♪ Bob and Brad the two most famous ♪ ♪physical therapist on the internet♪ -Hi, 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 Alright, let's get going Brad!
Today we're gonna talk about the absolute best exercise for Sciatica and a herniated disc
-wow Well I mean– we're not exaggerating here are we? -Nah, this is– this is proven, yeah And if you had a choice of what you're going to do with somebody, this would be it, right? This would be my first try, yeah
-Absolutely And it's the McKenzie approach, or McKenzie exercise Invented by Robin McKenzie, he invented this in the– he came up with this in the 60's And basically he discovered is that by
[jingling off screen] Doing a— Doing– certain movements of exercises– I'm sorry.
I got a little distracted by a dog back there. [laughing But by doing certain exercises you can actually centralize pain. Centralize. What are we talking about, Bob?
-We're going to show you right now. So, this is for people that have back pain with associated pain, numbness tingling, down their leg. -Yeah
-Should I stand, or…?
-Yeah, why don't you stand… -Should I just do this?
-Okay, there we go! Alright. So, when you have sciatica, quite often you're gonna have pain in the back, and then it travels all the way down the leg.
What he discovered, is by doing certain exercises, you can actually make that pain go out of the leg, and back into the back. And eventually, it's going to go away if it goes into the back.
-Right So what happens is, when you're doing exercises, what you want to see first is that maybe it goes out of the calf. Of course, I'm having trouble right away,, Brad [Brad] That feels better.
-Yeah, so it goes out of the calf.
All of the symptoms go out the calf. Then we do some more exercises, and now it goes out of the thigh. Okay, we do some more exercises and it goes out of the butt. It's– it may be even a little worse in the back, but eventually this goes away, too. This all goes away.
[Brad] And it's important to mention, that's the order you want it to come in. You don't want it to leave here, but still be in the calf. -Yeah, the worst sign with somebody, when they have Sciatica, is when this goes away, and this gets worse or stays around
-Right That's not what we want to see.
[Brad] And the.. the prognosis is if you can do the exercise that we're going to demonstrate, and the leg pain improves quickly It's a very good sign that you're going to have good long-term success with this We're going to show you at the end of this– We're going to show the exercise now, the basic McKenzie
-Right At the end of this video, we're going to show you then a disc– what happens with the disc when we're doing these exercise, so you can kind of have an idea. I'll do this, do you want me to do this?
[Brad] Oh, go ahead Bob. You're better at this than I– So what are you going to first start by doing when you have this, when you have a McKenzie therapist, they're gonna tell you to start by laying–
just laying prone like this. Now, for some people, even this they can't do.
-Right This this will even make their pain worse So, they actually have to start with a pillow
underneath them -Like that
-And then you can lay here more comfortably or comfortably Sometimes two pillows, I've even had to put three pillows underneath somebody A lot of times, I'll put the pillows this way instead of this way, but you do whatever works. Yeah, I've done it both ways, Brad So then, you want to lay that way for 5 minutes or 30 seconds or whatever, and then you see if you can pull the pillow away and get like this.
-Right Okay, and then eventually, you know, you can try for thirty seconds or so– There's no magic to the time of this, but then you eventually you might get up onto your elbows, which is a prone prop.
-Right, and this is assuming– You only do this if the leg pain and symptoms improve, particularly below the knee, or the furthest away. If they don't improve, at least they don't get worse, right?
-Right. But, we're hoping that you might get a little improvement even. That you might start feeling less tingling or less pain down there. Then, you're going to go progress to the actual exercise, where you're going to put your hands underneath your shoulders And you're going to do– I would say a half press up first, wouldn't you, Brad? Yeah, whatever is tolerated I like to say. and if you do 5 or 10 of them,
by the 5th or 10th one, it's getting easier, the pain in the leg,
or the symptoms in the leg I should say, cuz it could be numbness or tingling, improves, and you can get a little bit higher.
-Then you can go even higher. What you're not going to do here is this….
-Right You're looking to get an arch in the back.
You've got to get the arch. -That's critical.
-Yeah, I tell my patients, imagine there's a belt going around your waistline, holding your waistline to the table or the floor.
-And eventually, sometimes that's what we do to people. -Yep, that's true Again, you do half press-ups, and then eventually you're going to see if you can do full press-ups. -Right
-And most of you won't be able to do that, because your pelvis is gonna start to come off the bed, because you're going to eventually work up to that. And you know, as an exercise, you can do this 3- to 5- times a day, 10 times… I've even had people do it as many as every hour, if they can do it and they have the time
-Sure, if things are going well with it. Yeah, and if things are going well.
Now, what you should know though, is that quite often, it doesn't go that well. Quite often, there has to be little adjustments that have to be made, and that's where you're going to need to find a McKenzie-trained therapist.
-Sure We're going to show you that in the next video, how to do that. But right now, why don't we show, Brad, what we're doing–You wanna grab the… cups there? [Brad] So, there is McKenzie-trained therapists throughout the world We counted at 38 countries throughout the world, and that's how you can find if they live near you, so you can get one– There's these therapists– they're good, and they're experienced. Right, so we've got the lower vertebrae here… Do you want to show it on here, Brad?
-Sure So… You want to run up to the camera to show real quick? Ok, so we're looking– if we have an injured disc causing the symptoms down the leg, this red disc You don't have a red disc in your back, but that is a model of a bulging disc right there.
Can you see that, Lani? okay? We need to get that bulge back in, because that bulge is pinching the nerve, causing the symptoms down the leg. So, generally what you have– again this would be
L4 and L5, the two lower vertebrae of the back and in between it you have the disc, which is… You know, it actually provides shock absorption.
-Right. It's not a very– it's not a rigid structure it's actually pliable, similar to this model. And what happens is, whenever you bend forward–
and that's one of the McKenzie questions they'll ask you to see if it's appropriate for you–When you bend forward does that often give you trouble? and does that bring on your symptoms? -Or does does sitting?
-Or does sitting, yeah. And what happens is– what you'll see if you keep bending forward, bending forward It's fine on a healthy disc, but on a disc that start starting to… -Ooo, that's a good good example..
-It's starting to weaken or get… Are you picking this up, Lani, by the way? A disc that's starting to weaken can actually bulge or herniate towards the back, and there's nerves back there. and it's hitting those nerves, and it's sending pain down. So, conversely the idea is that if you bend back this way, you're pushing that bulge back in -Yeah, I like to see that, Bob. Push it back like this, it takes the pressure off the nerve. So that's a very simplified version of what's going on, but that's hopefully what is going to happen to you
-Right And again, you know you can try these things, but you really may need a therapist in the end
to help you out Yep, exactly So, we're going to show them that video on how to find one if there is one near them. -We'll do that one next! Oh, yeah, next! [laughing]
-Alright, thanks a lot wow