♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the internet ♪
- Hi 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.
- Today, we're gonna talk about neck pain or pinched nerve?
And how to avoid surgery and pain with two self-treatments.
- Right.
Bob, there's too many times I've had patients come in
after surgery and alls they did was had taken
some pain pills, maybe an injection,
and go right from there to surgery,
without any physical therapy involvement.
And it's like, they could've avoided surgery, possibly.
- Sometimes they could avoid it,
sometimes it's necessary right away.
- Right. - I can see that.
But there's cases, I mean, I would
definitely ask your doctor. - Absolutely.
- Say, "hey, could I try some therapy?"
- Right.
- And they'll let you know then,
if it's even a possibility, but.
- Sure.
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- That's right.
Okay Bob, let's go on with this.
If you got that neck pain, you know,
so many people are wondering,
it feels like I got a pinched nerve
or I did something it would go away.
Or, and that may or may not be a pinched nerve,
but one way or another, you got neck pain.
But I'm gonna tell you, if you have neck pain
and you start to feel numbness, tingling, pain, burning
going down your arm, past your elbow,
or even into your hands, it's very possible
and very likely that you have a pinched nerve,
usually up in the low neck.
- Now, if you have a really bad shoulder problem,
it could go down into the forearm.
- Yeah.
- And a very simple test for that,
to see if it's the shoulder or versus the neck
is just move the neck in different directions like this.
- Right.
- And if that brings on the pain,
- Yeah.
- Then, most likely it's from the neck.
- Right.
- And if it doesn't, this doesn't affect it at all,
then it's more likely gonna be shoulder problems.
- Exactly, I usually find rotation, yes,
but almost this.
- Yeah, this is the one.
- When you go back like that it,
oh it hurts here when I do that.
- It hurts there, and it might even send
more pain down the arm.
- Exactly, that's a very good easy self test
that you can do.
- Yeah.
- So people are saying, well, what are the exercises
or the treatments? - Sure.
- Okay, first before we get to it, we have to address this.
We have to address posture. - Yes.
- Because if your neck pain or shoulder pain,
arm pain, came across without any particular reason,
like if you fell or, you know, bumped your head or whatever.
It's just a gradual onset,
it's almost certainly from posture.
- Yes.
- Posture, sitting at the computer, driving, watching TV.
Head forward posture puts a lot of stress on the neck,
and those nerves come all from that area,
and it all works together, so.
- Yeah, the point is, if you don't correct the posture,
and you do these exercises, you're not helping
because you're gonna go right back into the problem.
- Right.
- The posture has gotta be corrected
or the exercise won't work.
- Exactly right, so that means,
you can see the weight on my shoulder,
we need to get those shoulders back, get the head up.
- Yep.
- And really monitor this.
- Remember, for every inch you move forward.
- That's talking about your head.
- Yep, that's 10 more pounds of stress on the neck.
- Right.
- So if you got two or three inches forward,
that's 30 pounds of stress on the neck.
The thing is, you may not even realize your head is forward.
- Right.
- You may need to look in a mirror,
you may need to have someone do some videotape of you,
or a picture of you. - Yep.
- And you might be surprised at
how poor your posture really is.
- Exactly.
- Because it's a sneaky thing, it develops over time.
- So actually, this first exercise does address posture.
- Yes it does. - So you do need a chair.
So, here we got a chair.
And because the first thing to do this exercise,
you gotta make sure you're seated straight,
your head is up, and this chair's really nice
because the back is fairly straight,
and I can go back to that, touch my shoulders
to the back of the chair, and tuck my chin in.
And I have good posture.
And the first part of this exercise is
kind of a progressional exercise, is a chin tuck.
I've had people that had neck pain just doing this
after doing about three or four of them,
maybe five, things start to improve.
Not always, sometimes we have
to add the next part of the exercise.
- And also I've had it where they start doing this,
it actually hurts the neck a little bit
when we're doing these.
- That's true.
- But it doesn't make this worse.
- Right.
- But they, you know, their neck is really stiff,
it hasn't been back in that good position for a while.
So don't be surprised if it actually is
a little bit of discomfort.
- Good point, Bob.
- But it should be a good pain, kind of
like it's gonna feel like it's heading
toward the right direction.
- Right, and this leads into the second part
of this exercise.
Typically, I would have had a towel roll.
People roll up a towel, so it's about like this,
and we got tape on here just so it stays together.
We're gonna put it here,
and just some gentle, not pulling hard, just snug.
And then we're gonna let the head go back.
Let's say you go back like this, and it's uncomfortable,
put the towel roll there and actually lean
up against the chair, relax the shoulders
so you have good posture, and go back and bump
into that pain, and then bump into it again.
And, typically what happens with a lot of people,
is every time they go back with the support,
they go back a little bit farther.
No more than 10 repetitions, by the way,
at a time, is my rule of thumb.
And by the 10th one, it's like it feels better,
a little more motion, and then try the chin tuck again,
and more than likely, you're gonna find
that is more comfortable than it was prior to that.
- Now, if you can go back like this
and it feels fine, then you don't need the towel.
- Right.
- You can not have to use a towel.
The other thing is this is not a one time a day exercise.
- Right, exactly.
- This is an exercise you're gonna do six
to eight times a day.
- Yeah. - I mean, really.
If you're serious about getting rid of your neck pain
and you're nerve pain, you're gonna have
to put some time into it.
- Well, really it's not much time.
- No, it's not much time at all.
- But it's consistency, because it only takes about
30 seconds to a minute to do this.
- And what's nice is you can do it virtually anywhere.
- Right.
- I mean I wouldn't do it in the car.
- No, not driving.
I did want to mention though, Bob, that,
oh, when I transfer people and they start
to do this with less pain, but it's not all the way,
I'll go from this to my hands, and just put your hands
back there, and sometimes that works.
Sometimes I skip the towel and go right to the hands,
it depends on how comfortable it is for the person.
- What's nice about the hands is you can vary
where you put them.
So you can put the pressure maybe up a little bit higher
on the neck with the fingers,
or a little bit lower on the neck.
And that can make a big difference.
- Yep. - On how you go back.
In fact, you may want to experiment around a little bit,
and see which one allows you to go back further.
- Yep, further with less pain, and that's
where you're gonna work it.
I usually find it's a little bit lower here.
I always feel the bumps, they call them spinus processes.
- Sure.
- I usually, around C7, C6 or C7, you won't know that
if you're not a physical therapist or someone in this field.
But that's the...
- I had a patient just who was a neighbor that I had seen,
and he was having trouble with a certain movement.
And we'd use just one finger, Brad, and found a spot,
and he could turn without pain doing that.
I said just keep doing that and I'm going off on a tangent,
here, sorry about that.
- It happens.
- Yeah. - Okay.
The next thing, and sometimes this is all we need.
- Sure. - The first exercise.
Sometimes, if this is not working, we'll go to traction.
- Sure.
- And with traction, we'll do it sitting here.
Again, good posture, always good posture, posture, posture.
We mention that a couple times in our videos.
Take that same towel roll.
Now it's gonna be a little bit hard for me
to do with my mic, it's gonna be bouncing around,
it might throw off my voice.
And underneath the occipital, that bumpy part of your head
right above your neck, we're gonna use that portion to.
- Probably should show them the side Brad.
- Yep, good point.
I'll actually go from the front.
- Front first.
- There we go, you can talk because my mic
is getting out of position. - Sure.
So he's pulling up at an angle, here.
Now he'll show that he's pulling up
and a little bit at an angle.
So you go for what's comfortable.
Again, we're looking for, now if he's having pain
down the right arm, what I often do,
Brad, is grab it with just the left arm.
I don't want to put any more pressure
on that arm than need be.
So he's gonna push up, now you can do pressure on,
pressure off, or you can just do continuous pressure.
And see if that'll decrease that pain,
especially in the arm.
You know, the further the pain goes out,
the worse your neck is getting.
The more the pain starts to centralize,
we call it, come up more into the neck
and stay out of the arm, the better it's getting.
So that's what, if you want to know if it's getting better,
that's what you're looking for.
- Right.
- Also, the numbness, if you have numbness and tingling,
like in your hand. - Yep.
- Or in your forearm, if that starts to get better
with any of these exercises, it's getting better.
- Right.
- If that starts getting worse,
or the pain gets worse, it's getting worse.
Then you gotta stop. - You gotta stop.
- You're only gonna do any of these if it makes progress.
Yeah, there's no pain, no gain, you do not use that.
- No, that's not.
That saying doesn't fit here. - Not at all.
- So you're gonna show traction on me now, Brad so I'm--
- Yeah, let's say that just traction is working,
it's like that relieves it,
it feels good. - You won't be able
to hear me anymore.
- But my arm's getting too tired,
which is pretty understandable.
But you can have, if you have a family member
that you trust, you take the same towel, lay down on a bed.
And I'm gonna put the towel underneath,
and so if I lift up like this, you can see the ears.
And then I'm gonna keep the towel ends close together
but not touching because it kinda squishes
up into the face, and we'll go back like this.
Bob's glasses are in the way a little bit.
Yeah, I would just, I always have my patients take
them off, too, but Bob I was gonna squish his glasses.
I don't care.
But he got them out of the way.
All right, so what I'm going to do is at this point,
I'm just gonna pull up and back.
And I may change the angle and ask Bob,
"Bob, which way feels better, is it up here?"
What is that up?
- No, back.
- Back, this just feels better, okay.
- I don't know why Bob wasn't talking. (laughs)
But actually, I know why, that's a long story though.
Now I'm gonna pull here, and as long as Bob says,
"boy that feels good my arm is feeling better,"
I'm gonna stay here and pull as long as I can.
Obviously I don't wanna get a back ache
or have any problems.
When I do this with a patient,
I can get maybe a minute, minute and a half,
and then I gotta take a break.
Then I let the pressure off and then I'll do that again.
As long as it continues to give good relief.
And that's usually three or four times,
then I'm kinda wore out
and the treatment's completed at that time.
And that can be repeated throughout the day.
Again, posture is a continual reminder.
If you put it on your bathroom mirror, whatever,
so that you have a reminder of that posture
because you don't want to do a treatment, get good results,
and then go back to where you were because of this.
- I gotta say that traction felt pretty good, Brad.
- Yeah, it's amazing isn't it? - It's comfortable.
It works pretty well.
So if you got someone that can help you out,
- Yeah. - It'll make a big difference.
- Maybe I can show your wife how to do it and she can just--
- Yeah she used to wrap it around my neck and pull on it.
That's what she'd do, so all right.
- Take care.
- Thanks for watching.
(cheery tone)