This article is a transcribed edited summary of a video Bob and Brad recorded in June of 2017. For the original video go to https://www.youtube.com/watch?v=01W9RCXKgys&t=614s Bob: Today we're going to talk about the big lie about trigger points, which you might know as knots, and how to get rid of them. This is a big topic for a lot of people. Brad: Right and we're talking seriously, we're using the three-letter word 'lie' so we have some attention here. Bob: Right, we need to back this up. Brad: There is a great bit of truth to this, so we're going to get into it. Bob: Trigger points are also sometimes known as myofascial trigger points. It's very controversial as to what causes them. That's been the issue for like a century. Generally what it is, is a hyperirritable spot and a common spot is like in the upper trapezius. You're going to find a nodule and you push on that and it really is sore. It just feels like a knot right in the area. You can get them all over different spots here, you can even get them in the low back, in the buttock, so that's what we're going to be talking about. Brad: Right and there's always a trigger point right about there on pretty much everyone. Bob: Yeah you can feel a little bit normally there and that's because a lot of people have bad posture. So for years, people thought, and this is back in the early 1900s or 1900-1950. They thought it was in the muscle itself and they called it fibrositis. That was a common diagnosis. That kind of went away and now what we believe in our opinion, in most cases, even though you're having trouble in the muscle, is it's coming from the neck or the spine. Brad: Right, another irritated tissue is causing the muscle to spasm or tighten up. A referral type of pain. Bob: Yeah it's being referred from the neck and it goes into the muscle. There are three signs that you can look at to figure out if it is really muscle or if it is coming from the spine. So we'll talk about those. Number one, if it is in the muscle when you test the muscle or put resistance on the muscle, it'll hurt. Brad: If it is a muscle issue, so this is not a good example but, if it's at the bicep and to stress that muscle you put it at mid-range. Bob: And I push on it and if it doesn't hurt there's no lesion in the muscle. That nodule you're feeling is not for the muscle itself it's from somewhere else. Brad: Right because we're stressing the irritated point if that's irritated the stress should cause more irritation. Bob: Let's talk about a muscle that most people do have trouble with, the upper trapezius. Now a simple way to test it, if you want to be a purist you actually have to bring your head back to the side, turn away, and then bring it up. Then you push on it. Brad: Okay so we're looking at this muscle, so this muscle is working to maintain that posture. I’m going to push here and that's going to make that muscle work even more and I’m pushing pretty hard. Bob: There's no pain. Now a simple way to do it is just to bring it up. I mean you're probably getting mostly upper trapezius. If you bring it up like this and again someone pushes on it and there's no pain. Same way, you can test the other side. Bob: You can test some of the lower trapezius and stuff like that by laying down. If I bring the arm up like this and you push on it. Brad: If I put pressure here with your arms up, so we're working that lower trap right here. Thumb up by the way. Or if I go out to the side, I’m getting the middle trap. Bob: So if none of those bother you, it's not the muscle. It's not hurting in the muscle so let's go to the next thing. Are the trigger points jumping around? I see this quite often in patients that at one moment it's over on the right, it's really pretty bad, and then you'll do a couple of things, you move around and it's on the left now. If that's the truth then obviously it can't be in the muscle. Brad: Right and that’s very common with upper back or lower back pain. One day it hurts in one spot and the next it's somewhere else. The muscle is not going to move around. Bob: The third thing is, can you create these trigger points by doing a movement? For example, if moving my neck makes one of the trigger points worse. That by far is probably the biggest indicator. Generally, if you find a movement that makes it worse, you can find a movement that makes it better. Let's talk about a few of those. So if you're getting trigger points up in the upper traps, one of the first things quite often you want to try is chin tucks. A lot of times people sit with a forward-head and rounded shoulders. This often brings on those trigger points because the neck's in this position. Bob: So you want to do a chin tuck where you're not bringing your chin down, you're not bringing your chin up, you're just going straight back. Bob: See if that makes things any better at all. Generally, that won't, but a lot of times what will start helping is if we start working on neck extension. Brad: One thing that I do, is I may have someone with a problem over in the left shoulder blade, and I'll start them doing a chin tuck and it changes the trigger point pain or that knot pain. If doing a chin tuck changes how that feels or moves the location of it, it's telling me I’ve got to look at the neck. It's not in the muscle it's in the neck. The neck is causing that muscle pain. Bob: So we're going to work on neck extension. Bob: If this is painful when you do this, one again it probably is the cause of it, but two just try shorter arcs if it hurts. If it still hurts you may want to try the towel trick which Brad and I have done many times. So, the Bradley Heineck technique is to actually just put the towel down low, pull down, and then you can lean back and work on doing some extensions. Quite often that takes a lot of the stress off the neck. Brad: I didn't have the other towel but the stretch strap works better than using the, what do they call it, the "selvage" of the towel. Bob: Right, a lot of times there's a little edge on the towel, and a different way to do it is actually taking that edge and putting it up underneath your ears and you're going to pull up now and work on extending back. Do you see how my arms are moving along with my neck? With this selvage or stretch strap, you can go lower too and work on different levels. Again see if that changes the trigger points. Brad: Now you're only going to do these if it helps and makes it feel better. If this irritates it you're just going to stop and you need to go approach it differently. Bob: Right. One last neck exercise that often works is the chin tuck and the side bend. So if the pain or trigger point is on the right, a lot of times if you chin tuck and bend to that side it helps. Again, you can do these every hour as long as it's making things better and not worse. Eventually, people get to this point and then they give even a little stretch. Brad: A light stretch, don't pull hard on it, it's just a gentle stretch. Bob: One of the problems I see with trigger points, especially in the upper trap and the traps is I think they're coming from right here. I don't think they're coming from the neck per se unless it's really low neck or maybe a little bit of what we call the upper mid-back. That thoracic area is really hard to treat. That's why a lot of times people go "well the neck is not affecting my trigger points at all." They need to get into this area and it's really hard to do so. Bob: I’m going to show you a couple of ways to try. One thing you can do is you can take a couple of tennis balls, I actually have two lacrosse balls, in a sock and you're going to roll on them. I want to show you on Brad where they are. So you put one tennis ball on each side of the spine and when you roll on this it'll help extend that part of the lower neck and upper mid-back. It can get some movement in there. Doing that every so often helps get that movement and takes away the trigger points. Brad: Right and you can do this on the table but you can also do it against the wall. Bob: I can tell you, my son was having trouble with this area and I worked on it manually. I mean, as a therapist I know how, but it's really hard to treat yourself sometimes and that's why these things stick around. Again all I have to do is take the two balls, and put one on each side of the spine and this actually works pretty well. I can roll onto it and I'm really working on that area. I'm not having to move too much. Brad: The sock is there to hold the balls in the general right location. If you don't use that they're rolling all over the place. Bob: We'll show the mid-back one and then we can go over to the wall real quick. The mid-back one, again if it's maybe even a little bit lower, it's good to get a ball like this and you can move it in different spots of the mid-back. Then you can do stretches up over the ball like this. Brad: A little spongy of a ball, not like a basketball or something that would be too hard. You need a little give in it. Bob: You can move it up and down and you can try to get that higher spot and it works. I can actually feel that it's going right into that upper area. Brad: I'll have patients, if they respond well to this, I'll give a little overpressure. As long as it feels good and they'll say "oh that feels like a good stretch." Bob: It does feel good. All right last thing, did you want to show it against the wall? Brad: Absolutely, so this is actually kind of hard to do by yourself until you get used to it. You're going to get the balls behind you and lean against them. I've got one a little higher than the other, but I'll have to work that out. Bob: It was easy to do it on the table, you just put a lot more weight on it then. Brad: Right, now that I've got it lined up this is wonderful. You could do it on the floor, a tight carpet even a hard floor. So another good use for lacrosse balls or tennis balls. You know, you just have to have some fun with this stuff. Bob: Remember folks we're not just pretty. Brad: Yeah we're pretty ugly. Bob: No, we're pretty helpful and handy. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble, Snapchat Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Back and Neck Massager Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Fitness: Resistance Bands​ Pull-Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stretching: Booyah Stik Stretch Strap Wellness: Bob and Brad Blood Pressure Monitor Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

We hope to convey to you one of the key points with all forms of sitting and back pain is the benefit of movement and change of position. The most important tactic you can use to combat back pain while sitting is to intermix sitting with walking and movement. The person who attempts to sit with the perfect posture should still intermix change of back positions, movement, and walking. I (“Bob”) hurt my back when moving furniture to a new apartment in 1985. I began to experience sciatica type symptoms. Over the next month I avoided sitting. I did all my notes for treating patients standing at a counter. Eventually the sciatica pain subsided, and I have not had any symptoms since. If I were to injure my back now, I would use a height adjustable standing desk (photo A) or desk converter (photo B). In fact, I am typing this document while standing at a desk converter. A B There are many great desk companies out there, but we have found the quality of our Flexispot desks and converters to be excellent. Adjusting your computer workstation Many of you work at computer workstations. This is why we thought it would be beneficial to discuss how your station should be set up correctly in order to lessen stress on your back. Adjusting your computer workstation Many of you work at computer workstations. This is why we thought it would be beneficial to discuss how your station should be set up correctly in order to lessen stress on your back. Computer Station Working on the computer has become a common source of back and neck pain. Note the “C” posture of the woman in the photo. Many individuals who work at the computer do so for hours on end without any breaks. As a result, the back muscles and joints do not get any movement (remember they need movement). As a result, we see many people who develop pain. Recommendations for your Computer Work Station: Always adjust your workstation in the following order: A. Chair B. Keyboard C. Mouse D. Screen E. Documents A. Chair - Your feet should be firmly on the ground. If they do not reach the ground, you may need a footrest. Ideally the footrest should be horizontal (not sloped) and as wide and deep as space permits. A large footrest surface encourages movement of your legs and feet while sitting. Use a chair with a firm and upright backrest. If necessary, use a back cushion to provide support to your lower back. Avoid chairs with flexible backrests. The flexible backrest will usually encourage your back to settle into a “C” position. Avoid crossing your legs. Crossing your legs places your back in an awkward position, which can result in more pain. If need be, you may cross your legs at the ankles. B. Keyboard - Your upper arms should be vertical (straight up and down) and your forearms should be level (if you need to look at the keyboard quite often). If able, type without looking at the keyboard, the keyboard may then be slightly sloped below level. This allows your wrists to be as straight as possible. C. Mouse - If you tend to use your mouse more than the keyboard, you may want to position the mouse in front of you, instead of off to the side. The placement of the mouse should be level with the keyboard. D. Screen - Position the screen approximately 25-40 inches from your eyes. The further you can sit from the screen, the less fatiguing it is for your eyes. To find your ideal eye-to-screen distance, keep moving your screen further back until it is difficult to view. Then, slowly move the screen closer until it is the most comfortable distance from your eyes. Most screens are placed too low. Use books or a stand to raise your screen up. The top of the screen should be at least a few inches above your eyes when your back, neck, and head are in good posture. If you are using a laptop computer, it is essential for you to obtain a separate wireless keyboard. If you wear bifocals or trifocals you should purchase a pair of reading glasses designed to be used with your computer screen. Sit so you can comfortably view your screen 30-40 inches away. If you don’t, you will be constantly putting your head forward and tipped back to see through your bifocals. It is impossible to obtain good posture in that position and it can cause neck pain and headaches. To avoid a glare, tilt your screen slightly. Don’t forget to blink. Dry eyes are a frequent problem for computer use, due to the tendency to stare at the screen. This can be especially bothersome to contact users. E. Documents - Use a document holder to reduce stress to your neck and upper back. The document holder is generally best positioned directly below your screen or to the side of it. Remember to move. Get up every twenty minutes and do some standing back rotations or back bends. Walk whenever possible. While you are at the computer you can perform shoulder shrugs, neck extensions, and tap your feet and your heels. Products: 1) Flexispot Desks: (Discount of $15 off Included in link ) 2) McKenzie SlimLine Lumbar Support 3) Kebado Lumbar Pillow 4) McKenzie Lumbar Roll Check out the full Sciatica series of videos along with downloadable guide sheets for each video on our website. DISCLAIMER We insist that you see a physician before starting this video series. Furthermore, this video series is not designed to replace the treatment of a professional: physician, osteopath, physical therapist, orthopedic surgeon, or chiropractor. It may however serve as an adjunct. Do not go against the advice of your health care professional. When under the care of a professional make certain that they approve of all that you try. This information is not intended as a substitute for medical treatment. Any information given about back-related conditions, treatments, and products is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this publication. Before starting an exercise program, consult a physician. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

Image via Pexels Regardless of what advertisers tell you, healthy living does not have to be expensive. With a little planning and preparation, you can improve your health without spending a fortune. The following outlines how to do so. Fitness Data shows that less than 25% of American adults get the recommended amounts of aerobic and strength-training exercise. There are low-cost exercises that you can do at home or outdoors. Many routines can be performed without equipment, but there is a variety of budget exercise equipment that you can purchase, including: • Resistance bands • Jump rope • Yoga mat Bigger equipment can often be found on sale or purchased secondhand. Check out yard sales and social media market pages. If you want to join a gym, there are a few ways to save money. Compare membership prices at gyms near your home and work. Many employers offer a stipend for gym membership as part of a wellness program, so check your employee benefits. If you aren’t sure how often you will actually be able to make it to the gym, offer to pay per visit rather than a monthly fee. If you have a condition, such as sciatica, that makes it more difficult for you to exercise, check out free physical therapy videos from Bob and Brad, and remember to always speak with your doctor before starting a new fitness regimen. Nutrition Another area where many individuals pursuing a healthy lifestyle worry about expense is nutrition. Although it is possible to spend hundreds of dollars every month on healthy food, a little planning can save you a lot. Swap fresh produce for canned and frozen alternatives. Not only are they cheaper, but they also last longer and are less likely to go to waste. Depending on the size of your household, there are many items that you may be able to buy in bulk to save money. When buying large quantities, purchase things you know you like and will consume before the expiration date. Packaged foods and prepared meals are generally more expensive than raw ingredients. Find healthy recipes that you can cook yourself. If you appreciate the convenience of microwavable meals, prepare meals in bulk and freeze them in single-serve containers. Finances For many individuals, physical and financial health are interconnected in a variety of ways. When money is tight, you may be more anxious and not sleep well. When your financial situation improves, you have more money to spend on your health. Fortunately, it is possible to stick to a budget while making healthier choices. In some cases, it may also be possible to monetize your healthy lifestyle. A wellness blog may supplement your income. If you want wellness to be a larger focus of your work life, consider opening a health-focused business. These are very trendy, so be sure to do thorough market research before investing much money. Find a niche that has not been overdone but is not so specialized that the customer base will be too small for success. A strong logo can solidify your brand identity. There are many online logo makers that can help you quickly and easily design the right image for your business; check into this online logo maker if you’re looking for one with great features. The wellness industry is growing, and prices are rising for specialized food and fitness classes. However, if you stick to the basics and focus on your needs, you can save money while improving your overall health.

This article is a transcribed edited summary of a video Bob and Brad recorded in May of 2022. For the original video go to https://www.youtube.com/watch?v=ULx0TJorq_Y&t=438s. Brad: We've talked about this before, but this is the mother of them all. We're talking about leg cramps. Because they're the most common. Hamstrings and calves are probably prevalent. But, you know, you get toe cramps or thigh cramps as well. Typical causes of cramps, number one, night cramps. That's not a cause, but that's when they occur for a lot of people. And I don't know about you, Bob, would you say that's more in elderly people? Maybe 50 and over? Bob: I would guess. Absolutely. I know myself, I get cramps when I stretch a certain way. Brad: Ah, yeah, yeah. I've had a number of patients, in the middle of the night, they are awakened by this painful cramps in their legs. And of course we taught them how to get through that. Bob: Right. Brad: Also athletes, people who exercise a lot, maybe they exercise too much, too much intensity. We can have some ways to deal with that. And cramps associated with fatigue. This is like when you're maybe exercising or walking and all of a sudden you start to feel pain associated with that. But there's something you have to know that it may not be a cramp, and people get this confused. This pain, they think it's a cramp, and it's actually a circulation problem. Bob: There is even a test, we could show you, that you could try. Brad: Yep, absolutely. So we're going to start with number one. Now, this number one, I've kind of put a few of them together and I'm calling it under one. First of all, medications. If you're on medications or you started a new medication or you've changed something, that could lead to cramps. Bob: There is always those side effects, Brad. Bob: Yeah, exactly. So you need to check with your doctor to make sure that's not a problem. Bob: Right. Brad: Dehydration. How many glasses of water a day, Bob? Bob: Right. Well, they say eight a day. But you might have to do more than that. Brad: Right. It depends how big your glass is. I think it's eight, eight ounce glasses, right? Bob: Right, it depends, how much you sweat that day and other factors. Brad: There's a lot of variables. But many people, I know my mother she's in her eighties and she does not drink near enough. And you know, we're working on that. Bob: As you get older, I think you have less thirst. Brad: Yeah. I don't know? She's still drinks a lot of coffee, though. Bob: Yeah, she does. That helps. Brad: Yeah. There's some water in there. Electrolytes, your diet. Make sure you're getting enough vegetables, fruits, good things like that. Or what do you use? Bob: Nuun tablets. I actually take them before I go out and golf. Because I often will get an imbalance. And so it helps. Brad: A lot of perspiration. Bob: Right. Brad: Anything like that. That's always an option. There are a lot of other products out there that offer that electrolyte in tablet form. So, and again, blood flow issues in a little more detail, if you are walking and you get cramps in your calf or your feet. My father had this, he always felt like his feet were cramping up. It was a matter of blood flow circulation. They weren't cramping. Bob: Claudication. Brad: There you go. That could happen in the calf. And possibly even a DVT, deep vein thrombosis. Or blood clot. Bob: So if you dorsiflex your ankle, or bring your foot up and squeeze on the calf and if there's pain that could be a blood clot. It could be a DVT. Brad: It may not. That's not the best test. It's still something you should get checked out. Bob: Right. Brad: Exactly. All right. Let's go to number two. Let's look at those night cramps. Now, if you get a night cramp you need to stretch the muscle to stop it. So in other words, if I'm lying here and I get a cramp in my calf, what's going to happen is my toes are going to point down and it gets painful. So either just pull your toes up, sometimes you can. If it's a bad cramp, you actually have to get out of bed, point it down and then put weight down, and stretch, stretch, stretch. Bob: It's not fun. Brad: No. These things are very uncomfortable. Painful, uncomfortable doesn't even describe it. Bob: It feels like you're going to tear the muscle. Brad: Oh, gosh. Or if you get a hamstring cramp then your knee is going to want to bend. Then you have to try and straighten it out. And if you cannot do it in bed or even if your partner in bed can grab your leg and help straighten that out. Ah! There you go. Brad: Or if you're by yourself and you get up and you try to go forward, when you flex forward that'll stretch that out. Brad: So I've had a number of people, if they have calf cramps, I'll show them the wall stretch. Before you go to bed. Bob: Yes. Brad: Some gentle stretching, it doesn't need to be too aggressive but stretch that muscle out, get relaxed. Do this one, the hamstring stretch you can do in bed, lying down. Bob: Grab at the knee and try to straighten your leg. You really pull the heel toward forward. Brad: And you'll feel those hamstrings stretch and loosen up. And hold that, that one's kind of hard to hold for 30 seconds, but try to get five to 15 seconds on each leg. Bob, do you want to talk about if you heat up the muscle to get circulation? Bob: Before going to bed I think it's a great time, while you watch TV, to go ahead and put heat on. The Thermotex is what we prefer because it's deep heat. Brad: Far-infrared heat. Bob: Right. So, how deep? Brad: 2.3 six inches, according to the studies. Versus if you just get a regular hot pack, they're going to just heat up the skin, essentially, but not get into the muscle. You can use a regular one, because these are quite a bit more expensive. But they do work well. So one way or another, get some heat on you. Bob: Right. Good for your back, good for your legs. Brad: Whatever muscle is the guilty one, if it's your hamstring, or the calf muscle, or maybe the quads, you're going to have it on there. If it's far infrared heat 30 minutes at least, maybe 45. Bob: Well it takes 10 minutes to warm up. It's even heat, though. Brad: Number four. Now this one's interesting, use apple cider vinegar. Now, this is a home remedy for the old fashioned type, but actually we have a video on this. Bob: With Chris the pharmacist. Brad: Yep. And he did extensive research on updated information. And if you go to our YouTube channel, the title is "Apple Cider Vinegar: Used for Leg Cramps, and More." And we not only have information from that, but also anecdotal evidence. Now, Chris cramps on a regular basis and he finds this to be useful. He was the last person to use it, you know, coming from a pharmacist and he starts using it and it works. So anyways, there's also other products that have apple cider vinegar as the base that claim they'll stop leg cramps or cramps. Bob: And do they work? Brad: Yeah! Actually, when he gets a cramp, as a matter of fact just last week he was getting leg cramps and he has to get out of bed and start to stretch it, then he takes one tablespoon of the apple cider vinegar in four ounces of water. You know, the pharmacist, you have to be exact. And he drinks it. He says, within a minute, it'll make that cramp relax. So, yeah, he's got it figured out. There's a whole thing with the nerve connection between the taste and how the cramp mechanism goes on. And it's a theory, but he swears by it. It works well for him. Again, that video will go through in detail. And number five, the last one. Bob, now, you actually found this originally. Bob: Right, it was sent to us, actually. It comes over the counter. It's called Theraworx. And, you want to talk about the reviews? Brad: Yeah. Over 3000 reviews. Four and a half stars, and it's for cramp relief or stopping cramps! I think it's Theraworx Relief. Bob: It's helping a lot of people. Brad: Yeah. So it seems to be working. We have not actually tried it Bob, you had it. Bob: Oh, I had. But I don't have cramps. Brad: Right. We should have given it to Chris but Chris wasn't with us at the time. But anyways, it's worth a try, I think, you know? It's got good reviews. It's a foam, you spray it on. You rub it in before you go to bed and there you go. I don't know, does it smell good? Bob: It's all right. Brad: So it's not going to be like one of those things that is going to be a problem. Bob: Your wife will still lay by you. Brad: All right, well, good luck with those cramps. They're very painful and we need to, as our motto says, help you feel healthy, fit, pain-free. Is that what is it? Bob: Healthy, fit and pain-free.. Brad: Got it, after 10 years, you'd think I remember that. Take care! Bob: Good luck. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble, Snapchat Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Back and Neck Massager Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Fitness: Resistance Bands​ Pull-Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stretching: Booyah Stik Stretch Strap Wellness: Bob and Brad Blood Pressure Monitor Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

Battery If the battery will not charge and the lights is off: Please charge your massage gun with only a USB-A to USB-C cable. The use of USB-C to USB-C cable will not charge it. Press and hold the power button for 8-10 seconds to start. Massage gun won‘t start. The lights are off: Please charge with only USB-A to USB-C cable. The use of USB-C to USB-C cable will not work to charge it. The indicator light is still on: Please contact customer services team for replacement. USB-C USB-A *The battery issue: This occurs after the guns battery was almost fully drained after use. When the charger was plugged in the battery level indicator should be flickering in every scenario. *Will not start: First make sure it is not plugged into the charger. It will not start if it’s plugged in. Hold the button in until it starts, usually between 8-10 seconds. If it’s still not starting, it’s most likely that the motor is seized because of the high pressure. The restart to this is actually very easy and requires you to charge the massage gun with USB-A to USB-C cable until you see the light flickering. *Every Bob and Brad product is backed by a 1-year warranty and award-winning customer service team. We want you to be completely satisfied with every purchase you make. If you are in any way dissatisfied with a product you ordered, we’ll exchange it, replace it or refund your money within the warranty period. Simply email us the problem, and we’ll take care of it. If your massage gun is still not working, contact our Customer Services team at +1 (612) 567-3035 or email us at support@bobandbrad.com for assistance.

We hope to convey to you that in order to reduce back pain while sitting, you must increase your movement and position changes. The most important tactic you can use to combat back pain while sitting is to intermix sitting with walking and movement. Even the person who attempts to sit with the perfect posture should still intermix back position changes, movement, and walking. Foam Back Supports We believe it is important to use back supports to help avoid the “C” position and to obtain a good sitting posture when in the car. Driving in a vehicle is generally very hard on your back. This is especially true if you are driving with a slumped posture. Vibration and road shock will place even further stress on your back. In this picture one can see a foam roll is being used to keep the spine from slumping into the “C” position. Proper placement of a foam support 1. The foam roll should be placed approximately at the level of your belt (either a little higher or lower depending on what’s comfortable). 2. Your bottom should be slid all the way back in the seat. 3. Lean back against the roll and attempt to keep your body in straight alignment. Your body type and specific back problem will dictate the size of back support you need. A larger person with greater curves is more likely to require a thicker back support. If the roll feels like it is too much, you may want to try a thinner support. Before you purchase a foam back support, we recommend you try the following: Take a towel and roll it into a tube shape. Place it behind your back when sitting and gauge your comfort level. We have also generally found our patients who are suffering from back pain want a thicker support (or a thicker towel). Those who are not currently having back pain generally desire a thinner roll. Experiment and decide what works for you. If you decide to use the rolled towel for a longer trial period, you may want to duct tape the ends to prevent it from unraveling. Once you have decided on a thickness, you have the option of purchasing a back support with a similar feel. We also recommend using a support to help prevent back pain from occurring or reoccurring. It is important to follow these rules when driving or after driving: 1. Avoid long trips when recovering from sciatica or a back injury. 2. If you need to drive, stop every half hour and walk a bit. Perform standing back extensions if allowed by your therapist. 3. Do not slump. Use a back support or rolled towel as already suggested. 4. Use your left foot to prevent your bottom from sliding forward on your seat (which can cause your back to slump). Use the stationary inclined footrest located to the left side of the brake pedal if this feature is available in your car. 5. Try moving your car seat slightly forward. When your knees are too straight, the tendency will be for your bottom to slip forward on the seat and cause you to slump. 6. Lower your hands on the steering wheel. The least stressful and fatiguing position for the arms, neck, and back when driving is with your arms hanging nearly vertical. This is accomplished by placing your hands on the steering wheel in the nine o’clock - three o’clock position or the eight o’clock - four o’clock position. Placing your hands on the steering wheel in the ten o’clock - two o’clock position will cause your upper back and shoulders to round forward. 7. Excessive back inclination will also cause your back to slump forward. 8. Avoid reaching to the back seat. This will cause your back to bend and twist. 9. Use the proper technique for getting into and out of your car. When getting out of the car, pivot your whole body as a unit on the seat while you bring one leg out of the car at a time. For support, grasp the doorframe or steering wheel. When both legs are out of the car, scoot forward on the seat. Move your feet back and under you as far as possible. Then, lean forward from your hips, keeping your back straight. Finally stand with assistance from the doorframe or steering wheel. 10. Do not lift any heavy objects immediately after a long car ride. A long drive leads to fatigue of your lower back muscles, increased pressure on your discs, and stretching of your back ligaments. You are at a higher risk for developing low back pain and sciatica when involving yourself with lifting activities after long car rides. Remember, your goal is to keep your back in proper alignment. By keeping your back in proper alignment, you are STOPPING THE CAUSE OF YOUR BACK PAIN. Products: 1) McKenzie SlimLine Lumbar Support 2) Kebado Lumbar Pillow 3) McKenzie Lumbar Roll Check out the full Sciatica series of videos along with downloadable guide sheets for each video on our website. DISCLAIMER We insist that you see a physician before starting this video series. Furthermore, this video series is not designed to replace the treatment of a professional: physician, osteopath, physical therapist, orthopedic surgeon, or chiropractor. It may however serve as an adjunct. Do not go against the advice of your health care professional. When under the care of a professional make certain that they approve of all that you try. This information is not intended as a substitute for medical treatment. Any information given about back-related conditions, treatments, and products is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this publication. Before starting an exercise program, consult a physician. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in August of 2021. For the original video go to https://www.youtube.com/watch?v=Kby8kvUpKvg. Brad: Hi folks, Brad Heineck Physical Therapist. Chris: Hey, I'm Chris the Pharmacist. Brad: Bob's not with us today, I think he's out golfing, having some fun somewhere else. Chris: Atta boy. Brad: But today we are going to talk about neuropathy, causes, and symptoms, with at-home treatment and medications. We're going to talk about what you can do yourself and the medications, how they work, and some good information on that. Chris will give us his expertise. Chris: All right. Brad: I do want to mention that with neuropathy, you're going to go through some of the details on it. You can explain it much better than I do, but for this channel, we're related to physical therapy and almost always in my experience, and I think most PT's would agree, that neuropathy is associated with diabetics, in our field. You could have neuropathy from r diagnoses as well. We're going to talk about it. Chris: I mean, there's a lot of things out there. Brad: Say a few of them. Chris: Post-herpetic neuralgia. I mean, you could have just an injury, a spinal injury. There are a lot of things that can cause it. Brad: Okay. So there are some neurologic things that could cause it. MS. So the treatments are going to be similar for those, but we will kind of relate to diabetes because it is so prevalent in that diagnosis and that's our experience. So what is neuropathy? Can you explain that? Chris: I hate to say it, it's not a real long flowery explanation, but basically neuropathy is that burning, stinging, pain, numbness that you get. How does it develop? With diabetes in mind, if our blood sugars are high and a lot of times our sugars are high, that means our cholesterol is high. So, circulation doesn't bid the nerve real well due to high blood sugars and probably cholesterol. As a result, the nutrients and oxygen that your blood flow carries, do not bid those nerve cells and they are not healthy. And as a result of that, they kind of die-off. So for lack of anything better to say, you just don't get what they call better neuronal transmission. So just think of it as a highway in your body and just the signal is interrupted. And so you don't get that good, nice confluent signal going back and forth as a nerve would. Brad: So what, what are the most common locations in the body? Chris: Well, a lot of cases with diabetic neuropathy, a lot of times it's going to be below the knee. So you're going to see a lot of problems in the feet and lower leg, which is why foot care is so important for diabetics. And we'll touch on that as we go forward. But I mean, you can have problems in your gut, particularly with a diabetic, but you can also have problems in your legs. You can have it in your arms and hands. So it just kind of depends on where it is on you, but the treatments in most cases are going to be similar, which is going to be pharmacological and physical therapy related. Brad: Okay. And in my experience, and I've talked to Bob about this too. Usually, it's below the knees, on both sides typically. Chris: Well, that's why we worry about, especially the diabetic foot. Brad: Yeah. What kind of symptoms do these people typically complain of? Chris: Symptoms kind of manifest themselves over time. So, I mean, the longer you're a diabetic, the more opportunity you have to become a patient that has neuropathy. So the less well-controlled your blood sugars are, and the longer you have diabetes, the more likely you are to get neuropathy. But they come in and they're going to complain about tingling, burning, pain, numbness. Even to the point where a diabetic with bad diabetic neuropathy could literally have a rock in their shoe, they could be walking around all day long and they won't even know it. So they lose that sensation and they might have like some very vague feeling, or it could have been one of my feet felt that way yesterday too. So it's so important as a diabetic, number one is to check your feet daily to make sure there are no little nicks, cuts, or blisters. Brad: Sure. Chris: Those are the things that can lead to infection and other problems. Brad: So with that, say there is a little stone in there and you walk on it. You did not feel it as a result of the neuropathy, and that stone may break the skin open. Then you have an open sore. And because of the lack of circulation, that can get infected and it's slow healing because of the diabetic side effects and it can actually lead to an amputation. Chris: Yeah. That is the worst worst-case scenario. So the things that we're going to talk about today guys, are we want to make sure that we're controlling our blood sugars, we're exercising well, we're eating well, and we're using our medications appropriately. And those are the things that will help to stave it off. Brad: So I do want to mention one other thing as a therapist, one thing that we deal with a lot with people with neuropathy, if they have numbness in their feet or their legs, you cannot feel the ground or the surface that you're on. That dramatically increases your risk for falls because your balance is heavily dependent on the feedback back from your proprioception, back from your feet where they're touching the ground. And it just really makes a big difference on your balance and a fall risk goes way up. So we do deal with that, we're not going to talk about that too much, that's probably all we're going to mention for now. We have balance videos out there. Can we go right to diet? How can these people with neuropathy change or manage their symptoms? Chris: Yeah, absolutely. I mean we know neuropathy has no cure. That seems kind of damning for a lot of people, but at the same time, we can make it better. And so one of the simple tools that we have is just eating well. And so if you're a diabetic, that means going to the leaner proteins, your fibrous fruits, and veggies, those types of things. Brad: Some examples of leaner proteins, we're talking about meats and fish? Chris: Yep. So we're going to go with poultry like chicken, we'll go with fish, lean beef like grass-fed beef, very lean protein, and eggs. For our vegan folks, it's going to be your nuts and legumes. Those are going to be good protein sources. So you're going to want your leafy green vegetables. That's going to help with the B vitamins, that's going to help with nervous system development. Brad: Spinach. Chris: Spinach, kale, broccoli. So all the things your mother loves. Brussels sprouts, there's another one. Alfalfa sprouts. There is a lot of good stuff out there. Brad: Sure okay. Chris: Just eating well, helps our body with the nutrients that it provides it. So it's going to actually help with the circulatory system. It's going to help keep our weight at a better level. If we're going to McDonald's and just eating fries and chips, I mean, that's going to create problems from a circulatory standpoint. It's going to cause problems from a blood sugar standpoint. So like we always say, we don't want anything in a box. Whole foods are ideal. Brad: Right. In the grocery store, down the aisles, we got all these quick-make things. You know, open it up, open up the rapper and just eat that. Those health food bar things that usually are not healthy. Chris: They're not as healthy as what they were advertised to be. Unfortunately, there's a lot of sugar and other processed things in there. Particularly for the diabetic too, and that's one of the things with advertising that makes it so challenging is, oh, well I'm having this particular bar and it seems like it's going to be a nutritious choice. Brad: A health bar, it says health bar right on it. Chris: Yeah they show people climbing mountains and everything else. And you think it's going to be a good thing to have, and all of a sudden it's made with tons of sugar or high fructose corn syrup and things of that nature. Brad: A big one that I always look for now is yogurt. I used to just think yogurt was yogurt. And I started looking at the sugar content, and there's as much sugar in a thing of yogurt as there is in a can of Pepsi. And it's like, whoa! Chris: There's a ton. It's kind of like the better it tastes, the worse it is. Brad: Exactly. So be careful, look at your labels. Chris: But you know, let's talk about yogurt. Yogurt is great, to me, it's kind of a power food you know. If you get plain yogurt. So what can you do? Add blueberries, add raspberries, or add some walnuts. You know, you can add the sweetness yourself. Brad: Yeah. That's my recipe. I do blueberries, blackberries, walnuts, flax seed, and chia seed. Chris: Yeah and all those products, nutritionally have actually kind of nutraceutical properties that will help your body. You have the flavonoids in those dark berries, those help with your circulation and with anti-inflammatory action. So there are a lot of nutrient-dense things in that. And then the yogurt it's got the protein, it keeps you full. So it's good for your muscles, it's good for your bones cause it's got calcium and vitamin D. Brad: So I do want to mention it, because a lot of times people say, "oh, stick to your genre." So, you know, he's a pharmacist, I'm a therapist, but we're talking about pretty basic health. I think we're covering the basis pretty safely. Chris: Oh yeah. I don't think we're too far out of our lane. Brad: Yep. Should we go on to the next thing? Exercise. Why do you need to exercise? If you're got neuropathy, how's that going to help? Chris: Well there are a lot of different reasons, but specifically, what happens when we exercise? Our heart rate comes up. So if our heart rate comes up, we're challenging our circulatory systems. That helps to bade those nerves and the muscles and it gives them some oxygenated blood that also is carrying nutrients from the good foods we've just eaten. And so that will help the body to develop and hopefully get stronger and more endurance and hopefully improve some circulation and moderate some of those neuropathy symptoms. So when you have better circulation, you have better strength, better coordination, and better proprioception as a result of exercising because these things all kind of build on one another. We hopefully help to minimize some of those diabetic neuropathy symptoms. So it's never going to be a cure guys, but it certainly could make them better and make your life a lot safer, more effective, longer, happier, and healthier. Brad: Let's move on to medications in regard to neuropathy and the diabetic. Can you briefly go over some of the most common ones and some information? Chris: Yeah, your physician is going to take into account, what's going to be best for you when you have neuropathy. But, what I see most often in my world, the big three are probably going to be pregabalin (generic Lyrica), Gabapentin (generic Neurontin), and then duloxetine (generic Cymbalta.) So those three are all widely recognized and used for the treatment of neuropathy. I mean, Lyrica or pregabalin is actually known for treating neuropathy. The advantage of pregabalin over Gabapentin they work similarly to kind of like Coke and Pepsi. So they have similar properties and they do similar things in the body, which is to actually improve neurotransmission and minimize pain. So basically that's what they believe is how it works. And so with that, if we can diminish the pain and discomfort, a drug like pregabalin, takes a lower dose, so it is less side effect prone. It acts faster than Gabapentin. The difference between those two drugs is pregabalin, a lower dose creates a nice effect. So we have to be careful because there is some addictive potential. So we have to be mindful of that. Caution with driving, because of dizziness and drowsiness are two primary side effects. And you'll see that with Gabapentin as well, but where they delineate, the pregabalin works better in a lot of cases. Whereas Gabapentin you keep having to take a bigger and bigger dose to get the same type of effects. And when we go to those bigger and bigger doses, what happens? Well, we have more side effects, so more dizziness, more drowsiness, and a little bit of forgetfulness. So things that we have to be careful with and, your doctor is taking that into account and your pharmacist is going to be talking to you about watching for things. Brad: Sure. Chris: So we do want you to be mindful. And the other one that I didn't really touch on was the antidepressant Cymbalta or duloxetine. And that actually works by raising serotonin, it raises norepinephrine or noradrenaline. So those are two different neurotransmitters. They actually work with the body's nervous system to minimize pain and also to help improve neuronal transmission, is what they believe happens with the medications. Brad: Okay. Chris: So, well-tolerated, generally not a lot of side effects associated with that either, so it's safe. Because there can be pain with neuropathy, it certainly is a great alternative to using opioids, which also is something that has its own series of bad. That's kind of where the utility came from. Brad: That's a whole other video there. Chris: Yup. Long video but I mean, those are kind of the main three. Any antidepressant and any antiseizure medication, just to kind of envelope them in, will have benefits for neuropathy. And sometimes if one, let's say pregabalin, Gabapentin, or duloxetine doesn't work for you, your doctor can try some of the more atypical things like maybe an old-school antidepressant, like a tricyclic amitriptyline or something to that effect. But, those are the things that your doctor would do based on your conversations, your appointments, and your follow-up. Brad: That's pretty individual. Chris: Exactly. Brad: All right good luck on this. Chris: All right. Bye guys. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble, Snapchat Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Back and Neck Massager Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Fitness: Resistance Bands​ Pull-Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stretching: Booyah Stik Stretch Strap Wellness: Bob and Brad Blood Pressure Monitor Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

1 – The Bob and Brad Foot Massager isn’t switching on or not working A) Make sure the massager is plugged in. Try to unplug the AC power adapter from the massager and plug it back in. B) If you have been using the massager for a long time, overheat protection may have activated. Turn the massager off and allow it to cool for at least 40 minutes. C) An unknown error occurred. Unplug the AC power adapter from the massager and plug it back in. D) The massager is making an unusual noise or emitting a strange smell. Turn off and stop using the massager immediately. Contact customer support team via support@bobandbrad.com or call us at +1 (612) 567-3035 (Mon-Fri 9:00 AM-4:30 PM CST) 2 – The foot massager doesn't heat up or you don’t feel the heat. A) Make sure that the heat option you are using is turned on. Because of the structure of the heating function, the heat massage heads will feel warm after 5 minutes due to the residual heat. Continuing to massage on level 3 in the same area even after turning off the “HEAT” may increase the temperature felt. B) If you don’t feel the heat even after 5 minutes with the heat on level 3, please contact the customer support team via support@bobandbrad.com or call us at +1 (612) 567-3035 (Mon-Fri 9:00 AM-4:30 PM CST) 3 – Remote control not operating properly or not responding at all. Make sure there are no obstructions between the Bob and Brad foot massager and the remote itself. The foot massager remote controls use infrared (IR) technology, which means they need to be aimed directly at the device you want to control. If there is an obstruction between the remote and the foot massager you're trying to control, your commands will not work. 4 – The massage intensity is too strong or too weak. Change the mode and intensity settings of the massager to match your preferences. There are four levels of air intensity. By selecting the manual settings of knead intensity, air intensity, or air mode you can experience a more relaxing massage. Our Guarantee. Today’s busy professionals need high-quality products and solutions that perform in real-world settings. We deliver innovative, high-quality, and durable health care products that improve physical activity. We stand behind all our products with a 100% Satisfaction Guarantee. This guarantee means that if you are not satisfied with any Bob and Brad purchase for any reason, contact us and we will replace the product, credit your account, or refund your purchase price. No hassles. No restocking fees. No kidding. With Bob and Brad, you will always be satisfied. We guarantee it! Why do customers continue to choose Bob and Brad? 100% Satisfaction Guarantee 100% Honest with our followers 60 Years of Combined Experience in Physical Therapy (We know what product works) Unmatched Product Selection If any of your Bob and Brad products are still not working, contact our Customer Services team at +1 (612) 567-3035 or email us at support@bobandbrad.com for assistance.

When you sit incorrectly, you are likely to settle into the C position (slouching, slumped, or flexed) with the accompanying stress to the parts of your back. For many of us, the sitting stress continues throughout most of the day. We sit when we eat, drive, work, watch TV and when we are in the bathroom. Many researchers believe the significant increase in cases of back pain and sciatica over the past few decades have much to do with the fact that more and more of us are spending our workdays in chairs. Improper sitting is a common contributing factor to back pain, sciatica, and the delay of healing. Yes, at the root of all back pain, one can generally find a chair. Even more distressing is that the poor slumped sitting posture begins to shape your standing posture. Your body remembers the sitting position and attempts to continue the posture when standing. Instead of having erect and correct posture like a marine soldier, you begin to stand slouched and slumped. Therefore, it is important for you to understand proper sitting and sitting postures. We recommend that our patients in pain avoid sitting as much as possible. We advise lying down or standing up whenever possible. Avoid sitting on overstuffed furniture, easy chairs, and recliners when you are experiencing back pain. If you feel that you must sit on such furniture, use a throw pillow behind your back to prop yourself up as straight as possible. Toilet sitting: one possibility is to sit on the toilet backwards, gaining support from the back part of the toilet. A bed pan is another option. We want to convey to you that one of the key points about all forms of sitting and back pain is the benefit of movement and position changes. The most important tactic you can use to combat back pain while sitting is to mix sitting with walking and movement. If attempting to sit with perfect posture, you should still mix in changing your back positions as well as increasing movement and walking. The following are some general rules or strategies for reducing the stress on your back while sitting at home: A. Lie on the couch with low back support using throw pillows. B. When sitting on a couch or recliner, vary the amount of recline in the recliner. Keep a throw pillow in your low back. C. Lie on the floor on your back with your feet up on the coffee table or couch. D. Lie on the floor on your stomach. E. Get up and walk around the room on a regular basis. F. Change positions every 20-30 minutes or so. Products: 1) Elevating Leg Rest Pillow 2) McKenzie SlimLine Lumbar Support 3) Kebado Lumbar Pillow Check out the full Sciatica series of videos along with downloadable guide sheets for each video on our website. DISCLAIMER We insist that you see a physician before starting this video series. Furthermore, this video series is not designed to replace the treatment of a professional: physician, osteopath, physical therapist, orthopedic surgeon, or chiropractor. It may however serve as an adjunct. Do not go against the advice of your health care professional. When under the care of a professional make certain that they approve of all that you try. This information is not intended as a substitute for medical treatment. Any information given about back-related conditions, treatments, and products is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this publication. Before starting an exercise program, consult a physician. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in February of 2022. For the original video go to https://youtu.be/wdymXr2b0H4 Bob: What are we going to talk about today, Brad? Brad: We are going to talk about the shoulder, separation versus dislocation. There’s a clear difference between the two and you need to know what you actually have. Bob: I think it’s often mixed up. I think people think separated is dislocated. Brad: Right, but not so! What we’re going to talk about is first a separated shoulder. We are going to use Sam (the skeleton). Here you’ve got your clavicle or your collarbone. Same thing. It comes over and there’s ligaments connecting the end of your collarbone to your scapula or shoulder blade. The bone on the end is called the acromion. There’s a ligament here from the clavicle to the acromion. There’s also another ligament that goes underneath and connects to the coracoid process. You don’t need to know these names. And a third ligament, the Conoid ligament. They all stabilize the clavicle, which is a really important part of your shoulder movement. Bob: Really, when we are talking about separation, we’re talking about the clavicle. It’s that bone right here, you can feel it easily on yourself. Brad: So, what happens if you have a separation, it’s the clavicle literally separating from the acromion and the coracoid process. These two bones. So, the line represents if you have a separation. There are three grades of separation: one, two and three. First grade is the acromioclavicular ligament is torn. If you have a second degree, it’s a little worse, the acromioclavicular ligament and the trapezoid ligament are torn. If you have a third degree, that’s the worst. All three of these ligaments are torn and this clavicle just pops right up. I had this happen to me and my wife has it right now after ten years but hers is not very noticeable. When it happens, the collarbone sticks up pretty high, it can, and it looks obvious. Bob: And it’s called? Brad: This is called the piano keys syndrome. Bob: I didn’t understand that at first but if you push down on it, it pops back up. So, like a piano key. Brad: Yup, you’ll see a bump there. I remember mine was dislocated and I moved around, and it really popped up. It hurt; it was no fun. I looked in the mirror and it was like; I didn’t think about piano key, but you can push down on it because there’s nothing holding it. You can push down, and it pops back up. After it’s happened for a while, for a few days, it typically settles down: it’s not so painful. Then you can push it up and down. Bob: What’s amazing about it is, quite often the body will heal it. Brad: Yes, it rarely has surgery. Unless it’s really severe or if you’re a high-level athlete and you need it, they may do something or if it’s an aesthetic, or an appearance thing, like if you’re a model and you have bare shoulders. Bob: You don’t have to worry about that, Brad. Brad: No, I have no problem with that! So, that’s a separated shoulder. Xray’s will show you don’t need an MRI. Same with a dislocated shoulder. Bob: You probably could almost see it manually. Brad: Right. You’ll get an X-ray to confirm things though. If you look at this side, here we have the shoulder joint. Bob: We have the humerus and the ball, and it fits into the socket right here. Brad: A dislocated shoulder has nothing to do with a separated shoulder. Everything is intact on the clavicle, but the head of the humerus pops out of the socket. Bob: If I remember right, like 95% go forward. They don’t go back like this. Brad: Yeah, probably the rest will go down or down and forward. It really doesn’t matter, it hurts! Bob: The mechanism for doing so is it needs to be understood. By turning your arm out, like this, that causes the head to move forward. Brad: Or if you have an outstretched arm and you fall and there’s a lot of leverage, it causes that same dislocation. Again, no MRIs are needed, just an x-ray. Usually, you can see it. Then, hopefully, it pops back in. Sometimes you have to go into the ER. Bob: The surgeon has to do it. Brad: It’s very painful. Hopefully they can get it done. My mother, she fell on the ice and hers dislocated. Actually, I saw the x-rays and it went down on the rib cage. She went to the ER, and they pushed it back in and then she was much happier. After that, typically no surgery. You need to do some strengthening. Let it settle down for a few days, and then get into some strengthening exercises. Bob: Let’s make this point, Brad. If you are younger and you keep dislocating your shoulder, then they might do surgery. You’re more susceptible to this if you are younger. The ligaments have more stretch. Brad: You might be considered hypermobile, maybe your joints are all a little lax. Bob: But, if you’re older, this is one of the few advantages of being older is they probably won’t do surgery. Brad: Sure, ha-ha. That does make me feel better. I’ve never dislocated a shoulder. Bob: Me either. Brad: There’s one thing I did want to mention here. Should we show them the sulcus sign? Bob: Sure Brad: So, if you have a dislocated shoulder, this bone, you pull down and you’ll see a bump right there. I’m going to see if I can relax, you can't see it very well. My ligaments aren’t loose. Some people are loose enough where you can see a gap here between the acromion and the humeral head. If you have a stroke and all these muscles are lax, that’s pretty common on a stroke patient. Brad: There’s rehab for this. We aren’t going to get into the dislocated shoulder, but I’ll just get it back into place, that’s the next step. We’re going to talk a little bit about the separated shoulder. We’re not going to get too detailed in this. Bob: Right, just give you some basics. Brad: So, you’re going to give it a break. Ice it, ibuprofen, all that stuff, when it initially happens. You may find yourself being suggested to wear a brace. When I had mine, I had what they called a Figure 8 Brace. I don’t have one here and I’m not even sure if they use them anymore. Bob: I don’t know if they do anymore. I don’t think so. Brad: I actually liked mine. I had to wear it for a few weeks, and it pulled my shoulders back and it supported it. Bob: You just liked it because it got you attention. Brad: No, I actually wore it underneath. Bob: You probably had it outside your suit. Brad: I would have, a blaze orange one. So, that may happen, it depends on your doctor or your surgeon if they want you to brace it or not. Also, avoid sleeping on it. It’s really easy to avoid it because if you roll over on a separated shoulder, in my experience, it woke me up screaming because it hurt like crazy, especially the first week. Bob: It’ll let you know. Brad: You get really good at sleeping on your back or the other shoulder. Once it's feeling better you can start moving it more. I was a therapist at the time and my surgeon said once it’s feeling better, do your PNF exercises and I just did it on my own and it worked very well. Basically, you might start with Codman exercises just to get it moving, in the flex position. Bob: When you’re doing that, you’re really relaxing. Brad: Right. From there you can do assisted flexion, just raise it up as far as tolerated. You’ll get so far and then it’ll start to pull and hurt. Then you go back down. Bob: The work is being done by the left arm. Brad: Right. I like using the ball actually. If this is my sore shoulder, you can just roll it out. Watch my shoulder, I roll it out and back. Brad: Then I can roll it out to the side. When that feels better, then you can go to the wall. Bob: Which adds a little gravity to it. Brad: Yup. Then you can assist it, roll it up and down. Ten repetitions. Turn sideways. It is going to be a little more challenging this way. Use a hand here and roll it that way. After about a week or two of that, it’s going to get stronger. Then you’re going to start strengthening it. But you’re not going to strengthen it until you can raise it up, pretty much all the way. You might need a little help with that. You have some favorite ones you want to talk about, Bob? Bob: Probably just external rotation, that’s probably the big one. Brad: Sure. We’ll take a band here. You want to start strengthening the rotator cuff to help stabilize things. You can do this one, scapular retraction. You’re going to want to do this one for sure, using both hands. Ten of that one. Brad: I do want to talk about resisted flexion. I like bands, I’m a band person. You can use weights, dumbbells, if that’s what you have. You’re just going to go up as far as you can. Bob: You can use a soup can if you want, to start. Brad: How about chowder? Bob: Whatever. Beans work too. Brad: It actually works good because you’re not going to need much weight or resistance. Out to the side. Make sure you go across your body because that’s a real functional motion. It’s going to pinch a little bit more at first, so be careful with that. Bob: Avoid pain. Brad: For the people that are not athletic or don’t do over head work, you can rehab this pretty easily. As long as you can reach up into the cupboard. I’m thinking maybe for people that aren’t that active or if you’re older, you know. Bob: That shows how the body is so amazing that it heals itself. Brad: I remember the doctor told me it’s going to heal up fine. Just keep working it and sure enough, it did. They said you’re going to notice it when you get older and I’m noticing it, but it’s not bad. Very good, good luck with your separated shoulder and we do have some dislocated shoulder exercises. Bob: Look for those on our YouTube channel. Thanks! Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble, Snapchat Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Back and Neck Massager Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Fitness: Resistance Bands​ Pull-Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stretching: Booyah Stik Stretch Strap Wellness: Bob and Brad Blood Pressure Monitor Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in March of 2021. For the original video go to https://youtu.be/UUOFtBu_M_U Bob: Today, we’re going to show you a 10-minute ab and core workout that Brad thinks is going to take longer than 10 minutes, in bed. Brad: Are we going to suggest doing these before you go to sleep or in the morning. Bob: Whenever you want to do them. I don’t care. Brad: The SleepOvation mattress is actually the bed that both Bob and I sleep on. Not together, we have separate houses. Bob: One thing I want you to realize, even though it’s really comfortable, I don’t sink in. I keep good posture. Brad: Yes, we’ve discussed that many times. Bob: The first one is going to be bridging. So, up, there you go. We’re going to work on core and you’re also getting the muscles that tie into the core. Those are just as important for your back and protecting your core. Brad: You can think about tightening your stomach muscles as you do this, so you get a complete core workout. Bob: This is one where you’d tighten your butt. Brad: If you wanted to, you could do this like 10 a piece instead of 45 seconds, that’s up to you. Bob: Okay. We’re trying to give them a good workout here, Brad. Brad: Make sure you breathe while you do this. We’re at 40 seconds right now, Bob. Bob: Alright, I’m going to give myself A 5 second break. Okay, hands in the lower back and ready? Now, we’re going to lift up like this. Brad: So, we’re still working abdominals. Bob: Yep. Now, we’re not just doing a sit up and bringing the head toward the knees. You're going straight up. Brad: Look at the head posture. Try to keep that neck so it doesn’t flex. Bob: I have my hands on my low back to provide support to it. The back of my hand, the palm is going down. How am I doing Brad? Brad: You’re doing excellent, Bob. Bob: My core looks good? Brad: Yep. We’re coming up on 40 seconds right now. Bob: Okay, next one. Elbows on back. I’ll get my back supported and I’m going to bring my knees up one at a time. Brad: Again, another core exercise. Bob: Now if you want to make it harder, you do it more rapidly and you can even not touch your feet down if you want to make it really hard. Brad: You could try to do a bicycle thing, that’s pretty advanced even though it doesn’t look like it. Bob makes it look easy. Bob: Touching is hard enough for me. Brad: You know, you do this, and I bet your core will start to get pretty warm. Bob: Yeah, I’m feeling it. I’m feeling it, there’s no doubt about it. I used to do stuff like this in bed when I was growing up. My mom would put us to bed at 8:00pm. Brad: What else did you have to do? Bob: Right. I had nothing else to do. Now, we’re going to do a side plank for 45 seconds. Just a good way to hold. Brad: Kind of like a plank. Bob: It is a plank. You could do it with your legs straight, but on this mattress, I start swinging around and there’s no stability. Brad: It’s probably a little more difficult on the mattress versus the solid floor. Bob: It is. I would agree 100%. Brad: If you’re new to these and you feel like your form is going, you’re getting really fatigued, you can just take a break. You don’t have to do the full 40 seconds. We’re coming up on 35 right now. Hold it, Bob, hold it. Bob: I’m holding it. Brad: Oh, you’re going to do the other side now? Bob: Yes, I’m doing the other side now. Brad: 40 seconds on each side. Bob: Yeah, I don’t want to be unbalanced. Brad: That’s right, otherwise you walk crooked. We’re coming up on 27 seconds, Bob. How are you feeling? Bob: I feel good. I feel solid. Brad: Breath. Bob: Oh, I forgot to breathe. Brad: You start turning purple in the face. What’s next Bob? Bob: Glute pumps are next. Brad: So, hip extension, technically, if you bend the knee at about 90 degrees. What that does is that takes out the hamstring or decreases hamstring activity and makes the glutes more activated, more promoted with that. You’re doing very good, Bob. Bob: I appreciate that. Brad: So, you’re going to do right, left, right, left, is the best way to do this one. We’re coming up on 29 seconds, Bob. Bob: Alright, let’s flip around. Now, the opposite arm to opposite leg. Brad: There is a lot of core work here. I like that. You can exhale when the hand touches the foot, breathe. There you go. I am not getting tired at all, Bob. Bob: Ha-ha. Yeah, you’re hanging in there. Brad: I’m going to have to have my wife do this tomorrow morning. I’ll watch and she’ll like it. Bob: You were always kind of a creep, Brad. Brad: Well, she likes me that way sometimes. I’m just kidding! I hope she doesn’t watch this or I’m going to have a rough week. We’re coming up on 40 now. Bob: Alright, this one’s a little different. Hands on the lower back again and you’re actually going to do the splits. You get a little legs but also, you’re working the core. Brad: You’re absolutely working the core as well as hip mobility too. Bob: Yup. Brad: Make sure you breathe. I am getting tired watching you do this one. Bob: It’s funny, you do forget to breathe. You start holding your breath. Brad: It’s easy to forget. In karate for 17 years, I had someone holler, they didn’t holler, they reminded me to breathe. It’s a natural thing. We’re coming up on 35 seconds here. I’m going to push you right to 40 seconds on this one though. Bob: Now we are just going to do side raises. What this does is strengthens the hip, but it also strengthens your muscles on the side here. Brad: Now, you have your left. Could you do it flat with the elbow down? Bob: You probably could. Actually, yeah, that’s easier. Up on your elbow is harder. I’m all about doing things harder. It works the core more. Brad: Make sure your toe is not pointing up towards the ceiling. Point it horizontal so it’s towards the wall in front of you. That works the hip abductor better. We want that. We want to keep that for stable walking. Bob: Alright, I’m going to flip and do the other side. Brad: So, if you’re doing this in bed, you’re probably going to have to get your sheets and your bed, quilts and stuff kind of off to the side. Or you could make the bed and do it on top of it. Then you can get the wrinkles out when you’re done. Bob: I’m glad you’re taking all these things into account. Brad: Well, these are things that people will be upset with us if we do not remind them. Bob: It’s interesting, you probably couldn’t do this with your spouse at the same time on the bed. Well, maybe. Okay, number 11 out of 14. Now this one is a little bit tough. Pointer dog. If you have trouble, you could just do arm and just do leg. Brad: This is a really good challenge for advanced people because you’re on an unstable surface. I would have a feeling most people haven’t done this are just going to do an arm or leg and work it that way. You’re still going to get a good workout. Bob: It’s the pointer dog. There’s the pheasant, Brad. Brad: Those pheasants, they are a pretty bird. I’m a hunter and I wouldn’t hunt those because they’re just too pretty. Bob: As in many birds, the male is the pretty species. Brad: The brighter color, yeah. You know why that is right, Bob? You have to get on your next exercise. Bob: Alright this is actually kind of tough, Brad. You’re going to get up like this and you’re doing clamshells while the feet are up in the air. Brad: Oh, so you’re talking like, look at this gap here. You’re really giving these people a challenge. People are going to appreciate this or they’re going to hate you for this. Bob: This is the hardest one. Brad: If it’s too hard, just let your legs, the bottom leg, lay flat on the bed. I can just imagine what your neighbors are thinking when you do these in bed and the windows are open on a nice cool morning. Bob: What!? Why didn’t I do this one first? What was I thinking? Brad: You’re coming up on 40 seconds right now. Good job, nice work, Bob. Bob: Now, let’s do the other side. Brad: I give you a lot of credit here. I feel glad that I didn’t do these. I went swimming this morning though. Bob: Yeah, I ran this morning too. Brad: You’re doing good, Bob. You still have 30 seconds to go on this side. So, the bird that the male is the bright feathered one because that makes the female when they have their chicks, they’re safe because a predator will see the male bird and that’s a good thing. Bob: Right, you’re peacocking. You ever heard that term? Brad: Oh yeah, when they fan out. Bob: They show off. Brad: You’re almost there, Bob. You’ve got 7 more seconds. Breathe, are you breathing? Time! You can go to the next one. Bob: Alright, this last one is just a forward plank. You can just finish off and you’re just going like this. I guess I can go on my feet. Brad: Get your body straight, Bob. I don’t want anybody hollering at us. Bob: Where’s it crooked? Brad: Well, your butt’s too high. There you go. Bob: Oh, I thought it was too low. I’m touching the mat. Brad: Yeah, that’s the thing with the mattress. This is a challenging plank. That’s alright though, we’re going to go for 2 minutes. Bob: My toes are giving away. We’re not going to go 2 minutes. My feet are slipping. Brad: You’re at the end of this, you can take a break and relax. Bob: Alright, that’s its folks. You can pick out the ones that work for you but at the end of the day, you’re going to have abs that people will be proud of. Brad: Oh yeah, you are going to tighten that stomach up. Bob: Take Care. for Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble, Snapchat Bob and Brad also have a Podcast where we share your favorite episodes as well as interviews with health-related experts. For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun (US) Fit Glide Q2 Mini Massage Gun (US) Knee Glide Back and Neck Massager Eye Massager T2 Massage Gun Foot Massager X6 Massage Gun with Stainless Steel Head Leg Massager Fitness: Resistance Bands​ Pull-Up System Pull Up Bands Wall Anchor​ Grip and Forearm Strengthener Hanging Handles​ Hand Grip Strengthener Kit Stretching: Booyah Stik Stretch Strap Wellness: Bob and Brad Blood Pressure Monitor Bob & Brad Amazon Store and other products Bob and Brad Love Check out our shirts, mugs, bags, and more in our Bob and Brad merchandise shop​ The Bob and Brad Community is a place to share your experiences, ask questions and connect with others regarding physical therapy and health topics. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

Is this a vital task? Can someone else perform this task? Try to load the dishwasher in batches. You should save dishes on the counter until you have enough to fill the dishwasher. Keep your spine in locked position throughout the task. See previous video, "How a Locked-in Spine Can Help Your Back Pain or Sciatica," Open the door of your dishwasher, with one arm supported on the counter to reduce the stress on your spine. Open the dishwasher door and kneel to the floor using the lunge technique. Use a pillow if necessary. Roll out the lower tray and fill with dishes while keeping your spine in the locked-in position. An alternative technique is to remove the tray, place the tray on the counter, and fill with dishes. Use a proper lifting technique to lower the tray back into the dishwasher. Check out the full Sciatica series of videos along with downloadable guide sheets for each video on our website. DISCLAIMER We insist that you see a physician before starting this video series. Furthermore, this video series is not designed to replace the treatment of a professional: physician, osteopath, physical therapist, orthopedic surgeon, or chiropractor. It may however serve as an adjunct. Do not go against the advice of your health care professional. When under the care of a professional make certain that they approve of all that you try. This information is not intended as a substitute for medical treatment. Any information given about back-related conditions, treatments, and products is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this publication. Before starting an exercise program, consult a physician. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate Disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.