The goal is to get your pants, shoes, and socks on without putting your back in the C-position or another painful position. Putting on pants Put your pants on in bed. In bed, lie on your back and flex one leg toward you. Slip one pant leg in and repeat with the other. Put your pants on in a chair. If you have very good hip range of motion you may be able to place the right ankle on the left opposite thigh and slip the right leg into the pant leg. Repeat with the left ankle on the right opposite thigh and slip the left leg into the remaining pant leg. All of this must be done with your back held straight. Put your pants on using a “reacher” or “grabber”. Putting on shoes Your shoes can also be put on in bed. In bed lie on your back and flex one leg toward you. Rotate your hip and bring the foot closer to you. Slip on the shoe and tie it. Repeat with the remaining leg. Use slip-on shoes or Zeba shoes (a hands-free shoe brand). Use elastic shoelaces and a long-handled shoehorn to slide your shoes on. Get help from your friend or partner. 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.

In the first blog of this series, we looked at hypermobility and the connective tissue disorder Ehlers-Danlos Syndrome (EDS). We learned about the common symptoms of EDS and how this can impact someone’s life. I hope you enjoyed learning more about this condition. We mentioned in that blog two other conditions that can often go hand in hand with EDS : Postural Orthostatic Tachycardia Syndrome (POTs) Mast Cell Activation Syndrome (MCAS) Some people have all 3 conditions, and it has become known as The Terrible Trifecta. But what are these other conditions? POTS Postural Orthostatic Tachycardia Syndrome is a disorder of the autonomic nervous system. It comes under the general umbrella term of a form a dysautonomia. Our autonomic system controls all the things in our body we are not consciously aware of, like blood pressure, heart rate, pupil dilation, movements of the digestive tract and body temperature. POTs can therefore affect the heart rate, blood vessel dilation, blood pressure, blood pooling and body temperature. One of the key features of POTs is orthostatic intolerance. What’s orthostatic intolerance? If the blood vessels are not constricting as they should, when we move from sitting to standing, there can be blood pooling in the legs and abdomen. The blood vessel constriction is designed to pump the blood up the legs when we stand up. If this doesn’t happen, there can be a shortage of blood in the heart and brain. Standing up can cause dizziness, light-headedness and even fainting. This can be especially common after eating, as lots of energy is directed to the digestive tract. To help avoid these dizzy episodes happening, I recommend doing some simple ankle circles or calf pumps before you stand up or get out of bed in the morning. This helps pump the blood up the legs and can prevent dizziness. Try not to stand up too quickly so that you can give the body a chance to adjust to the change in position. Some people also find increasing their water intake and wearing compression garments useful. A medical doctor can also prescribe sodium tablets or other medications if necessary to help control the POTs. The majority of people with POTs are women aged between 15 and 50. It is not known what causes POTs but it sometimes seems to be triggered by what the nervous system considers to be a trauma of some kind. For some people, trauma can be coming into puberty and having a big hormonal change, for some it is pregnancy or menopause. For others is can start after a viral disease like glandular fever or after a surgery. Everyone will respond differently to events in their life, and this makes the onset of POTs very unique for each individual. The symptoms can range from mild to extremely disabling. Like EDS and other connective tissue disorders, POTs can be an invisible illness. It can not be seen on the outside but can be a very disabling condition for many people This can make it hard for people to understand what is going on as someone can look well and healthy on the outside. Like EDS, there is still a lack of understanding and awareness about POTs and how it can present itself and disrupt someone’s life. Living with POTs can be extremely challenging both physically and mentally. I have worked with clients who are unable to be upright for long periods of time, they suffer regular fainting episodes especially with exercise, they can experience brain fog and cognitive dysfunction. Exercise must be carefully approached to avoid increasing dizziness and discomfort. The good news is there are safe options for exercising with both EDS and POTs and we will be exploring this in more detail in the next blog in this series. MCAS Mast Cell Activation Syndrome is a complex condition, but I’ll try to explain it as simply as possible here. It is a condition that causes the mast cells in the body to release an inappropriate amount of certain chemicals into the body. Everyone has mast cells – they are essential blood cells that are part of your immune system. When you get sick, the mast cells activate to help you fight infection and inflammation and return to health. If you suffer from hay fever for example, mast cells are responsible for this allergic reaction to pollen. I explain that having MCAS is like having hay fever in any part of your body. Because the mast cells are everywhere in the body, pretty much anything can be impacted by a mast cell reaction. But what does happen if those allergy reactions start overworking? In a healthy individual, mast cells release chemicals called mediators. One of these chemicals is histamine. A reaction could be itchy skin, swollen skin, hives, mucus, headaches, wheezing and breathlessness. These reactions help to protect and heal the body and they should be short lived until the reaction passes. In someone with MCAS however, these reactions can have a very negative impact on the body. They can become part of everyday life and something that must be managed carefully. The ‘normal’ reactions we need to protect us start to go into overdrive and create an excessive response to things that should not normally be considered a ‘threat’. For example, people with MCAS can react inappropriately to Heat Cold Perfumes Foods Medications Infections Stress Exercise In addition to the normal reactions listed above, someone with MCAS may experience all or some of these too: Inflammation Vomiting Chronic pain Constipation / Diarrhea Palpitations Flushing Low blood pressure Chronic Fatigue Sweating Again, this is another invisible illness – it is not well recognize in the medical world yet and getting a diagnosis and treatment can be challenging. There is no cure, like EDS, so it is a case of managing the symptoms and calming the mast cells down so that they do not continue to overreact. Medications like mast cell blockers and antihistamines can be prescribed together with lifestyle changes like reducing stress, mindfulness, meditation, pacing, dietary changes and getting adequate rest. Living with all three conditions Having had an overview of all three conditions – EDS, POTs and MCAS – can you imagine how it would be to live with these all at the same time? It can be very challenging at times with the need to balance many different aspects of life to avoid flare-ups of the conditions. Unfortunately, many people do live with all three and that includes me. I was diagnosed with hypermobile EDS in 2018 after developing MCAS due to a very stressful event in my personal life. And although I always suspected I had symptoms of POTs, I was officially diagnosed in 2021 following a Covid-19 infection. As we discussed above, POTs is often triggered or made worse after a viral illness. As a movement therapist, I was well placed to help myself rehabilitate my body and mind from the chronic pain of EDS and hypermobility. I now work with individuals all across the globe to help them navigate The Terrible Trifecta, or maybe just one aspect of this trio. Everyone is so different, everyone responds uniquely to these conditions, and everyone has a different story to tell. My role as a movement therapist is to help people find a safe, effective way to move well so that the body and mind can help calm the nervous system – ultimately helping to reduce the impact of these conditions on everyday life. In our next blog, we will be examining how to find that safe, effective movement therapy program. You can read more about my movement method in my two books – Pilates Without Tears and Hypermobility Without Tears. My YouTube channel has a variety of movement classes designed for these conditions that you can try at home too. Jeannie Movement Therapist and Hypermobility Specialist www.jeanniedibon.com www.thezebra.club

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://www.youtube.com/watch?v=Py-NHBcdEkM Brad: We’re got Chris the Pharmacist with us today, and we're going to talk about Advil. Everything you need to know if you want to learn the basics of it and some details, how much to take, etc. It won’t take very long. All right, Chris, let’s talk about Advil. What is it? Chris: Advil is ibuprofen, also known as Motrin. It’s been around for a long, long time. Brad: That’s the same thing? Chris: Yeah. Motrin, Advil, Ibuprofen, all three are synonymous. So, I usually just use Ibuprofen because it’s the easiest thing for me to remember. The reality of it, it comes as a 200-milligram tablet, or it comes as a liquid form for kids, or people that can’t swallow well. Brad: Kids, is that 12 and under? Chris: Yeah, you can use it as low as a year or less depending upon because we use it for fever reducers for kids if they’ve been sick. We dose down to their body weight. It’s not going to be just a package. The concentration that ibuprofen comes in liquid forms is a hundred milligrams per five milliliters. Brad: Is that kids as in infants? Chris: Yeah, babies. You’re going to dose it down and you would tell us the child’s weight, we would calculate out the proper weight and give you a dose. So, either talk to your doctor, your nurse, or your pharmacist to get the appropriate dose. Sometimes they get a vaccine, they’re uncomfortable, they get an ear infection, feverish. So, you provide the ibuprofen, reduces it. In absence of an allergy which would be one of the reasons we wouldn’t take it. It also has cross activity with aspirin. So, if you have an aspirin allergy, don’t want to use ibuprofen unless your doctor’s tested you and given you approval to safely use it. Brad: And that’s all ages? Chris: All ages. That’s for ever and ever. The other utility for adults and the cool thing about ibuprofen, it works for pain, it works for fever reduction, and it’s biggest utility is, it’s an anti-inflammatory. So, you have the sprained ankle, you have the bum knee, the bad back, you have the headache or a cold fever, COVID, whatever you got, you can use it. Brad: So, swelling is the inflammation? Chris: Yes. It’s going to help contain that. Often, that’s a byproduct with pain. Let’s say I blew my knee out. Swelling around the knee, it’s stretching, it’s pressing on those nerves, it’s uncomfortable. We can reduce some of that swelling with ice and other things too, but ibuprofen is going to work from the inside out to try and give you some comfort and give you some relief. Brad: Take that pressure off. Chris: Take that pressure off, but it's also analgesic, so not only is it reducing the inflammation but it’s telling your body, “Hey, I don’t care as much about the pain” So, you’re a little more comfortable and you can rest and allow your body’s natural healing capabilities to kick in. Brad: Okay. Dosing. Chris: Dosing, it comes as a 200-milligram tablet, 12 on up, it’s going to be one to two tablets every four to six hours apart as you need to a maximum of eight tablets, in the day. Often doctors may suggest it, because it’s a 200-milligram tablet they’ll tell you to maybe take more per their guidance. You’ll hear that from physicians to say, “Ah, just take this but we’re going to have you take a little bit more. The maximum dose that we really don’t want people to do is just two tablet every four to six hours apart. Eight in a day is your max. We want to protect our stomachs. One of the side effects of this is long term use of ibuprofen is stomach ulceration. We do have to be careful with that. Brad: What’s long term considered? Chris: Well, it’s going to be months of regular consistent use. Let’s say you have osteoarthritis, sometimes people get a lot of pain, it’s the wear and tear arthritis. As we age, it’s something that we would use for more than just your average bear because it doesn’t go away. We haven’t invented something to fix that yet. That way, I would see you for physical therapy to try and come up with other ways to go non-drug, but, in the short term we would like it. If you’re using it all the time, there are some risks to the stomach and kidneys. The other unique thing rather for people with ibuprofen, if you’re on blood thinners, it’s an absolute no-no. If you’re taking drugs like warfarin, Eliquis, Xarelto, Brilinta, Clopidogrel, these are all things that your pharmacist and doctor would tell you that you cannot use anti-inflammatories like ibuprofen. It can be dangerous, it can cause the bleeding stroke. Three percent survivability on a worst-case scenario. Not an area we want to go in. Brad: Right, that’s good information. Chris: For pain and inflammation, it’s my favorite go-to for recommendation to patients. If I’m not checking off kidney problems, blood pressure problems, blood thinners or allergies, it’s my go-to choice. You’re going to come in to see your pharmacist or doctor and they’re going to tell you, “Yeah. Any problems? No, go through our list. Okay, why don’t we try some ibuprofen.” Brad: As a rule of thumb, if someone has an acute problem, they use that 3-4 times a day. How many days in a row? Chris: We would say up to seven. That’s kind of that benchmark. If you’re getting worse while you’re taking it or if you get to day seven and things haven’t improved, it’s time to contact your doctor. We must get the pros in there that can figure out the crux of the matter to ensure that we can get you back to well. Brad: Right. In case there’s something else going on. It could be more serious. Chris: Tough on the tummy. You always want to take with some food or at least a glass of milk. Brad: Before or after? Chris: I would have it after you eat. This way you have something in there and it’s not so much that it’s acidic and it’s going to burn a hole in your tummy, that's not what happens. It reduces prostaglandin, it slows down the absorption, helps your body to kind of pick it up and makes sure it’s minimally problematic. Brad: If you eat something it’s fine. Chris: A little something is how to take it. Brad: And if you’re in a big hurry, I think you’ve told me you must at least have some milk. Chris: Yes, and we’d like you to stay hydrated because it likes to go through the kidneys. We want to take care of that so people who have renal problems, it’s another thing that you must reduce the dose greatly or talk to your doctor if it’s even safe for you. Brad: Okay. So, just drinking water. Chris: Water is ideal. Brad: What kind should you buy? Chris: Anything that’s inexpensive is fine. The brand names are Advil and Motrin. Ibuprofen is always right next to it. Generic is fine. Brad: If it says ibuprofen on it and some unusual name you haven’t heard of? Chris: Two hundred milligram, you’re good. Brad: It’s good. Chris: There’s no reason to spend more for a shiny, prettier box. Just buy the cheap stuff, it works the same, your body doesn’t care what the name on the box is. It cares what it does in the body. That’s the important thing. Brad: So, I think we hit everything. All right, thank you Chris. Chris: You’re welcome. Have a good day! Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble 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.

Finding a comfortable mattress is a very personal choice, but here are some guidelines: 1. The base of the mattress should be firm enough to support your spine in a straight position (spine should be in an S-curve as opposed to a C-curve). 2. The mattress does not allow sagging. See photos to compare: supine straight and supine sagging, side lying straight and side lying saggy, prone straight and prone saggy. 3. The upper layer of the mattress should be comfortable and conforming, reducing the pressure at the contact points. 4. Medium-firm mattresses have been found to be better for back pain than firm mattresses. 5. If you are a smaller person with less prominent curves, you will likely be able to tolerate a moderately firm foundation mattress with a firmer top. You won’t sink into the mattress easily because of your size and because you have less prominent curves you can tolerate a firmer top. 6. If you are a heavier person with prominent curves you will likely require a firm foundation mattress with a less firm top. You will likely sink into the mattress easily because of your size and because you have prominent curves you will benefit from a less firm top. 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://www.youtube.com/watch?v=Gb3NdwZbNK4 Brad: Paul Reuteman, Physical Therapist, is here with us today, he drove over from La Crosse. What are we going to talk about today? Paul: We’re going to be talking about physical therapy school and admissions. Brad: Anybody out there interested in becoming a physical therapist, this information is going to help you out with a lot of questions that you probably have. I know this is going to be good. He’s going to talk about what it takes now and what future school are evolving and changing to fit the needs of students, right? Paul: Today’s student, correct. Brad: Let’s get some of your background first, how you know this. Paul: I’ve been at University of Wisconsin, La Crosse, and their physical therapy program for the last 20 years as a full-time faculty. Then, also for the last 10 years now, I have been the chair of the admissions committee at UW-La Crosse. Prior to that, served on the committee for about five years. So, I have about 15 years of admissions experience working with reviewing applications, identifying how or what applicants look strong, what applicants don’t look strong, and then providing them admission to the PT program. Brad: So, your part of the decision-making on the individuals who you say, “I think this is a good person for our PT school, this person maybe not.” Paul: Yes, I’m one of four on the committee that make the final decisions, but yes. Brad: Okay, and this information, you’re at UWL, I’m an alumni there as well, but I think this information will kind of fit across the whole United States, right? Paul: Yes, every school had kind of unique admission standards, but for the most part, there are specific things that a lot of the schools really look for these days in the applicants of their program. Brad: So, did you have a place you wanted to start? If there are people out here who are just thinking about “Do I want to be a therapist of not?” Or they know they want to, and how to apply. You go ahead. Paul: Right, I think the best place to start with anyone who’s interested in applying to PT school is on a website called PTCAS. It’s a centralized application website. It’s very similar to a lot of the other healthcare professions now that have a centralized application where you fill out one application and then you can submit it to many programs across the country. What it also provides for you is all the programs that enlist into PTCAS and gives you some details about those programs in terms of how many students do they accept, whether admission standards, just some baseline information about what they look for in their applicants. Brad: Typically, can you go to a PT school? Do you have to have you bachelor’s first, or can you do a three year, not get your bachelor’s, and then roll into the PT school? Paul: Good question. So, a lot of the programs right now are of the traditional four years of an undergrad degree, and we’ll talk about what the best or ideal undergrad degree is. Then it’s three years of PT school. So, it’s a total of seven years. Brad: And then you get your doctorate. Paul: And then you become a Doctor of Physical Therapy, and you can practice as a Doctor of Physical Therapy. Brad: So, you get to be called doctor. Paul: You do, you still must complete a licensing board exam for the state that you work in. That’s almost with all healthcare providers must complete a licensing exam. Once you complete the PT school, then you’re qualified to sit for that exam. Brad: This is different than a PhD? Paul: It’s different than a PhD. This is considered a clinical doctorate. So, you have some coursework that mimics a PhD, but not the extent of the research that you would get with a PhD. Instead, what it does though, is it trains you to become a clinician in the field of physical therapy and work in a variety of different settings. Brad: Right, I know I’ve had students from UWL work with me. I’m telling you, you guys do a good job because I’m thinking, these people were farther ahead in their knowledge and skills than I was when I was with you, because they had an extra year and good instructors like you, I’m sure. Paul: Right, right. Brad: If someone listened to this and say, “Wow, that sounds good.” And you have any like personalities, or you said, people that you’re looking for. Paul: Right, so I think what we should probably start with is if you’re interested in physical therapy school, you need to start thinking about what the prerequisites are to get into or to apply. So, majority of PT schools have prerequisites that they require you to take prior to applying to the PT program, and the majority of those are science courses. So, biology, chemistry, physics, anatomy and physiology, psychology and statistics. Those are kind of like core foundational prerequisites that most PT schools require. Each PT school has its own unique requirements as well. That’s where you’re going on to PTCAS, you can identify what those prerequisites are, or if you so choose, go on to each PT programs website, and on each website, they’ll have the list of the prerequisites that are required. That’s the first thing. Second thing is then start deciding, what is a good undergraduate degree for you to pursue. That’s always one of the major questions. If they’re, let’s say a freshman in college, and they know they want to get to the PT school, they always ask what is the best undergrad degree? I’m going to tell almost everyone across the board right now, the best PT degree to get into is the one that most interests the person. If I tell everyone to get a biology degree and they hate biology, boy, they have a long four years ahead of them. So, choose any sort of ungraduated degree that is of most interest to them as long as they meet those prerequisites for the PT program, it doesn’t matter what your undergraduate degree is. Brad: So, I’m going to go off the edge. What if someone’s interested in, well, psychology? Now, there’s a lot of psychology involved with treating a patient. So, that would all fall in the place too? Paul: Yes. At UW-La Crosse, we’ve had cake design as their undergraduate degree. Brad: No way. There’s no such thing. Paul: There is such a thing as cake design. Brad: I must investigate it. Paul: They went back to school to get their prerequisites. They kind of went a different route than most people go. Let’s say, we’ll use psychology. So, if you choose psychology as your undergraduate degree, then you just must make sure that you also hit those sciences in your studies to satisfy the requirements to get into the PT program. Brad: And pretty much for every school across the nation, I’m assuming GPA, they want to have a high GPA? Paul: Right, so some of what we’re trying to do at UW-La Crosse, we’re trying to now develop a holistic approach to evaluating those people who are applying to the program. So, that does include GPA. Your prerequisite GPA, which are the grades that you get in those prerequisite courses, but then your overall GPA as well. So yes, that does apply. A GRE score, the GRE is kind of the equivalent of an ACT for grad school. So, some PT programs are requiring a GRE, some are not. So, at UW-La Crosse, we still require a GRE. It’s a standardized way to assess all students on an equal level, right? Then the holistic part of it is, what types of outside opportunities or experiences has the student engaged in? We look for leadership, we look for healthcare experiences. We look for any sort of interaction with people who, let’s say, have physical or emotional or psychological delays that require some sort of interaction with the student and those individuals. It just prepares them much better to become a physical therapist in the future. So, it’s not just grades and it’s not just standardized exams, but it’s also what have they done to kind of improve their ability to work and interact with individuals. Brad: So, and I’m assuming, like you said, if you’re in the medical field, if you’re a physical therapy aide, I think would be ideal because then they have a direct experience of what a day-to-day work is for a therapist. Paul: Yes, but the unfortunate thing is there’s a lot of people interested in physical therapy school that don’t have the opportunity to work as a physical therapy aide. So, people think, “Ah, then I shouldn’t get any other jobs.” Really, it’s any sort of opportunity that they’re working with people. The ideal would be everyone to become an aide for a period, but that’s just not realistic. Brad: And I can give you an odd ball example of how someone got into therapy without any medical history. That’s myself. I worked in industry, worked on the large industrial equipment, electrical equipment for ten years. Sold my part of the business and went to school to be a PT. I didn’t even know what a PT did, really. I worked my way into it and I was passionate about school. I don’t know what happened, you know? But here I am. Paul: But you displayed that you’re able to hold a job for 10 years. You displayed that you’re in a leadership position that you’re able to manage a business. All those things are things that we look for now, not just how good you did in your undergraduate studies. Brad: My point is, if you think you want to be a PT and you’re somewhere else in a completely different world, it can be a benefit. Paul: Yes, it can be a benefit. We’ve had a lot of people who’ve decided that the career, that path that they’re following right now, is not for them. They’ve chosen to go a different career path, such as yourself. They do have to go back, get some of the prerequisites, and once they complete those, then apply to the PT program. Brad: Oh, and I do want to ask because I have a feeling there’s going to be several physical therapy assistants out there wondering, “Well, I’ve been doing this.” Does that help quite a bit, or does that depend on the individual? Paul: It does help because they have that perspective of what the profession is, yes. The unfortunate thing is that a PT assistant degree does not qualify them to apply to the PT program. They still must go back and get extra training and some of the advanced sciences before they can apply. So, that’s the challenge. We love it though, when PT assistants apply to our program because they do have that background, but we don’t get a lot of them because it is kind of a challenge to go back to school once you’ve been out practicing for a while. Brad: Well, you know Aaron Cast. He worked for us as a PTA and then we lost him. He was one of my best employees, but he did take the extra classes. For a year, year, and a half at least, before he could even apply. Paul: He did a great job. Brad: Yeah, and he’s been out working. He has kids and everything. Paul: We don’t want to tell him he’s a good PT, but I guess we just did. Brad: Yeah, he might be watching this. He’s done a few videos. He got certified for lymphedema. Paul: Did he? Okay. Brad: Yeah. He did some videos with us, very helpful. Very, very nice. Paul: Neat, good. Brad: Well, that’s interesting. Is there another point we want to bring up? Paul: If you are searching our PT programs right now, do your homework. There’s a lot of different opportunities out there, and options that exist. I mentioned, UW-La Crosse is the traditional four plus three. There is an avenue where you can go a three plus three. So, three years of undergraduate degrees and then get undergraduate degree work and then go to PT programs, so it cuts a one-year off. There are a lot of schools that are kind of adopting that hybrid program now. Brad: So, when you’re a junior, you’re applying. Paul: You’re applying as a junior, yep. Those are specific to a specific undergraduate degree. And again, there are some programs. If we talk about the State of Wisconsin, Marquette, Carroll, have those opportunities where you can go three years and then apply into a PT program in your fourth year. So again, UW-La Crosse has that option as well and some of the other state schools do as well. Then there’s some unique hybrid programs that are out there now with smaller, private institutions where it’s more intended for those individuals who maybe are choosing PT as a second career, or maybe don’t want to uproot and live in a different location where they can take a lot of the coursework online, and then they have to go to the university, maybe three, four times a year, spend about a week and a half, two weeks there to do a lot of the hands on course work. Those are unique. Those are starting to pop up a little bit more across the country, but you’re going to have to do your homework on those to find out where they exist. Brad: Right, right. It is a matter of sitting down at the computer and start searching for all these schools and see what your options are. Paul: Yes, those programs aren’t for everyone though. There’s not as much of the face-to-face interaction that you get with a traditional program such as ours. So, I’m a little biased of course and I think those are probably a good route to go, but for some people who are more self-directed learning, they might succeed in these hybrid programs. Brad: Sure. I remember when I was in school, a year behind me, there was a woman, she had two or three children that were in middle school, and she went back to school, and she did outstanding. I can think of another PT that worked for us, she left to become a PT too, and she had two or three kids. There are these people who are motivated, they’re smart, and you don’t have to be a traditional student. Paul: Exactly. We do call them “non-traditional students” and we really enjoy having those non-traditional students in the classroom because they provide a certain amount of leadership to the class because they’ve been out, they’ve been working. They know what the world is like out there. They have a positive influence on a lot of the students who’ve been doing the more traditional route going from undergraduate degree right into PT. Brad: Do you have many non-trads or is that rare? Paul: We have a class of about 45 and I would tend to think somewhere between five to 10. We have non-traditional every year. Brad: When I was a non-trad and then we had two or three others, she had one woman, she was 53 years old, went back to school. Paul: We’ve had a few. Not many of that. Brad: Yeah, that was kind of rare, I think. Paul: You do remember that when you were in PT school, Brad, they were still writing on chalkboards. Brad: That’s true. Paul: I think you had to go back behind the building and clap the chalk dust. Brad: Yeah, that was if you were bad. So, what about job future growth? Paul: Future growth right now is positive still. There’s been more PT programs that have been popping up, which obviously means there’s going to be more PTs in the job market, but.... Brad: Always a “but”. Paul: Our professional organization has kind of been keeping an eye on this and at least right now, it looks like there’s still a positive job market that will exist for the next 10 to 15 years as the age of the population continues to grow. There’s going to be a need for physical therapists. Brad: And as far as wages because everyone wants to know how much you’re going to make. Can you just give your range from 10,000 to 20,000? Paul: Right, I think the wages right now are probably somewhere between 60,000 all the way up to maybe 90,000-100,000 but it depends on the location where you go. Ironically, in some of the larger metropolitan cities, the pay wage isn’t quite as high because there is a greater amount of PTs. It’s in the small rural areas where the wages are higher because the demand is so much higher for them. Brad: What about traveling PTs? Paul: Traveling PT still exists. It’s not quite what it used to be 20 years ago, but there still are opportunities for you. If you want to experience short-term employment at different locations where they’re in a dire need of PTs, they’ll put you up in certain residences and have you work for six weeks to three months at locations. Brad: And the pay for that? Paul: Pay has always been good. Brad: But then you’re jumping around. Paul: You’re not really establishing yourself anywhere, but some people want to do that right out of school. Brad: I think I would’ve. I mean, I was married and had a child at the time so that didn’t work that way. But, if I was 25, I was 35 or 36 when I graduated. Paul: I moved right out of PT school down to Chicago and that was fun. I was able to rotate around Chicago working at a couple different clinics. Living in the big city was fun, I got it out of my system and now I’m in a smaller town. Brad: All right, anything else? I think we covered a lot of ground. Paul: I think we covered it all. Brad: I hope this was helpful for you and I’m glad Paul could come in and give you some direct information from his point of view. So, good luck if you want to be a PT and I say, if you want to, you can. Good going. Paul: Yep, thanks for this opportunity. Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble 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 August of 2021. For the original video go to https://www.youtube.com/watch?v=N0HWZlN57hM Brad: Today we have a special guest, Chris, and we're going to cover in detail, the latest research and information on Lyme's disease. And the title of this video is, "Lyme's Disease is a Growing Problem. Where, symptoms, treatment, and prevention,” we're going to cover all those sections. You're going to find out some very interesting, updated information I'm completely unaware of, but I'm glad I know now. We're covering all the bases. Chris: All the bases. Brad: So Lyme's disease, something that people, I think across the United States for sure, everyone's heard of it. Chris: Yep. I think it's a growing, a spreading problem. And a lot of that comes down to climate change, there's a lot of it, they like warm and moist. And let's face it, things have kind of changed over the last 20 years. When you look at some of the maps that are available, it shows the spread pretty dramatically over the last 20 years. Midwest, out east. Out east is particularly bad, but the Minnesota, Wisconsin area is a pretty big hot zone, too. Brad: And we do have a really nice map showing statistically where the cases are and where they're intensified. You know, if you want to go to the end you'll see what those look like. Chris: We'll place those maps for you. Brad: That's right. Another thing, I don't think Chris minds me mentioning this, is one of the reasons we did this topic is because someone here actually has Lyme's disease. (It’s Chris) Chris: No longer. I'm cured. Brad: So you're really motivated to get, or extra motivated, to get more updated information on how to treat it and how to get better. Chris: Yeah. You know, as a pharmacist, I deal with customers and patients that come in all the time, and I've always just kind of counseled them on their meds, but I really never took much. You take it for granted what people feel like until you actually perceive it yourself. Brad: Sure. Chris: And frankly, I think I was in denial. I thought it was a spider bite or something at first because I had these two small bites kind of in the hip region, and it was just kind of started spreading to a rash. And my wife's like, "You need to go in. "I'm like, "Nah, it'll be fine." She's like, "No, you really need to go in." Brad: And so it's from a tick. Chris: Yep. It's from a tick. When I went in, and this is one of the problems with Lyme disease, Lyme disease mimics, they call it the great pretender. So it looks like a lot of other diseases. So arthritis, flu, you can have headaches, so migraines, Bell's palsy where it actually can cause facial paralysis. Yeah. Brad: So it's not actual Bell's palsy. It's kind of symptoms. Chris: No, yeah because it can actually go into your cranial nerves. You have the 12 cranial nerves, and so what can happen is the spirochete, which is what the bacteria is, it can affect those nerves and actually requires pretty intensive IV antibiotic therapy to get the patient out of it. So, and there's three stages of Lyme disease itself. So it's the variety, the severity and when you catch it, are all critical in its treatment. And so the key is early detection, and that's the problem. If you can get it in the first stage, that’s great. And usually when does that happen for people? The stage one is going to be, you probably see the rash, it could feel a little achy, weak, tired, fatigue, even kind of confused, your thought process isn't that great. Brad: Is rash location always associated with the location of the bite? Chris: Generally, but not always. And actually, only 70% of the cases have the rash. So there's another full on 30% that don't even show this rash. Brad: Okay. Chris: And that's why Lyme disease can be so devastating, even to the point where it's fatal. So that's the scary part because it can progress to things like Lyme carditis where it affects people's hearts. And that can cause arrhythmias and ultimately fatality. So, that's the worst case scenario. Brad: I have a good friend. She was in her sixties, lived on our farm all her life, and all of a sudden, very healthy person, very aware of her health, and she got Lyme disease and it did affect her heart, and she actually got a pacemaker as a result of it. Chris: Yup. Yeah, and they do talk about that quite a bit in most of the research. It's some scary stuff, and the key is early intervention to get it treated as quickly as possible. Hopefully your doctor is knowledgeable about it. And that's one of the problems is, we're a pretty travel prone society. So let's say you're up from Kentucky, camping in Minnesota where there's a lot of tick problems, or in Pennsylvania where there's probably more ticks than any other state. All of a sudden you get bit, you go back home, and you have a rash, you don't really think about it, or let's say you don't get the rash, and you're just kind of achy and feverish, and like, “oh, I must've picked up a virus.” Brad: Sure. Chris: You know; you can't really discern what it is because it does so many different things in your body. Brad: Sure. Chris: So if you go and you see your doctor. “Oh, it's just a virus, it'll pass.” And all of a sudden, you're two months into this thing and all of a sudden, your face is not working right, you can't sleep well, you're crabby, you're moody, your muscles ache, you have an arthritic joint that just blows up on you for no reason when you didn't have any history of arthritis. Brad: Okay. Chris: When they say it's the great pretender, it picks up just about everything head to toe. Brad: Wow. Chris: It can cause brain and thinking issues. It can cause, essentially, the burning and tingling like a neuropathy, which we've talked about in the past. Brad: Yup. Chris: So, you know, these are things that, you know, when you talk to your doctor, you want to be, super-duper careful with that and make sure that they're knowledgeable about the symptoms. Brad: Now typically, when people get bit by one of these little baby deer ticks, you can hardly see them. Because they're most infectious when they're in their baby phase? Chris: The nymph stage. Brad: So that's like a baby deer tick. Chris: Yeah. So that's the third stage. So mom lays eggs in the fall. They're actually disease free, which is what I found pretty interesting. They hatch. They emerged, become a larva. They attach onto a mouse or a bird. That's where they pick it up. They take their blood meal, then basically they molt and they grow into the nymph stage, which is about the size of a poppy seed. So if you've ever had a lemon poppy seed muffin, that's the size you're dealing with. And most people don't see those, and that's why they're more dangerous at that stage than anything else. Because the contact time for a tick bite, the CDC actually says that, and most of the entomologists and disease specialists and the bug specialists say it has to be in place for about 24 to 36 hours for the disease to transmit into your body. Brad: Yup, I've heard that. Chris: So you can't see a nymph. And the other goofy thing these little buggers do, although they're arachnids, is that when they bite you, they contain a little bit of an anesthetic, so you can't even feel the bite. It's completely numb to you. So most people don't have a clue that they even were bit by a tick. Brad: So that leads me into the previous question I was wondering. So after they bite you and you cannot feel it, but like, I was bit by one, and I did have the red ring. Nothing happened as a result, but do you always get the red ring around the bite, or typically? Chris: We'll touch on that. Most times you do, but not always. And then also just because you got a red ring around the bite does not necessarily mean you're going to get Lyme disease either. Brad: Which is what happened to me. That was clear. Chris: Yup. And probably in more cases than not, that's going to be the case. Brad: Oh really? Chris: Because, it’s interesting, they think there's about 300,000 cases per year, but they only have definitive diagnosis for about 30,000. So when you go in and get lab testing, most doctors, and that's why that number is skewed by we're talking, you know, 10%. I mean, it’s a big number, 300,000 down to 30,000. But I think most of the cases, doctors will basically empirically treat based on your symptomology. And we have a lot of very experienced clinicians out there that recognize, at least if you're in the Minnesota, Wisconsin, out east, New York, Massachusetts, New Hampshire, Pennsylvania. All those states are just huge with tick populations and Lyme bearing ticks. Brad: Sure. Now the other thing I wanted to mention, this is our talk about virus, bacteria. This is not a virus, right? Chris: No, it's a bacteria. Although, ticks are filthy. So they carry, I mean, everything. I mean, they got viruses, parasites, but in this particular case, the bacteria, it's a spirochete. Brad: You're not making me feel good about going hunting again, or hiking. Chris: No, I know. Well, but we'll talk about how to make sure you don't get bit too. Brad: Okay, good. There's light at the end of the tunnel. We can continue to be active in the outdoors. Chris: Yeah, no, we want you outside. We want you to be doing those things, but we just have to be smart about what we're doing and when we're doing it. Brad: Sure. So you get the bite from the little, nasty creature. You get the red ring. You go into the doctor. Is there a blood test or something to get a positive diagnosis? Chris: That's what's interesting, yes. The tests are tricky, you see online advertising saying, "Get tested for Lyme disease now." These tests are great, but they're not great early on. It takes about six or so weeks to develop antibodies. So you have to have the disease for a while. And that's the problem is sometimes you just don't remember having a tick on you. It's one thing when you see a wood tick. We've all seen those. Those are the big flatter ones that you recognized right away. Deer ticks, particularly if it's a nymph, are so dang small. I don't know how you're going to see it. So it'll just sit there, drop off you when it's had its fill, and move on. I mean, that's literally what happens. Little bastards. Brad: It's a family show! Chris: I'm sorry, I'm sorry. Nonetheless, I have an intense dislike for ticks. I'm sorry. Brad: Yeah, well, that's understandable, because you've been diagnosed with the antibody, so you've had it for a while. Chris: They didn't do the lab. I foregoed having the lab test done, because it was pretty obvious with the rash and some of the other symptoms, the cardiac symptoms I was experiencing. And so the doctor felt like, no, we're just going to throw you on an antibiotic for a month. And that's what happened. And I'm good to go. Brad: Yeah, because I remember we were biking. We were doing some sprints, and Chris is typically faster than I am. And I was like keeping up with him almost passing him like, “yeah, I'm getting in better shape.” And then, Chris says that, "Something's going on with my heart." It's like was it a heart attack or what? We found out it was from the Lyme disease. Chris: Yeah, but it still took another, what, five, six weeks for me to get better from that with antibiotic therapy too. I mean, I didn't really come around until about last week. Brad: Yeah. What about the rash? Is that clear? Chris: The rash is gone. Rash went away last week. It went away last Saturday to be honest. So I had the rash for five weeks, and that's about normal. And it spreads too. So it's not always just located where you get the bite. It can go all over. I ended up with it on my shoulders, wrist, arms, legs. So I had it all over, and that's more common than what people believe. Brad: You got bit where? Chris: Right in the groin area. Brad: That's very interesting, because that's exactly where I got bit. Chris: Yep, and it is. They're sneaky little buggers. They like to go where they're not going to be seen, because it takes them a while to feed. And they'll hang out and feed for a long, long time to engage themselves, like days. So it's one of those things. And so if you do get a tick on you, the best way to remove it is thin nose tweezers where basically you want to grab right by the head at the base where the tick is actually inside you, and you want to pull straight out. You don't want to twist, because if you twist, you can leave the mouthpieces in there. And the mouthpieces pieces are barbed, so they can get a good attachment, so they can just suck away. They're, I'll call it, one of nature's impressive beasts, because they know what they're doing. I mean, they inject you with an anesthetic, so you can't feel them. Like I said, they're sneaky little buggers. So they feed, they drop off, and they move on. But what most disease specialists suggest is that it has to be in place for 24 to 36 hours for you to actually even pick up Lyme disease. So it's not common. Not every tick bite's going to infect you. And that's why the nymphs are so dangerous, because we can't even see those things. Whereas, an adult you're like, "Oh, I got a tick on me." And so we take care of business. Brad: Right. The only other thing before we get into some treatment and how to avoid getting these bites, this started, this was discovered in the United States 1970s? Chris: Yeah, 1975, Lyme, Connecticut. Brad: So that's how it got its name. Chris: Yep, that's how it's named, Lyme, Connecticut. And basically a woman had just recognized, there were 51 cases that this woman observed, and 39 of them were kids, that all had basically arthritis. So that's unusual, kids under the age of 14 having big swollen joints, pain, and as the progression went on, I mean, there was more and more studies. Yale kind of started to pioneer most of the studies with it. And then there was also a very special person, Willy Burgdorfer, he was the guy that basically isolated the disease. And in '82 it was named Lyme disease officially. By 1987, it was a named disease state. Brad: But then by that time it had been spreading. And it seems like in the last five or 10 years the spreading increased? Chris: In the last 20 years it's been pretty dramatic. And then we'll see if we can attach that to the end of this too. You can just kind of see the spread. It's actually a scatter map where they use little tiny dots to just show cases. And you can see out east and through Minnesota and Wisconsin in particular. Brad: So we're in that area. Chris: Right, basically if you look at the United States map, I90, they call it the tick highway. Brad: That's that interstate section going right by La Crosse. Chris: So it's kind of interesting. Like I said, it's the number one vector-borne illness around. So, ticks, as I said, there's an egg. They're disease-free. They attach to a mouse. They get bigger. They go to the nymph, and they find a bigger blood meal, and then they become their adults. Brad: And evidently, they do go to deer, and I don't know how that name is. Chris: Deer, people. It's just mammals, but I mean actually it's a black-legged tick, but we call them deer ticks specifically. Brad: How do we prevent it? That's a big topic. Chris: Yeah, prevention is kind of interesting. This is where I kind of look at both natural and chemical treatments. There's a lot of repellents out there. They hate the smell of lemons. They hate the smell of eucalyptus. So those are more natural treatments that do repel, as well as DEET, and you want something like 20% DEET, but a lot of people are not crazy about DEET, because some people can get some nervous system problems with excessive DEET exposure. And when you compare it to permethrin, which is an extract from chrysanthemum, the flower, mums would be another name, so when you look at that one, the half percent permethrin seems to be more effective. In a lot of cases, when you treat your clothing with it and let it dry, a tick will curl up and fall right off. They cannot deal with permethrin but DEET is not quite as effective. Brad: Permethrin, where do you get that? Chris: You can get it online. You can go to like a Cabela's. You can go to just any kind of outdoorsy store. Brad: And just look at the active ingredient? Chris: Yeah, and if you just go and you go to their bug repellent area like probably the camping section would be a god spot in most sporting goods stores or online, you want a good permethrin based, and it's 0.5%. And you can treat you clothes with it. It's not generally recommended to put directly on your skin, but you can put it on your shoes. Prevention is the key to avoiding tick bites. So when you're outside, we want to make sure we're wearing pants. We want to tuck our socks into our pants. You don't look too cool, but it definitely works to keep them out. Brad: Just cover up. The longer the sock, probably the better depending on if you're going to layer like you said. Keep them, so they have to work to get to your skin. Chris: Exactly. And then, it's like when they're out there when ticks are on the hunt, so to speak, they detect our CO2 and our perspiration and smells. So they're really sensitive, little critters. Brad: They can sense that? Chris: Like a mosquito does. They sense your breathing, your CO2. Brad: How do they? Do they ask them or what? Chris: I don't know. Well, I would take a room of 1,000 ticks, and I would actually start to individually question each one, because that's how I roll. Brad: Sometimes you wonder how they know, but anyways. Chris: They've figured it out, some smarter people than you or I, for sure. Brad: Bugologists. Chris: Yeah, there you go, etymologists. But, what they do when they're hunting, they call them a quest. So I don't know if they're into like "Lords of the Ring" or something, but they call it questing. So they kind of hang out on leaves and blades of grass, and they kind of extend their legs. And you walk by, they'll just kind of sneak right on aboard, and then they're going to start looking for a place to eat. Brad: Kind of like Velcro, or it just catches. Chris: Yeah, kind of. They're sneaky, and they're opportunistic, but they sense you coming, and they're ready. They just know that there's going to be a meal on the way. They just see meal tickets. So they don't care if you're a person, a deer, a mouse, a bird, lizards. They found it on all sorts of different things. So usually your bites are going to be the hairline and the groin area in particular, because those are not areas that people readily check. So if you've been hiking... Oh, the other thing, while we're talking about prevention before I digress too far, when you're walking on trails, try and walk more in the middle away from brush. And in your yards, keep everything kind of pruned. So if you're on a wooded lot, you want to make sure everything's kind of trimmed back. Mow your lawn regularly. Brad: Walking through tall grass, brush, are things you want to avoid. Chris: Those are prime targets. So those are the things that you want to do to avoid. And then when you get back, either use a mirror, so you can check your body, backside, all the weird cracks and crevices you normally don't look at, because that's where they're going to be, or just a trusted loved one that can kind of look you over really quick. Brad: What time of year is it most prevalent? Temperature wise I'm assuming. Chris: Temperature wise is kind of interesting. They like the hot and humid is what's ideal, but like you said, you were talking about deer hunting. Deer hunting is a prime opportunity. Even though it's colder, the adults are out looking for a meal. But it's more prevalent in spring and summer. But you can get bit in the winter. You used to think that it had to be like a 70 or 80-degree day for a tick to be active. Well, they found ticks are active in the 40s like in December in Wisconsin and Minnesota. So you get that nice day, and you're out there, they'll hide in the underbrush and leaves, so it's not really snow packed. So you just have to be mindful that it's kind of a year round problem. And because we're such a mobile society, if you end up with symptoms, just make sure you say, "Hey, I was in a tick area. "Can I be checked for Lyme?" Especially if you're like in a stage two where it's been like four weeks or a couple of months, and you got weird symptoms, you don't know what the heck's going on, and they can't figure it out, just, "Oh, I was in Wisconsin, Minnesota, Pennsylvania, "New York, New Hampshire, wherever." But those are all high tick bearing areas. And let's not forget about our friends over across the pond. There are very similar tick-borne diseases in Europe and UK and those areas as well. So it's good to be mindful of these types of infections. And the treatments are going to be the same no matter where you go. Brad: Okay, so they're going to work with the antibiotic for that bacteria. Chris: Exactly, and so the primary one is doxycycline, which is a tetracycline antibiotic. Brad: Lots of words. Chris: Lots of words, but it's the drug of choice. You want to be on it from 14 to 28 days depending. The studies vary. I would tell you three weeks to four weeks is probably most ideal, because it's a tricky thing to test. There's some studies that say seven to 10 days is enough. I flatly disagree with those. I think that I've seen enough people in my profession come back, "Man, I'm back for more." And it just didn't treat it. So, I mean, if we treat it long enough and strong enough right out of the gates, that's great. But what do you do if you're allergic to tetracycline type drugs like doxycycline? Well, then you can use amoxicillin, which is a penicillin based or Ceftriaxone, which is a cephalosporin based drug. Brad: And that's all your doctor will refer? Chris: Your doctor's going to take care of business. Your doctor's going to know what’s best, but those are the big three drugs. Basically, it's doxycycline to amoxicillin. If you're allergic to penicillin, then you go to Ceftriaxone. So that's kind of the progression. Brad: All right, well, everything I wanted to know and more and sometimes less, but very interesting, very informative. I learned a ton that I didn't know about these little creatures. Chris: Yeah, I learned more than I wanted to, but I felt like I was forced to. Brad: And you're feeling much better. Chris: I feel much better 100%. Brad: Absolutely. Chris: So it's treatable, guys, and the sooner the better. If you do recognize just weird stuff, think about where you've been and let your doctor know that you were in a tick area, because oftentimes Lyme's is missed. Let's say you live in Florida, there's cases where people had heart transplants, because they missed the Lyme diagnosis. So that's how bad it can get. So it's one of those things that it goes long. You can have basically chronic Lyme disease, so it's just we got to pay attention. Just be knowledgeable about it. Just remember, could I have been somewhere outside where I got bit by a tick? You've got one of the most active audiences I know, so that means you guys are out there doing, which is the best thing for you. We just have to be smart about it. Chris: Sure. All right, very good. Thank you, Chris. We appreciate the wonderful information. And be careful and tick-free. Chris: Thanks, guys. For maps visit: https://www.cdc.gov/lyme/datasurveillance/maps-recent.html https://lymediseaseassociation.org/cases-stats-maps-graphs/ Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble 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.

It is very important to get adequate sleep when trying to manage and heal your back pain/sciatica. A day of pain from back pain/sciatica can wear you out mentally and physically. A good night’s sleep can help you restore the energy required to battle the monster known as sciatica. These are suggestions to help you sleep pain free. The key is to try the different positions and see which ones work for you. 1. Sleeping on your back with a leg wedge in place- Brad, at times, will go to sleep with an ice pack inserted underneath his back with his legs up on the wedge. He will wake up a few hours later with the ice pack no longer cold, and he will take the cushion out, turn and sleep on his side. 2. Sleeping with lumbar support- We suggest first taking a rolled sheet and pinning it around your waist. The rolled sheet will provide some support for the arch of your back while sleeping on your back and on your side. If you find it comfortable you may want to purchase a night roll lumbar support by McKenzie. If you are a thinner person with minimal body curves you may not need much support. If you are larger with more cushion on your buttock, you may need a larger support. Night Roll Lumbar Support 3. Sleeping on your back with one, two, or three pillows underneath your legs. 4. Sleeping on your side with a pillow between your legs- You will have less rotational stress on your spine with a pillow in place. Eventually you may want to purchase a knee pillow. A pillow between the knees may be more comfortable when sleeping on your side. 5. Sleep on your side with the painful leg (sciatica) on top. Place both ankles and feet on one to two pillows to see if that position alleviates pain. 6. Some of our patients are forced to sleep in a recliner. If so, place a lumbar support or throw pillow behind your back and recline the back of the chair as far as possible while still maintaining comfortable levels. 7. 90/90 on chair or stool 8. If your mattress is sagging, put it on the floor or put plywood between your mattress and box spring. 9. Sleep on the floor with a mattress topper. Products Mentioned: 1) Elevating Leg Rest Pillow 2)McKenzie Night Roll Lumbar Support 3)McKenzie SlimLine Lumbar Support 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 December of 2021. For the original video go to https://youtu.be/aEuAjvBobjA . Bob: So, my nephew’s wife started a new job. She really likes it. She’s on her feet all day long, 9- 10 hours on her feet. Brad: Concrete floor, hard floor of some sort? Bob: I don’t know what it is, but I know that her legs and her feet get very sore. Dogs are barking by the end of the day. Brad: We’re not talking about Fido. Bob: Yeah. She asked me for some suggestions, and I gave her some that she could do at work. But I also gave her one that she could do at home that’s been verified by research. So, let’s get into that. Let’s talk about first what you can do at work. She can’t even sit down most of the time. Brad: She’s not in one place, she’s on her feet but she’s walking. Bob: Right. What you can do is some ankle pumps. Do one at a time. Brad: Just get the ankles and the feet moving. Bob: Also, do a circle with your foot. It’s going to make a big difference. Then, when you get a chance, you can grab onto a countertop or something like that and stretch the calf. I’m bending the knee to give a little more stretch. You can do it straight too. Brad: Yeah, get two different muscle groups. Bob: All right, on breaks, when you do get a break, finally, you want to take a ball and throw it down on the floor. You’re going to roll the bottom of your foot with it. Brad: Yeah, this spike ball is my favorite. I picked it up for a dollar, right at the checkout of a store. It’s soft, but it has these little prickles on there. You can take your shoe off and just roll it on the bottom of your foot. It’s amazing how good it feels. It feels good on the bottom of your feet. It kind of wakes you up that way a little bit. It’s good for the same reason these balls are. Bob: You’re really stretching out the fascia, stretching out the muscle. It’s good for the bottom of your foot. All right, now we’ll go to what is it that you can do at home. The study was called, and this is what supports this idea, is “Intermittent Pneumatic Compression for Prolonged Standing Workers with Leg Edema and Pain.” Brad: Wow. Bob: Yeah. In other words, if you stand all day and you’re getting leg pain, this is for you because what they found is that people had significant leg pain and discomfort and swelling improved after using intermittent pneumatic compression. Brad: So, we’re talking about someone that has been working all day? Bob: Right. Brad: But not an athlete that has sore muscles. Bob: We’ll talk about that too. Brad: Okay, good. Bob: This is from iReliev and it’s called the leg and foot air compression system. (*Update: Bob and Brad have come out with a Air Compression Leg Massager). I think if you are a person that wants some relief at the end of the day from working, and kind of have a treat where you don’t have to do much besides strap it on and let it go. You can put your feet up while you’re sitting on the couch and off you go. Brad: So, I have this one, well, two. One for each leg, then there’s the pump unit, it does plug in to 110 volts. You can vary the intensity. There’s low, medium, and high. Bob: They’re also called sequence, or you could do the whole thing at once. Brad: Right, now I’ve got it on sequence. It compresses differently on the foot and then on the calf. It has a sequence where it goes back and forth versus compression on the whole thing. It’s not squishing my legs so it’s painful. Again, you can adjust it through different levels, but I can feel it. It’s kind of nice. I get some of that pressure on the arch of my foot on the bottom, which feels good and the top. Bob: Well, my daughter tried one of these and she liked the compression. Now, if you are an athlete, they did a study called “A Randomized Controlled Trial of Massage and Pneumatic Compression for Ultramarathon Recovery.” So, these are people that were running ultra-marathons. What is that, about 50 miles? Brad: 50 to a hundred. Bob: Oh geez. So, after they were done, they used this for 20 minutes and it did give then relief, subjectively. Brad: Yeah, felt good, oh yeah. Bob: But over the next seven days, they didn’t find much difference between not doing anything and using this. Brad: Except for feeling good. No recovery, nothing that they could measure. Bob: So, it was one study. I know that the marathoner in our group, Mike, he really likes it. I mean, he’s using it, but we can’t say studies support it. Besides it feels good. Brad: Yeah, anecdotal. Bob: Right. Brad: Which, there’s nothing wrong with it. If it doesn’t hurt something. Bob: And as they come up with some studies it shows that it does help. These things are not going to hurt anything, that’s the positive thing about them. So, very good, again if you work all day on your feet, honest living, this is going to help you. Thanks! Interested in learning about the products mentioned: 1) Bob and Brad Air Compression Leg Massager Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble 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 November of 2021. For the original video go to https://youtu.be/0hlK6szwDoQ. Brad: Bob is not here today, but we're absolutely honored to have Chris here. He's done some wonderful research and we both have an extraordinary history of sore muscles. So, the title today is how to relieve sore muscles, including DOMS. That means Delayed Onset Muscle Soreness. That's when you work out on Saturday, but you don't feel the sore muscles until Sunday or Monday. Oftentimes it skips a day and it's into Monday, it's delayed. And it's an interesting concept. Chris is going to go through this in detail. We're gonna give you some health information, about how you can avoid sore muscles. Chris: Well, like we said in the title, DOMS, Delayed Onset Muscle Soreness, not fun. And no one is immune. It doesn't matter if you're the novice, the average guy that exercises on a consistent basis, or the elite of the elite athletes. We are all subject to becoming a victim of it at some point in our lives with workout programs. Brad: That's kind of strong, Chris. A victim? Chris: Well, it's painful. Brad: Yeah. Chris: I mean, it hurts. At some point, if you're sore, you kind of feel like you've been victimized. You know you're gonna pay the piper at some point or another. I'm going to actually pay for it tomorrow with what I did this morning. But it's one of those things where is it bad, is it good? It's been kind of a debated question and when you consider that with athletes, you've got trillions of dollars invested in these athletes all around the world between Olympic athletes and pro athletes and college athletes. But we don't really have any clear answers as to how do we solve the mystery of DOMS. The true remedy is time. Brad: Okay. Chris: But there's aspects of it that we can help to try there are and minimize it and hopefully make it not quite so severe. But at the same time, we always want to have a guideline, so what is it? Well, it's the pain that you get. It's not the pain that you get when you're working out, you know, that's more fatigue of the muscle, maybe some muscle soreness. That goes away after you've been exercising. So if you've been doing squats and your muscles are burning, but as soon as you stop doing squats and you walk away, go drink some water, do some stretching, that's gone. Brad: Right. Chris: It's not that type of pain. This is the pain that shows up, actually, one to two days later. Most often, like you said, it skips a day. So it's usually days three, four, and five are usually the range for most people. For most of us when we're well-conditioned, about 72 hours is the window, it seems to go away, but not everybody, it can go up to five days. If it goes beyond five days, or if you have more severe pain, we'll just kind of do a quick, make sure you check with your doctor here kind of thing. So if you have pain that's extreme in nature where you can barely walk upstairs, it is excruciating. If you are hydrating well and you have dark urine, this is a sign you've got some serious muscle toxicity going on and you do want to report that to your doctor. Brad: Sure. Chris: It could actually be very serious. And actually, some of those occur like in basic training where a lot of newbie military members that may have not been training so hard, they go all gung-ho. Brad: Day after day after day. Chris: They hammer into basic training and they have very clear, the US military and I'm sure other militaries show examples of how in fact you can end up with DOMS and/or something more serious. Brad: For the average person, pretty unlikely? Unless you're doing some really, strenuous training. You've got to give your body a break when you're sore, and that's what we're gonna talk about. Chris: Yeah, well, that's what we're gonna talk about. There's exercises that can be used to induce DOMS. And so a lot of researchers are gravitating towards that, we'll talk about maybe some light at the end of the tunnel where I think they might be getting a better handle on this. So we'll talk about that towards the end. So what do we know? We work out, it usually happens, there's basically an eccentric contraction is usually when it's the efficient contraction. So if you're doing a curl, that's the exercise when you're going down, your muscles getting longer, or if you're doing a squat, it's on the way down, your muscles are getting longer or running down a hill or even going down in a pushup. So those are all examples of eccentric contractions. Brad: Right. Chris: And then if you're going up, that's the concentric contraction, that's the one that seems harder, but it's not. So that's where the damage gets done. And again, it's not happening at the time, it's just going to show up later. And so you get this pain, you're like, "Wow, I'm tender, I'm sore." You lose range of motion. So what do you do? Well, I think one of the best things is just gentle exercise. We talked about cross training, we were kind of breaking this down the other day. There's a variety of different things you can do, but something like walking, biking, swimming, gentle stretching, I think those are all things that certainly are physical things that you can do. Brad: So if you're starting a running program, you haven't done anything and you ran two miles, you felt pretty good. But then all of a sudden, all this muscle soreness, up and downstairs, all this pain. Now, what I do, I still get this because I'm always pushing the limit a little bit, especially if I'm training for a race. I'll run one day, I'm sore the next day, I'll go for a two mile walk. And that's it. Chris: Yeah. And I think that a walk is one of the simplest ways to help to relieve that pain. It's an active recovery. Now, the relief is temporary. I mean, I'm sure you remember after you've taken that walk, you feel pretty good during the walk and even shortly thereafter, but you go and sit down and maybe have a good protein meal and maybe get some fruits and veggies in you. Which nutrition is very important with this, and we'll touch on that a little bit, and hydration. But then you stand up from the table and you're like, "ooh I'm tender again. It's not gone yet." So it is temporary, in time your body will go through it. And your body adapts to that, so that eventually when you repeat said workout, say, day five, because you want to give your body some time to heal. It's gonna be repeatable and you're gonna come back stronger. Brad: So the next time you run that same distance, you won't be near as sore. Chris: You won't be near as sore, it's gonna be a little easier. And it's how we become adaptable to training. That's why whether you're the novice, whether you're professional, everything becomes adaptable, and that's where progress is made. So from a development standpoint. Other things that we've found, what else can you do after a workout? Immediately after, one of the studies suggests actually heat right on the muscles right away. Brad: Ah! Chris: Yeah, so they took a whole bunch of people that were actually in really good shape. They took elite hockey players and they had them doing squats to induce DOMS. And basically they found in one group that they would actually apply heat wraps, so something like ThermaCare, which is about 104 degrees. It sounds pretty hot, similar to a hot pack. So, but, you know, keep it in mind, after you've just done intense exercise, last thing we find comfortable is applying heat to ourselves. But if you can do heat and gentle stretching right after, they've found that it helps with the blood movement in and out of the muscle. Brad: Yep. Chris: And also that flexibility because you've created all these little micro tears. It just kind of helps to lengthen those muscles and help with the healing process. And you'll still have the DOMS pain the next day, but it won't be as intense, which allows you to get back into your workouts more aggressively, sooner. But at the same time when we're experiencing DOMS, you want to make sure that we're not, if you just did the run, all of a sudden it's day two or three and you're feeling miserable, don't do something intense, do something gradual. Brad: Listen to your body. Chris: Yeah, very, very important with that. Brad: If you had a hot tub at your house, you could use that for heat. Chris: Hot tub, yeah. Brad: That would be a little more fun. Chris: Exactly, that's way more fun. For a variety of different reasons, but this is a family show. But that said, yeah, that will definitely help you. People have all said, well, what about cold? Well, that was an interesting aspect of the study. They said, cold in a lot of cases, like a cold pack will relieve pain because it deadens the nerve endings, so it seems to work pretty well. But it didn't actually seem to improve or speed up the healing with DOMS, which I thought was kind of interesting. But if it feels better, I say do it, because I mean, the reality of it, it's your comfort level. And if it helps you feel a little bit better. And you've had excellent experience with ice. I mean, it's one of your primary recommendations. Brad: Yeah, I'm slowly changing, and it may vary too, but for this, you know, for people who are exercising, you get soreness, I really encourage you if you haven't experienced it before, because you just are starting a program. Get through it, it's going to get better. Use some of these, you know, if you ran and you got sore from running, well, maybe ride your bike the next day. Very gently, very gently. And that's the hard part if you've got that, go-go attitude, you got no pain, no gain. That's the hardest thing on DOMS. People have to learn to relax and just settle down. Chris: Well, and that's one of the things too. A lot of trainers also emphasize that it's not so much the no pain no gain anymore. I mean, you can still get excellent muscle development without hurting yourself. Brad: Sure. Chris: And that's something to take home. And actually starting a program to minimize DOMS. I mean, you're going to want to warm up, you want to start gradually. We don't go to the intense stuff right away. We're not jumping off that cliff. Brad: Right. Chris: We're going to warm up to this thing so that we can gradually improve as we get in there. Brad: Right. Chris: A couple other things that seem to give some decent relief. Foam roller. So the foam roller is a really nice tool so far as trying to help to move fluids. So you can kind of roll that out, then basically, Brad, you can probably show it just a couple of techniques to maybe improve things. Brad: Sure. You're going to do this on the floor, not on a bed or a soft surface, but for demonstration. If I had sore calves, I would roll back and forth like this, and then I would turn sideways to get that aspect of the muscle. Chris: Yeah, because it's going to get that connective tissue and the other muscle fibers. It's moving fluid. Brad: Yeah. I could put some pressure, but I'm probably not going to, because remember, we don't want to get too aggressive. Crossing my ankles puts all the weight on one, having your legs apart divides the weight up between both. You're going to do this for 30 seconds or a minute and just get that blood flow and that circulation improved so that those muscles can heal. And you know, you can do this on your hamstrings. You can roll pretty much anything on your body. Some arms and traps and lats are difficult, but legs are good. What are you looking for? Chris: I'm looking for my ball. Brad: Oh yes, a tennis ball. Chris: Yeah, this guy. All right, these things are actually genius, and this one's pretty fancy because it lights up. I think Brad said you found it at the dollar store. Brad: It cost a dollar. Chris: So if you were working your biceps, here's a very simple way, you can just kind of get some decent circulation to the area. Little pressure on it, kind of get that fluid moving. And so it works pretty well. And these little fingers actually kind of dig in a little bit. Brad: Yes. Chris: So it kind of works out pretty well, but a tennis ball works great as well, there's a little compression with that. So you can use your forearms if you're doing hamstring, quad. So these types of things, totally inexpensive, you can travel with it. So if you were doing a race and right afterwards you want to just try and get a little bit of a massage into those muscles. These work phenomenally well. Brad: Yeah, so if you're traveling, you're in a hotel, you'd done with your event, jump in the hot tub, get your little fancy ball, your tennis ball. You know, if you happen to have a massage gun, they work great too, but you're not going to get real aggressive with it. Chris: No, you have to keep it on those low settings, because you don't want to get overly aggressive. And that's the same thing with like massage too, we have to be careful, like a deep massage, I've actually shown that it can actually create DOMS. So you wanna be real careful with that. But on a low setting, these are a little bit more expensive, so we favor the cheap on this show. Brad: Right. Chris: And I think the foam roller and balls work great, but those work excellent too. And so if you can give yourself just about three or four minutes of treatment, I think you will find it'll go a long way to helping those muscles heal a little bit quicker and minimizing that painful interval. Brad: I do want to mention a really nice way to work these so they're not so aggressive. You put the round head on it, like this has, and instead of taking it straight into the muscle, which it's a lot more aggressive, you turn it sideways and it's very gentle and it spreads out the massage to a larger area. It's a really nice alternative. Because some people may already have these. Chris: Sure. Brad: I wouldn't buy one just for DOMS. Chris: No. Brad: Unless you want to, you can use them for all kinds issues. Chris: You can use them for a variety of different recovery. Brad: I mean, your whole family uses them. Chris: We use them all the time. Critical for recovery, in my opinion. Brad: Yep. So anyways, there we go with that. Was there another one, Chris? Chris: Well, I guess we were talking about cold beer, lol. Brad: Well, I was just having fun when I was writing my notes down. I thought you said that if you get a dark beer like Guinness, there are some properties in it. Chris: Actually, Guinness has some properties actually. And they actually did a medical study, probably in the early two thousands that shows the flavonoids in beer, and actually coffees have the same type because it's dark, basically they're free radicals, so they help improve circulation. So believe it or not, a dark beer is probably something, or even a red wine or even grape juice for people that don't want alcohol. Because alcohol can dehydrate. But it's one of those things that might help out a little bit. Brad: But you know, we're from Wisconsin, it's just part of the culture. Chris: Beer is in our DNA. But you know, the other interesting thing, like I said early in the video is that, they're doing lots of research on these and they're finding that there's other things that may be more, they're actually finding that DOMS might be more of something that might be due more to connective tissue and fascia tissue. Brad: Ah, yes! Chris: So there's an interesting book that you alluded to when we were talking about this pre-production and also with respect to a couple of new articles that came out in September of this year and October of this year in PubMed, actually are showing that maybe that connective tissue has much more of the nerve firing and maybe causing that discomfort. Brad: I can't remember the title of that video, but I did it and I read the book. This woman, I believe she's from the UK, and she's dedicated her life basically to working with the fascia and pain relief through fascia. Now they're studying it more. We could do a video on that. Chris: I think so, because I think it's kind of the tip of the iceberg. Even though we don't fully understand it, the takeaways I think are really, if you're new to exercise, start gradual. Brad: Yes. Chris: Warm up before you get started and then ramp up the intensity as time goes by and your fitness level gains. Brad: Sure. Chris: So just don't all gung-ho right away. Brad: If you're 50 years old, you may take two weeks before you ramp up to a level, so you avoid that pain versus going into a class and getting hurt easy, and then you can't walk the next day. Chris: Slow and steady wins the race. I think we all are naturally driven to try and do our best. And so, we think we have to get in there and work it out for a great sweat, but if we ease our way into it and cool down afterwards, it's very important. And then either using the massage, the foam roller, the guns, the hydration and eating well. You're going to want to get some protein in your diet. You're going to want to have fruits and veggies to get those flavonoids, to help circulatory issues and natural anti-inflammatory aspects. I guess I didn't touch on the NSAIDs. Ibuprofen and naproxen are over the counter pain relievers that might give you a little bit of relief, but the jury is now out on that saying that, you get some of that pain relief, but it doesn't solve DOMS, it's not going to make you heal quicker. It might be counterproductive because the inflammatory factors that happen from muscle breakdown are what's helping with muscle development. Brad: Ah! Chris: So if we take an anti-inflammatory, we could be slowing down our progress. So maybe some of the pain rubs like Bengay or a capsaicin containing thing, like Tiger Balm, for instance, may be better for topical analgesic relief. Brad: Right. Chris: More so than the anti-inflammatories, coupled with the massage, the hydration, resting, active rest, meaning taking a walk rather than a run or swimming or biking. Brad: Right. Chris: So those I think are some of the keys that are going to help us to minimize DOMS and hopefully keep us more successful, more effective, and getting out there and doing more. Brad: Absolutely. Stay healthy, active and pain-free, and keep the DOMS away from you. Thanks for helping us, Chris. Chris: Thanks, guys. Interested in learning about the products mentioned in today's video: 1) OPTP Pro roller standard density foam roller- 6" 2) C2 Massage Gun, Q2 Mini Massage Gun, T2 Massage Gun , X6 Massage Gun with Stainless Steel Head Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble 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.

Your spine is very vulnerable in the mornings. Your discs have been imbibing fluid (taking in fluid) throughout the night. Therefore, you are generally taller in the morning. With the discs bloated with fluid you are more vulnerable to pain/injury. Your back is generally vulnerable for the first 1-2 hours after getting out of bed. Avoid pain maker positions during that time. Many typically get out of bed in this manner. Incorrect method for getting out of bed Getting out of bed in this manner puts a lot of stress on your back. Note the incorrect “C” posture. Try these tips instead for avoiding back stress. If you have pain rolling in bed, try the following: 1. Roll with your shoulders, abdomen, hips, and legs all as one unit (like a log). 2. Before you roll, tighten up your abdomen (press fingers in sides to feel) and arch your low back to a neutral position. 3. Maintain a tight abdomen throughout the roll. Roll to your side. Correct method for getting out of bed Tighten your abdominal muscles and then push your upper body up using your arm. Push up until you are resting on your elbow. Then use both arms to push yourself up to a sitting position. Once in a seated position go from sit to stand, making sure to keep your back straight. See the proper method for going from sit to stand and reverse. To lie down in bed, you should reverse the process. Make certain you are tightening the abdomen while performing the steps to get into bed. Why does your back hurt with rolling? It may be that your back is unstable. If so, you should avoid back cracking (manipulation) and begin strengthening your core as outlined in a future video. Bob speaking: I had a brief episode of very severe back pain. I tried to lie down in bed using the rolling method and it was too painful. Luckily, Brad had shown me an alternative method a few days before. It worked like a charm. The following is that method. Alternative way to get in/out of bed: To get in bed, approach the bed from the side. Your body should be turned and facing the head of the bed. Place the hand of your arm closest to the bed on the bed to help control your balance. Tip your back forward while simultaneously lifting the leg closest to the bed (performing a golfer’s lift). Your back should be kept straight the entire time. Slide your body onto bed and lift your remaining leg onto the bed. Roll on to your back with all body parts moving as one (shoulders, chest, hips, and legs), like a log roll. To get out of bed, roll on to your abdomen with all of your body parts moving as one (shoulders, chest, hips, and legs), like a log roll. If painful tighten your abdomen first and during the roll. Slide over to the edge of the bed and lower one leg to the floor. Spin your entire body to allow the remaining leg to touch the floor. Use your arms to press your body up into a stand. Your back should be kept straight the entire time. Be sure to tighten your abdomen throughout this method in order to provide additional support for your back. 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 January of 2022. For the original video go to https://youtu.be/7IPAvp_NLWg Bob: We’re going to go over five rules, you can’t break them, for arthritis pain. We’re going to start with number one. If you have arthritis in a joint, you want to decrease the weight on that area, especially if it’s flared up. If you’re going to use a cane, that’ll help take some of the weight off there. Not permanently, but until it calms down a little bit. Brad: Right. Just a quick side note, if it’s your left knee, you’re going to use your cane in your right hand. We have some videos on how to properly use a cane. Bob: Now, if it’s your shoulder, don’t be leaning on your shoulder when you’re working at a computer or something like that. You know, take some weight off it. Number two, keep it moving, but in a non-weight-bearing manner. A lot of people say, “Oh, it hurts. I should let it rest.” But that’s not the way arthritis works. If you get some movement, you get synovial fluid, which is like the grease for the joint. Brad: It’s the lubricant in there and it will help settle things down. You must work with it gently at first and take your time and get things moving, whether it’s your shoulder or your knee. Bob: Yep. Just bend and straighten it like 10 times. Brad: If it’s your shoulder, I might take my good arm and use that to help move it up and down. Bob: All right, number three, you want to make sure you keep it stretched out because if you’re lacking motion that will make the joint hurt worse. So, if you’re lacking, you can’t fully extend your knee. That’s going to work a smaller area and it’s going to wear out the knee faster. You want to make sure you take the time to work on stretching the knee into full extension. This is something you might want to do every hour. Just a little pressure on, pressure off. Bob: Same with bending it. Brad: Now, if it’s not your knee or you want more details, just go to Bob and Brad and look up stretching for whichever joint, stretching for the shoulder, for the wrist, for the knee. You’ll see we have videos that will cover each joint in detail for range of motion and stretching. Bob: Number four. Also, very important to keep the joint as strong as possible. So, one way, let’s use the knee again, you can do isometric. With the knee, very simple, fold the pillow in half and put it under the knee. Now I’m going to push the knee down to the bed and I’m tightening the quadriceps and making it work. So, hold for a count of 10 and then relax. Three sets of 10. Brad: Oftentimes, you don’t have to go to the gym. You don’t have to buy fancy equipment for this kind of strengthening. You can do things like this. Bob: Three sets of ten, three times a week and you’re good. Brad: Again, we have complete videos on every joint in the body and you can find exercises you can do at home. Bob: Number five. This may be a little unusual to people. You want to make sure you eat right. There are anti-inflammatory foods. We had a lady on who had trouble with Rheumatoid Arthritis. She helped combat it just by changing her diet. Brad: Are you talking about Jodi? Bob: Yeah. Brad: Yeah, she was fighting it. She did not tolerate the meds. The meds were not going well with her. She was getting kind of mad at her doctor. She did some research on diet and she found she could get off her meds and control things by her diet. Bob: She also lost weight, too. Brad: Yeah, it’s a double win. The big thing is sugars. Bob: Right. Inflammatory. Brad: Yep, all these foods that are in the center that are highly processed, a lot of sugar. Bob: Refined carbohydrates, too much bread. Too much pasta. Brad: All those things that a lot of people are now aware of. It’s still not easy if you’re used to eating that. She had a real problem stopping eating pasta. Bob: Oh yeah, me too. Brad: Yeah, people really like it. For me, it’s chocolate. If I have it in the house, it’s going in my mouth. I meant it! Bob: It’s going in the little chocolate hole. All right, that’s the five quick rules. Make sure you follow them, and your arthritis pain will go down. Brad: That’s right. It’s all very good. Bob: It’ll go down, which is good. All right, thanks! Visit us on our other social media platforms: YouTube, Website, Facebook, Instagram, Twitter, Pinterest, LinkedIn, TikTok, Wimkin Mewe, Minds, Vero, SteemIt, Peakd , Rumble 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.

As Moms, there are twists and turns that push us to limits we never imagined. Everything changes, whether it's toddlers who stay up all night. Or teenagers whose schedules demand a master's degree in business management. Everything changes, and you have to figure it out all over again. There's no denying that being a Mother is difficult. It's the only full-time job that doesn't have weekends, holidays, or even sick days. Your day is undoubtedly always chaotic. So, taking care of yourself does not mean neglecting the other vital tasks you do daily. Whatever way you slice it, we all have 24 hours in a day. No matter how busy we are, we need to include the things we value in our daily routine. Whether you are or what you do, staying fit is essential for a long-term health strategy. Here are some simple ways to help you establish healthy habits even if you're under a lot of stress and time constraints. 1. Make Yourself a Priority. The first step to staying healthy as a busy parent is prioritizing it. It will only take you two minutes to complete this task! First, write down what being a "fit Mom" means to you. Every Mother sees this differently! Second, look at what you've written and build a list of things you can do to make them a reality! You're not just stating you want to be healthy anymore; you're doing something about it! "Being fit" becomes more attainable when you are intentional. Set objectives and make realistic action steps. Make your health and self-care a priority from now on. As a busy mom, it's easy to let your health fall between the cracks. Make a list and create a "picture" of what it means to you to be a healthy mother. It can help you achieve your goal. 2. Follow a Healthy Eating Habit. Finding a diet that works for you is the next most important thing you can do to keep healthy as a busy mom. We're not talking about a "diet," but rather an eating pattern that works with your schedule and family. We know it is irresistible and easy to grab your lunch through the drive-through. But it might be detrimental to your health. Junk food is high in saturated fats and processed sugars. It could increase your risk of various ailments and cause you to gain weight. Aside from that, you don't want your children to be into "fast-food culture." Spend a few hours each week preparing nutrient-dense meals that you can take to work. Remember that your children will imitate your actions. So, it's critical to instill the importance of eating a well-balanced diet. It's simple: choose a health goal. Then pinpoint an area in your current eating habits where you can make adjustments. You are the one constructing a "diet" that works for you! You have complete power over your diet and eating habits. Match your eating habits to the goals and routine you've established for yourself. It is SO much easier to create a diet that is more like a lifestyle! 3. Sneak-in Movement. You can always do things to get moving, even if you don't have time to conduct a complete workout. For instance, take the stairs or ride your bike or walk as much as possible. Simple early morning workouts are also extremely beneficial. These minor tweaks could shift your passive to an active lifestyle. Making this extra effort every day will first feel like a chore, but it will soon become a part of your routine. 4. Make a Plan. Most of us have trouble finding time to exercise from time to time. Your inbox is overflowing, and your boss wants to schedule another meeting. You need to bathe your kid, and you haven't had an entire conversation with your partner in weeks. A date with your yoga mat is probably the last thing to do. You feel like you're running out of time. But you are not. Even 20 minutes of physical activity may enhance your attitude, mindset, and well-being. Perhaps you can... ● Make yourself an energy/protein shake for 5 minutes in the morning. ● 15 minutes of fast home exercises in your nighttime regimen. ● Add 20 minutes to your nighttime ritual to read a chapter of a book you've been meaning to read every night. Busy moms are that for a reason: you are a BUSY MOM! It will be well worth your time to set aside 5 minutes right now. Go through your daily schedule and see where you can fit those action items in. 5. Stay Hydrated. We all know how essential it is to drink enough water every day. It's necessary to maintain our bodies hydrated and working at their best. Here are a few of water's advantages: ● provides you with energy ● can keep good regulation ● can prevent headaches ● aid in the removal of toxins ● can help you look younger ● aids with weight loss When you're busy, it's easy to forget to drink water. But there are applications out there to keep track of your daily water consumption. 6. Yes to Exercise! One of the most common reasons busy moms abandon their exercise routine is that the nearest gym is too far away. You're driven and thrilled at first, so it doesn't matter how long the drive is. Yet, after a few weeks, you're sick of traveling for an hour or two every day to work out. Every day, more and more online workout programs are becoming offered. There are programs for everyone. You can buy treadmills, stair masters, and dumbbells if you have the means. These items are getting increasingly compact and easy to store, making them less of a burden. Finding an exercise routine that works for you will help you stay healthy and improve your self-esteem! Should I consult with an expert before beginning a physical exercise program? Most people don't need to contact an expert. But, if you have a chronic disease, consult a professional to determine the type and amount of physical activity that is best for you. Final Word It's never simple to keep in shape, let alone while caring for children. You may get the fit figure you want and inspire your kids to stay healthy with time management and ingenuity. Life is full of surprises. Things happen and could go awry from time to time. Every day is a new chance to start over and achieve your goals! So, have faith in yourself; you can achieve everything you set your mind to. Regardless of how busy you are!