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, the big lie about MRIs and x-rays
Imaging in general. What should you know? What should you do? Sure and we're gonna go over that by the way
We're joined by Sam the super skeleton. This is from 3B Anatomical if you're looking for a skeleton
That's where you want to go 3B Anatomical
They gave it to us, really a high-quality, and it's got all the information you need on there, and he's very pleasant
I like the fact that his head moves. Yeah, you really get a good range of motion, it's cool, and it's Gumby so Bob all right
We're talking about lies with the MRIs pretty strong language
We got to explain what we're talking about, we want to make sure we explain ourselves because we don't want to get too dramatic here
but the fact is
We got a whole bunch of studies that we're gonna cite here, and I think it's gonna help you determine
Why we think it is a problem quite often, when an MRI is done or imaging is done
But before we do that Brad if you are new to our channel, please take a second to subscribe to us
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I saw this actually on Twitter believe it or not, I'm a Twitter guy
And they had a whole bunch of studies cited that went basically from almost like the head down to the toe of
Different areas and let's just talk about one right away. That'll explain it. So there was a study where they had
1211 people now these people had no symptoms whatsoever
No pain, they were living a normal life. And they did an MRI of their neck, and of that
1211 people
75% who were in their 20s had a disc bulge
So like the beginning of a herniated disc, so there's no pain. There's no symptom
So is there something to get excited about? Of course not
It's a part of aging, and I remember studying that Brad when I was in school
They said neck deterioration begins in your 20sm your early 20s already so take this scenario
What happens if someone with neck pain goes in and they have an x-ray done or imaging done and it shows a
bulge, what are they gonna say? The bulge is the reason, the bulge is causing the pain, when in fact there's a
Really good likelihood that that bulge had been there for a long time
And it could be from another source of irritation
Right, it wasn't the problem right and and so this person gets all upset
I have a bulge in my disc
And I need to take care of it, do I have to have surgery, psychologically it's a burden
It is a burden to carry right so let's go down Brad on Sam the super skeleton here
Let's talk about the shoulder, now they did a study this was a smaller one
They only had 53 people and they were aged 45 to 65 that again no symptoms now on the shoulder
There's a little ring of cartilage called the labrum and they found out that 72%
Had a tear in that labrum, but they were functioning normally, no pain no
Decreased function I mean everything was fine so again. They go in with a shoulder problem
They find that tear they're gonna go
You need to have surgery, when in fact it may be that they were washing windows, and they actually have an impingement problem
But it's the labrum shows up, and it's like oh
That's where the attention is drawn and not from the fact of the impingement, which could be the problem
We're not saying
You don't ever not have surgery on the labrum because there are times you do need to
But I'm just telling you it gives you pause and what I would prefer
Quite often is that you try therapy first and let's see if we can find out a solution to it
But let's go on further Brad how about the low back? Yeah?
This is a big one here Brad so this one
We mentioned this one before in the book Pandemic by the way
They had a really a lot of studies cited with this
But this one had 3,110 people that they looked at no symptoms of those
3,110 people
80% had a disk degeneration so
the disk
Is losing height, it's shrinking basically 80% and 36% had a disk protrusion
That's actually the disk pushing out, bulging out going at that herniation
Right so again. You have low back pain
And what's gonna happen as soon as you see that if someone points that out you're gonna go
I have a disc bulge or disc herniation. I have to have surgery
When in fact no you should really try some therapy, and you shouldn't probably even have the imaging done at all, so
I'm gonna mention these guidelines right now Brad
These are guidelines that were put out by the American College of Physicians, and they realize this too
I mean first off
This is no knock on physicians by any means we know the pressure they're under
A lot of patients want to have an answer
And a lot of them are pushing the doctor to get an MRI
I hear patients say it all the time. I want my MRI. I want to find out what's wrong with this right now
Let's get the MRI. But these guidelines by the American College of Physicians that was put out they said
Clinicians should not routinely have these imaging done
With just nonspecific back pain the only time they should have it done
Is if they really highly suspect that there's pushing on a nerve, some neurological you're getting pain all the way down the legs they're getting weakness
Or if you suspect something you know a little more nefarious like cancer or if they've had cancer before and
You're worried that there may be cancer there, right and that's something the doctor has to determine
I've got a friend that he was a physical therapist when I first started and he became a
Radiologist and I asked him after he became a radiologist he was working I said so why should you have an MRI on your back?
He said if you're gonna have surgery
So they could look in there and have the best
Knowledge of what's going on in there and he didn't say that was the only time, but that's a really good time
But he said yeah, it's overdone. Let's go down to the hip
We've got two more, the hip and the knee
This was a study again not that many people forty five people
Aged 15 to 66 no symptoms
69% had a labral tear again, that's kind of cartilage in the hip. Right it's like a labrum in the shoulder different joint
Let's go to the final one the knee Brad
Forty four people they took a look at no symptoms
But what's amazing about this forty three had some abnormality in their knee so that's well over ninety percent
Yeah, 95 percent. That's almost 98 percent. I would imagine
Of course I'm not that good with numbers, I don't wanna get into that
so again
Why is this a problem if they find this because psychologically
What happens is you start thinking you can't get better, in fact they looked at this over the past
Several hundred years and the amount of
people with back pain has not changed, I mean it's staying about the same people have had back pain since the year 1400 or
In the 1400s, well since it's been documented. Yes, since it's been documented, but
Although that rate has stayed the same the amount of disability has gone way up, and it happened right around in the 40s
And that's when they started with doing imaging, and not that imaging is not needed because it is
But it's probably overused
Brad and I run into this all the time. I hear statements like well I have a disc bulge and therefore
I can't do stuff anymore.
They basically become disabled in their mind because of what they found out on the imaging so
You know the alternative thing which Brad and our
approach always is and it doesn't work for everybody and there are people that should go on and have surgery if that is the case
But basically no matter which joint it is if it's neck back
Shoulder or knee or hip you're gonna try to get movement going and you want to find a movement that actually
Doesn't hurt, you know actually after you do the movement or the stretch
That it actually feels better and you regain some more movement, and then you know you're right on the
Exact prescription for the movement, right so we thought we'd take the hip, we talked about the hip
A very common one again that people started having some pain in their hip expecially as you get older and
One that I like that's really easy to do is let's say I'm having pain in this hip
What I first do is I'd put this leg up like this and see how high the knee goes
Is up and how far I can push it down and
This is measuring external rotation on the hip, now I put up the one that's giving me pain
Let's say that's up like this, I can see that
It's tight and that's usually the case. It's gotten tightened on you, and so what you're gonna
Do is you can start doing some
Stretches on this
Yeah, just a gentle pressure on pressure off pressure on pressure off and I go oh that
Doesn't really hurt. You know if it actually feels better afterwards,
That's a good sign
So you're gonna keep stretching out that hip and a lot of times that correlates with a
Reduction in pain, so another one would be hip flexion
That stool would work well,
So you test one and the one hip doesn't go as far as the other and you can feel it when
You do it
So if I put this one up this one goes way down like this so you can see the hip flexion going on
But this one only goes this far again you can just gently work into that pressure on pressure off
Pressure on pressure off if you get sharp pains produced it's not the stretch to do you need to
Stop that and look for another one that is going to be productive and pain free, these can be done at every joint
The neck is full of joints the shoulder is a joint
Give you something to hold on to for balance there so I'm gonna stretch this one right here
So I'm just gonna go ahead and I'm gonna lean forward like this and now I've stretched this out
so right here
We're getting that hip extension and people who sit a lot this can be a problem if you have a desk job
And then you drive you know a long way to work and back
This muscle commonly tightens up, very often tight on people
So this is a great one to do to start loosening up
That's just to kind of give you a little
Taste of what you can do for your joints because you know it's funny
I have a friend that ended up having a hip replacement, and I to this day of course
I'd never say this to him, but I really think he could have avoided it if he would have stretched out
It just wasn't that bad. I hope he's not watching this video. Yeah, he won't know who he is
All right
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