♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together, we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Okay, today the title of the program is
Advancement and Progression
of the Number One Sciatica Exercise.
We're gonna assume you watched the video before this
in the series, called The Number One Sciatic Exercise for
Disc Bulging and Herniation.
This is the advancement of that.
- Right. - All these videos
are part of a series of videos on sciatica.
If you want the series, go to bobandbrad.com
and go to the program section.
Completely free, have no strings attached.
We don't ask for email or anything.
Just watch it.
- Right, it's a heck of deal.
- It's heck of a deal.
It's got a printout too.
- Yeah, the printouts are great, so you can refer back to it
and not have to watch the video.
And you may need to, but oftentimes,
just the reference will trigger your memory,
that recall memory, and you'll be fine.
- Okay, so on the last video where we left
off is that you were laying--
You had got to the point where you had progressed.
You could lay like this or even lay like this.
Lie like this, Brad, I'm saying it right.
Lie like this, and it wasn't making your pain worse.
It might have even been making your pain better.
- Right, and as we mentioned, if it's centralizing,
in other words a symptom numbness, pain,
whatever, is moving, is out of the foot, out of the leg,
and seems to be going up, it might be getting a little worse
up here but better down here.
That's a good sign, as long as it's within reason.
- Okay so the next point, the next progression in exercise,
you're gonna start baby press-ups.
This is Brad's term, baby press-ups.
- [Brad] Baby.
- So, what you're gonna do is you're gonna put your hands
beneath your shoulders like this,
and you're gonna press just partially way up.
And what you'll find with a lot
of people is that your back is so tight,
that your pelvis might even lift off the ground.
- [Brad] Right.
And that's why we start with the baby ones.
Just let's stretch that gradually and get
to that back moving again.
You're trying to get the arch in the back.
- [Brad] Right. - Can you point
that out, Brad?
- You bet, let's--
Go ahead, Bob.
- So I'll go straight.
There's no arch.
- I always say, people imagine there's belt
around your waistline holding your waist down tight
to the floor or the bed.
- And we'll be showing that
in just a minute, - Yep
so they won't have to imagine anymore.
So you keep working this way.
So again, you're gonna, as repeated before, I said before,
you can do do five to ten reps.
- Yep.
- But you can repeat this five to eight times a day.
You can do it every hour.
If you can't, if you can only do it three times a day,
do it three times a day.
- And I want to clarify that you go up.
When you start to feel pain or it starts
to become uncomfortable, you just bump into it
and go back down.
You're not gonna force yourself into pain
because that can flare things up.
You have to work with this and allow that herniation
to get back and where it goes.
It takes some time for that.
So be cautious and again, Bob said five to ten reps,
and give it a rest.
- Yep, and I think also that you're doing other things
besides working the disc.
You're working on the joints and the muscles,
and you're getting movement, - Yep.
and who knows all what's happening, and so--
- We're gaining range of motion.
- Yeah, we're gaining range of motion.
- Without increased pain.
- So eventually, now things are loosening up,
you want to try go to full press-ups.
So now you're trying to completely extend the elbow
while keeping the pelvis on the mat or the floor or the bed.
So if--
- Down, down, down.
- If you get up to this point and still comes up,
that's too far.
Just go up to this point then.
You gotta keep working until you can go all the way up
like this and still keep the pelvis on the floor.
You may not get to that point.
Some people don't.
- Right, and that's okay.
- Go as far as you can.
And I even have sometimes people bring their head like this.
- Yes, yep, so do I.
- So, you can get up to this point.
Now, let's say you get to this certain point,
and you get stuck.
It just doesn't go any further.
It's not causing increased pain, but you're just stuck.
Then you can go ahead and try a rolled sheet
or a belt or a towel--
And do you want to grab me the sheet, Brad?
- Yep.
- Or do you want to show--
- Yeah, I just want to show one.
So the goal is if we're in the clinic, what I do is
I have my hand here, and I stabilize the pelvis.
And then I ask the patient to do it,
and that can help things move along in the right direction.
But by yourself, the option is is if you can take a belt,
or we're gonna use a sheet here,
and you put it around the back.
And put your hands on it.
- Yep, the hands are gonna provide the stabilizing force.
- Yep.
- And now when I go up like this, do you see
how the sheet is providing the same support
that Brad would have done with his hand?
So it's helping stretch the back,
give a little more overpressure.
Now what's nice about the sheet,
you can move it up and down.
It's hard to keep it down.
- It always wants to slide up this way.
- Yep, always want to slide up.
- And that's the challenge when you're working by yourself.
- And if you want it up higher, that's great
because that's where it wants to go.
But you want to try to keep it down in that low back.
You might have to bring your hands back
even a little bit further.
- Yep.
- And work it that way.
A stretch-out strap works out real well too.
We'll put a link down below on these.
These are inexpensive great ways
to stretch your entire body.
There we go, thank you, Brad.
- Well, of course.
I did want to mention, you'll know what location it is
because your body's gonna tell you.
It's like I'll ask a patient, can you press up?
And then they say it feels like it's too high.
And then you move it down, it's like oh, that feels better
because the back and the leg feels better,
and you can go a little higher with less pain.
So, it's all symptom guided.
- Nice about the stretch-out strap, it's got loops.
You can put your hands through it and still keep you hands
flat, like this.
And you can provide the stretching.
If you want, you could take the stretch-out strap
and run it through your loops of your belt.
- To keep from sliding up.
- To keep it from sliding up.
- Yep.
- But this works out really well.
- If there's someone at home to help you, like what I'll do
at the clinic, I'll just move back with my hands,
and I'll hold it. - Yep.
And then do that, so you can a family member, friend,
or whoever work with you.
- So eventually, you can go back to just not using anything,
if it starts feeling better and to the point where
you get all the way up here--
- Right.
- You don't need to use the belt anymore.
But again, it can help progress things along.
Same thing, five to ten repetitions,
five to eight times a day.
I know some people complain that, gosh,
you think we're gonna do exercises that often a day?
Well if you're having pain all day long,
I think you're motivated to try to get this thing resolved.
- Right.
That's assuming when you do it, you have success.
- Right.
- Each time, it feels a little bit better.
This pain is centralizing up the leg,
that's when you gotta stay after it.
- Right, that's when you gotta get at it.
I don't want you to get discouraged though,
if you have three good days and all of a sudden a bad day.
That almost always happens.
- Yep.
- I mean, always.
It is always three steps forward, one step back,
then two steps forward, one step back.
I mean, it just always--
- There's usually a reason for you.
You've bent over wrong or you sat slouched for a long time.
One way or another, it happens.
And when you watch some of our other videos,
all these little reasons and--
- Just don't get discouraged by it
because it happens. - Right.
- And generally when it does go back, it doesn't go back
to where it was at the start.
You regress a bit.
- Right.
- All right.
Why don't you watch the next video in our series,
if you get the chance?
- Thank you.