♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Howdy folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous
physical therapists on the internet.
- In our own opinion, of course, Bob.
- Today, we're gonna talk about three most common cures
for sciatica by Bob and Brad,.
- There you go.
- It's kind of the three-step approach that we do
with all of our patients where we first see them.
These are the three things we kind of cover.
- I'm gonna restate that, but after.
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Bob, you know, I was thinking this week
after treating my second patient with back pain
and associated leg pain, sciatica,
and looking back over my 22 years
of physical therapy working with back pain,
and we discussed this.
These three home exercise programs
or instructions, if you will,
come up more than any other
in our opinion with our patients.
And they're very successful,
and we wanna share them with our viewers.
So actually, I had it with a 41-year-old woman yesterday.
She had sciatica 10 years ago,
and now the back pain is coming
with similar symptoms cropping up.
It's coming back to get her.
- And that is quite often the case.
Once you've had it, you may get it again
because you're doing some of the same things to bring it on.
- Which was the case.
She couldn't remember the exercises anymore,
and some of the things she were doing was irritating it.
And I had the same thing with a 61-year-old male last week.
- Okay. - Had a similar situation.
And we're gonna cut to the chase.
Dare say, what are the three things?
- All right.
- Well, the first one, almost,
and this is pretty much with all back patients,
is we address their posture,
particularly in the seated position.
- Right, everybody always thinks that back pain
and sciatica is a lifting issue.
- Right.
- It's really much more, because of our society now,
become a seated issue.
- In general, people are seated at work.
They're seated in the car.
They're seated in school.
It's incredible.
- And that actually puts a lot of stress on the discs.
And it can cause a herniated disc.
It can cause a bulging disc.
You know, it creates that scenario.
- Particularly chairs that are soft, cushy, or the person,
Can you get at this?
- So, we've got an actual car seat here.
- In this case, if you sit in your car seat,
and it's like this one,
it actually kind of goes in the opposite direction
of what we prefer.
And if you slouch like this a little bit,
then it really curves that back.
Anytime, whether you're in a couch, a car seat,
or in a desk at school or at work,
and you're slouching, leaning forward,
it puts more pressure on the discs.
The simple solution, this is number one,
scoot your bottom back in the chair.
Sit upright.
If you have, Bob, can you grab me a lumbar support?
- The other thing is you wanna make sure
the seat's fairly upright, too.
- Right, yep. - 'Cause if it's back.
Actually, wanna show real close,
Yeah, if it's back, you're gonna round out
'cause you're gonna get your eyes level.
And you're gonna,
- If you're driving, you're like this.
- [Bob] You wanna get the seat up fairly upright.
- There we go, that feels good for me.
Yep, and if you don't have an actual lumbar roll,
you can just take a towel roll like this.
And you're gonna place it right at about the belt line.
And it kind of depends where the injury is,
but typically, it's a lower lumbar area.
And when you put it in there,
it should feel immediately like good support.
The size of it may vary.
So, you may wanna get a larger towel roll or a skinnier one.
It shouldn't feel like a big bump there.
It should feel like oh, that's good.
It takes the pain away or relieves it normally.
- Yeah, the size is gonna be dependent upon your size.
- Right.
- If you're a fine-boned person,
you're gonna probably need a smaller one.
And two, it often depends on how bad the sciatica is.
A lot of times, I have found people
who are really in the throws of it,
they like to have a bigger one.
- So once you've found the towel size that works well,
smaller or larger, then you can get a bought-en one,
which are more comfortable.
And they usually have a strap that go on the backside.
We like the McKenzie Roll.
We have really good luck with those over the year.
- Well, for one thing,
he invented the whole idea of using a lumbar roll,
and he also invented the exercise we're gonna show you next.
- So, address your seated posture.
Get it so it feels good when you're seated
whether it's when you're in the car
or at home, in the office.
- Yeah, if you're on a coach
or a loveseat or some type of recliner,
you can take a throw pillow and put it behind you.
And just fill in that gap.
You just wanna stop the slumping from occurring.
You wanna restore that arch in your back
while you're sitting so that you're not gonna play
into getting the sciatica and the herniated disc
or the bulging disc.
- Then, the next number two is extension in line
or laying on your stomach and doing.
Robin McKenzie really kind of authored this in a way,
but it's been very successful for sciatica.
- Well, what's interesting about this, Brad,
is that actually prior to this,
they did not recommend that you do this at all.
They thought this was harmful for the back.
You had the patient lay down,
and the patient laid down wrong,
and they were laying like this when he came in,
and their back pain got better.
But that's neither here nor there.
But what you're gonna do is you're gonna start off,
and sometimes you're gonna be able to start just
by lying down flat and maybe lying for a few minutes
to see how you tolerate it.
And then eventually, you might get up to on your elbows
and take a little,
start getting a little bit of the arch in your back.
Ideally, eventually what you're gonna get to is
you're gonna put your hands beneath your shoulders
and you're gonna start doing press-ups here.
And with the press-ups,
you wanna keep the pelvis right down,
kind of glued to the table.
- Right here, yep.
- So what you don't wanna see is this.
- Right, right.
- And that often does happen because your back is tight,
and it shows me it's tight in this direction.
So, you wanna work it in gentle oscillations here
until you get up further and further.
Eventually, you'd like to see it
that you're all the way up this far.
- As you do more of them,
the leg pain that's going down the leg into the foot,
or it maybe should be disappearing and going away,
and you should start to feel more in the back.
If that's the situation, continue to do these.
If it just makes it worse,
you're either being too aggressive with it
or maybe some other exercise.
And we do have some videos on sciatica
that with difficult problems.
- Yeah, we've got advanced exercises
that you do beyond this.
But that's a critical point you were making, Brad,
is that you want, the leg pain should be getting better.
Otherwise, this isn't the exercise for you.
If it's actually making the leg pain worse
and the back pain better, that's still a bad sign.
- Right, you need to stop that exercise.
But in general, we've had really good success
with this approach.
- So again, a lot of variations on this.
We're just kind of touching upon it on this video.
- Right. - This exercise portion of it.
We're trying to give you the three general things to do.
So, grab some of our other videos
if you're interested in getting more details on that.
- You bet, and they're titled as such.
As number three, but not the least,
but this is some of the things that people are not aware of
that make their back and leg pain and sciatica worse.
Simple things like they bend over
to pick up something improperly.
- And it doesn't even matter if it's a pencil.
I think that's what throws a lot of people off.
They think well, I'm not lifting up anything heavy.
But your back is getting in that rounded out,
- Yep, right there.
- So, you wanna go down,
keeping your back in a good straight position.
Brad and I often,
we have an exercise using the Booyah Stik actually.
It's good training you can do.
Actually, is you get it behind you like this,
and when you have good posture,
you're gonna have three points of contact.
- So, the head, the mid-back,
and then right about at the belt line or the sacrum,
touch here, touch here, touch here.
Your spine is good alignment.
- Yep, it's like you have a back in a cast,
and it's staying in good position here.
So, if I can translate that
into picking something off the floor,
you know, going like this,
I'm gonna keep the back out of trouble.
You can also do kind of a lunge like this.
- [Brad] Sure.
- And I'm keeping the back straight the entire time
while I'm picking it off the floor.
- That really helps that sciatica heal a lot much faster
when you treat it properly.
Other little things like when you're brushing your teeth,
you may not realize it, but you're bending forward.
- Right, over the sink.
- Right, I have a lot of people say
when I'm brushing my teeth, my back hurts.
And that's because they have this.
So, get in that position and really be aware of that.
Walking, if you're walking uphill,
you lean forward just to balance.
And that's a little thing.
- Same with stairs.
I mean, if you can avoid using stairs.
Some of it is, as you're trying to help your sciatica,
is an avoidance thing.
- Sure.
- You wanna avoid picking things up off the floor.
You wanna void picking up your child at that time.
I actually, when I had a bout of sciatica,
I was a student in physical therapy, and I wouldn't sit.
I just did my notes on the countertop,
and I avoided sitting because it was a lot harder
to keep your good posture when you sit compared to standing.
- That's why they have sit-stand tables now,
and it's becoming very popular in the workplace.
- So, you know, the whole idea is if you keep that posture,
you're giving your back a chance to heal.
And the body wants to heal.
So, you throw that along with the exercises,
and quite often, we get a fair amount
of success just from that.
- Right. - Those three things.
- Exactly.
So, once again, Bob, we can cure just about anything except,
- A broken heart.
- There you go.
- But, boy, are we working on it.
- Yeah, we won't stop either, Bob.
- All right, thanks for watching.
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