good Brad. - Up, good and tall.
- Yep, so, I'm just gonna pull up,
pop off his head comes.
Nope, and if he goes, "Oh, that feels good,
and I actually released some of my pressure."
This person may be a candidate for traction.
- Right, and I've seen it with patients of mine
when I do that it happens right away
and without a lot of pressure, they say,
"Oh that feels pretty good."
if that's not the response.
- Yeah, if they go, "Ow, ow."
It actually gets worse and you stop right away.
And there's a whole different issue going on.
- Right. Right.
- And Brad, you're gonna show how you do it.
Checking, a lot of times, as another test,
you might check somebody laying down too.
- Right, now, in the clinic,
this is the way I do it.
If I do someone seated
and I do the traction
and they say, "Oh, that feels better."
Especially down the arm.
Then I take 'em supine
and I'll start like this.
I'll put my fingers, my fingertips, right under the occiput,
can you just relax Bob?
And now I'm gonna pull towards me really gently
and have the patient or Bob just completely relax your head.
This is a very general traction.
I'll see how the response is.
And if they say, "Oh, well, that feels okay."
Then I'm gonna put one hand here
and one hand here,
Bob, can you gently close your teeth together?
Okay, and just gently,
and then I'm just gonna pull this way real gently.
And this is not much pressure at all.
Bob, do you have any diff, any response to that?
- Yeah this feels good.
- And the thing is is they can't talk like this
except for through your,
go ahead and try talking Bob.
(indistinct)
So, so what I do sometimes is very,
if I pull here, if it feels good,
I just want you to shake your head, yes.
And if it feels bad
and you really can't shake your head really pronounced
but you can tell.
Yeah, yes or no.
You can tell when you're holding on,
if it hurts, I'd say take your hand
and say that's for stop.
- I tell 'em to gimme the finger wiggle
if it's bad, stop, you know.
- I like to do the whole hand Bob.
- Okay, sounds good.
- And, and if I get positive response of that
it's too hard to do traction manually.
So, then we'll go to something like the
Saunders Cervical Traction Device.
- Right, we have a video on that.
I'll put that out in the end of this one Brad.
- Yeah, that's a good link.
- The, thing is about the research,
the research is a little bit spotty,
but I think Brad and I have found that
there's times where it really does help people.
- Oh yeah.
- It's, you know, it's one of those things
that you'll find some, the research says, "Yeah, it's fine."
And some of the research says,
"Ah, it didn't really make a difference."
So, you know, if you're, you follow the precautions
there's really no harm in trying it.
As long as you go through the step process, so, yeah.
Neck, you know, it can help your neck pain.
It certainly helps with a pinched nerve quite often
or a radiculopathy, so.
- Yeah, and again, it doesn't take much pressure
and the
the results go right now.
And when that happens, I feel pretty confident.
I don't care what the research says.
I'm gonna do it.
I have good results with those.
It's not a lot of people, but Bob.
- Yeah.
- Beeping.
- And sometimes people wanna do,
they'll do this in addition to some other things
like the Mackenzie technique or something like that.
- Sure, you bet.
- All right, I'll put that video up at the end here.
All right.
- Good, I see it. - Yeah.