♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Is this going up on Saturday, Liz?
- This Saturday. - Oh, okay.
Today we're gonna talk about 90-second exercises
to stop sciatica and piriformis syndrome,
and you can do it in bed.
- Exercise.
- Did I say exercise?
- I thought you said exercises.
- Exercise. - Okay.
- I meant to say exercise.
- Right yeah, this is a very nice exercise to do,
and it just works.
- Well it's almost not even exercise,
because you're just laying there.
- Right. - In a position.
- It's just getting to that position,
and we're gonna show you how to do it.
- We'll probably show you some exercises
in addition to that, right?
- Oh sure, there's always bonus.
- Yeah, by the way, if you're new to our channel,
please take a second to subscribe to us.
We provide videos on how to stay healthy, fit, pain-free,
and we upload every day.
Also, go to bobandbrad.com, go the the giveaway section.
We're always giving something away.
We're in the transition day today,
if it's Saturday. - Yeah.
- It'll start tomorrow, check it out,
what it's gonna be. - Sure.
Go to BobandBrad on Facebook.
On Sunday it'll be pinned to the top of the page.
- Right.
- Twitter, Instagram, or TikTok if you want
a 60-second version of our program.
- That's right, all right, 90-second exercise.
It's like you said, it's not an exercise
like traditionally, you think.
- Right. - It's a position.
- It's a position.
- It's actually positional release
is what it's called, or?
- Strain Counterstrain.
- There you go. - Is what it used to be
called.
- So there piriformis muscle, here in the,
oh should be just, I think it's
a good idea, Bob. - Let's just show that.
- Here, we've got Sam is here to help us out.
- It's kind of our crew delineation, here,
that we made, kind of a model here.
- Right, and this is really nice.
- It actually does work.
- We used a little loops, exercise band.
- And the piriformis muscle is about this size
and it connects to the greater trochanter,
the part of the femur,
and then it goes underneath,
we call the anterior aspect of the sacrum,
exactly like this does
except for on your piriformis
you don't have a G and an E on there.
(laughter)
And the sciatic nerve actually comes
from the back and you can see this green banding
representing the sciatic nerve goes underneath.
Now if this muscle tightens up,
it pinches that sciatic nerve,
therefore getting that sciatica symptom down the leg,
possibly all the way to the foot and toes.
So, we need to relax this muscle.
- [Bob] Yeah, now the nerve can actually pierce
through this muscle, too,
or I had it, Brad, where this muscle was damaged.
- Sure. - It was actually torn.
- Your muscle?
- No, it was a patient of mine.
- [Brad] Patient.
- [Bob] And just by the actions of how it occurred,
it pretty much assured that it got tore.
- [Brad] Right. - I think it healed up
and it healed up tighter.
- [Brad] Sure. - You know what I mean.
- With scar tissue
- [Brad] Scar tissue, you had to break that up.
- [Bob] So, we need to get this muscle to loosen up
to see if that's gonna to take away your pain.
- [Brad] Right, now I'm gonna to show this exercise.
Is that okay Bob? - Yeah.
- Now I looked at some studies on this
and actually they show about 15%
of sciatica comes from piriformis,
usually it's from a disk or something else,
but that's okay
because this series is gonna show you
how that transitions and very efficiently.
- [Bob] Yeah, so basically what Brad's gonna do here,
if you actually have sciatica from your back,
this may be good for that too.
- Yep, this is a win-win.
- So, this is a win-win.
Yeah, this is gonna be...
Tuck your shirt in, Brad, by the way.
- Oh, Bob, I'm sorry.
I didn't realize... - See Liz is upset too.
- Well, she's laughing at me now.
Sorry.
- [Bob] So, that's what's nice about this.
We're gonna kind of show you,
if you have piriformis sciatica, not sure,
try this and see if it helps you,
it may help in both cases.
- So you can do this on your bed,
if it's a really soft bed,
that's probably not gonna to work so well.
- [Bob] If you're sinking in too much.
- Right, then you can use a carpeted floor,
and, you know, that's always fine.
If you want to try your bed, that's fine too.
Now, you're gonna to lay prone, or on your stomach.
You'll probably want a pillow.
I'm not gonna to use it because it's throwing my mike off.
So, just bump that out.
Now, let's say it's on the left leg.
So, I've got that sciatica pain, numbness, tingling,
going down that leg.
You're gonna take the left leg like you're crawling,
but alls you're gonna do is gonna bring the leg up,
like this, okay.
Now, you'll find that, you need to give it a little time.
See if it feels comfortable like this.
If the leg pain starts to go away,
if things start to feel better then you know you're
on the right path.
Now, you can adjust your hips right to left a little bit.
You may want to take a towel roll or a pillow.
You want to grab that
for me, Bob? - Yep.
Brad, are you up on your elbows, or not?
- That's a good...
Bob, you're blocking me, people can't see.
That's an option.
- Okay. - If it feels better
down here, stay here.
If you go up like this, and it clearly feels better,
then do this and then take a pillow
and so you can relax. - Gotcha.
- The idea is, once you find the position
of maximum comfort with the pain in the leg,
you may want to put something like this, here.
- [Bob] Under the knee, or you could put a pillow
underneath the knee. - Right.
So, the exercise is 90 seconds,
but it does take a little bit of time to figure out
the position of maximum comfort.
- [Bob] We're really trying to put that muscle,
that piriformis muscle on slack.
- Exactly.
- [Bob] And that's optimal slack position.
- Perfect.
- So. - So, let's say, I find it
right here, let's say, oh, I need this right about there.
There you go, I'm feeling pretty good.
Then you get your cellphone out or your stopwatch
and then you hit the timer
and you just completely relax.
Think about your breathing,
nice relaxed breathing and take some deeper breaths,
and you must stay for 90 seconds, no less,
90 to 120 seconds.
They've studied this scientifically.
- [Bob] Generally, by getting in this position, Brad,
right, the pain is already gotten better.
- Right. - Right.
- Yep, as things continue to get better,
then after 90 seconds, or a little bit longer,
then you're done.
If, well let's go on,
when you're done, then you're gonna take your position,
you know, your towel roll.
- Position device out of there.
- If you're using one,
and then you're slowly get back
into a position where you can get off the bed
or off the floor, if you're doing it on the floor,
and take your time.
Everything is done slowly, relaxed.
It's not a hurry thing,
and, then, at that point, you know you can move around
a little bit
and then we're gonna recommend going for a short walk,
relaxed walk, on an even surface,
not up and down a hill, or out on the lawn
where it may be uneven surface.
And then, you can go on with your day.
- Again, win-win, this should all these things
could be good for sciatica too
if you have it coming from your back.
The thing is, here, a lot of times, you think about it,
the piriformis muscle, it gets fired up.
Oh, the piriformis muscle gets fired up
and once it gets fired up, it kind of stays cyclical.
You know, the fire up causes pain.
- Sure. - And the pain causes
the fire up even more.
- Sure. - And so,
this knocks it out of its cycle.
- Right. - The pain cycle.
- So, you may want to, you know,
let's say halfway through the day,
six or eight hours later,
it's tightening up again, you're getting similar symptoms.
Repeat this. - Sure.
- And so, you can repeat this a few times a day.
However, Bob, I mentioned before that
typically sciatica is not from piriformis,
it can be. - Right.
- Let's say you did this and you're trying to position
maximum comfort and it's just not working.
- Sure. - It's like the leg pain's
still there, it still hurts no matter what I do.
I position, I put a towel roll here, pillow there,
shift around.
It may be from your disk.
- Right.
- And then, while you're in that position,
you want to move again, Bob, thank you.
So, you went through this, and it's not working.
It's like, geez, this is 90 second thing,
I can't even get to that point.
Well, then put the leg back down,
and then what we're gonna go is into a McKenzie technique.
Okay, actually this is from two different, not authors,
but practitioners
that started these systems.
But then you're gonna, you're here anyways,
you might as well see
if the position release is not working.
Then, get yourself in prone position,
and then start some press ups.
As a matter of fact...
- [Bob] I'll do those.
- Yeah, because my back doesn't bend that way
because of my spondylolisthesis.
- So, you're in this position,
hands underneath the shoulders,
and you're first gonna see, does this position feel okay?
- [Brad] Yep. - I want to make sure
this isn't worse.
Sometimes people have to start on pillows.
- [Brad] Sure. - They have to lay on pillows.
- [Brad] I have a feeling if they can do roadkill,
they probably will.
- I think they probably won't.
- You never know.
- You sometime have to start like this.
- [Brad] Yep.
- And, sometimes, you just lay like this for awhile,
and then, eventually, you take the pillow out,
and it still feels okay.
All right, let's say we get to this point,
put the hands under, and you're gonna do what we call
micro press ups and you're gonna see how the back responds
to that.
If it's taking pain out of the leg,
and it's staying up here in the buttock and the back,
that's a good sign.
- [Brad] Right. - We don't want
the leg pain to get worse.
That's a bad sign.
But you do the micro press ups,
you're not lifting the pelvis off the floor, like this.
- [Brad] Right.
- You're using the arms and you're bending the back.
There's a slight arch to the back.
Eventually, over time, you want to work it to the point
where you get more arch.
And you're still keeping the pelvis on the floor,
it's not lifting up like this.
- When he says, overtime, it might be
by the time you get your 10th press up,
it might be coming better.
Or, it might be a matter if you do three sets
of these in a day, or the next day it starts to get better.
- It might be days or weeks.
I mean, it might take you a long time to get up
to this point.
- [Brad] Right, I'm always more optimistic than Weez.
(laughter)
But it might.
So, one way or another, if it makes it worse,
you stop.
- Yeah, and eventually, the ideal thing is you get
the higher and higher you can get up,
a lot of the times the more the pain starts to go
into the back, itself, and eventually it goes away.
- [Brad] Right.
- So, these press ups can be really quite amazing
if they work. - Right.
- Right, there's other advance techniques that we've done
for those, too, but we don't want to cover all
of those today, do we?
- Right, for example, if you tried these
and the piriformis, the 90 second positional release
doesn't work, this is not working,
then you're gonna have to go to BobandBrad,
go to the sciatic...
- You can put advanced sciatica exercises.
- Right, and then you'll pull up some of those videos,
and we have other options you can try.
- Yep, all right, thanks everybody for watching.
Remember, Brad and I can fix just about anything.
Oh, except for...
- A broken heart. - There you go.
- We're working on it. - It's right here.