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
How to relieve your sciatica pain when you're sitting, we got three fast pain relief methods
Kind of magic Brad wouldn't you say?
Well they can you know it really can turn the pain from down the leg to turning it off
But first of all we want one more thing, yeah in case you are new to our Channel
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All right, we're gonna first show you why sitting is generally bad for sciatica
And that's why in fact sitting can often cause sciatica right right and that's one of those things that is oftentimes overlooked
You know we often times mention Robin McKenzie
And he's really one of the fathers of therapy for sciatica
And this is where he discovered and always brings up posture with sitting and then you sit even with good posture
Your low back is stressed and those are stressed
Particularly if you're slouched and so we actually have a model here so that you can visualize what's going on, so we're gonna show you
What's happening here. So this is the spine and the spine is lined up just like me right now
Here's where the head would be here's the pelvis and
We're nice and straight right now but if you sit down and
You slouch like this and so the spine is like this
Brad's going to show you what happens to the discs, right
So this represents L4, L5 2 of the low back vertebrae right here and the green ball
Represents the disc and in your discs does have fluid in it
And that's what can cause the herniation so when you sit slouched that low back
Will do this and it bends forward and can help force
That disc into that bulge
Which then pinches a nerve which then creates a sciatica down the leg all that pain
Now this doesn't happen to a healthy disc a healthy disc you know you go for years and years where you're slouch and nothing's happened
But over time the back of the disc becomes weakened and that's where you have the nucleus pulposus
Actually start pushing out through the center, there you go there, so technically speaking nice job
I feel like we're a magician here like we gotta duh duh duh duh. I don't know if we'd make it in Las Vegas
Okay, so keep that in mind when you're sitting you got back pain you have sciatica
Remember that if we want to get that pelvis to actually go to it anterior tilt or a lumbar lordosis
So we keep that bulge wants to stay in so again here the the pelvis now is turned backwards
This is a posterior tilt we're gonna tilt it this way which actually you know puts a curve in the back
It's the natural curve. It's the neutral or the way their spine is meant to be so we want to get that anterior tilt
This way, not this way should have put the tape on my belt. Yeah
Bob I don't know, so the first thing and this is not oftentimes utilized is
Your chair if you have a computer workstation chair sometimes
They actually have a seat pan that tilts forward and some people aren't even aware of it
There's gonna be a lever underneath, and if you have a look for it
And you can actually tilt the chair forward and what that does is that puts your
Pelvic and that anterior tilt, now this chair
Actually tilts backwards so sitting on this chair with sciatica is actually gonna
Accelerate and make that pain worse so we're gonna
They make seat wedges or where they're thin in the front about two or three inches in the back. Yeah
And this one's actually the wedge seat. I'm going to read it brad is by Ergonomic Innovations
I'll put a link down below. Okay it
It's a really high-quality one. It's got a nice
Kind of breathable fabric
And you're not gonna slide off of it and so you sit on there
And I've had patients use these and they say jeez it feels funny
It feels like I'm falling off the chair, and it's because it tilts you forward
And it just naturally puts that natural tilt into the back
And that's what you're looking for it's kind of like when well if you're my age
When you start wearing seatbelts when you were about 16 when they made it a law
Seatbelts felt really awkward and funny
But after you wear them for a while just becomes natural and that same thing would come with putting the
Seat tilted forward or using a wedge. It'll just feel natural after a while then you'll feel awkward in the wrong position
I think the one place where this has a role Brad is if you sit a lot
And you're working forward at a station like this
And you really can't use the backrest because if you use the backrest you slouch
So this kind of, if you tend to work like this it's gonna help keep you in that position
The other place where it really comes in handy
I think is if your seat has like a bucket seat on your car,
Because that bucket seat is gonna really cause your low back to round out
I mean if there was any place I would recommend. It would be in the car
You got that seat that has an actual it's a hole in there
Yeah, drops your pelvis right in there and rounds that back or an older seat too
The other point we're gonna make is that you know the sciatic nerve
Comes out of the back. You know a bunch of nerves come together, and they go through the sciatic notch
Which is near your sit bone, so you know your nerve is already irritated
The sciatic nerve is already irritated
So the cushion here sometimes feels nice on the sciatic nerve, you know some of the pressure off
So you're getting a double benefit there, yeah now along with this is you could go
Use this and a lumbar support or just a lumbar support by itself and
There's three basic lumbar supports that I'd like to recommend. I think Bob is in the same boat
There's like a halfmoon one
There's the round one and then there's the larger
Type like this, for a full seat almost
Full back, and we really like the one with the memory foam and
Bob actually likes to use this one, I like in my office chair. I don't like it in my car
You like it everywhere. I love it in my car is
I can't grab it without anymore, and I like it in my riding lawnmower
You're quite a sight Brad
Yeah, so everyone's a little different you have to kind of experiment with each type and what that's gonna do is help
Maintain that arch in the low back
This is probably Brad
I probably should have me show this because you've got a black shirt, right black on black
We don't need that so we're gonna go ahead and
We're gonna show it on me now you can see how that creates the arch
There you go now. I actually like it a little lower in the kind of hitting my pelvis here
And that's where it feels really comfortable for me
And I think a lot of people do because when I tell people to put it down to the point where it feels comfortable
They usually go down to almost like beltline and a little bit below
And you'll know where the right place is you're gonna adjust it to fit where it feels the best you're gonna lean against it
it's just gonna feel like a
Wonderful feeling it's support where it's supposed to be now Bob
You said you like this one in your computer chair, right
Because it actually kind of keeps me forward again because I work like this
I'm not working back like this so it gives me support even though
I've got to kind of a lean forward, sure you bet the other point
I was gonna make Brad is that what I have found just has been my experience
When people are in the throes of back pain
They're having sciatica
They tend to like the thicker ones and then after a while once the pain is gone
They tend to go to a thinner one, it might be like this and oftentimes
Larger people will use a bigger one, if you're a real thin person
It's probably gonna be thinner it does depend on the chair back the framework of it and how soft it is
Generally as a recommendation here. We recommend is just take a roll towel to start off with Bob
Oh there we go
Yep, and then you can decide what thickness you want and you can see does it work for me at all
I mean don't spend any money unless you have to it, give it a try and see if this helps
If it helps you're sitting then go ahead and maybe make the purchase and get something that you're gonna use on more of a
Permanent basis right yeah, I actually did that a little bit backwards, but that's alright
Start with the roll towel and see what diameter you need, and if the roll towel works fine, you may wanna just stick with that
People will talk about you in office, but that's alright yeah,
And you can use it if you get wet you can unroll it and you know wipe off a little bit. Wipe your tears
Well, I'm trying to picture you cutting the lawn Brad. You don't use black socks with shorts do you?
So what?
Don't give that away
What's the next thing? Then the last thing is very simple, Bob every 20 minutes or even sooner depending on your symptoms
Just make sure you get up and stretch or even better go for a short walk
You know if you need to walk to the printer, if you're a truck driver you're sitting
Hopefully you can you know stop and take a break and go for a walk any of these
Locations and jobs that require long term sitting if you can get up and do some walking is gonna help
Yeah, and to be honest Brad. With a lot of my patients with sciatica
I tried to tell them to avoid sitting
If they can and like you said a lot of them can't if they're driving or such the other thing
I think you tried quite often especially if they have the electronic adjustment
The lumbar role in your vehicle
Some people have that where they push a button and it comes out and give them support, you talk about
Varying that right through the ride, you're not gonna have it out
Usually I say bring it out as far as you can or whatever is comfortable
Which often times is as far as you can
But after you know an hour that way or thirty minutes to an hour you may want to vary it and go in a little bit
So it changes the back you're not going to go in so far that it rounds the other direction
But you can vary back and forth every you know twenty minutes half hour
Half inch or so so your spine isn't stuck in one position for prolonged period of time, one last thing too Brad is
We did a video on using one of the sit to stand desks
And I just set mine up even after all this time, and I do love it
I mean, but I have two computers, so I when I work on one computer let's just say email
I stand and then I go to the other computer, and I sit
It's just really a nice balance it really helps my posture, so you got the sit and the stand
I just leave it up
Yeah, I leave it up completely and then I go to another desk which is already lowered, but with that Flexi spot
Sit to stand you don't have to do that. You can just lower it down and sit
Exactly. It'll do both. So okay, all right anything else Brad? No Bob once again
This is just another step getting closer to fixing that broken heart. We can fix just about anything except for a broken heart
Thanks a lot