♪ 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're the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Okay this video's entitled how to sit pain free
in your vehicle when you have back pain or sciatica.
Ideally when you have back pain or sciatica
you're gonna avoid sitting in the car as much as possible.
This isn't the time to go on a long trip, Brad.
- Right.
- This is the time to see
if you can figure out an alternative.
'Cause even if you have ideal posture
when you're in the car with sciatica,
it's still gonna be hard on your back.
- Right.
- When you're in the car, this is gonna simulate the seat,
by the way, of the car and this is the spine.
Let's see, Brad pointing that way,
even if you have perfect posture like this,
there's still lots of shock absorption
and stress on the back.
- Right.
- And unfortunately, a lot of people also tend to sit
somewhat rounded here,
so that's what we're gonna try to avoid
and show you today how to get out of that.
- Right. - Alternatives.
- Even if you have perfect posture
and you sit in the car for an hour, two three hours,
it's not gonna be good for sciatica situation.
- Right and so that's, we're gonna talk about some,
well what to do if you are forced to drive for a living.
- Right.
- So, to get to work and back.
- Exactly.
- Let's start, Brad.
I'll get in the chair here.
So the first thing with the seat
is that you wanna make sure that you slide your butt
all the way back, as far as possible.
- Right.
- 'Cause that's, if it's forward like this,
you're gonna slouch.
- Yeah, there's just no way around it
and you'll feel it.
When you push in, you can tell you're getting good posture.
- Right.
Now your seat might have a built in lumbar roll,
lumbar support.
- Right.
- If it does, make use of it.
- Right.
- Because you don't need to use a different one
'cause that will also adjust to your particular curve.
- Right, and some cars,
I've had patients that didn't even know
they had it in their car with back pain
so I'd literally go out into the parking lot with 'em
and show 'em how to use it.
Sometimes it's a mechanical one--
- Sure. - Where you turn.
Sometimes it's a button where it's electric and it goes--
- Those are really nice 'cause you can actually adjust them
throughout the trip then.
- Right.
- As you're driving along.
All right, let's say you don't have anything.
The first thing you're gonna do
is probably try a rolled towel because, wouldn't you say?
- Right, except for the note of changing the seat angle.
- We'll get into that.
- Okay.
- Yeah, we'll talk about that.
- All right.
- Well let's start with towel if you don't mine.
- Sure, yup.
- If you're a thinner or slighter person
you're probably gonna not need as much support
as if you were a larger person with a larger buttock.
You can see there's gonna be more of a gap there
in that type of person.
- Right.
- So I typically use a very thin foam
that I put in my low back,
actually almost, right by my belt line
or even a little bit below and that is plenty for me.
As you can see even this,
starts to almost put too much of an arch in there.
- And you'll feel it.
It'll feel comfortable when you put it in there.
If it's too big, you're gonna feel it.
It's like, oh, you'll know.
It's very clear.
- Yeah, that's what's nice about the towel,
you can adjust it to fit what is gonna work for you.
So then once you decide what size you need,
you can then get something more permanent
and these can actually wrap around the seat
so you don't have to keep adjusting it.
- Right.
- And you don't have to keep looking for it.
This one is actually fairly thick.
- Right. - So, and dense.
- Yup, so these are Mckenzie lumbar supports.
They make a good support
and they make a variety of sizes, you'll see.
There'll be round ones.
That one's called the D shape.
- Yeah, look at this one.
Look how far I am with that one.
- Yeah, and if you have a really soft car seat
or a old car seat where it's hollowed out,
you're gonna need a thicker one
even if you're a thinner person
so there's a lot of variables you have to take account for.
- Yeah, this one's a little less dense, isn't it Brad?
- Yup.
- This one's getting closer to what I need.
This one actually doesn't feel bad.
Here's an air filled one, again another Mckenzie one.
Kind of nice because you can adjust it a bit.
- Yup.
- My wife likes this one.
She uses one like this in the car.
- Yup.
- And it actually, I would like this one too Brad.
It sits right on my sacrum nice
and it gives me good support.
- Yup, it conforms nice.
- Let's show 'em yours.
- Yeah, I've tried all of these.
- You wanna sit down and show 'em?
- Doesn't work for my back
but I've got a different situation
but this is the one I use.
It's memory foam and it supports the whole back.
It does have a little bit of a lumbar support
and I put it in there like that and it's very nice.
Oh, should we mention the dead pedal?
- Yeah, why don't you go ahead and jump on to that?
- So Bob mentioned that you should scoot your bottom
all the way back in and in most cars
in the left hand corner on the floor there's a surface,
it's not as big as this
but it's where you can put your foot on.
- I call it a stationary inclined foot rest
and you called it a dead pedal.
- Dead pedal.
- Yeah, they both make sense to me.
- Right, so it's that little spot there
on the left hand side, it's the angled platform solid.
You put your foot and push your bottom back
and you're gonna do that while you drive--
- Exactly.
- Regularly, every 10 15 minutes,
'cause you'll slide down like this
and you gotta get it back up in there and it'll feel good.
- A surprising thing again Brad on that
is a lot of people don't know they have it in their vehicle.
- Right, or why it's there.
- Or why it's there,
so what Brad was alluding to before
is that you wanna have the seat fairly upright.
- Yeah.
- Because if it's back like this, sit back like this,
the thing you're gonna do
is you're gonna reach for the steering wheel
and you're gonna round out,
so you want to have it fairly straight upright.
You wanna be fairly close to the steering wheel.
If you're not, if you're,
for example if the steering wheel is way over here,
again, you're gonna round out.
- Yeah.
- And also you wanna keep your feet fairly bent.
If they are really straight like this,
it's gonna be easier for your seat to slide forward.
- Sure, sure.
- So that's a nice adjustment to make too.
The steering wheel,
we're borrowing your imagination here now
so here's the steering wheel.
Ideally they tell you to be at 10 and two.
- Right.
- Yeah, that's gonna start causing you to slump a little bit
so we prefer nine and three.
- Yeah, bring it down.
- Or down to eight and four?
Yeah, eight and four, right?
- Right, that's good for your shoulders too.
- Yeah, it's gonna be better for your shoulders.
It's gonna be a lot less stress on them
so you wanna do that also.
Let's see, we're also gonna talk about
actually getting out of the car and into the car correctly.
- Sure.
- So when you get out of the car,
you don't wanna do, if the door is right here,
we open it up, you don't wanna do what's typical
where people, open this way, they don't wanna do this
where you get the one leg out
and then you start coming out, you know?
- Right, one foot at a time.
- You wanna actually,
yeah, you wanna put one foot, another foot,
turn all the way around and then get up straight like this
as opposed to getting out like this
where you're twisting and turning and bending.
- Right, right.
And sometimes if your back is pretty sensitive,
a lot of times there's a hand hold above.
- Sure.
- You might wanna use that to help do the twist.
- So getting in to the seat would be the same thing.
- Right.
- You'd open the car door, you'd go ahead and sit down,
again keeping a nice and straight back
and then bringing in one leg
and then bringing in the other leg.
- Right, taking your time.
- Do not try to reach to the back seat.
This is really bad on your shoulders actually
and it's really bad on your back
to be reaching to the back seat and grabbing something.
I do this all the time, Brad.
This one thing, I gotta listen to myself.
(Brad laughing)
I forgot something and I needed it in the front seat,
I'm like, you know I'll be back there like that.
- Yeah, reaching back,
plus it's just not very safe particularly if you're driving.
- No, well I don't do it when I'm driving
but I am unfortunately guilty of that at times.
The other thing is after you drive for a while,
you really don't wanna get out of the car
and lift anything heavy for quite a while.
When you're sitting like this,
the back ligaments are stretching out
and your back is less stable,
plus there's that pressure on the disc.
- Right.
- So your discs are a little more vulnerable
to having a problem and I remember Brad,
this happened to me specifically.
I went on a three hour trip back home, got home
and I grabbed a cooler out of my back trunk
and I'm like, "Oh."
I mean I felt it right away.
- Right, yeah.
- So it's a very vulnerable time.
- Get up, walk around
and you'll probably notice if you are having back pain,
when you get out of a car,
you've been sitting there for a while
it takes a little walking before you feel comfortable
and straight up again.
- And Brad, yeah, brings up a good point.
As much as possible, you should try,
if you have to go on a trip,
break up the trip into increments.
- Right.
- Try to stop every half hour or every hour and walk.
- Right.
- And also you can do standing back extensions.
- Sure.
- So because you've been flexing a long time,
a lot of time if you take your hand and bend back like this
and do a repetition of 10 reps--
- Sure.
- That can help offset the bending that you've been doing
for quite a while.
- And if you're sore and that's not tolerated,
I hate to say it, but you should lay down on your stomach
and do some press ups.
- Yup.
- I didn't see it but I had an instructor of mine
from a Mckenzie course and one of his patients,
out on the interstate--
- Oh no kidding.
- Oh no, yeah, and he did his press ups,
not on the road but well in a safe area but--
- Yeah, you could bring a piece of cardboard along.
I mean, we joke somewhat but really not.
I used to have patients that were in a factory setting
that they got a piece of cardboard
and they would lay on the cardboard
and do press ups on the floor, so--
- Right, and if you're not familiar
with the press ups on this video,
you'll see it a number of times on our series.
- Yeah, it's one of the exercise videos that we'll allude to
so, remember you're trying to stop the pain makers
and sitting is a pain maker
so you want to sit as correctly as you can
but avoid it as much as possible too.
- Very good.
- All right, thanks for watching.
- Drive safely.
(chimes sounding)