♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we have the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- The one bad sign
that your sciatica slash herniated disc may not heal
without surgery or some other type of intervention.
- Right, we don't like to jump the gun,
but there's times when we need to go that far.
- I've had people come in and I see them I'm going,
"I can't help you."
And I think that's basically what we're saying Brad.
Therapy is kind of binary as you'd say,
it's either gonna help you or it's not gonna help you.
And I can usually tell after one treatment,
and especially if you have this bad sign,
I'm gonna be saying,
"Sorry, you better go back to the doctor"
and maybe they'll try an injection or something like that,
but I can't help you.
So we'll get to that in just a minute.
- Which is not very fun as a therapist.
- No, it isn't,
we don't like to see that at all, of course,
we like to be superheroes and that doesn't help.
All right Brad, in case you are new to our channel,
I know you aren't, but if you are,
please take a second to subscribe to us.
We provide videos, how stay healthy, fit, pain-free.
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And also if you get a chance, go over to Facebook,
because Brad and I as children,
it's the sad story of a lifetime, we're not liked.
And so we're trying to turn things around.
So we got Bob and Brad at Facebook.
- Like us on the 'book.
- All right, so let's go to it Brad.
So when somebody comes into me,
the first thing we're gonna try to do,
is we're gonna see if we can find an exercise
that changes the pain.
And if I can't find an exercise that doesn't change the pain
no matter what I do, the pain kind of stays the same.
Or even maybe,
even if it gets worse sometimes that's a better sign
than if nothing happens.
- Right, and what we're talking about is an exercise,
oftentimes we're using directional exercises,
a certain direction that will change the pressure
on that sciatic nerve.
And it's either gonna make it feel better
or make it feel worse.
And one way or another, gives us information on
how to set up an exercise programed to heal you.
- Exactly, but if it stays the same no matter what you do,
or if it's constant also in your lifetime,
like you have it all night long, and all day
and there's no time during the day that you don't have pain,
that's a bad sign.
It can mean that there's,
a piece of disc on the nerve and it's not moving.
- Right, it's in there, it's pretty tight,
and you're gonna need to get some more medical attention.
- So we're gonna show you some of the things
you wanna try if you have sciatica,
especially coming from a herniated disc.
Give these a try, and see if they start changing your pain.
If they change your pain, that's a good sign.
And can you describe what we're looking for Brad?
What do we mean by changing the pain?
- So with sciatica, it's oftentimes
in the back into the buttock
and refers down the back of the leg,
sometimes it wraps around the side.
It can go to the knee, it can go to the ankle
and all the way up to the toe.
So that's all symptoms of sciatica.
Now when we do an exercise, and particularly
if it makes a change in your leg pain or symptoms,
like it gets better down in the foot.
That's a good change.
It could be that the pain goes down to your knee
and you do an exercise and it goes from your knee,
and it goes down to your foot.
That's a bad change.
But it's still a change, it means that
we can probably modify the exercise.
- We can almost show it with your white pants here Brad.
So pretend this is the pain, the stripe.
Now let's say you do an exercise,
and now it only goes to the knee.
That's a fantastic thing we're gonna see.
And if goes up even further,
we don't wanna show too much Brad leg.
- No, keep the leg not exposed.
- This is a family show, come on.
- If we do an exercise and the pain drops down to there,
- That's not what we wanna see.
- We want it to go this direction.
If you never had this you're probably wondering,
what are they doing with the leg?
But if you've had sciatic and you know
how the pain down the leg feels.
- It's pretty classical actually.
- So now they wanna see some of these Bob.
- This all, I want you to start with.
Most people you're gonna start laying on your stomach.
And for a lot of people you might have to start
with pillows underneath you.
Because just laying on your stomach alone
might even make the pain worse.
- Especially if your posture's like this
and you have a hard time straightening up.
Those are the people when they walk in the clinic,
I'm almost certain I'm gonna have to put pillows down.
- Yeah, we're gonna start off with the two pillows here,
you can give 'em one for their head too if they want one.
- I'm gonna give you a towel roll,
this is what I do a lot of times.
- And you're gonna lay here,
and you're gonna see what your symptoms do.
Now if they don't get any worse
and they don't get any better, that's fine.
But you lay here for a while,
and then if that works out fine,
maybe even in the first session,
sometimes you might do this for a day or two.
- Sure.
- And usually what we have people do these exercises
like five to eight times a day.
I mean, you can do 'em every hour
if you're up to it.
- And as long as it makes it better.
- Right.
So let's say we're moving along well.
Let's say, "No, that feels fine, Brad,
I'm gonna go ahead and go down to one pillow now."
Same thing, it actually maybe feels a little bit better
or it's certainly not worse.
So then I'm gonna go down to zero pillows,
and I'm gonna lay on my stomach and try that same thing.
- So to clarify this,
if there's any question
this may happen in a period of one session,
in a therapy session.
I start with two pillows and within 10 minutes
we're down to no pillows.
On the other hand, it might take a day of two pillows
before the back can stretch off.
- Yeah, if they're really bad I might send them home
and say, "Lay like this, put a ice pack on your back
while you're doing it
and see if you can lay for five minutes."
And give her a try.
So let's say again, we're progressing along,
it's doing quite well.
Now I'm gonna maybe have him do
what we call a prone prop,
where we're just propping up on our elbows.
Same thing, maybe even feels a little bit better,
you know, in the one leg.
- Right, so the pain, when used to go down to the foot,
and now it's only goes to the knee.
If that's the situation, boy you're gold,
things are going the right direction.
- Usually it doesn't go that well.
So usually we're gonna start having to do press up.
So you put your hands underneath your shoulders,
and you're gonna start pressing up like this.
The key to this Brad, as you know,
is do not lift your pelvis up.
- Oh yeah, we don't want that.
- Yeah, you're trying to lift up the upper back
and you're trying to keep the pelvis
planted into the mat.
And you're trying to get an arch in your back.
And for a lot of you you're not gonna have
much of an arch there,
and that's why you ran into this problem.
So you're gonna have to work on it.
You might start just doing some shallow ones like this.
And work your way up to it.
And this is where we start to hope
that you do start to see a change in the pain.
Where you start seeing some of the pain improve.
But again, it's not uncommon for it not to happen,
right Brad?
- You get stubborn ones.
That's when a therapist needs to come up with some tricks,
and we've shown on our videos a number of tricks that we use
to get that leg pain out of there.
- We're gonna do it right now again.
So the first one I often try is the banana.
So with the banana now,
let's say I'm having pain down this leg,
- [Brad] The right leg.
- I'm gonna shift my hips to the left
my legs back to the right, my shoulders to the right,
and I'm forming a banana.
You wanna show the shape Brad?
- Right, so he's,
if I look at it from behind his body goes,
it looks like a C or a banana, and it curves his body.
And then he adds some press-ups.
And sometimes when you do this, that will be enough,
a directional exercise to make the leg pain improve
and go up towards the hips or the back.
- But if it doesn't do not despair
because we have some more tricks, right Brad?
Do you have a sheet?
- Yep. - Okay.
- You can use a towel or rolled up sheet like this.
- And you're gonna put it right
underneath your pelvis like this.
And the same thing, you're gonna go ahead
and you're gonna try some press-ups.
Had this one work quite often,
worked for a lot of people.
So, I don't know which one of these is gonna work,
but hopefully one of 'em does.
- Right.
- And then you're gonna go ahead,
and if that doesn't work, you might try the roadkill one,
which I think is similar to this Brad,
do you ever think about that? - Yeah.
- I think this lifts the pelvis up
- This is just a little more aggressive, I think.
- Yeah, it lifts the pelvis up and that's why it feels good.
And the other one lifts the pelvis up.
- Now I just wanna say on this one,
the leg that has the pain is the leg
that you're gonna bring up most of the time.
You could try the other leg, but usually this one.
And I found when this one works, it works really good.
And as soon as they bring the knee up, they say,
"Oh that feels a little bit better already."
And then we add the press up.
- Yeah, so I'm bringing the,
my foot is actually touching my left knee.
And I'm going up like this.
And again, doing the press-ups.
Again looking for the sign that the pain's gonna travel up.
Now, if all this starts to work, and they're like,
"Wow, it's really good, but I've only got
to a certain point, I kind of got stuck now.
And now I can actually do it this way."
Now you might wanna start doing some over pressure.
- Sure.
- You wanna hand me the strap, Brad.
- Sure.
So over pressure, you'll see what he means,
we're gonna demonstrate what he is talking about.
- So you can take a belt or a rolled up sheet.
I'm using the stretch out strap here.
And what's nice about this is you can
actually go put your hands in the loops if you wanna.
But you're gonna go ahead and you can actually,
now I can put pressure on my back
and stretch it a little bit more.
- I don't think they can see 'cause your arm is in the way,
but the strap is going across the low back
and it helps support the back.
And when you do that, it should actually feel better,
and the pain should even go further up the leg.
The goal is to get the pain to go to the center of the back.
And if that happens, I've had people do this exercise
and say, "Geez, it hurts right there,
right in the center of my back."
And then I'm smiling because
I know things are going right way real fast.
- So we're gonna show just a couple things
they might wanna try along with this
while you're going through this period, Brad,
one is the Sleep Roll.
Where did we put it? Oh, here it is.
A lot of times in order to help you sleep at night,
it's good to get the back in the proper position.
So you tie this around you,
and that keeps an arch in your back.
And it also gives you support
on the side when you're laying,
so your back isn't collapsing.
Let me show you what I mean by that.
So if I lay like this on my side,
my back is kind of rounded out like this.
So this gives me support right in there,
and you tie this around you.
I dunno if it'll tie around me because I'm...
- Yeah, this Sleep Roll is a smaller size.
- It does fit actually.
- Well you can tie it. - Yeah.
And then you can also lay on your back like this
and now it's still giving support.
- Right, if you don't have a Sleep Roll
you can take a towel like we've done here,
and then use that.
It doesn't work quite as well, but it can be successful,
and you use that and you can pin it up like that.
- Yeah, give that a try first because,
what the heck was that?
- Well, I'm just kinda, throwing something in there.
- How about the Leg Wedge, Brad.
A lot of people who have trouble sleeping at night
really like this one.
This one's kind of a nice universal one for back pain.
I would say. - Yep it is.
Back and hip.
- Back and hip, yeah.
You slide her in there, and boy,
I don't know what it is,
it's something about this part of it.
That slips right in there, and feels really good.
- It offers support and I think it puts
a little bit of a tilt on the pelvis and
takes stress off that lower back.
I've had so many people,
I use it at work and they say, I wanna get one.
And they either order one online
or they go downtown and they buy one within a day or two.
- Yeah, and they're fairly inexpensive,
they aren't you know, a large amount.
And the other thing you might wanna try,
this is the last one, is that you can take two pillows,
and you can actually,
so let's say you're having pain down the left leg.
You put upper leg on top, you lay on your side,
and you actually lift up the ankles like this
and you put two pillows underneath them.
- And it depends how thick your pillows are.
You want it to put a little twist on the spine
and when it works, it works well.
I mean, you'll know it right away.
- Yeah, it starts to relieve the pain immediately,
if it's gonna work.
And this will allow you to sleep.
- If you're take a nap, use a pillow there.
- All right.
So Brad, once again,
I believe that we can fix just about anything.
- Except for,
- A broken heart.
- I thought you were gonna say
they've wasted another 12 minutes.
- Yeah,
you wasted another good 12 minutes on us.
- Good old click and clack.
- Thanks for watching.