♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi, folks, I'm Bob Schrupp, physical therapist.
- I'm Brad Heineck, physical therapist.
- Okay, we got the most famous physical therapist
on the internet. - Again, in our opinion, Bob.
- It's always our opinion and it's always right
according to us, not our wives.
- Right. - All right,
today, we're gonna talk about, Brad,
exercises to help heal a bulging disc
versus a herniated disc.
Do we have to do different things between,
you know? - Sure.
- That's what we're gonna discuss today.
You know, what is the difference between the two?
- Yeah, this is a kind of a technical question, actually.
- It is somewhat, but I really believe that,
more often than not,
a bulging disc is probably not even giving you trouble.
It's more often the herniated disc
start giving you trouble. - Sure. Right.
The bulging disc can,
but generally enough I don't think they're bulging enough
to even hit the nerves. - Right.
- So, let's talk about it.
You've got the disc,
which is made up of a tough fibrous, outer lining.
- The green ball, our disc looks like that, Bob?
- Oh, we're doing a little analogy here.
So a tough fibrous, outer lining
and then it's got a soft inner lining
like a toothpaste almost. - Right.
That's the nucleus pulposus. - Mm-hmm.
All right, so-- - Walking with a walker.
We got two vertebrae here
which you'd pull out of the back, right, Brad?
- Right. Exactly.
So this would be like L-5 and L-4.
It's usually the lower lumbar area
that gets the injured disc. - Disc trouble?
Right? - Mm-hmm.
- Now normally the disc, a healthy disc like this,
it gives you a little bit more height
and it helps the vertebrae move without giving trouble.
- [Brad] Right, so your back can flex, extend,
and rotate a little bit.
- [Bob] But over time, if you do a lot of sitting
and a lot of lifting, the back of the disc
can start to wear out.
And eventually, what can happen is we can actually--
- [Brad] You gotta use some real muscle on that.
- [Bob] All right, you to got the angle that?
- [Brad] Yeah, I really don't wanna break our cups here,
but we there have,
I don't know if you're gonna consider that
bulging disc or a-- - That would be
a bulging disc, okay?
'Cause what happens with a herniated disc
is there actually ends up being a crack in here
and some of the fluid starts coming out.
That's a herniated disc.
- [Brad] Okay, so that--
- [Bob] A bulging disc it just bulges like this.
- [Brad] Sure. Right.
- And it's not uncommon as you age
to have a bulging disc.
It's not uncommon as you age to have a herniated disc.
They're very common.
In fact, as you get up to '50's and '60's.
- So, okay, 'cause they've done MRIs
on people without any symptoms, they have bulging discs,
they have herniated discs without any symptoms.
The body has adapted.
It has not pushed into some sensitive nerve or whatever.
- So Brad and I, this is how we approach it.
No matter if you have a bulging desk or a herniated disc,
we're gonna go by symptoms. - Exactly.
- We're gonna treat your symptoms.
What can we do to change and make your symptoms better?
That is the key here. - Right.
And we're gonna even go into a little more detail on this,
but there's some people that have not watched us yet.
And let's just inform 'em on how we continue.
- Right. In case you haven't already,
you know, just new to our channel,
please take a second to subscribe to us.
We provide videos on a stay healthy, fit,
pain free like this and we upload every day.
- Exactly.
Bob, before we go on
I just wanted to show this little model quickly.
- Yeah. Why don't you go up to there.
- 'Cause this is a pretty good real life model
of a disc here.
We've got the same vertebra.
Is it clear Lonnie? - Yeah.
Okay, so we got the L-5 here, L-4 and the disc here.
And they have a little model,
this red bump right here represents a bulging
or herniated disc.
And then, they have an actual little model
of more what maybe a disc may look like.
I don't know if this--
- [Bob] That almost looks like a herniated disc
'cause look, the red stuff the nucleus pulposus
has actually extended out beyond the borders.
- [Brad] Right. Right.
I think this model had a healthy one here
and this was a semi-healthy,
but this is probably more of the shape
and the look in a real disc.
I thought when they'd say you slipped a disc
I thought it would stay like this
and the whole thing would shift over to the right
a quarter of an inch.
And then, you get your back cracked
and it would shift it back in in life would be good.
It's not how it works.
This model, I think, is much more realistic.
- So, bulging disc herniated.
I mean the first thing, if you have a bulging disc,
let's stop it from becoming a herniated disc.
Exactly.
- So one thing you're gonna first do is
make sure when you're sitting you're gonna sit correctly
just 'cause a lot of times it's prolonged sitting that,
you know, quite often now lifting.
I mean, back pain and herniated discs have become a problem
of prolonged sitting, not lifting.
Can I have a rolled towel, Brad?
- You bet.
- So one thing you're gonna wanna do is when you're sitting
in your chair or in your car, you're gonna wanna make sure
that you ...
Just wanna gimme one of those. That's fine.
- [Brad] I got a roll.
We lost our rolled towel, Bob.
- A lot of times what we do is we take a towel
and we roll it up and then we put tape on it.
We just put like duct tape on it.
That way it holds in place.
But you can take a rolled towel.
What's nice about this is you can vary the size.
With some people, especially when they're having
a herniated disc or a bulging disc,
oh, you found it, they want to have a larger towel.
I found that with people that they tend to like
and then over time, as it feels better,
they go to a smaller towel. - Right.
- Put it in the low back around the belt level.
You'll find out where it feels the most comfortable.
And that's gonna put a little bit
of arch in your back and that's gonna help prevent
that bulging disc from becoming a herniated disc.
- Lot of the car seats now, Bob,
have some pretty good lumbar (indistinct).
I've had patients-- - Support, yeah.
They have the, my English.
I've had patients that had nice lumbar supports
and didn't even know it.
I walk out to their cars show 'em how to work it
and their eyes open and say, "Wow, is this nice."
- "Wow, my car does this?" Yeah, exactly.
So make sure that you don't already have it in place.
The other thing you wanna make sure
is that probably limit your lifting
and also lift correctly when you are gonna lift.
Exactly.
This type of lifting,
when you're bending the arm back like this,
this is what helps push that disc out.
So you can even bend your knees
and still lift incorrectly.
See how I'm rounded out here, Brad?
- Yep.
- So do you wanna use the stick real quick?
- Sure.
- Not that you have a stick in place or with you
but this will give you a good visualization.
If I'm lifting correctly, there's contact points
on my head-- - Here.
- mid back and low back.
I'm lifting correctly now.
I keep it all straight.
If I'm lifting incorrectly, there's only one contact point.
- Gap here. Nothing here.
- Even though I'm bending my knees,
I'm still lifting incorrectly.
- Puts much more stress on that area.
- Yep, and that's gonna turn your bulging disc
into a herniated disc,
so let's get those two things in place.
Limit your sitting as much as you can.
We talked about this when we both had back pain.
- Right. - Both of us didn't even sit.
We would either stand or lay down.
I mean, I did that for when I was in the midst of school.
- I've got a friend right now. His wife is an attorney.
She's sitting all the time. She got this same problem.
She bought one of the computer stands that stand up
so she can actually work while she stands at the computer.
- Yeah. Wonderful idea.
It's nice to have those available now.
Do lots of walking too.
Walking is really good for your back.
Gets oxygen to it.
Try to walk for at least 20 minutes.
That's just gonna be good for it.
- Walking on a flat surface.
I mean, if it hurts so bad, you can't walk,
you're not ready for it yet, but when you are,
typically a flat surface, not up and down a hill
or on a crowned road where you're--
- Very good point, Brian.
All right, so then you're gonna start your exercises
which normally the treatment of choice for
bulging disc or herniated disc is the McKenzie Method.
We have lots of videos on this,
but usually what you start off with,
you're gonna start off in what we call
a prone position on your stomach.
And you might start off just by laying here
a little bit.
You let your back straightened out.
Some people can't even lay flat like this.
Sometimes they have to have a pillow underneath them
to start off, Brad. - Right.
As a matter of fact, should we show that, Bob,
so they really do it gist of it?
Just take a pillow right about at the waistline
and that'll make it feel better, tolerable.
- I've had people that had to use two pillows.
And then, eventually they were able
to work away from that, get away from the pillows.
And then eventually, they could get up
to this position on prone on elbows, the prone prop here.
And then, eventually, we start putting
the hands underneath the shoulders
and we start doing press-ups.
Can you see how that might push that bulge back in, Brad?
Can you visualize that?
- Well, I can.
We'll hope that our viewers can, but it's--
- It's bringing the bones together.
So it's helping push that back in.
- And we've got some other videos,
if they look at that model and try and visualize that.
- Now a herniated disc,
you may have to do some other things,
which are kind of some more advanced methods.
But with just a bulging disc,
quite often I think you can just
do press-ups like this. - Sure.
- And then, eventually you want to get all the way up here.
And at some point, sometimes, you need to even do a little
over pressure with a belt or with a rolled sheet.
- Yep. - Do we wanna grab a sheet?
- Sure.
- Okay, so you take a sheet and you're gonna roll it up.
- That's done very well. Like a tornado.
- I didn't really do it that well.
- I know, but you did. You have done it well in the past.
- I've tried.
And then, so you're gonna go long like this.
And now, you're gonna use your hands
to actually give a little over pressure here
and now I'm gonna stretch it like that.
- Can you move this elbow so you can--
- Yeah. - There you go.
Try it again.
So the sheet is actually locking down and putting support
on the low back and that helps push that bulge back in.
- As therapists, sometimes we actually put
our hands on their back and do it.
- Oh, yeah, you bet.
- And provide the over pressure.
- But don't have your spouse do that to you
or your children because they might not know
what they're doing.
Again, I really wanna emphasize Bob, all these techniques
you are only gonna do 'em
if it makes your back feel better.
If the first time you do it, it's not so good,
but you do it two or three times,
and it clearly is feeling better continue.
But after the second or third time, or if you've been laying
on your stomach for a while and it doesn't get better,
you're not ready for this yet
or you may have a different problem.
- It goes back to our whole point, Brad
that we're going by symptoms, aren't we?
- Exactly. - If it's making
the symptoms better it's making the pain go up your leg
and into your back, it's working.
If it's not, it may be making it worse
and so you gotta stop.
- And we've got a really nice playlist.
They're titled under sciatica,
'cause oftentimes they're related.
And if you look at those, you're gonna
get a nice education on how to treat your back.
- I will link that at the very end here, Brad.
I'll put the whole playlist
at the end of the video, which is coming up right now.
- Yeah, it's been very successful.
- I'll put it down somewhere-- - People are very happy
with this playlist.
- All right, thanks for watching.
And remember Brad and I can fix just about anything.
- Except for that-- - Broken heart.
- Oh, you're gonna put it up there?
- Yeah. - Boom, boom.
- Where do you think it's gonna be?
- I don't. - All right, thanks.