♪ 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.
- The name of the program today is
first step to stopping back pain/sciatica
is to begin walking.
We'll talk all about that.
This video is a part of a series of videos
on treating back pain or sciatica.
If you want to see the entire series
go to bobandbrad.com and click on series or programs
I'm not sure what it's going to be called.
Alright, why do we want you to walk?
Walking, to us is a quick win when you're trying
to help heal your back.
Because when you walk, you're going to have
increased blood flow, increased synovial fluid
the endorphins are going to get built up.
It's like a natural balm for your back.
- Bomb?
- Like a balm, you know like a rub?
- Oh, sure! (chuckles)
But, again, if walking does create pain
for whatever reason, don't try and push through it.
- No, not at all.
That's what we're trying to show you today
is some things to try if you're having pain with walking.
- We'll clarify that as we get through the video.
- Number one, quite often if you're having pain
with walking, it might be because you're walking
with poor posture.
I see a lot of people like this out on the street Brad.
- Sure.
- They're walking along, and they're like this.
What we're going to recommend is you actually take
a broom handle or stick and Brad you can demonstrate
with the Booyah Stik.
And just to see where you're at.
To use it as a locator to determine
what your posture is like with walking.
- Because you might think you're upright
and then you put something straight like the Booyah Stik
along your back and if you're not touching here
in between your shoulder blades and your head
you're not straight, you don't have good posture.
- Right here Brad is just making contact in one position
right on the mid back.
If it's in good position, he's going to make contact
on the pelvis, mid back, and head.
So, a common one is that
people have that head forward don't they Brad?
- Yep.
Now let me get this hand so we can see that.
So, this is very common.
And when the head goes forward
inherently you lose a little bit on the lumbar,
the low back as well.
So when this starts to go forward,
it hits the lumbar, which is going
to directly increase that sciatica and low back pain.
Everything works with each other, with the human body.
There we are and we're going to have exercises
a video on exercises to help maintain that,
so you're body awareness is better.
But just walking, if you have a cane
if it's a short cane, too short
that's a problem.
It's got to be higher, that's why we like a stick,
or if you have a walking stick (buzzer)
that helps keep you up (buzzer)
and reminds you to maintain that posture upright;
three point posture.
- And the nice thing about a walking stick or a cane
is that if you're having pain with walking,
it might unweight the spine a little bit
it might take a little bit of the stress of the spine.
So it is one of our recommendations that you could try
is a walking stick or a cane if you're having pain.
Again, these are all suggestions for what to do,
because the walking needs to be pain free.
Otherwise you don't do it.
The other thing you can do to check your posture,
obviously you're not going to carry the stick along with you
unless you're using it as an guide.
- An aid. - An aid.
You can actually just take you're hands
and put them behind you like this
and pull them back a little bit,
which will pull the shoulders back.
And then at the same time I want you to do a chin tuck.
You're going to bring the chin back like this,
you're not going up like this,
you're not going down like this,
you're just going straight back.
Get all lined up and then walk.
- And I've got tight shoulders
and inherently it's hard for me to reach back.
And there's going to be other people like that,
so if you're having a hard time with that
you can just take
like a glove
or just actually a towel
- A towel. - A towel.
and you can walk around with that.
For me, this is much more comfortable
and I still get the benefits of that better posture.
- You can put the towel around your neck-
- Yep there you go!
- Look like you're ready to finish boxing
or something like that. - Ya then you're cool.
- Ya then you're cool!
Okay, number two,
this might really surprise a lot of people,
but if you're walking too slow...
And I just saw a patient that does this.
He goes, "I'm hurting so I need to walk slow."
We picked up his pace with walking,
actually the stress on your spine is less
when you pick up the speed.
So you want to try and walk a little faster.
And also moving your arms.
Don't walk real stiff like the robot.
I know you're having pain,
but a lot of times, the movement creates
a little bit of motion, helps get that synovial fluid going.
So try to pick up the pace.
See what I mean, I've had many patients that go,
that had a surprise look on their face like,
"Wow it actually feels better to walk fast."
- And I think when you walk faster
inherently your posture improves.
- Good point Brad!
- Just to maintain the balance-
- It's harder to walk with bad posture at a high speed.
Number three, you've got to really monitor this,
and this is the important thing is that you want
to try probably small circles to start off with.
Because you don't want to get out too far
and go, "Oh my God I'm hurting, I can't make it back."
- I always suggest people, if they live in town
just go to the end of the block and come back
and repeat that so you're always close to home,
so when it starts to hurt-
- In case things go bad.
- And actually measure it somehow
either time it or measure it.
I know when my back, and I had sciatica down my leg,
consistently at 3/4 of a mile,
my leg started getting numb and tingly all the way down
to my calf and I knew not to go farther than that.
- The other thing it'll let you know
if you are progressing.
- Right, exactly.
- So that's a great way to keep monitoring things.
We talked about unweighting the spine,
we already talked about that.
Some people too, I think they just tighten up so much Brad
from walking.
You may want to try some relaxed breathing.
There's the one technique we call Foursquare.
You actually breath in for four steps,
hold your breath for four steps,
let it out for four steps
and then hold it for another four steps.
So it's four by four by four by four.
- If you feel short of breath
because you can't make four steps
go to three steps.
Try to get a rhythm.
And I had this happen many times where my back
is bothering me and I'm all tensed up
because my body's naturally trying to protect it
and I'll think about it, let things relax
and slowly get through it.
And then start to pick things up.
And then you realize,
"Oh I was tensed up-"
- You were tensed up and making it worse-
- Anticipating pain.
- This doesn't necessarily need to happen.
Sometimes people taking too long of a stride.
If my foot hits... I really jam
now the forces are coming up through the leg
and into the back.
So rather than taking a long stride like that
I try to hit with my forefoot and my back foot
at the same time my heal.
And just a shorter strides,
a lot of times that helps cushion your body
a little bit more.
So just think about that.
You can walk faster, but shorter strides.
- Nice and smooth walking. - Nice and smooth.
- Don't... avoid hills and avoid uneven surfaces.
- Yeah very good point Brad,
I forgot to mention.
I can't remember which that was underneath
but (speaker cut off)-
- Well that's why I'm along.
- That's why you're here!
The other thing you might try,
especially if you're walking around
and there's some good solid park benches around
you could decompress the spine every so often.
Brad you want to show it over there?
- Yep.
So you go up, and it's best if you can lock your elbows out,
it takes less energy from your arms.
And I'm just going to put my weight through my arms
and I'm unweighting my legs,
which actually decompresses the spine.
And when you do this, the reason you're going to do is it
because it feels good, now if you do this
and it gets a sharp pain, it's not the thing to do.
I do want to mention, when I used to walk
and my back pain was not sciatica though,
it's a completely different situation,
but I would make my back pain feel better by doing this
which you're not going to do with sciatica.
- Probably with spinal ostesis,
but it's a good point that you could do that,
give the pain a little break,
break it up and then go back to walking again.
- And I could keep going.
If you get stenosis, that might be an option.
We're kind of mixing things up a little bit.
- Try this too, this decompression.
- You can do it back this way too, or facing.
- Make sure it's a good solid surface
so you're not pushing on something
that's going to tip over on you.
Also, you may want to tighten your abdomen,
or change the arch in your back.
Try just experimenting around with this,
sometimes people are surprised,
if they just mess around with it a little bit,
there's less pain when they're walking.
- This pelvic tilting, for some people
they don't have the body awareness,
because of whatever reason.
And this can be a little difficult
to figure out.
- Understand or how to do it.
- Understand how you're body's moving.
But if you work with it, and you feel like...
With my back, if I go this way, my back feels better
all the time as opposed to this way.
- And with sciatica it might be more arch in your back
that might feel better, it may not.
Everybody's so much different.
Finally, for you pet owners out there,
especially if you own a dog,
you got to understand if that dog's in a leash
and that dog is one that's pulling on that leash,
you're getting rotational stresses on your back
almost constantly.
And so I hate to say it,
but you're going to either have somebody else walk your dog
or your going to have to teach your dog to walk by along-
- To heal.
- To heal properly.
I can't tell you how many patients who have injured their...
A lot of times shoulders, but in this case a back too
from that jerking motion.
- It is amazing because I've had-
- Well you get a squirrel running,
that's dog's got to hit set.
- And I've had a couple patients that fell
because they got tangled up in the leash
and down they went.
Got to be careful with all that.
So that's it for this video.
Go ahead and check out one of the other videos in the series
to take you on that road to getting rid of your
sciatica and back pain.
- There you go, good luck!
(bouncy chime)