♪ Bob and Brad, the two most famous physical therapists ♪
♪ on the internet. ♪
- Howdy 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.
- Brad, today, we're gonna talk about bedridden people
and what kind of positioning you wanna make sure,
I guess this is for anybody who's spending a lot
of time in bed.
We wanna make sure they're in a comfortable position
and they don't have skin breakdown
and they're not gonna get like sore shoulders
and sore backs.
- Exactly.
- So it could be for anybody really,
- Right. - who sleeps a lot.
- Right. If you're in bed for a number of hours per day
for whatever reason from an illness or whatever,
these are gonna be wonderful hip tips.
- It might even be good for just regular people out there
'cause these are good positioning tips for anybody.
- Right. If you have sleeping problems,
let's try 'em out.
- And by the way, I've seen a couple new people
out there, Brad.
- There's more than two, Bob.
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- Right. And you can sleep better with this video.
- That's right.
- Okay. So again,
let's start out with you need the basics, Bob,
a decent mattress.
Typically not a real soft one, not a real firm one either.
It's kind of a little bit of that as a personality thing,
how your body is.
A real thin person may want a different mattress
than a larger person.
- I've seen people take a mattress
and even put it on the floor, Brad,
to see if they'd like a one that's firmer.
- Sure.
- So they put on the floor, lay on it,
and try to sleep on it that night.
If they sleep better maybe they need a firmer mattress then.
- Sure. Exactly.
So get a mattress that works for you.
Okay? And at that point, if you have,
if you're gonna buy a bed and you happen to have
the luxury of having some money to get a bed that elevates-
- Makes the adjustments.
- Yep. You push the button, it elevates in the front
and the legs come up. That's great.
Most people are not gonna have that option.
- Well, if you're cheapo like us
and Brad always laughs at this one, I don't know why
but when we were first married and our mattress wore out
we took a piece of plywood and put it...
- Why wouldn't I laugh, Bob?
- put it between the mattress and the box spring.
And it gave additional support.
- How thick of plywood did you-
Onto the-
- Other things that are less expensive adjustments
you could make for the bed?
What, like this, right?
- Well for example, yeah, you can purchase
one of these wedges. This is a foam.
It needs to be relatively firm.
And why don't you lay down on here, Bob?
And the reason you're gonna possibly need one of these
is if you're getting fluid buildup in the lungs
it's gonna help drain that down
so that you can breathe better.
And things are-
- There are people that have to have this
in order to breathe.
- Right.
And other people, it may not be so much that,
but it gets you up.
And if you aren't able to sit up yet, for whatever reason,
you can eat some food, drink, you can watch the TV.
- That's what I would say. This is just a nice-
these aren't that expensive.
- Right.
- I know what they are, do you remember?
- No, I think they're around 40 or $50.
- So for 40 or 50 bucks, you can put it
underneath you and now you can easily watch TV,
especially if you put a pillow under here.
- Sure. We got a pillow.
- I don't even need to-
Now I can watch TV without being in an awkward position.
- Sure. You bet.
So get that wedge, stay right there, Bob,
'cause there's more.
Also, people are gonna have a lot of times swelling problems
circulation issues with their feet.
And if the feet are below the heart, it's a problem.
We need gravity to help pull that fluid up.
So we have an answer for that and it's called the leg wedge.
Now these are wonderful.
We talk about these for back pain.
- Yeah. - So it's gonna benefit you
that way.
As well as circulation.
- I had a lady contact me on Facebook, Brad, that said
that this was the only thing that allowed her to sleep.
- Oh really? Yeah. I believe it.
- Yeah. She found this answer.
She'd gone to therapy for years and didn't get any response.
And this is what made the difference for her.
- And you can get these for 30 or $40 as well online.
Now Bob's a good example of-
he's a six foot six person.
- Yeah.
- And see how his legs are down.
This is what we wanna avoid.
So if you're a tall person, these,
I don't know if you can get longer ones.
- I don't know if you can or not.
You'd have to look at the dimensions.
- If you're bedridden, you're gonna need a bunch of pillows.
Okay. Now can you lift your legs up, Bob?
If you a little higher there, there we go.
Get one pillow and you might even wanna put two in there.
You see he's still down.
Right now I have a patient who has a lot
of swelling in his legs and he's a taller person.
- Sure.
- And he bought one of these online
and he uses one or two pillows for this exact same reason.
- Gotcha.
- He's got so much edema in his legs.
- And then you can do these.
- [Both] Ankle pumps.
- Right. Get that circulation moving.
Get that fluid moving where it needs to go
towards the trunk.
How do you feel Bob?
- I feel relaxed. I feel like,
I think I'll just take a rest of the rest of the video.
- You wanna take a nap? Okay. I'll finish the video, Bob.
I'll just shake you if I need a little input
or if I need you to move.
But seriously speaking here, this is comfortable.
But if Bob lays like this for more than two hours
it puts him at risk for skin break.
- Yeah, we always want movement.
- Right. So typically in a hospital
or a skilled nursing facility
the rule of thumb is every two hours
we need to shift the person.
- Right.
- So if they're laying on the back,
the next thing is we're gonna go to the right side,
couple hours later we're gonna shift them
to their left side.
But you have to be careful if there's a shoulder problem
or a hip problem, obviously we have to respect that.
So we don't really-
- And we can show you some variations
on how to get around that if you have a shoulder problem
- Exactly. Now when you're gonna roll to one side
or the other, you can't have the wedges in.
- Right.
- Because it's gonna twist your body all up.
So it's time to shift you Bob.
- Yep.
- So we're gonna take that leg wedge out.
Okay. Now, if someone is ill
and they're having a hard time, you may need two people,
one person to help the person adjust,
another person removing the wedges and the pillows.
- I'm putting my mic over here, bro.
- Okay. Yeah. Be careful with the mic.
So we're gonna get the person over to one side.
The first thing that I'm gonna do is a pillow
between the knees.
- That's almost universally a lot more comfortable.
- Yeah. Actually the first thing I'd probably put one
or two pillows.
- You're trying to keep the neck in the middle if you can.
You don't want it too far this way
and you don't want it bent that way.
So right in the neutral position is the best way.
- Right. So straight out.
- And sometimes, Brad, with this pillow between the legs
sometimes you wanna get it between the ankles too.
- Yep. - The ankles are bony.
- You bet.
- And they skin could break down there
if they're up against each other.
- You bet.
- So it's not comfortable either.
- So here, this is a pretty good general position
for right sideline.
- But ideally, Brad, you wanna be back a little bit more
like this, so you're off the point of the shoulder.
- Sure. You bet.
- Go ahead.
- Okay. Which we can't, now, if the person's weaker
just normally you fall asleep.
What might happen is the person goes back like this.
So you may want to take another pillow
and you're gonna wedge it back in here.
- You're gonna wanna invest in pillows here.
- You do need about six to eight of them.
Okay.
- It helps hold me in place.
- And it feels better, doesn't it?
- Right. It does.
It gives me support.
Another variation, Brad, here is if you wanna lay
on that shoulder and this is a great idea
for almost anybody with shoulder problems.
First off, try to avoid laying on the shoulder if you can.
But if this is my painful shoulder
you can take a small pillow, like a throw pillow,
- Right.
- And you lay here
and now you see how I have a gap here, Brad?
- Yep.
- It's like a tunnel or a canal.
And it's not nearly the amount
of stress on the shoulder that there was before.
- Right.
- It's taken away some, a lot of the stress
and then you can even lean back a little bit like this.
This is how I sleep at night, Brad.
I have a throw pillow right here
and I put it right in between.
I lay like this
and my shoulder just feels really comfortable.
- It makes some difference.
- Yes. It makes a huge difference.
- You bet. Okay.
- Where are we headed now, Brad?
- Well, Bob.
- Oh, I was gonna show another one, Brad,
in case the, let's say it's the upper arm
that's bothering you.
Can you throw, gimme two pillows?
- You bet.
Oh yeah, yeah. How can I forget that? Thanks, Bob.
- If you're having trouble with this upper arm,
you're gonna put one pillow here
and then you're gonna put one pillow right up
into the armpit like this.
- Yes.
- Like this.
- Actually, this can be done
even if you don't have a shoulder problem.
- Right.
- It just feels good.
- This is wonderful.
And I know they have those full length body pillows
too, Brad,
- Sure
- that actually can go between the leg
come all the way up here and you can hug it.
And then you'd only need one more pillow, probably
in the arm to help hold it into place here.
So this is a great one for a sore shoulder
'cause we really don't want you laying on it
if you can avoid it.
And so then you'd wanna put it and support it.
It takes two pillows though, Brad.
- Yeah. If you go the one, it tends to do this.
- Yep.
- So you need to have both of them to help it up.
- You bet.
The next one I did wanna cover,
if you're a patient, let's put that back under there.
So you have that there. You'd have to have another one.
But if you have some back problems,
and how you position the legs can affect how the back heals.
- Yeah. It rotates the pelvis.
- So again, another pillow will be needed
and I'm gonna lift both legs.
Let's take the pillow so they can see
what we're doing here, Bob.
I'm gonna lift both feet up.
I'm gonna put a pillow underneath the ankles of both feet
but then we are going to wanna put this pillow in here.
There you go.
- This is good for sciatica, Brad.
- Sure.
- If pain is in, the sciatica is in the upper leg
that's where you put the pillow underneath the ankles.
- Sure.
- And you want to give it a try
and see if that calms down the pain.
- Right.
- So if it was the other leg
then you'd lay on the other side.
- Sure. You bet.
- It'd be going down this left leg.
- So the pillow companies are gonna be happy with this.
- Yeah, we gotta, we're gonna have some endorsements here,
hopefully. Pillow Incorporated gettin' ahold of us.
- Oh my gosh.
Anything else you wanna include, Brad?
- No, Bob.
I think that pretty much covers a good basis.
So get a lot of pillows. Get a good mattress.
And again, every two hours we need to change
because of the skin irritation.
You can get skin breakdown and open sores
that can really cause problems.
- Yeah. Then you got infections
and all sorts of-
- Yeah, we wanna avoid that.
- All right. Thanks for watching.