♪ 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.
- Sciatica, Brad. - Mm-hmm, that's the term.
- Yeah, that is.
Today, we're gonna show you how, the best way
to walk, sit, sleep and drive when you have sciatica.
- All right, because we all do those.
- Yeah, it's a nasty condition, isn't it, Brad?
- Right, yep.
And these little things can make a big difference
with this particular diagnosis.
- By the way, Brad, as I look out on viewer land,
I can see there's some new people out there.
- Oh, absolutely.
Greetings.
- Greetings, if you are new to our channel,
please take a second to subscribe to us,
we have a subscribe button over here
on the left side of Brad, you're right.
We provide videos how to stay healthy, fit and pain free.
- Very good.
- And we upload every day. - Absolutely.
Sciatica, how are we gonna walk?
Well, first let's talk about walking.
The one thing about sciatica, is you're pulling on a nerve,
the nerve all the way along the length of the leg.
And so, if you take long strides,
you're gonna pull on that sciatic nerve.
- Right. - And irritate it.
- Especially if you're pulling
and you're pulling your toe upward,
I dunno if you got that down there,
but that is gonna stretch that nerve a little bit,
and it may cause some irritation.
- Yeah, in fact, we do a test on people,
we do it sitting or laying down
where we actually take, and lift their leg up like this,
and we pull the foot forward like this,
and if it brings pain along the leg up into the back,
that's positive, meaning that you do have sciatica.
- Yep, some nerve involvement.
- So you can see when you're walking,
if you walk and you take long strides,
and you'd go off your toe like this,
you can actually stretch that nerve.
- Sure.
- So what we want you to do, is just very simply,
is to take very short strides,
and hit about midfoot while you're walking,
so you're not irritating that nerve on every step.
- Right.
- Because once you irritate a nerve it stays irriterted.
Irritated, not irriterted. What?
- Whatever, Bob.
We'll get that speech therapist.
- Yeah.
So you want to get things calmed down,
and a lot of people may find out, you know,
you're walking all day,
and then you wonder why it hurts at night,
it's because you pounded on that nerve all day long.
- Sure, yep. - You wanna grab a cane, Brad?
- Yes, I do, Bob.
- Okay.
- It would be worth your while to try a cane,
because sometimes I think it helps gap the foramen, Brad.
- Sure, so in other words,
the nerve is gonna not be as pinched as much,
and less irritated.
- Yeah, the spinal nerve comes out.
the nerve root comes out through the hole,
you know, in your back, one of the little holes.
- That's called the framing. - The framing, yeah.
- Right there, and it drops down.
- If you can maybe make that hole a little wider,
or give it a little more room, you know, with a cane,
it might take some of the pressure off.
- Now the thing is, Brad,
I don't know what side it might help on.
I would think it might help
if you used it on the side of the pain, wouldn't you?
- Right.
This is one of those things,
you just try it and see what happens.
- Yeah, because it's also possible,
let's say the pain's on this side,
so I would first try it on this side,
but it's also possible that if you lean this way,
it might open it up this way. You see what I'm saying, Brad?
- Right.
It's gonna depend on the body mechanics, on how you walk.
This is one of those things you have nothing to lose
and everything you gain,
if it doesn't work, you don't use it,
if it does, you'll know it,
because it's gonna feel better when you walk,
and you're gonna say,
"Oh, this is all right, to use a cane-"
- Quick tutorial on the cane, Brad.
- Sure.
- When you're, the height should be to the point
where if you put your your arm just slightly forward,
like this, the cane should hit you on the wrist.
- Right there. - Right there.
So this is a little bit low for me.
- Too short for Bob, yep.
- So you wanna be able to lean on it
and keep the arm fairly straight.
All right, why don't we talk about sleeping, Brad?
- Sure.
You wanna take a nap?
- Yeah, I always, it's a good time on the day to do that.
(Brad laughs)
All right, a couple things you can try,
one, you could just try a rolled towel, Brad, like this,
and you could put it in place
when you're laying on your back,
I don't know what position you're gonna sleep in,
but if you like laying on your back,
you can go ahead and put it right in the gap there,
and it'll give a little more support to the back.
- Okay, get your hand outta there, so they can see.
- Right.
- Belt line, about, you'll know,
it'll feel good if it in the right spot.
- Yeah, when you lay on your side then, Brad,
you can also leave it in place.
I got my mic there, so let me go on the other side here.
So I lay on my side here,
same thing, it fills in that gap.
- And what that's doing is helping line up the spine
to keep it in a neutral position
so you don't close that frame and then pinch on the nerve.
Again, you'll know it's the right place,
because it's gonna feel good right away.
- Yeah, we're all looking for just decreased pain here.
Now, another alternative, they actually make a back roll,
or what do they? - Sleep roll.
- Sleep roll.
- Yeah, McKenzie's sleep roll, to really wrap around.
- It's a long roll that goes around,
does the same thing, but it stays in place that way.
I mean, you could take a sheet and just roll it up like this
and tie it in place
and then you'd be, you know,
especially, this would be a good thing to try
- Right. - and see if you like it,
and that way you can know if you maybe wanna purchase one.
- Right, yeah, it's a good trial, exactly.
- So you see the same thing here, Brad,
if I'm laying on my back, it's automatically in place,
and if I lay on my side, it's automatically in place.
- Right.
And the thickness of this may vary
depending on the size of your body,
or the firmness of your bed,
you might need it a little thicker, or less,
and you do that by rolling up your sheet.
- Yeah, and you might take two sheets and roll up
if you need a thicker one.
- Yeah, look at that,
and then you can play games with your kids.
(Bob laughs)
- God.
Don't a lot of you feel bad for Brad's kids?
Or, Brad's kid?
So, all right, another one, Brad,
before we go to the wedge. - Yeah.
- This is a simple one, but you take the,
let's say this is the painful leg.
Okay? Left leg.
So you're gonna lay on your non-painful side,
and you're gonna put two pillows...
Do you remember this one, Brad?
- Yes, I do.
I had a patient once, I did this with her,
and she had a smile go on her face right away.
She said this did it just like that, it reduced...
- Again, it readjusts your body
so that it takes some stress off the sciatic nerve.
- Right.
- So, again, it's just as we just showed you,
you lay on the side that is non-painful
and you put the painful leg up on the top,
and you're gonna put two pillows
underneath the ankle and feet.
- But, just remember,
make sure you got a pillow or two under your head too,
not like Bob.
- Right, this would not be good,
that would be a little bit... - Put that under there, Bob.
We don't want to give them the wrong idea,
we're getting a kick. - All right.
So there, we got it?
- All right. - Okay.
Now, you wanna show the leg-wich?
- Yeah, I love the leg-wich.
- You know, we often don't want you to go out and buy things
but this is probably one of the exceptions
we're gonna make here, because this is really worth a try,
wouldn't you say? - Throw me in a pillow, Bob,
I wanna get comfortable.
Yeah, I would say, occasionally,
I have someone who will use this,
and they say it's not helpful with a back issue,
but I'd say, nine times out of 10, at least,
people are very happy when they lay down
on their plinth at work
and I put this under their legs,
and they put a smile on their face and say,
"Oh, that feel good."
And something about the shape
that we've talked about this before, Bob,
but the support on your hamstring area,
in your pelvis, in your legs.
And it's nice to put a cold pack under here,
it's just a good, comfortable position.
- Or, you could also just have that lumbar roll
- Sure. - underneath there.
Or the sheet that you tie around you.
- That one would be too big, Bob,
give me the black one.
Yep, there we go.
The size of the roll,
oh yeah, that's better,
will vary from person to person.
- And you know, the thing about this, Brad,
is what we talked about,
we're not certain why, but this seems to work better
than just putting pillows under the legs, doesn't it?
- Yep. Yeah.
Pillows under the legs
would be a good secondary thing to try.
But primarily, we think this works better.
Again, we gain nothing by telling you this,
we don't sell these or anything like that.
- Right, it's all anecdotal,
but from our patient use, my personal use,
I can sleep with this, if my back is bothering me,
I can sleep with it-
- You said, you just had an episode the other day.
- Yeah, I was in my car for 350 miles,
and one day sitting in the hospital because my dad was sick,
and I had a back ache from all this that night,
the next night I was really sore,
I used this, laid down, slept for two hours like a baby,
my wife woke me up, and then it was time to eat.
It was a good deal.
- Yeah, it's funny,
because he acts like a baby a lot of times too.
- Oh, Bob.
- All right, let's talk about sitting, Brad.
The first thing we're gonna say, Brad,
is to avoid sitting as much as possible
when you have, especially a herniated disc,
because it's just kind of promoting that,
it's pushing the disc out, it's not helping it heal.
- Right.
- And I know I had an episode of sciatica
when I was in school, physical therapy school,
of all things, and I was at a clinical,
and I would spend all my time
either standing up or laying down.
I would write my notes standing up, on a countertop.
And it takes a little discipline,
but my back got better rather rapidly because of it.
Now, we know, though, there are times you just have to sit.
- You can't drive your car standing up.
- Right. (Bob laughs)
- So you're gonna wanna try to get some type
of lumbar support,
and you can just take a rolled towel to start off with,
and why I like that to start off with
is because you can vary it depending on how much you need.
- How thicker the diameter, you know?
- My experience has been, people when they have,
right when they're in the throes of sciatica,
that they tend to like a little thicker towel.
And later on, then, when it's kind of calmed down,
they like a thinner towel.
So you just roll up a towel, we put a little tape on it,
and you can go ahead,
and usually you slide it down to around the belt level.
But again, I'm gonna go by comfort on this, Brad.
Some people like it a little bit lower.
And you put it in there, and you just lean up against it,
and it kinda keeps that arch in there
and keeps the back somewhat out of trouble.
- Yeah. Maybe move that.
- Oh, sorry.
- Now, that's about where it'll go.
But you'll know, I mean, once you get it there,
you'll say, geez, if it was up a little higher,
thinking you go back and reach and you move it,
and then it tunes right in, self-tuning kind of a thing.
- Now, if you're working at a desk,
I want the the back upright, a good solid chair,
I don't want one of those flexible chairs, Brad.
I mean, that's just not gonna give you good support.
Now, if you want to lay down at night in a recliner,
I have no trouble with that, Brad, watching TV.
- Right.
I do that myself,
and I'll have my patients do that as well,
but I'll tell 'em, get a throw pillow, a lumbar support,
and get that back supported in a good position.
- Brad makes a good point.
Like when you're in some of those softer chairs,
this won't even be enough,
and you take one of those small throw pillows
and put it in there, and that seems to do the job.
Doesn't it, Brad? - Yeah.
Bob, I don't know if we've got enough time,
but I just had an experience
with my mother having neck pain, back pain,
she was gonna get an MRI with her neck.
She bought, actually, I bought her a recliner that was firm,
everything went away, back pain went away, neck pain away,
she didn't need the MRI anymore.
It was just a matter of posture in a seated position.
- The only other thing we're gonna say with dri,
we talked about sitting in the office,
but sitting with driving,
there's just two things I wanna point out.
One, is if you're driving to try to take frequent breaks,
I know that's difficult, because you're on the road
and you want to keep going, but it really helps to stop
and walk around the car a couple times
or walk into the gas station or whatever.
But the other thing is, there's a little foot,
what'd you call it?
A rest? - A foot plate.
Foot plate, where your left foot,
they'll have a rubber area that's firm and hard.
And there's a reason for that being there,
and you use it to push your bottom into the seat.
- So you may not even know your car has this, or truck,
if you look on the left side, there's a little foot rest,
or foot plate, and you can put your foot there,
and like Brad said, you can use it to push you back in
and keep you locked in up against the seat,
and put that lumbar support in there.
And that just feels really good to get you...
- Yeah. Makes a big difference.
A lot of cars do have built in lumbar supports.
Find out, some people don't even know they have them.