Hi folks
I'm Bob Schrupp physical therapist, Brad Heineck, physical therapist. Together we are the most famous physical therapists on the internet of course in our opinion of course. Today Brad
we're going to talk about sciatic pain
exercises that will work for you, now we're talking about two different types of sciatica at least two
maybe we'll go to three, we'll see how much time we have and
really depending on what type you have you really need to take different approaches and
that's why we're here
Together we've got over 55 years of therapy experience, and we're just taking all that from our knowledge history
I have to add it up, but I think maybe more than that, pushing on that 60-year marker. Yeah well
We don't want to think about that
We're gonna educate you on how to kind of self diagnose so that you use the proper
exercises that are gonna work, give you some things you can try and see if one works for you
And if it doesn't, maybe try the other opposite
method. By the way if you are new to our Channel
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Okay, let's start off with the first category, okay, so sciatica
Let's just go to the basic, it means you got some back pain that radiates down one leg
And it can go usually past the knee, down to the calf, the ankle, and the foot, you get pain, numbness, tingling
and even weakness if things are really getting bad. Right now I have a patient
His just goes right down to his calf right here
It's specific and then three of his toes are very numb
And we're having some success with getting rid of that. We're having little problems, but
This is exactly the same mindset that I use when I work. There's always problems
Yeah, I mean it usually doesn't go smooth, right, but that's why we've got options
Okay, so if you're in a situation
that your legs symptoms, whatever they may be, numbness, tingling, burning
Etc, if they commonly get worse with sitting or when you get up from a chair
It's kind of hard to straighten up, but once you get moving it improves
or if bending over, if those three things increase your symptoms and pain down the leg and
Walking usually feels a little bit better then
We're gonna give you five options of exercise, these are the ones you're gonna want to try if that's what you're feeling
Oh, yeah, and generally if it is worse, in 80% of the cases
this is gonna help, if bending forward makes it worse. So the first thing if walking typically feels good
That's the first thing is get out and walk more
Make sure you walk on the flat. Don't walk up and down hills or a road that's crowned make sure it's flat
That's gonna be the best thing for it--and don't walk beyond the point where it starts hurting
It could be a little troublesome if you get out so far, and you can't back
Yeah make sure you can call your wife or family member, they can come pick you up with a car if you're two miles out
You'll usually walk around the block or something
You're close to home, something manageable, but the walking really is good for your back, it almost always is good for your back
Unless it's making your pain worse and we're gonna talk about that in a little bit
Okay, Bob. Should we go to the gold standard exercise?
All right
You're gonna want to start with again the problem has been bending forward so the solution is bending in the opposite direction
And a lot of times we start off with
sometimes people can't even lay like this can they Brad, they have to start with a pillow underneath them and that's alright
I don't need to show that right now
Hopefully if you can lay without the pillow, you may want to lay here for a few minutes and sometimes
even get up on the elbow for a few minutes
The gentleman I had worked with yesterday
He would be in this exact position and his leg symptoms in the calf and the toe: back to normal
within a minute. Wow and it was like it was just that easy
then you want to progress to get a little more aggressive, if you want to start putting your hands underneath your shoulders, and you're
gonna start pressing up
The key to this is that you're keeping the pelvis on the bed, you're not lifting the pelvis up like this
If your back is really tight, which often it is in sciatica
Because you haven't been bending in this direction, you may only be able to go this high to start
And this is exactly the case with this gentleman, my patient
I have now, he gets about this high, and then his whole pelvis comes up, so we're working on that
So one thing to do is just gently start stretching it more and more
But the other thing is to actually take a strap or you can take a roll sheet
We like our yoga strap here don't we Brad. That's a nice product, so what's nice about this
it's got the loops. You can put your hands in the loops and be comfortable
I was using this this morning Brad to stretch my hamstrings
And I could relax and so I was trying to wake up so you can see here now
I can give a little over pressure and it can help stretch it more
And if you want to work your way up on the loops, you go like this and stretch it even more
And I can keep going up the ladder here
That doesn't contrast well with my shirt does it, well the red's okay, I've been flipping it yeah
This actually feels really good.
What's the next step Brad, because I know there's some variations here, we're gonna show. Right well actually
Well, yeah, you just stay there. There's one in the middle here I'm going to throw out that I always have people
Just try quickly is some self traction
so at home if you can get a couple chairs or a countertop and
just go between here and gently lift yourself up, trying to keep your core relaxed
So we're going to use the weight of our legs as traction and our low spine to help
separate, get the gap where that nerve is coming up
Take that
stress off of there and get rid of the symptoms, now if this is gonna work, it typically works as soon as you start taking
weight off right there. It's like oh that feels good
So he can lean forward a little bit, put his weight on his toes
I'm not going to
do this because I'm too tight in the stomach
We just sort of stay relaxed here, lean forward and gently take the weight off off your feet. If this works
this is something you can do every hour sure I mean
We're not saying you will do it every hour, but that's how often you can do it
So you can do it five times a day four times a day and this one you're gonna know it right away, now the gentleman
I'm working with, this one does not work for him at all
but it's okay because your other ones work great right but
It's an experiment quite often where we got our crazy lab going here, so
on your back, this is a
rotation, on my back, yep, okay
This is gotten me out of trouble a number of times with patients where the prone press
that's not working, haven't been shifting them and
So you bring the knees up like this
Now this with a patient you do it on a table
But if you're doing this by yourself, you can do it on a carpeted floor because you don't want to fall off
And we're just gonna rotate this way
and
back, you know this one. Yeah. Yeah, actually.
Generally what you want to do is go to the painful side, first
because if the pain is going down this leg you want to bring it up and
go this way and what it does, it actually opens the
little hole that the nerve comes out, the frame,
I wanted to use a layman's term here
and they can actually gap in and give you some relief, so one thing I do is I
have the patient lift up your butt a little bit and shift away
Yep, so you're already kind of in that motion, it just helps, one of those little tricks
all right, and then of course the roadkill and
why do they call this roadkill? I'm not really sure
But you could call it whatever you'd like. Again it would be the painful side, right yep
We're going to assume the painful side is my right side, the right leg
So I'm gonna bring the leg out like this and you can actually put the foot
touching the opposite knee, right looks kind of like a figure four looking down from the top
Now typically if this one works, as soon as you put the leg up there things start feeling better
Okay, and then you can add the press up with this
And sometimes as a variation of that people just take a towel, you were thinking that
We've been working together a long time haven't we Brad?
So he puts a towel just underneath my pelvis and you can try that without the roadkill
and quite often that'll do it, another one just real quickly Brad is you can shift,
Yep, you can shift your hips away from the pain. Yeah, so I'm making a banana
Show the banana yeah, so if you're looking down from the top
The right leg is painful so you're gonna shift your hips
Yeah, and it
And then you do the press up with that shift in there, so basically we have this big bag of tricks
And we keep pulling them out to find out which one's gonna work. Now if you find yourself
normally, you're like this and
you're kind of hurting, and you can't straighten up, and you feel like you're walking crooked like this
Then if your shoulders are shifted to the left, you're going to take your left shoulder
Go to the wall, this arm I'm going to bend, I'm going to hike that shoulder up a little bit.
Putting it right here
Because I'm shifted here, and I'm gonna actually make the shift go away gently
I'm gonna press in here and straighten my back
And I'm just gonna do that gently and over periods about five to ten repetition, now
as you're doing it you're getting straighter, and the leg pain feels better
The whole thing about it is you if you have this body shift, you have to do this or you're
You need to get straight up and down, you have to get straight
So after doing these then you'd feel like you're back up in line. You may be doing this for a couple days
And you can do it gently and be careful with it and you'll do fine alright
Let's talk about the other situation
Where you actually have pain down the leg, a lot of times more often in this case,
I think the pain is often down both legs
We're talking about the other type of sciatica
And it often goes down to just the knee. It doesn't go down further. I know ones I've seen anyway. Well
Yeah, I'm not gonna, I don't agree with that, but that's alright, either way, it's the same treatment
Well, it's just in my experience. Yeah, so and well talk about the symptoms Brad
Well whether it's down both legs or one, but either way standing in one spot usually starts to irritate the back and the leg pain
Walking and if you find yourself with a grocery cart, and you lean forward it feels better
Yeah, they actually call it grocery cart syndrome and that's a really big sign
is if you lean forward and if feels better when you're walking
Or when you're standing and you're walking and that leg is bothering both legs, and if you sit down and it
consistently improves as soon as you sit it's like oh man
the symptoms come out of the leg and then what we were just describing and you're doing the opposite things actually
you want to bend the back in the opposite direction
Right and this is a much simpler protocol, isn't it Bob
So you're doing a single knee to chest first
so I'd
probably start, if you're having pain down one leg
or down both legs, either way you start with one leg like this. And you give a little bit of stretch here
Start pressure on, pressure off, pressure on
These should feel good, this should feel like a nice healthy stretch
You can also do it on this leg, stretch it, then you're gonna stretch both
by bringing one up first and then bring the other one and then go ahead and stretch like this
Now if this is difficult for you to do, you might have to take a sheet or a rolled towel underneath it or
you can again take the yoga strap
and you can go underneath like this and this works out really good because you get into the loops
This is for people, if you're a
rounder person, you don't have to, you have shorter arms, you can't reach your knees. It's not uncommon
Pressure on, pressure off, pressure on, pressure off,
Alright, then hook line rotation. Yep now
This is a little different than the one we showed you before, the one we showed you before you actually
In this one before we brought it up and went over, this time
we keep the heels down
And I call this the windshield wiper because you just go back and forth like windshield wiper and you're gonna
just go gently, if going one direction is uncomfortable, avoid that direction, go the pain free way
And typically the other way will loosen up with time
Again ten to twenty reps of these is good, this is a good one to do out of bed in the morning
Or any time you lay down
Yeah, you wake up real quick with that so, all right the last one Brad is kind of your deal, isn't it?
Yeah, this is one, because I do have some
Stenosis in my back and it typically goes down
one leg and my left when I put my leg up on a step at home or on a chair
But I usually just step and I'll just go like this and I'll stretch and I'm really flexing that out
And it just feels like a good stretch, and it makes that leg feel better quite rapidly
So you can try that one. So you like it a lot like when you're out and about like watching an event or something like that
Track event and I'll go up to the bleachers, stretch it out like that
That's a good little tool, for that tool chest for you to try, so all right Brad well
we better wrap it up here, we're way over time, I didn't realize that, the way time flies. Thanks for watching.