♪ 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're the most famous physical therapist on the internet.
- Well in our opinion of course, Bob.
- Real common problem here, Brad,
I've seen a lot of patients,
peripheral neuropathy relief in feet and legs.
These are physical therapy treatments.
- Right. This is oftentimes related to people
who have diabetes, it's very common with that,
so which is becoming more
and more, unfortunately, more prevalent.
- It is, and I saw two patients yesterday
with peripheral neuropathy
and it's really difficult to live with
because it does get very painful.
- And interferes with your balance,
your walking, a lot of other things.
- Yeah, it can cause falls.
cause you can get foot dropped and such.
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All right, the thing with what's going on,
with peripheral neuropathy,
peripheral means the nerves
on the in the extremities basically
not the spinal cord we're not talking about.
Or the brain.
These are the nerves that provide motor function
and sensation to the extremities.
And in some fashion they're damaged.
I mean, that's what peripheral neuropathy is.
There's an abnormal addition of the nerve.
- Often time a gradual, starts with very little bit maybe
in the feet or the toes and kind of works its way
approximal.
- Yeah. Right.
And it tends to be more common
in the feet than it in legs than it is in the hands.
I mean, but you can get them in both.
- Sure.
- And there are medications and stuff, which, you know
our goal today is going to be
you want to increase the circulation to help promote healing
and regeneration.
Now I read at one point Brad, there was
like a hundred different types of peripheral neuropathy.
That's that's how many different variations are of it.
But, and you know, the
the amount of regeneration you get may be minimal.
But what you definitely wanna try to do is
stop the progression of it.
- Right? If you can't reverse it, stop it
from getting worse or getting worse at a slower rate.
- Right.
- You know, unfortunately, that may be the best you can do
- The best you do, right.
So you'll want to first get a medical workup
because there's a lot of things that can be
causing peripheral neuropathy that are maybe
a lot more easily treatable, such as, a vitamin deficiency.
One that you can treat easily
but it would be alcoholism.
I mean, you gotta stop, stop your drinking
obviously in that case.
There's medications that can lead to this.
And of course, diabetes that we already mentioned.
- Right, but along without circulation is a base.
A basic need for all of,
no matter what type of neuropathy have.
Circulation's very important and it's gonna help.
- So let's start off with the first one, Brad.
I like to always do a stretch to the calf.
Do you wanna give me a strap or a strap right up in there?
- Sure! We'll just use this one, Bob.
Funny we have one here.
I can't get to it.
No, you can use a belt or you could take a
a rolled up sheet.
Here's the stretch out strap.
Or we haven't used this one in a while,
have we, Brad?
- No, but it still works, Bob.
It last a long time.
Now here's a towel roll.
You could do that if you want.
- You don't need to buy anything
but this does have a nice loop
and you can go ahead and put it in there.
- It works better.
- And then you can put your hands
in the loops and it's just really easy to do.
- If you have problems with grip,
the loops are really handy.
They take that problem right away
and he's getting a nice stretch
his ankle and in that calf muscle.
- Yeah. And one of the reasons we wanna stretch it is
because if this muscle starts to become weak
the one that helps hold your foot up,
all of a sudden you're gonna find out
you're going to lack the ability to bring the foot up.
And then you're gonna start dragging your foot
when you walk.
- Right, you get that toe dropper or foot drag.
- Foot drop.
Then you're gonna start being more likely to catch your toe,
and then you're gonna be more likely to fall.
So, I mean, you wanna keep this stretched out
and you wanna do it on both sides.
A good 30 seconds to a minute stretch is all you need to do.
- And usually works better with the shoe
on cause it kind of grips
to the strap you can do with the shoe off,
but the shoe on is a little easier.
- Now these next ones you can do just on the bed like this
but it might be helpful to have a
foam roller or we have a rolled up sheet.
Remember that Brad, too?
- Oh yes.
We'll just use this one.
- Yeah. Just take a rolled up sheet.
We got some tape around it to make it easy
but this is nice cause it brings your foot up.
- Right, it elevates it.
- So you're gonna wanna start doing,
you know, the ankle pumps
and these are ones that I would not only recommend doing it
during your exercise period.
But throughout the day you should be trying to
perform these ankle pumps
while you're seated, while you're
- Right, you don't have to have it elevated.
If you're sitting at an office desk
do them all, you're seated.
Still gonna get some more fluid moving.
- Yeah. And then you're gonna do circles too.
- Ah, yes.
- You're gonna go clockwise and counterclockwise.
And if you don't know which one is which,
it doesn't matter.
You just do both.
- You're clear.
- You're eventually gonna get to the right one.
- Just don't tell anybody you don't know which way
is which.
- We try to keep it a secret.
Okay. Next one Brad, is a nice one to do is
is actually just straight leg raises.
So I'm gonna lay down.
- And now you might think why
or was he just doing straight leg razors,
cause it's got nothing to do with the ankle.
- Exactly.
- But it does.
- It does because you want to promote circulation
through the whole leg.
The arteries, you know, coming from up the
in the body here, the vein femoral nerve artery vein.
So you wanna make sure that you're working everything.
I put the one leg up like this
and you just start doing some straight leg raises like this.
- And you know, one thing, you know
the fluid all has to move this way.
Anyways, if you've got, if you're plugged
up here and it's not gonna circulate through so to speak
it doesn't really get plugged up.
But you know, we want that motion
that fluid moving throughout the whole leg.
Plus you got gravity when you're up here
you got gravity working down
which is a big help, you know, taking of it.
- Those are not that easy to do either.
By the way, I was starting to feel it by the
in the 15. Of course I got a long limb here.
- Yeah, he's six and a half foot tall.
He got a six foot leg, you know.
- All right, then we're gonna do hip abduction, Brad.
I don't know if this is my best side
but we're gonna go ahead
and go out and start doing some abduction here.
I'm keeping the to straight forward.
- I'll stand here so you can see your leg.
- I'm not going like this.
I'm not going down like this,
I'm going toe straightforward.
- So he was talking about, you know, if you didn't see
that, because the tendency is for this to happen.
So keep it this way and that's gonna work the
the stabilizing muscle, make your walking more stable too.
- So I'd say just again,
you don't have to take a long time.
A lot of these you can do in bed before
you even get out of bed.
- Sure.
- And a good set of 15, you can work on in doing that.
So then we're gonna go ahead, Brad
and we're gonna go ahead.
You wanna show the standing ones?
Just get behind a chair.
- These are good.
I like these throughout the day, even.
Could you pan this way?
Yeah, get Bob out the picture, he's out of camera time.
- That's right.
[Bob] so you'll do heel the toe raises.
- And this is one, you know
just to have some balance here.
You know, I had someone
in the last year he had peripheral neuropathy and
he was pretty, he couldn't feel the ground very well at all.
And he had a hard time doing these
but we did have him do that to get more circulation.
His fall rate was pretty high, actually.
He couldn't feel the floor with his feet.
So that's unfortunate, but he was a walker,
and you know, that was helpful.
[Bob] Can I emphasize, I would do these throughout today.
Not just pick one moment and then you can go
to the single, he's gonna go ahead and do single leg.
Oh, single leg raises too, Brad.
- Oh yeah.
I wanted to do some hip objections, first.
- [Bob] Yeah. That's a good idea.
- And then,you make sure you get both sides.
Notice the toe is not pointed out
but like this.
- [Bob] Brad is a Maverick.
He just, he basically does.
- Well, you know, once I get my mindset, Bob,
you're not changing it.
You know, my wife knows that
and you know it well enough too.
- [Bob] Yeah, I do.
- Soon. Liz will also.
When this is too easy, and some people, you know,
especially older people,
- [Bob] They may never get to this.
- They may not get to the, the single leg.
- [Bob] That's hard work.
- Right.
But if you can, that's a good way to progress to it.
So, and it's important that you go back up
and pull the toes up as well as get the heel up.
They're both important muscle groups
for walking for balance circulation.
- [Bob] And then speaking of balance bread, can you just
show how you can go ahead and, and balance on one foot?
You can maybe start with both hands.
- Both hands on the cupboard,
on a good solid chair, not a flimsy chair.
And you can just stand just last week I had, this is what
a woman of mine, she, this was one of her exercise at home.
Stand on one foot and see if she could do it.
You know, if you're 60, 70 years old, you know
you can go for five seconds.
You'll probably balance is fairly decent.
- [Bob] Yeah. And you may wanna start
by hanging out with just one arm.
As the progression two arms to one arm to no arms.
- Yep. And then you can actually have go to fingertip.
You know, three fingertips, one fingertip.
And I'm not kidding either.
- [Bob] Well, it makes a big difference.
- Yeah. It does, one little touch
like that can make a big difference and then like this.
So, they're all good exercises to do
whatever you need is for
- All right, we're gonna mention one product,
and I feel a little bit bad
about this because I have not used it on somebody
with peripheral neuropathy, but it makes big sense to me.
We've mentioned this in a different video,
it's a massage or for the feet.
And I'll tell you, the response has been on our end, as far
as using it on people inside like our clinic and stuff.
I mean, I haven't found yet a person that hasn't loved it.
I mean, they, it's just I've had many people say
that they were having foot pain for quite a while.
They started using this and their foot pedaling went away.
Now again, it's not gonna make peripheral neuropathy
go away.
- Right, but some of the symptoms will be feeling better.
You know, this actually compresses put some pressure
on the leg to help push
out some of the fluid if you have some edema
but then it massages particularly the bottom
of the foot with some rollers.
- Yeah. And I wanna definitely try this
with somebody with peripheral neuropathy.
So if you guys are out there and you wanna come in over
to our clinic and judge.
But anyway, it's the hopfu.
H O P V or H O P F U Shasu foot massager.
- You gotta say Shasu, Jasu.
- And it's got two holes in there you go ahead.
I'm just gonna stick one in there right now.
And it does have a heating setting
but the heat is very minimal.
I hardly even feel it to be honest.
- It's not gonna, it's like, and in the wintertime
you're not gonna warm your feet up.
Right. But you're gonna get the massage and the compression.
- It's got three different modes.
But to me that that's not that important to me
the most important mode is the strength mode.
There's a low, medium and high.
And I would definitely, if you get this
start with the low to see if, if you know
you can tolerate it and then move on to the medium.
And if you're a younger person,
you maybe go to the high
or if you have pretty decent feet, you can go to the high.
- Sure.
- Cause I can go to the high, Brad.
- Yeah. The high is, it is a little on the aggressive side.
- Yeah, it is.
- It's good to start low.
And you don't have to do one foot at a time
like Bob is, you know, you can put both feet in.
- No, you definitely wanna put both feet in.
- Well, I didn't know if you were.
- Yeah. There's no reason why I'm not.
- You got slip-ons put them in.
- Okay, okay!
- You know what, what are people gonna think?
- Yeah. Now I can't get my foot in there
cause it's being massaged right now.
I have to wait.
- Hold on.
- People aren't gonna hold on,
they've get things to do, Bob.
- No, they will.
Okay. All right,
as we you're going off into the sunset
we'll just remember we can fix just
about anything..
- Except for
- A broken heart.
- There you go.
- But we're working on it.
- Enjoy.
- Thanks.