♪ Bob and Brad ♪
♪ The two most famous ♪
♪ physical therapists ♪
♪ on the internet. ♪
- Hi folks, I'm Bob Schrupp, physical therapists.
- Brad Heineck, physical therapists.
- We're the most famous physical therapist on the internet.
- In our opinion of course, Bob.
- So the L5 nerve root?
- Bob, when you talk about sciatica, low back pain,
there's a very high probability
that the L5 nerve root
is gonna be involved. - Involved.
- And there's specific tests
that you can actually do at home to figure this out.
Now therapists and doctors have these tests
and you can go through them pretty quickly.
- Right.
- We're just gonna go through them so you can see
and understand it.
- And quite often we're talking about is a herniated disc.
- Mmmh. - Right, causing the sciatica.
- Exactly Bob, which is very common as well.
Bob, are we gonna talk about anything else?
- No. (laughing) - Okay.
No, we're gonna finish the video.
Sam, come on over big guy.
Sam is having problems. - All right.
- Now let's look.
- Brad has constructed, the kind of, a sciatic nerve area.
- Right, well actually, just the L5 nerve root.
So here we have, don't be, this is not a real nerve,
(Bob laughing)
but they kind of like this color of them.
- Right. - Similar.
It's a nerve root that comes out
and it does go down in the same area that the L5 does.
Right up here is where it starts.
So we're gonna point right here.
- [Bob] That's where it's getting pinch.
- [Brad] Yep.
Yeah, right in this area is where that disc
is gonna bulge, pinch it right in here
and then you can have symptoms down.
It comes through the pelvis out here,
down the back of the leg
and then actually goes over across the little calf,
the calf there, and down to the front of the foot.
Yeah, we've got this mapped out on Bob's leg
in a nice bright color so you can see,
but we want to show you on the skeleton.
Sam, thank you we're done with you now though.
Just excuse yourself.
- Keep that in mind,
as we do the one test where we do a straight leg raise.
- Yes.
- You'll understand why we're pulling the nerve.
- Right.
Exactly.
So as far as symptoms that you will feel
is gonna be numbness, tingling,
burning, some unusual symptoms
and the same area where this pink or red
or whatever color tape this is.
- [Bob] Pink.
- You call it pink? - [Bob] That's pink.
- That's pink.
Okay, say no more.
And it'll go to the top of the foot
in the middle three toes like that.
So sometimes it moves around a little bit,
but that's a general area.
- Right.
- Okay.
So the next step is there's specific muscles
that this nerve root will innovate.
- Sure.
- And the one that most people test is your big toe.
- Yes.
- The muscle that pulls your big toe up.
- And a lot of times I think people are surprised
that it's weak.
They don't know its weak.
- Yeah, exactly.
- And when I would test people, I say hold it
and it would immediately give way and they'd be surprised.
- Yeah, why don't you put your foot up so I can.
- Sure.
So can you pull your big toe back?
He's pulling it back and I'm just gonna go like this.
Can you hold it?
Hold it, hold it.
And usually I'll do it on the good foot first
- Right.
- And they can hold it really strong.
Oh, oh.
And then on the other foot, hold it?
Hold it?
It drops right down.
- Right.
- They say oh,
that's kind of weird isn't it? - Yeah.
- And I'll say, must be 'cause that's probably
because your L5 nerve is being interrupted.
- Effected.
- Yep, exactly. - Right.
- So that's the great toe.
We call this the great toe, not the big toe, by the way.
- Right. (laughing)
- In the medical world.
- The king toe.
- (chuckling) The king toe.
All right, what's the next one?
Do you want to lie down, Bob?
- Sure.
- You want to go on the other side?
- Sure. - Just so the leg is closer.
You want a pillow?
- No, I'm fine.
- Your gonna tough it out?
- I'm all right.
- So in the supine position,
we're gonna do the straight leg raise test.
So remember, like Bob had mentioned
that nerve exiting the spine goes to the pelvis
on and around here, all the way up to the foot.
- So if you visualize it,
you should be seeing how easy it is to stretch the nerve.
- Exactly, so I'm gonna take Bob.
Did you wash your feet this morning, Bob?
- Nope.
Of course I did.
- Of course.
Keep the knees straight and have the person relax.
I'm gonna lift Bob's leg up.
Now a normal straight leg raise
will typically go up somewhere up in this area
and what's gonna happen on a normal one
is a person gonna say, "Oh, I feel my hamstring
- Exactly. get tight".
That's normal.
Now on this,
somewhere between 30 and 70 degrees, they found.
Which say 30 is somewhere in here.
70 would be up in here.
We get up and all of a sudden
- Ah.
- That nerve is being pulled
and often times, especially if they say,
"Oh, I feel pain in my buttock"
is a real common one or in the back.
You can be rest assured that your nerve is involved.
- Right.
- And if you do this and pull up like this,
that can even make it worse and make the person really jump.
- And even worse, you bring your head forward like this.
- Yeah, because that nerve goes to the spinal cord,
the spinal cord goes to the head and everything's connected.
And you can double check, go to the good leg
and you'll find out,
you can do all these things and they say,
"All I feel is hamstring pulling a little bit".
- Maybe half stretched
- A little calf stretch, - Right.
- But they're very distinctly different.
So that's the next test that you do.
Now, typically for a nerve, there's also.
- A reflex.
- A reflex test,
but there's no good reflex test for L5,
so that's off the board.
So it makes it easier.
- So, you're really looking at two main things,
location of the pain and the straight leg raise.
- And one other thing is look at the person's posture.
- Sure.
- Now this can happen at different levels,
but it'll happen at L5 or L4.
It may be all three,
but L5 is so common.
The person maybe, say if it's on the right side,
leaning to the right and forward a little bit,
and Bob likes to talk about the pig thing.
(both laughing)
It's one of our.
- It makes look like you're carrying a patient.
- Yeah, so what happens is
because there's a bulge there, your body naturally wants
to open up that area so the bulges has less pressure on it.
Take the pressure off.
And the person kind of walk like this.
They come into the clinic walking like this and right away.
- They're trying to lean away from the pain.
- Right, so right away, I'm thinking,
man, that looks like we've got a bulging disc.
- Right.
- But you can't make that assumption.
You have to do the other tests first.
Did we miss anything else, Bob?
- No, we have a specific treatment for that too.
You can just look up our YouTube videos,
crooked back, basically.
- Crooked back?
- Crooked back that's what we called it crooked back.
- Oh, that's the title?
- Yes.
- If you go to our lower back pain programs,
there'll be 40 videos all dealing with sciatica
and that will be one of those 40.
- So, go to bobandbrad.com.
Go to the program section
and look for the one on sciatica.
- Right, exactly.
And the neat thing about this is you can print off a PDF.
It's gonna show the exercises, a review of the whole video
and it's all for free.
Absolutely nothing, so take advantage of it.
You can get rid of that sciatica.
- Sciatica. - Yep, there's a good chance.
- The L5 nerve root pain.
- Exactly.
All right.
Good luck with your self-diagnosis.
I hope we've helped you out.
- Thanks for watching.
- Be careful.