Hi folks I’m Bob Schrupp physical therapist, Brad Heineck, physical therapist. Together we are the most famous physical therapists on the internet of course in our opinion of course. Today Brad we’re going to talk about sciatic pain exercises that will work for you, now we’re talking about two different types of sciatica at least two maybe we’ll go to three, we’ll see how much time we have and really depending on what type you have you really need to take different approaches and that’s why we’re here Together we’ve got over 55 years of therapy experience, and we’re just taking all that from our knowledge history I have to add it up, but I think maybe more than that, pushing on that 60-year marker. Yeah well We don’t want to think about that We’re gonna educate you on how to kind of self diagnose so that you use the proper exercises that are gonna work, give you some things you can try and see if one works for you And if it doesn’t, maybe try the other opposite method. By the way if you are new to our Channel Please take a second to subscribe to us We provide videos on how to stay healthy, fit, pain-free and we upload every day, also go over to Facebook and “like” us because Brad and I as children Oh Bob, do you have to keep going back, we were not liked Okay, let’s start off with the first category, okay, so sciatica Let’s just go to the basic, it means you got some back pain that radiates down one leg And it can go usually past the knee, down to the calf, the ankle, and the foot, you get pain, numbness, tingling and even weakness if things are really getting bad. Right now I have a patient His just goes right down to his calf right here It’s specific and then three of his toes are very numb And we’re having some success with getting rid of that. We’re having little problems, but This is exactly the same mindset that I use when I work. There’s always problems Yeah, I mean it usually doesn’t go smooth, right, but that’s why we’ve got options Okay, so if you’re in a situation that your legs symptoms, whatever they may be, numbness, tingling, burning Etc, if they commonly get worse with sitting or when you get up from a chair It’s kind of hard to straighten up, but once you get moving it improves or if bending over, if those three things increase your symptoms and pain down the leg and Walking usually feels a little bit better then We’re gonna give you five options of exercise, these are the ones you’re gonna want to try if that’s what you’re feeling Oh, yeah, and generally if it is worse, in 80% of the cases this is gonna help, if bending forward makes it worse. So the first thing if walking typically feels good That’s the first thing is get out and walk more Make sure you walk on the flat. Don’t walk up and down hills or a road that’s crowned make sure it’s flat That’s gonna be the best thing for it–and don’t walk beyond the point where it starts hurting It could be a little troublesome if you get out so far, and you can’t back Yeah make sure you can call your wife or family member, they can come pick you up with a car if you’re two miles out You’ll usually walk around the block or something You’re close to home, something manageable, but the walking really is good for your back, it almost always is good for your back Unless it’s making your pain worse and we’re gonna talk about that in a little bit Okay, Bob. Should we go to the gold standard exercise? All right You’re gonna want to start with again the problem has been bending forward so the solution is bending in the opposite direction And a lot of times we start off with sometimes people can’t even lay like this can they Brad, they have to start with a pillow underneath them and that’s alright I don’t need to show that right now Hopefully if you can lay without the pillow, you may want to lay here for a few minutes and sometimes even get up on the elbow for a few minutes The gentleman I had worked with yesterday He would be in this exact position and his leg symptoms in the calf and the toe: back to normal within a minute. Wow and it was like it was just that easy then you want to progress to get a little more aggressive, if you want to start putting your hands underneath your shoulders, and you’re gonna start pressing up The key to this is that you’re keeping the pelvis on the bed, you’re not lifting the pelvis up like this If your back is really tight, which often it is in sciatica Because you haven’t been bending in this direction, you may only be able to go this high to start And this is exactly the case with this gentleman, my patient I have now, he gets about this high, and then his whole pelvis comes up, so we’re working on that So one thing to do is just gently start stretching it more and more But the other thing is to actually take a strap or you can take a roll sheet We like our yoga strap here don’t we Brad. That’s a nice product, so what’s nice about this it’s got the loops. You can put your hands in the loops and be comfortable I was using this this morning Brad to stretch my hamstrings And I could relax and so I was trying to wake up so you can see here now I can give a little over pressure and it can help stretch it more And if you want to work your way up on the loops, you go like this and stretch it even more And I can keep going up the ladder here That doesn’t contrast well with my shirt does it, well the red’s okay, I’ve been flipping it yeah This actually feels really good. What’s the next step Brad, because I know there’s some variations here, we’re gonna show. Right well actually Well, yeah, you just stay there. There’s one in the middle here I’m going to throw out that I always have people Just try quickly is some self traction so at home if you can get a couple chairs or a countertop and just go between here and gently lift yourself up, trying to keep your core relaxed So we’re going to use the weight of our legs as traction and our low spine to help separate, get the gap where that nerve is coming up Take that stress off of there and get rid of the symptoms, now if this is gonna work, it typically works as soon as you start taking weight off right there. It’s like oh that feels good So he can lean forward a little bit, put his weight on his toes I’m not going to do this because I’m too tight in the stomach We just sort of stay relaxed here, lean forward and gently take the weight off off your feet. If this works this is something you can do every hour sure I mean We’re not saying you will do it every hour, but that’s how often you can do it So you can do it five times a day four times a day and this one you’re gonna know it right away, now the gentleman I’m working with, this one does not work for him at all but it’s okay because your other ones work great right but It’s an experiment quite often where we got our crazy lab going here, so on your back, this is a rotation, on my back, yep, okay This is gotten me out of trouble a number of times with patients where the prone press that’s not working, haven’t been shifting them and So you bring the knees up like this Now this with a patient you do it on a table But if you’re doing this by yourself, you can do it on a carpeted floor because you don’t want to fall off And we’re just gonna rotate this way and back, you know this one. Yeah. Yeah, actually. Generally what you want to do is go to the painful side, first because if the pain is going down this leg you want to bring it up and go this way and what it does, it actually opens the little hole that the nerve comes out, the frame, I wanted to use a layman’s term here and they can actually gap in and give you some relief, so one thing I do is I have the patient lift up your butt a little bit and shift away Yep, so you’re already kind of in that motion, it just helps, one of those little tricks all right, and then of course the roadkill and why do they call this roadkill? I’m not really sure But you could call it whatever you’d like. Again it would be the painful side, right yep We’re going to assume the painful side is my right side, the right leg So I’m gonna bring the leg out like this and you can actually put the foot touching the opposite knee, right looks kind of like a figure four looking down from the top Now typically if this one works, as soon as you put the leg up there things start feeling better Okay, and then you can add the press up with this And sometimes as a variation of that people just take a towel, you were thinking that We’ve been working together a long time haven’t we Brad? So he puts a towel just underneath my pelvis and you can try that without the roadkill and quite often that’ll do it, another one just real quickly Brad is you can shift, Yep, you can shift your hips away from the pain. Yeah, so I’m making a banana Show the banana yeah, so if you’re looking down from the top The right leg is painful so you’re gonna shift your hips Yeah, and it And then you do the press up with that shift in there, so basically we have this big bag of tricks And we keep pulling them out to find out which one’s gonna work. Now if you find yourself normally, you’re like this and you’re kind of hurting, and you can’t straighten up, and you feel like you’re walking crooked like this Then if your shoulders are shifted to the left, you’re going to take your left shoulder Go to the wall, this arm I’m going to bend, I’m going to hike that shoulder up a little bit. Putting it right here Because I’m shifted here, and I’m gonna actually make the shift go away gently I’m gonna press in here and straighten my back And I’m just gonna do that gently and over periods about five to ten repetition, now as you’re doing it you’re getting straighter, and the leg pain feels better The whole thing about it is you if you have this body shift, you have to do this or you’re You need to get straight up and down, you have to get straight So after doing these then you’d feel like you’re back up in line. You may be doing this for a couple days And you can do it gently and be careful with it and you’ll do fine alright Let’s talk about the other situation Where you actually have pain down the leg, a lot of times more often in this case, I think the pain is often down both legs We’re talking about the other type of sciatica And it often goes down to just the knee. It doesn’t go down further. I know ones I’ve seen anyway. Well Yeah, I’m not gonna, I don’t agree with that, but that’s alright, either way, it’s the same treatment Well, it’s just in my experience. Yeah, so and well talk about the symptoms Brad Well whether it’s down both legs or one, but either way standing in one spot usually starts to irritate the back and the leg pain Walking and if you find yourself with a grocery cart, and you lean forward it feels better Yeah, they actually call it grocery cart syndrome and that’s a really big sign is if you lean forward and if feels better when you’re walking Or when you’re standing and you’re walking and that leg is bothering both legs, and if you sit down and it consistently improves as soon as you sit it’s like oh man the symptoms come out of the leg and then what we were just describing and you’re doing the opposite things actually you want to bend the back in the opposite direction Right and this is a much simpler protocol, isn’t it Bob So you’re doing a single knee to chest first so I’d probably start, if you’re having pain down one leg or down both legs, either way you start with one leg like this. And you give a little bit of stretch here Start pressure on, pressure off, pressure on These should feel good, this should feel like a nice healthy stretch You can also do it on this leg, stretch it, then you’re gonna stretch both by bringing one up first and then bring the other one and then go ahead and stretch like this Now if this is difficult for you to do, you might have to take a sheet or a rolled towel underneath it or you can again take the yoga strap and you can go underneath like this and this works out really good because you get into the loops This is for people, if you’re a rounder person, you don’t have to, you have shorter arms, you can’t reach your knees. It’s not uncommon Pressure on, pressure off, pressure on, pressure off, Alright, then hook line rotation. Yep now This is a little different than the one we showed you before, the one we showed you before you actually In this one before we brought it up and went over, this time we keep the heels down And I call this the windshield wiper because you just go back and forth like windshield wiper and you’re gonna just go gently, if going one direction is uncomfortable, avoid that direction, go the pain free way And typically the other way will loosen up with time Again ten to twenty reps of these is good, this is a good one to do out of bed in the morning Or any time you lay down Yeah, you wake up real quick with that so, all right the last one Brad is kind of your deal, isn’t it? Yeah, this is one, because I do have some Stenosis in my back and it typically goes down one leg and my left when I put my leg up on a step at home or on a chair But I usually just step and I’ll just go like this and I’ll stretch and I’m really flexing that out And it just feels like a good stretch, and it makes that leg feel better quite rapidly So you can try that one. So you like it a lot like when you’re out and about like watching an event or something like that Track event and I’ll go up to the bleachers, stretch it out like that That’s a good little tool, for that tool chest for you to try, so all right Brad well we better wrap it up here, we’re way over time, I didn’t realize that, the way time flies. Thanks for watching.