- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we have the most
famous physical therapist on the internet.
- In our opinion, of course, Bob.
- Brad, today we're gonna use donuts.
- Mhmm.
- To show you how your herniated disc can heal.
- Oh Bob, come on.
- A lot of people, - A donut?
- Yeah. A lot of people ask this question of us
will my hernia. They get the diagnosis
of herniated disc. - Right.
- And they wanna know if it's gonna heal.
So we're gonna show you right here today that it can.
But first of all, we wanna make sure
that you understand what happens with the herniated disc.
- Sure.
- Right, Brad?
- Sure. Should we start with bone apart?
- Yeah we'll start with bone apart.
- Start with the big picture?
So herniated disk we're talking low back, is a very
common place for whether they get herniated or injured.
So we're gonna look, can you zoom in here, Lonnie?
- You might even wanna come closer already, Lonnie.
- All right. So here are the lumbar vertebrae L5, 4, 3, 2
and often times between L5 and S1 or in this particular case
the model has a red spot here
which shows a herniated disc, represents a herniated disc
between L4 and L5.
So here's the disc.
Here are the two vertebra and it's low in the back,
that's where the majority of the forces
in irritation happens in the low back.
So we're gonna use this model here
and just imagine we pull those two out.
And so we can take a look at that disc.
And we're just gonna quickly show this right here.
Here's L4 and here's the disc.
Now, discs are not like this.
They're not like a solid piece of rubber.
They actually have an annulus or an outside, and inside
there's a jelly and
that's makes them - Here, show 'em like this.
- Oh, there you go. Good idea, Bob.
That's what I like to see some good.
- [Bob] How's that Lonnie?
- There you go.
You see that red?
- [Woman] There you go.
- Oh, that red shade in there.
That's kinda like what they call the nucleus
pulposus or the jelly or the fluid inside the disc.
It's kind like a jelly donut.
That's how we all came to this.
- [Bob] Right.
- This jelly donut analogy.
- [Bob] Exactly.
- [Brad] This is getting exciting now.
- [Bob] All right.
So let's go ahead and show how this works first.
- [Brad] Okay.
- [Bob] You wanna go ahead and
put the ball. - [Brad] Sure.
- This is the disc.
- This represents lumbar vertebra L4 and L5.
This is a really nice model of a disc because it has fluid
and it allows you to bend forward, backwards
rotate a little bit, and a good.
- [Bob] If you do too much bending forward after a while
the back part of the disc
begins to weaken. - [Brad] Right.
- [Bob] And then some of that fluid,
it can first bulge. - [Brad] Yep.
- [Bob] And then eventually it can actually
the fluid in the disc can actually herniate out.
- [Brad] Right. And that's called, is that sequester?
- [Bob] There's a lot of different names
out there actually. - [Brad] Yeah. So.
- [Bob] Some people call it a slipped disc.
So, that's a herniated disc.
So it actually goes out.
So we're gonna show you how a donut actually,
how it works with a donut.
Where's our donut?
- [Brad] Oh, ah, yes.
- [Bob] And the problem back here, there's the spinal cord
and there's the spinal nerve roots.
And so that's when you, if you get pressure from the disc
on the nerve roots, you're gonna get that pain down the leg.
That's sciatic nerve pain.
So that's where the problem begins.
So, all right.
- [Brad] And you'll hear this a lot I think,
in the clinic where the therapist will say
your disc is kind of like a jelly donut
and you may not understand that analogy and now, you will.
- [Bob] Yeah, this is the first time I believe this has ever
been done on camera. - [Brad] Yes. Mhm.
- [Bob] And you are here to witness it.
- [Brad] You better believe it.
- [Bob] So Brad, you wanna be do the honors?
- [Bob] Yeah.
- [Bob] So if you're doing it again, a lot of, let me see
I'll be the guy. - [Brad] Yep.
- [Bob] I'm bending forward, bending forward
doing too much bending forward,
not keeping my back straight. - [Brad] Right.
- [Bob] So Brad's bending forward.
Oh, look at that. - [Brad] Oh!
- [Bob] How it started. - [Brad] Ah!
- [Bob] There comes the jelly.
- [Brad] Ah the jelly! - [Bob] Here comes the jelly!
- [Brad] Oh. - [Bob] It's coming out!
- [Brad] There.
- [Bob] And what happens is it pushes up against the nerve.
- [Brad] Right. Now, in your back,
your fluid inside the disc typically doesn't
drip out like that. - [Bob] Right.
- [Brad] It makes a bulge.
But it could. Now I think that term sequester
refers to when it actually does come out.
- [Bob] Right. And it comes all the way out
and it's no longer attached to the disc. Then you're right.
- [Brad] Yeah, you get that fluid actually into your system.
So what happens then?
- [Bob] So how in the heck can this heal, Brad?
- [Brad] Exactly.
- [Bob] So there's two things that can go on.
One, is your body is just a wonderful thing
because the tissues in your body
after a while, can do what we call resorption.
So they actually make chemicals that are actually
gonna take this fluid
and they're gonna re absorb it into the body.
- Mhmm. Oh Bob.
- So I'm the body, I'm the tissue.
You absorb the tissues
or the fluid.
So, and also can even,
if there's disc fragments. - Yep.
- If part of the disc is broken off, like
if part of the donut broke off here.
- Yeah.
- That can also get re absorbed.
- And then you'll get healing actually
and they'll get tissues that the annulus will heal over.
- Right. But to help that along
you're gonna wanna do what we call the Mackenzie technique,
where you actually do some bending backward.
And I'll actually
put that video up of our. - Sure.
- Our top three exercise
or top two exercises we use for sciatic nerve pain.
- Mhm.
- I'll put that right up here
and you click on that and that'll show you the exercises.
So that's how, I mean, it'll heal.
In the vast majority of the cases, 'cause in fact,
only one out of 10 people end up requiring surgery
with a herniated disc. - Sure.
- One outta 10, that's a really small percentage actually.
So don't get too dismayed.
It is a problem because it is very bad pain.
I mean, it can be very bad pain.
And if it gets to the point where, you know
you start losing function or you start losing muscle,
you may have to have the surgery.
- Right, exactly.
- But until then. - Yeah.
- Keep getting jelly donuts.
- I got some of your chocolate.
- Yeah, that's good.
I like chocolate better than jelly anyways. So, yeah.
Again, we can fix about anything
or tell you how things get fixed in your body
but - Can't fix a broken heart.
- Yeah we're working on that though.
- All right.
- I think this donut thing has got a good, it's going
in that broken heart area.
- I don't think mine has any jelly.
- You got ripped off.
- All right.
- What's going on?