This article is a transcribed edited summary of a video Bob and Brad recorded in February of 2021. For the original video go to https://www.youtube.com/watch?v=22NHTTkQtr4&t=52s Bob: I'm Bob and this is Mike, who's joining me today. He's going to help me out here because we both have had experience with this title today, Gassy, bloated, constipated, how to treat. And we both, individually went on the FODMAP diet. Let's just say right at the start here, Mike, we're not dieticians, or nutritionists. Mike: I'm a PT assistant who's worked with Bob, so that's how we know each other. Bob: And I'm a physical therapist. So we're not experts on this but we're here to tell our personal experiences, and our approach about using the FODMAP diet, and I think it could be very helpful to you in the end. Mike: Yeah. Bob: So, Mike, what do you want to talk first about? I want you to tell me what your symptoms were and why you even looked at the FODMAP diet. Mike: So for me personally, it was a lot of uncomfortable amount of bloating and gas, and it would get worse throughout the day. So I've done different eating styles over the years. When I was young I didn't really know what caused it. It wasn't terrible, I just thought I was a gassy person. Bob: You've had it a long time. Mike: Yeah, and then when I got older, I was eating more cleaner foods, but still getting a lot of gas. And the joke is, you know, when you're eating more protein, it's protein farts, when you're a kid. But honestly, it's not that at all, when you start to look into it. Bob: No its not. Mike: It's carbohydrates fermenting in your stomach. So for me, it was never like IBS symptoms or anything terrible like that, or like I don't coeliac disease or anything. But for me it was just, it gets uncomfortable. And if you live with someone they really don't want to be around you, you know, if you're having all this gas basically. Bob: Yeah, and I think this is a good time to say here, Mike too, this isn't about eating healthy versus non-healthy. There's a lot of healthy, almost all our FODMAPs are healthy foods. Mike: Yeah, there's a wide range of foods which are good to eat or not good to eat. And then everyone's going to be different, which foods they can and can't eat. Bob: Now, my symptoms came on like over a period of like two or three months, and just recently. Mike: Yeah. Bob: So it was a way different situation than Mike's. But it would like every day around two o'clock, it seems like it would start picking up. Mike: You had a time? Bob: Well I did, and I don't know if my mind started creating that time but it would go until almost till bedtime. I thought it was miserable, Mike. I mean, it's the same symptoms you had, But I mean, I was like, who can live like this? I couldn't lie on my stomach, like when I would read, I couldn't really concentrate really very well either. Mike: Yeah, it's very distracting. Bob: It is. Mike: And it's like, you almost have to plan not to be around people as the day goes on, if you're having gastrointestinal issues like that. Bob: It definitely can increase anxiety and stress. Like, I would start getting stressed out around two o'clock, that's true, because I knew what's coming on. Mike: Yeah, and this can happen from like people that are eating, you know a standard American diet can have it, people eating you know, any style that you want, low carb, high carb, it doesn't matter. Some of these FODMAP foods are in every genre. It's not just like, only this does it, only that does it, like there's a list of foods. You can do numerous diets and do FODMAPs, I should say. Bob: Yeah, so you could be a vegetarian and do FODMAP, a little more difficult, but you certainly can do it. Let's talk about what FODMAP is. First off, it's basically your body is not processing carbs very well. Mike: Yep, they're fermenting in your stomach essentially. Do you want me to read what it is? Bob: Yeah, why don't you read that. Mike: So this is from Monash university. They are basically the university in Melbourne Australia that coined the term FODMAP. You can go to their site, they also have an app. According to their site, FODMAPs are a group of sugars that are not completely digested or absorbed in our intestines. So when FODMAPs reach the small intestine, which is right after the stomach, it goes into the small intestine, they move slowly attracting water. When they bypass into the large intestine, which is also known as your colon, if you're curious. FODMAPs are fermented by gut bacteria producing gas as a result. So the extra gas and the water cause the intestinal wall to stretch and expand. So this is known as bloating for us. Because people with IBS have a highly sensitive gut, stretching the intestinal wall causes exaggerated sensations of pain and discomfort. So this is commonly used for people with IBS. Bob: What you should say is Irritable bowel syndrome. Mike: Yeah, which we're not diagnosed with IBS. Bob: It's hard to be diagnosed with it actually. Sometimes it’s by omission, you know that it wasn’t another things, so they call it IBS. So, and inflammatory bowel disease, same thing. Mike: Yeah, there's a lot of these stomach issues, FODMAP come help. Like I know people with Crones have also looked at it, SIBO. Bob: S-I-B-O. Mike: It's another one. Bob: Gastro intestinal sensitivity. Mike: Yeah. Bob: Just like what you kind of alluded to. Well right now we should tell you though, the studies had showed that it helped like 85% of the ones with IBS. So I mean, there's a good chance this is going to help you. It definitely helped us two. And my daughter had stomach issues for years I actually was thankful that I got this because I passed it onto her. And she's finally, she says, it's the best it's felt in years. It's finally getting over it, so. Mike: They do say like 15% of the world's population has IBS. Bob: That's one out of seven, yeah. Mike: And then like they said, you know typically three out of four people have success. So, you know, there is like a small percentage of people that don't find a lot of benefit, but it helps most people. Bob: So obviously there's different numbers out there because I had said 85% and I also saw three out of four too. Mike: Oh yeah, I mean, 75, 80% of that. Bob: Right, I think part of it is that, all people that have IBS don't even know it sometimes. Mike: Yeah, I mean, I didn't know what it was called. I just thought I was a gassy person. Bob: I mean, you know, it's miserable. It really is. I can't say that enough. I just thought it really affects your life. It affects whether you go out, it affects your anxiety levels. So, why don't we talk about what FODMAP stands for? F-O-D-M-A-P, I can start with the F. It's the fermentation. So you're fermenting the carbs and they give off carbon dioxide, methane and hydrogen, which is gas, gas, gas. Mike: Yeah. Bob: So, yeah, again, for me, I felt like I always had to go, have a bowel movement. Mike: Oh really? Bob: Yeah. Mike: Mine didn't feel like that. Bob: And I never would. You know, I'd go on to the toilet and it would just be gas. Mike: Yeah. Bob: So, all right. How about the O? Mike: So the O stands for oligosaccharides. Oligosaccharides are known as fructans or galactans. So these are typically found in wheat, rye, legumes, various fruits and vegetables, such as garlic and onions. So all these saccharides, they're going to be numerous of them. Oglio means there's a few. The next one is disaccharides. Di Means two. So disaccharides is the D, that is lactose. Bob: Yeah, that's mainly lactose, I think they kind of talked about, was this sucrose too, was that? Mike: That's a different one. Bob: That's a different one, okay. There was one other thing that really wasn't a problem though. Mike: Yeah, lactose, you know, that's in your milk, your yogurt, your soft cheese, most people know that's lactose intolerant. This is technically part of FODMAP. Next would be monosaccharides. So this is fructose, found in various fruits including figs, mangoes, sweeteners, such as honey, Agave Nectar, where fructose is your main carb source. Bob: The other one is high fructose corn syrup which is, I'd be honest, you shouldn't be eating any way. I mean, that's one ingredient you should avoid all the time from a health standpoint. But, yeah, that's the one you'll have to look for in the ingredients. Mike: So now we're on letter A, that just for and. Bob: And there we go. Mike: P is polyols. So this is known as sorbitol or mannitol. Those you often see ingredients in like sugar-free gum or mints like that. They're also found in stone fruits or they're also known as drupes. But they include stuff like avocados, peaches. A stone fruit is typically a fruit that has a large pit, essentially, if you want to look into that. Bob: So yeah, polyols are sugar alcohols, but it's basically any ingredient with the itol. You know, mannitol, xylitol, sorbitol, right. So, you know, we should say right now like, well, all these foods, how am I going to know what to do? Now, you put down in the comments a list, I mean, you can Google it too. You're going to find a list. Mike: Yeah, you just look up low FODMAP, is what you want to eat if you have these problems and high FODMAP are the foods you typically want to avoid. So what they recommend is sticking to the low FODMAP foods for four to six weeks, roughly and then try to add certain high FODMAP foods back in that you like and see how your body reacts because some of those high FODMAP foods aren't going to affect everyone the same. So it's like, it's an elimination at first. And then you put back in what doesn't cause these symptoms, essentially. Bob: Yeah, and you have to watch portion control too. That's very difficult. And I want to say right here, Mike, that a lot of times you're going to find discrepancies and people saying how much they should use and should not use. I always relied on Monash as the reliable authority. They are they're the ones that had done the testing on it. They actually have an app, you just look up Monash in the app. And I got the app. It was definitely worth it. My daughter got it. It's on your phone then no matter where you're at you can just push on it, it has fruits, vegetables, everything in there you can find it really. It's got recipes in there. It tells you exactly how much you can have. Like almonds is a good example. There are galactans and you can have 10 almonds. Mike: Yeah, some of them are limited. So like, for me, I primarily eat keto now. So there's not as many options on keto, so that just naturally helped a lot of these FODMAP issues. But there are some foods I eat that are high FODMAP. Like I eat almonds and cashews and stuff. I eat nuts. They don't really bother me. Avocado is technically a high FODMAP, and that is a pretty big staple in my diet. So all I do is I like half or one at a time. I may get a little bloating, but it's not like I'm uncomfortable. It's like a natural amount. And even if I produce gas from it, it doesn't have like an odor. Bob: The methane. Mike: Yeah, the methane odor is what happens with FODMAP. Bob: When you really have a smell and it's likely the methane, a byproduct that's not getting absorbed. And so, you know, one thing you should know about this too is that relief is fairly rapid. If you start this, you're going to be motivated to continue on it. Because I started getting some relief within a day or two, and then I wasn't being really strict. And it was same with my daughter, she wasn't being really strict. And so it was like just kind of hanging in there yet. And then I got really strict and then it went away. I mean, you know I don't know you're going to be 100% better in seven days, but you're going to be so much better. Mike: Yeah, I believe on their site on Monash site, it said typically within two weeks, people will notice a lot of change. And when you do reintroduce foods, they say, just do one. Don't like try to add three things, because you're not going to know which one causes the problem. Bob: And you also, this is one thing I found out and this kind of messed with my daughter, is that, if the food is affecting you, it's not going to affect you like right after the meal. It's going to take like four to six hours. So it's something that you ate four to six hours ago or even a day before. If it's affecting you right after the meal, that's not FODMAP, that's something else. You might have some type of sensitivity or something, some issue going on but it's definitely not FODMAP. So again, you can also go online make a copy of the foods, or you can get the app. Mike: Yeah, and they're broken down into every category, so it'll be, you know, fruits, vegetables, grains, oils, meats, whatever, milk and stuff. And they'll have like alternatives to say you have something you really like, it'll give you alternative options as well. Bob: Yeah, now like we said, it's a two phase thing, the elimination phase. I had a book, Mike, that actually talked about just doing the elimination phase for like seven days even. So, I mean, you don't necessarily have to go the six to eight weeks, but you know you can experiment. I think I went like three to four. Mike: And those recommendations are based off people that have pretty bad IBS. Some people with IBS, like I had a friend that had it bad and he would like have to go, like all of a sudden we'd be driving, he'd have to pull over. He would have to run. I mean, he was taking Imodium, you know at times to control it basically. But he's since cleaned up his diet a lot he doesn't have these issues either anymore. Bob: Sure, the other thing is, some of these in addition to the foods, you have to look for ingredients too. Like when you're getting certain foods you have to look for onion powder. Mike: Yeah. Bob: Garlic powder. Mike: You're going to have more troubles with processed foods. If we're being honest. Like a lot of those you don't always know what it is because if the ingredient list is this huge, you can't pronounce half of it. Yeah, you're probably better off just staying away from it unless, you know, it doesn't bother you. Bob: Yeah, “itals” are going to be one to skip away from. And also if you look at the ingredients, the ones that are the highest concentration are the first ingredients. Mike: Yeah. Bob: So like, if it's listed way down the list, you might be able to get away with it. You know, if there's onion powder and it's the last ingredient of 30, it would be very little in there. So, I want to point out this to Mike, I had trouble getting enough fiber when I first started on this diet, because suddenly I switched to eggs and meat and you know what I mean? And so it was a little bit difficult for me. I actually got constipated at first, which is not fun either. Mike: Yeah, I mean, I guess I didn't have that issue as much. I mean, when I went to keto I guess I get less fiber in general but that's more like my body was getting used to the increase of fat intake. So that kind of led to like loose stool for me. But that corrects itself very, very fast. Bob: Yeah, I agree with you Mike. I just started eating a little more fiber as far as... I ate actually a lot of peanuts, which you can eat almost unlimited. Mike: Yeah. Bob: And there's a lot of fiber in peanuts. Mike: Yeah, you could find ways around it. Like everyone's fiber intake's going to be different. Like mine's pretty low, like I'm typically 20 grams or less a day of fiber. Bob: See, I'm way higher. Mike: I know if I eat too much fiber I tend to get a little more bloated and stuff. Bob: And I can eat 50 a day. I think I have to actually watch it how much I'm taking in because you can overdo fiber without your knowledge. Mike: Yeah, you can. Bob: The other thing is I found out Mike, right away, I was hungrier than usual. My gosh, especially after breakfast, and I was eating a fair amount, but it's just, I don't know if it wasn't because it wasn't carbs or what? Mike: Yeah, I mean, a lot of these foods, like, breads are, especially with like whole wheat ones, they're pretty fibrous dense. Or like if you have, lower glycemic index carbohydrates it takes longer to break down. And for me, like that was an issue, like when I was eating carbs. So, going from Brown rice to white rice, white rice was just better for me because it digests so easily and fast, but it does leave you hungrier faster if you're used to that full feeling. That was my biggest issue is I could have no bloating and gas running off carbohydrates for my fuel source, but my energy sways were greater. And then I was just like, well I know keto keeps my energy real consistent and I don't have the bloating and gas. So that's basically why I just switch back to going with it. Bob: But also understand this, if you're thinking, well, I'm going to go on a FODMAP dive and choose to stay on it. Which first off, you're going to miss certain foods. But secondly, FODMAPs are really important. They're rich in vitamins, minerals, fiber, antioxidants. So really, to help keep a healthy bacteria in your gut, you need some FODMAPs. So you have to try to reincorporate them. In talking to Mike, it sounds like you really had something from every category. Mike: Yeah, I mean like lactose to me, I can have lactose free milk fine. I can have yogurt fine, bread causes issues. Bob: You had nuts, that were some trouble with you, weren't you? Or wheat, bread. Mike: Wheat and bread caused problems with me. Lactose causes some issues with me. Bob: Apples. Mike: Yep, apples, so fruits, a lot of these fruits cause issues with me. I have something from each category I need to avoid. Bob: Well, I think mine is mostly fructans, which is the oligosaccharides. And I think this is, if I read it right, that's probably the one of the most common ones is fructan. Mike: Fructans are in a lot of different things too. Bob: They're in a lot, they're in a lot of fiber foods. Mike: Yeah, and everyone's going to vary. I just know, yeah. I'm much happier eliminating this stuff and eating more strictly and feeling better. Than like trying to add some of these things in just to not feel good later, basically. Bob: Right, no, I mean you can get very motivated to get rid of this, and you feel good, And you're like, gosh I kind of forgot what it felt like to feel good anymore. So, I would also say that it's a lot easier to prepare meals ahead of time. I don't know if you do that Mike, at all, we put together like I'll make salmon ahead of time. You're less likely to run into problems, like, what am I going to eat tonight? And just to grab some food that you're not supposed to eat. Mike: I mean, I'm pretty content with having like six staple meals and just rotating. Like I'm a pretty simple person. Bob: That's the same with me. I’m a person of routine. So this was easy for me to do it once I got the routine. Mike: Yeah. Bob: But if you like variety, you're going to have to work a little harder. Mike: Yeah, you have to pay attention. I mean, the app might be more beneficial to you then. So you can kind of suddenly just look, if you want to be more creative with what you eat or what you make. Bob: But I mean, even as being consistent as I am, I use that app a lot. I used it this morning. I'm always looking at it like how much, what is the thing that I want to reintroduce, what food group is it? You know, what carbohydrate is it? Mike: Yeah, like for me, I used to like apples. I still think they taste good, but they just, yeah, they're just don't agree with me. Like when I was eating carbs, I switched to citrus fruits. Citrus fruit didn't bother me, like pineapple, oranges, stuff like that. Bob: Now pineapple's low FODMAP, I found out. Mike: Yep, and so even on keto I have like some berries they're pretty low FODMAP. I think blueberries you have to watch. Bob: Blueberries, you have to watch, blackberries can be bad. Mike: Okay. Bob: Yeah. Mike: Oh yeah, they're in one of the groups. Bob: Okay, well anything else Mike, you want to add? I think I covered all the points that I would today. Mike: Yeah, I think I'm all right. Bob: I really like to encourage you to give it a try. I mean, what would it hurt? If it doesn't work, it doesn't work. Mike: And if you need help, a lot of registered dieticians know this stuff, and they're taught this, and they can definitely work with you, and you can work with it, with your doctor. You know, if you're unsure or you can ask them. Bob: I mentioned it to my doctor and she said that she had a lot of patients that were helped by it. I mean, I already had been helped by it. Mike and I were both self-taught on this. Which with our own reading on it, there's a ton of information online. So, give it a try and put your comments below, if you're not listening to the podcast. Mike: Yeah. Bob: Put your comments below, and tell what has helped you and what has not helped you. Mike: Yeah, and down below I'll link the university's website on FODMAP. I'll link some high FODMAP, low FODMAP list sites. And then the other ones just kind of like the history of the FODMAPs, if you're nerdy and you want to read about that? Bob: There we go. All right, thanks everybody. Mike: Thanks. Resources on FODMAP: High/Low FODMAP Food Chart https://www.ibsdiets.org/fodmap-diet/fodmap-food-list/ Origins of FODMAP: https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.13685 Monash University FODMAP Page: https://www.monashfodmap.com/about-fodmap-and-ibs/ Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew 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. 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This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2021. For the original video go to https://www.youtube.com/watch?v=2EcimMpcaGI&t=496s Bob: We're going to talk about, why you should not buy a massage gun, and but we're also going to tell you why you should. Brad: Sure. Yup. Bob: And let's get right into it. Brad: Put it right out there. Bob: Number one, if you have hard to reach places, you might need a partner if you're using a massage gun. Brad: Right. Right. Bob: Obviously your back and upper traps. Brad: You just cannot reach. Bob: Yeah, you can't get the leverage on it. So yeah. Brad: Are we going to talk about that now? Bob: Yeah, this one would work better for that, the handheld massager. But this doesn't have the power as much as a massage gun. HANDHELD MASSAGE GUN Brad: Yup. Bob: It's fine. It's going to be fine for someone who is maybe a slighter build or not as muscular. Brad: Yeah. You may want to get one and have a massage gun too. These are not too expensive and they have their place. Bob: All right, next one, for disc herniation or sciatica, this is not going to heal a disc herniation or sciatica. Brad: No. Bob: You might feel better for some secondary reasons, like the muscles have tightened up because they're, sore from the sciatica, but really don't buy one of these if you think it's going to heal your sciatica. Brad: Right. Again, you may feel better, but the nerve is still pinched. Bob: Brad, do you want to talk about neck pain and headaches? Brad: All the time. Yeah. If you have neck pain, we're talking like base of neck up. You're not going to use a massage gun on the neck here. The muscles are there, but you cannot do it without hitting the bone, the spine. And that spine is very delicate if you will. Bob: Yeah. Brad: When you're hammering on it, because that's what's going on, the gun is traversing back and forth. You could hurt your spine, as a matter of fact, you could cause a problem. I made a mistake years ago, with one of these. Bob: I did the same. Brad: I was massaging a patient's shoulder, and then I went up to the neck and I saw by the look on his face, I was doing the wrong thing. And I felt really bad as a therapist. Bob: Right. Brad: I said, “what am I doing?” And anyways, it worked out fine. Bob: You try it on yourself, and you’re like, “Oh my God.” Brad: Don't go directly on the spine either. Bob: And the same with the head. You wouldn't be doing it for a headache. It's just not good. Brad: Oh! You're not going to do it to your temples. Your head, you can do it with your hands. Bob: Right. And that leads us kind of to the next one, Brad. You really want to avoid bony surfaces. There might be some exceptions like when you have quadriceps tendonitis or you have the suprapatellar pouch, sometimes you hit the knee cap a little bit and you use the air-filled one. Brad: Yup. They're soft and squishy. If you hit the edge of the bone, it's not so bad. Bob: Yeah. Even tendonitis. Like, if you have a tennis elbow or golfer's elbow. Brad: You'll know if you get too close, it's going to hurt. Bob: Yeah, it's going to hurt. Brad: You don't massage that kind of, in that fashion. Bob: Next, you shouldn't go over a pulse. Brad: The arteries in the neck, or the brachial artery in your arm. Bob: Right. On the back of the knee, a lot of nerve, artery, veins there. I won't go over your heart either. It's never a good idea. Brad: Yeah. The other thing, I don't know if you had this on the list, but don't go over lymph nodes. Bob: No! I don't. That's a great one. That’s a good point. Brad: Particularly, in your femoral crease right here. Bob: Right in the groin. Brad: They're very superficial, right under the skin. Bob: Well, obviously right under the armpit too. Brad: The axillary, yup. Because if you hit those lymph nodes, I mean you could cause some problems. If not anything, you just irritate them. And I know I had some lymph node issues and the doctor, I thought it may be cancer, well, he ruled that out. He says, “if it's bothering, you just stay away from them. Cause this is going to make them worse.” So when you irritate a lymph node, it just gets worse and it's no good. Bob: Gotcha. All right. During pregnancy, obviously don't go over the fetus. I mean, we always want to say that. Brad: Yeah, obvious. Bob: Generally, you wouldn't do it over a bursa if it's inflamed. And a bursa is a fluid-filled sac. Brad: It'll be tender. Bob: Right. It'll be tender and I wouldn't go over that. Brad: And you have bursas in almost every joint in your body. Bob: All the joints. So you have to be careful. Brad: Yeah. You go over the muscle belly there not the joint or you'll feel it. Bursas hurt. Bob: If it makes pain worse, and the pain hurts afterwards yet, you shouldn't do it. Brad: Right. Bob: All right, if you have a bleeding disorder or bruise easily, obviously you're not going to want to do the massage gun. It is pounding, I mean, it's percussion. Brad: Yeah, if you're one of those people, when you bump into a piece of furniture, you got a bruise there, you're going to bruise from this if you're getting aggressive particularly. Bob: Yeah. Brad: So, yeah. Don't even think about it if you're really a bruiser, you know, easily bruised. Bob: Now, if you've had surgery, I want to make sure you have it approved by your physician or medical provider before you do massage because after surgery, you're actually at higher risk for developing blood clots. Brad: Sure. Bob: Let's say you do a massage in your calf, you loosen a blood clot and send it up to your lungs and it kills you. So, we obviously don't want that. Brad: Right. Bob: So we want to avoid that. This is, I would say again, you want to get it approved by your doctor. If you have some type of nerve disorder, like if you have multiple sclerosis or epilepsy, unless it's approved, I wouldn't do it then either. Brad: Right. Bob: Open sores, obviously, skin tears, you don't want to go over. This is very obvious to us, Brad, you would think everybody would know this but it's not. I guess people have done this before. They've had a broken bone or a healing fracture and they start massaging all over it. Brad: Oh! Bob: So, they want to make it feel better. Brad: I mean, that could be well after it's healed, and you've been walking on it or many weeks after. Then you may want to have scar tissue break up but not during the healing process. Bob: All right. Well now, why would you buy one? And there actually are very good reasons why. Brad: Yeah. Indeed, a lot of them. Bob: One, it's very easy to use. You don't have to get on the floor like a foam roller. So, if you can't get on the floor, and you want to massage an area. Brad: Foam rollers work well but, it takes more effort. Bob: Yes, they do. And you know what? The cost actually, like, if you use one of the less expensive ones, like the handheld, is almost comparable to a foam roller. Brad: Yeah. Or even one of these smaller ones, like the Q2 mini, that really do a heck of a job. Bob: Yup. Many people believe it or not, Brad, and I have used this in our clinics for years and, I found 50% of the people actually prefer the gun over our hands, or our assistant’s hands. Brad: Again, we're not professional massage people. Bob: Right. Brad: So we can't talk. But we know what we're doing as far as the muscle groups. We're trained. But it's not like we're masseuses. Bob: Right, right. Brad: So keep that in mind. Bob: All right, it never gets tired and never says no to you. (chuckles) Brad: Well, unless you run the battery down. Bob: Yeah. Brad: You have to keep them charged up but they hold a charge for quite some time. Bob: Yeah. What's nice about it is you can also use it with the whole family, generally. Yeah. I mean, seriously. Brad and I gave away some of these massage guns to some teachers. Brad, I am still getting great compliments from them. Brad: Yeah. Bob: And the principal, he uses it every day. His kids say “you're in love with this thing.” I mean, it's just been funny. And another principal, she said her whole family uses it. Instead of going on vacation, they went and used the massage gun. Brad: So did the principals hogging these things from the teachers? Bob: Yeah, apparently so. You know, if you're a principal you could do what you want. So, it's great, these are really great. I use them in this manner to warm up the muscles before I run. Brad: Yeah. I should probably do that. That may help me. Bob: Problematic muscles at least. I mean, I don't do all of them, by any means. But seriously, I hit my calf muscles before I run. It’s just a great way to stretch them out and get them warmed up before you go out. Brad: Sure. Bob: So you can also use it for cooling down. So, I mean, they're really great for that too. And that's what I'm talking about with muscle recovery. But it's also good for muscle strains or scar tissue or tendonitis. It really works well for that because one thing, your hands are going to get tired if you're doing a self-massage. And the massage gun, you can apply for 10 to 15 minutes, like just like you should. Brad: I'm telling you, for most people, I think I can speak across the board. If, you've got a massage gun or you're going to massage by hand, chances are if you're going to do it by hand, you might just skip it. With the massage gun, you look forward to it. It's so much easier, it feels good. And it just feels good when you're done. And if you get that feeling for the next 15 minutes or so, it's worth it. I mean, these are popular for good reasons. Bob: Yeah, there's a reason. And the last thing, I've given so many of these away, Brad, it's honestly one of the best gifts you can give. Brad: It is, yeah. Bob: It is! There's not anybody, hardly anybody that's going to say, "No, I don't want a massage gun." I mean, most of them find out they really like it a lot more than they thought. Brad: Sure. Bob: They're surprised at how much they like it. Brad: Just make sure you get the right one for the right person. I think like Mike's grandmother, she had one of the massage guns, and it was way too aggressive. And then she went for one of the handheld massagers. And it was, much more appropriate. Bob: It was appropriate, yup. So this video is a part of a series of videos on massage. If you want to check out the entire series, go to https://www.bobandbrad.com/programs ! And in that section, you're going to find a whole bunch of topics like we have a program on plantar fasciitis. We've got a program on sciatica. Brad: TENS. Bob: TENS. And shoulder, and some of the other ones are coming out. Brad: Right. Bob: Find the program on massage, check it out, figure out which videos you want to watch. There’s going to be like 20 of them, or 30 or 40. Brad: There'll be a bunch. Oh! There is a PDF printout so that you can look through a review of the whole video you just looked at, print it out and keep it handy until you basically memorized it. Bob: And how much are charging people? Brad: Absolutely, Bob. It's astonishing. Zero. Big zero! Bob: It's our gift to you. Brad: Not even an email. Bob: Nope, just come on and use it. Thanks for watching. Interested in learning about the Bob and Brad's Massage Gun products: US: C2 Massage Gun: https://amzn.to/36pMekg Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 X6 PRO Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv Handheld Massager: https://amzn.to/2TxZBqU T2 Massage Gun: https://amzn.to/3GfflX1! Canada: C2 Massage Gun: http://amzla.com/t4qn7uniltfb Q2 Massage Gun: http://amzla.com/s506onkyq2cm UK: C2 Massage Gun: http://amzla.com/rhdco5f8zprk Q2 Massage Gun: http://amzla.com/qe4bmn3puczb EU: C2 Massage Gun: http://amzla.com/skpiccayp2rc Q2 Massage Gun: http://amzla.com/rhdco5f8zprk AU: C2 Massage Gun: https://amzn.to/38JLxSv Q2 Massage Gun: https://amzn.to/3nb9pa Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew 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.

If you are using an iReliev TENS unit we provide step-by-step video instruction on how to use the following types: iReliev 1313 iReliev 5050 iReliev 8080 Just go to the program section at bobandbrad.com and click on the TENS series. Under the series look for the videos with the 1313, 5050, or 8080 TENS units. If you are using a TENS unit from another manufacturer you will need to follow the instructions provided with the product. Where to Place the Pads: There is NOT a specific right way to position or place the pads. The best approach is to place the pads wherever they relieve pain the most. Experiment and see what will work best for you. General Guidelines for Small Area of Wrist Pain: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad directly below the pad (at least a pad’s width apart) or above the pad. Use one channel and two pads. Place one pad directly above the pain and one pad directly below the pain or place one pad on each side of the pain. General Guidelines for Larger Area of Wrist Pain (Back or Front): In our examples channel one has yellow pads and channel two has green pads. Back of Wrist One pad from channel one is placed above the area of pain and one pad is placed below the area. One pad from channel two is placed in front of the area of pain and another pad from channel two is placed behind the area of pain. This arrangement forms a cross pattern. Front of Wrist One pad from channel one is placed above the area of pain and one pad placed below the area. One pad from channel two is placed in front of the area of pain and another pad from channel two is placed behind the area of pain. This arrangement forms a cross pattern. Reminder: Do not place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Wrist Treatment: With your opposite hand grab the side with the painful wrist and apply some traction. While applying traction rotate your forearm back and forth. Do this for 20 to 30 seconds only if this can be done pain-free. For more information on the TENS programs visit: https://www.bobandbrad.com/tens-program If interested in purchasing the TENS/EMS unit by iReliev visit: https://ireliev.com/bobandbrad/?uid=15&oid=1&affid=10 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 June in of 2020. For the original video go to https://youtu.be/00wo6t4lPqw Bob: You want to burn away body fat? For the millionth time, spot reduction is a myth, do this instead! We've all seen the videos, Brad, "How To Get Rid Of Belly Fat", "Burn Away Belly Fat", "How To Get Rid Of Arm Fat", right? Brad: Yeah! Bob: Under the arm. Brad: Yep. Double chin. Bob: Yeah, how to get rid of the thigh fat. No, you can't do it through spot reduction. It just does not work. It's been proven beyond a shadow of a doubt; you can't spot reduce. So if you're working on your abdominal muscles and your core, that's not going to reduce the body fat in your stomach. Brad: Right! The body is going to take the reduction in fat where it wants to. Bob: Right. Brad: There's some genetics involved. There's a number of things but if you think you're going to reduce the fat in your stomach by doing sit ups, no. You're going to definitely tone up the muscles. Bob: Yeah. You'll have tone muscles underneath the fat. Brad: Right. Bob: It's basically what you're going to have. Brad: Right. Bob: Same with triceps. If you're working triceps, you want to get rid of the arm flab? You'll have strong muscles underneath the fat. Brad: Right! Bob: Same with thighs and muscles in the inner thigh there, you can strengthen them but you're not going to get rid of the fat. Brad: By no means are we saying you should not exercise or exercise these muscle groups but just don't think that because you exercise that muscle group, you're going to lose weight right there. Your diet is going to be the big key. Brad: Exactly. Bob: And it's a combination diet and exercise is great. Brad: Yeah! And we'll talk about that. Now you can build muscles site specific. Bob: Sure. Brad: We all know that, right? You can build your chest muscles. You can build your biceps, triceps, glutes, quads, calves. All those, you can work on a specific area. Bob: Right. Brad: You just can't reduce fat. Kind of as a general rule of thumb again, fat reduction occurs at the dinner table. Strengthening occurs at the gym. Bob: Right. Brad: That's a general phrase you might hear once in a while. So you need to burn more calories at the gym if you want to reduce fat. Bob: Right. Bob: Now we're not dieticians, Brad and I obviously, but I think we can make three statements about things if you want to reduce fat intake and reduce the fat output basically in your body. Basically, number one, you have to decrease the amount of sugary drinks that you drink. Especially those fruit juices, they're terrible. Brad: Right. Bob: Just full of sugar. Brad: Sport drinks, oftentimes have a lot of sugar. Bob: Good point Brad! Brad: And it doesn't really matter. I just look at the sugars on what you're eating. Not only just drinks but the food you eat, all these carbohydrates. We've done a lot of studies on this over the last couple of years and had great success ourselves in losing weight without cutting down. Bob: Around, the abdomen too. Brad: Yeah absolutely! Bob: Look at our old videos. You can see our puffy shirts. Brad: Oh my God! I’ve got a video from four years ago, swimming, I don't even like to look at it anymore. Bob: Actually, Brad, you did a video that showed the sports drink was similar in sugar or had more sugar than a can of pop. Brad: Yeah. Pepsi or Coke, with all the sugar, you might as well just drink pop because they had the similar amount of sugar, just that it was carbonated. Bob: And as Brad alluded to you, you don't want to eliminate your carbs but you want to watch the refined sugars. Brad: Right. Bob: The white bread and of course candy. Brad: Right. Bob: And again, the sugary drinks. The carbs. Definitely, big difference in my life just decreasing the carbs. Even if you just get rid of the bread in your life, that alone can make a big difference. Brad: Right. I cut down 90% of the breads, all ice cream, although I still really like it, and no pastas. I'm not a big pasta eater anyways. But like for oatmeal, I'll eat, organic steel cut oatmeal. Bob: Sure! Brad: And it's wonders for me and it's a carbohydrate but it's not refined. Bob: Well pasta's Brad, I've been eating a lot of the whole grain pasta. Brad: Sure. Bob: You have to look at the ingredients to make sure they really are whole grain. But that made a big difference. You still can get your pasta fix and decrease your carbs. Brad: Exactly. Bob: Eat more fiber too. Fiber fills you up and it keeps you regular and it's going to help with the body fat too. Brad: Right. Bob: Now, in addition to that, you do want to do some resistance training. Because when you do resistance training, not only are you burning calories while you're doing it but you continue to burn calories after you're done. Brad: Right. Bob: That's why we always want you to do some weight training. And usually we work on separate body parts depending on the day of the week because you always want to give a day of rest at least after you've done a body part. Brad: And I do want to clarify it Bob, weight training and resistance training are the same thing. I do a lot of resistance training but I do no weight training. Bob: Sure! Brad: All mine is with bands because I really like it and there's a lot of benefits to it. Bob: It’s easy on the joints. Brad: Right. So whatever works best for you. I never used to do resistance training, all I did was aerobic, bike, swim and running. I changed in the last three years. I started doing resistance training and I realized that over the next day I'm burning more calories. It's amazing. I got to eat more and not gain any weight. Bob: The muscles are basically trying to recover, and that's why they're burning a little more calories while they're going through that. Brad: Right. And then I started bulking up too. Bob: Well he started bulking up. But also as you get older, you start to becoming weaker and so you have to make up for that. If you don't do anything differently, you can lose like 5% of your strength a year. And that doesn't take long before you're down to zero. Brad: Right. And then more chance for falls and all these other problems that come along with it. Bob: So you can do cardio too but with cardio, we recommend a High Intensity Interval Training, the HIIT. Basically quite often, you're doing really high intensity for like a minute and then you're resting for a minute. There's a lot of variations on that. Brad: There is, really can do a lot. I still like to do the long duration exercising because it's gives me a chance to air my head out. But yeah. Bob: I do both. Very stress reducing. Brad: The HIIT is less time consuming. If you have the time issue, you'll get the cardiovascular benefit. Bob: Again I like to do a little bit of both. Almost even both most days. All right, now we're going to bring in that new product that we're talking about, Brad, that we're all excited about. So this is actually made by the Teeter Company which actually makes inversion tables. Brad: Which we really do like, because they're high quality. They are. I really like 'em. Bob: So I found it very interesting that, Teeter, a man named Teeter, made an inversion table like a teeter totter. Brad: Right. I wonder if he changed his name? Bob: I don't know? Brad: I think we looked that up. I don't think he did. Bob: We've got to find that out. So this is called the FreeStep LT1. And they're trying to compete a little bit with the NuStep. I'm not sure if you're familiar with the NuStep, more of a commercial model. But this is a model that you can use at your home. It is a little more expensive maybe than some home equipment, I don't know. It's $750. Brad: Right. Bob: It seems to be pretty reasonable to me. Brad: Compared to the NuStep or other models like the NuStep, those are in the thousands. Bob: Right, NuStep's stripped down version, is at least $4,000. Brad: Yep. I think it's more than that actually. Bob: Yeah, I think it actually could go up to $7,000 very rapidly. So this has different resistance and as you can see, despite me being very tall, it fits me quite well. Brad: What are you? Six foot? Bob: I'm six foot six. Brad: Right, I'm five foot 10 and I had that adjusted for me and it just easily adjusted for Bob. Bob: What I want to show you on this is I'm not using my arms here because you can really get humming on this thing. And so you can get high intensity interval training on this where you can work it hard for a minute and then you can calm down and rest take your cardio down a little bit. Brad: And you certainly can use arms with that as well to get more muscle groups involved. Bob: And there's resistance so you can actually get some leg resistance once you’ve got it set up at the highest setting. Brad: Right, if you want to get that resistance training without so much cardio. And it's just a little knob that you turn. Bob: It's in the back of the seat. Brad: Right. Bob: We'll do a full review on this thing. I like the fact too that, like I said, it adjusts for me and it fits for me. And I also like the fact that, it has a great seat. Brad: The lumbar support is adjustable. Bob: Yeah, I like biking but this thing, really gives a good seat. Unless you have a recumbent bike, you're not going to get this kind of support while you're working out here. Brad: And it's extremely quiet, which is a big advantage for the home. Bob: Exactly, this thing is whisper quiet. You can watch TV. Brad: You've never seen anything that quiet. Bob: I've never heard anything that quiet. Brad: Had to get that one. Bob: And it is easily movable. Brad: Yeah. Bob: Yep even Brad can move it. Brad: Yep I'm not afraid of it. Bob: We'll see you later. Brad: Goodbye! Bob: Remember Brad and I can fix just about anything. Brad: Oh yeah that's right, except for-- Bob: A broken heart but no, we might have the answer right here. Brad: Well, it's part of the puzzle, Bob. Once again, we continue to be-- Bob: Amazing! Brad: Wow! Bob: Thanks. Interested in learning about the products mentioned in today's video: 1) Teeter FreeStep:https://shrsl.com/2e6mm Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in March of 2021. For the original video go to https://youtu.be/jd7J0PiTcRk. Bob: Today we're going to talk about neck pain, pinched nerve, when do you need to see a doctor immediately? Brad, we're going to actually break this down into two categories. The first category is not as urgent, but you should schedule an office visit. You should see a doctor. But two is when you probably should seek emergency medical care right away. So let's start off with the first one, Brad, for an office visit, if your neck pain just keeps worsening, despite your self-care, it's probably time to go in and see a doctor and make sure something serious isn't going on. Brad: Right, right. Bob: You may need physical therapy, so you need to see the doctor. Brad: If it's restricting your sleep, and it's getting no better, or getting worse after two or three nights. You can't sleep. I mean, you've got to get sleep, things don't heal well if you don't sleep. Bob: That's right. Brad: It's just a bad situation. Bob: It landslides, in the wrong direction. If the pain is radiating down your arm or legs, especially your legs, that means that could be really serious, and it seems to be from your neck, I would definitely go in and see a doctor then. Brad: To be clear, pain could be numbness, tingling, burning, feels like cold water's running down your arm. All those things are associated with a nerve being irritated. Bob: Those weird sensations. It's amazing, if want a variety of different sensations, get a nerve involved. Brad: Right, yup. Bob: If neck pain it's accompanied by headache, numbness and tingling, I would probably go in too. Especially if it comes on suddenly and it's the first time you had it, then it might be an emergency. So if you're one that normally doesn't get headaches, and all of a sudden you get a headache, and a numbness and tingling, yeah. Brad: Especially if you look up and that gets you a headache, or dizziness associated with some head movement. Bob: Sure, sure. If the pain is so bad, like Brad kind of indicated before, it's just affecting your normal activities and your sleep, it's time to go in. You know, you’re sick of it. Brad: Like, I had that pretty severe bout a couple of weeks ago, but it happened on a Sunday night, Monday night, Tuesday night were very uncomfortable, but by Wednesday it started getting better. Bob: Well, you know what you're doing, too. And you knew what caused it, too. Brad: Right, right. But probably if it's not better within a week, you have to get it checked out. Bob: Yeah, that's the next one, Brad. Brad: Oh! Bob: If it lasts for weeks, it's time to go in and check it out. We talked about tingling, if there's any tingling in any part of your body, emanating, it seems to be, from your neck, check it out. If it comes with urinary or bowel incontinence. Now this is actually an emergency. I don't know why I've got that in office, I would say that's more of an emergency. Brad: Right, yeah if you cannot control your bowel movements, or your bladder control is clearly thrown off, and you have these other symptoms, that is an emergency. I've only had two people over 20 some years that actually went in and they didn't need surgery. Bob: I had one person and it was the same thing, he went in and it wasn't that. I've treated people after the fact, though, that had it and became paralyzed. Brad: Yeah, so that is something obviously we'd want to get at immediately. Bob: This one too, you know, could be an emergency if it comes on real suddenly, if you have weakness in your arm or leg. If it's a gradual thing, comes on slowly, then you can probably set an office visit. But, we're always worried about whether or not it's a stroke, or something like that, so you want to make sure. Brad: Yeah, if you can't pick something up that you normally could, and you've got numbness and weakness. Yeah, you have to go in. Bob: It's time to go in. These are definitely emergency medical care situations, and we'll go into these now. One, if you've had a traumatic injury, like a diving accident, or you're in a car crash. Don't mess around with it because you could have a fracture and not even realize it. You could have what is called a hangman's fracture and your neck is unstable and you could actually become paralyzed. So you really don't want to mess around with it. If you have a high fever, along with your neck pain, then we're worried about meningitis. And the membrane covering your spinal cord and brain can get an infection and you don't want to mess with that. Brad: It builds up pressure. Bob: You want to go in and have that treated, obviously. If you have a severe, persistent headache accompanied by nausea and weakness, it's time to go in right away. Brad: Right. Particular if you're one that doesn't have headaches, or headaches like that. Bob: Yes. Yeah, if you have migraines and you're used to it, I mean, that's a different story. Yeah, nausea or vomiting, that is probably beyond the neck pain. If you have a rash, if you have sensitivity to light, if you have a racing or irregular heartbeat, along with the neck pain. Difficulty breathing, like we said before pain or numbness radiating down the arm that just started suddenly, and pain in your chest, or jaw. Then we're obviously worried about a heart attack, so you want to make sure you check that out. Brad: And I think if you had all of a sudden pain or numbness down both arms at the same time, then get in, because that's more unusual too. So get that figured out, it very well could be something that's not serious but definitely get that checked out. Bob: You always want to be on the safe side here. Thanks everybody for watching. Brad: Very glad, oh! What about our PDF, we'll skip it? Bob: Oh, sure, well this program by the way is part of a series of videos on neck pain. If you want to check out the whole program, go to https://www.bobandbrad.com/programs, look for the neck series. There's about 30 videos, you pick out the ones you want to watch. You don't have to watch each one. They're all free, we don't require an email, or anything of you, you can just check them out. Brad: And they have a PDF printout, a little review of exercises and what we've talked about on the video. It's all free, there's no email or anything, it's just our gift to you and would hope that you improve and become healthy, fit and pain free. Bob: Well, like this one now, on this video you can look at the list, see what symptoms you have and what you should be doing. Brad: Sure, right, yep. Bob: So you don't have to write them all down. Brad: Yeah, that's a good deal. Bob: All right, take care. Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew 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. 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How to Use a TENS Unit with Neck Pain. Correct Pad Placement. If you are using an iReliev TENS unit we provide step-by-step video instruction on how to use the following types: iReliev 1313 iReliev 5050 iReliev 8080 Just go to the program section at bobandbrad.com and click on the TENS series. Under the series look for the videos with the 1313, 5050, or 8080 TENS units. If you are using a TENS unit from another manufacturer you will need to follow the instructions provided with the product. Where to Place the Pads: There is NOT a specific right way to position or place the pads. The best approach is to place the pads wherever they relieve pain the most. Experiment and see what will work best for you. General Guidelines for One Sided Neck Pain: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad directly below the pad (at least a pad’s width apart) or above the pad. Use one channel and two pads. Place one pad directly above the pain and one pad directly below the pain. General Guidelines for Neck Pain (Both Sides): In our examples, channel one has yellow pads and channel two has green pads. Place one pad from channel one in the upper right corner of the area of pain and one pad from channel one in lower left corner of the area of pain. Place one pad from channel two in the upper left corner of the pain and one pad in the lower right corner of the pain. This arrangement forms an X pattern. Reminder: Do not place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Do not place pads over the carotid arteries! Neck Pain Treatment: Neck extensions with towel. For more information on the TENS programs visit: https://www.bobandbrad.com/tens-program If interested in purchasing the TENS/EMS unit by iReliev visit: https://ireliev.com/bobandbrad/?uid=15&oid=1&affid=10 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 June of 2021. For the original video go to https://www.youtube.com/watch?v=me9Ufp_idBY&t=222s Bob: Today we're going to talk about knee pain. 12 signs that you should see a doctor immediately. Brad: How about a dozen? Bob: Sure. Brad: There you go. Bob: Cheaper by the dozen. So if your knee pain was caused by an injury, so sports, a fall, work, and so on, you should seek out medical advice or attention, if any of the following conditions exist. Brad: Right, let's do it. Bob: Number one must be the most obvious, if you have a deformity, like you have a bone sticking out. Brad: An obvious deformity, yeah. Bob: Right, if you compare the one knee to the other knee, and there's something just not right, visually. You may have broken something or dislocated something. Brad: And you have to look around the knee, around the joint, like just below the kneecap. You might see a little, if the meniscus is actually torn, popped up, but there's probably going to be some pain associated. Bob: Well, the kneecap could be over. Brad: It usually doesn't happen without notable pain. Bob: Number two, if you have significant bruising or swelling. Bruising generally means you've had some artery damage. You know, it's strain on the arteries. The more bruising, the more swelling, the more likely you've experienced a serious injury. Brad: Sure. Bob: So get it checked out. Brad: And typically with that, the range of motion is going to be painful too. But not always. Bob: Number three, let's say you have difficulty walking after an injury. So it's causing you to limp. The intense pain can could indicate a bone fracture or a torn muscle or ligament. Brad: Right. So, in other words sitting, it's not too bad, and maybe you can range it out but as soon as you put some weight on it, it makes you jump. Bob: Yeah, and number four fits right along with that. Let’s say we're walking and your knee won't hold the weight. Like you actually, step and it gives way. Brad: Yeah. Obvious. Bob: That's an obvious sign that you should go see the doctor. Brad: Yeah. You don't probably don't want to wait and see if it gets better for a couple of days. Bob: Let's say it's not that severe, but it feels unstable or instable, you know, that can often be ligament damage too or even the cartilage damage. You know, it's just not holding it in place like it should. Brad: Yeah, you can walk, but it just feels like it's going to give out at any time. It's that really queasy feeling. Bob: And this is interesting how often this happens, the next one, you actually hear a popping noise and you hear a lot of people that say that well, like they especially have, they tore their ACL or something. Brad: Oh, you mean when, at the time it happens. Bob: Yeah, at the time it happens. I remember even sometimes people would say they heard it in the crowd. That they heard a popping noise. Brad: Yeah. I've always wondered. Because I always think that sometimes the person who's having the knee thing they hear a pop, but nobody else can be because, you know, you can feel it. Bob: It's a vibrational thing. Brad: Yeah. You don’t even associate that, but when they say they hear it from the audience. Then you know it's the real thing. Bob: If you have reduced range of motion. So if your knee is not straightening all the way or not bending all the way, again, there's a lot of things going on there that could cause that. One is a torn meniscus. Brad: Sure. Bob: Or torn cartilage. Brad: So bending just means all the way like this, you know and all the way straight. Bob: It might be swelling. Just plain, old, swollen. Brad: Right. Yeah. Bob: That's stopping it, but, if there's that much swelling, you probably should have checked out. Brad: Sure. Bob: So if there's less sensation in the knees, so you can't feel part of the knee or around the knee anywhere, then it could be even sciatica or some non-knee condition. But you want to get checked out. Brad: So you touch it and it just feels numb. There's a numb area in the knee. Bob: Now, if, if you didn’t have an injury, like a sports injury or fall, but you've had long-term pain or discomfort in your knee you know, and it's chronic, it's ongoing, you may want to check out a doctor and just see where you're at. Brad: Right. So you injure it. Yeah, you can walk on it. It's not too bad, not much swelling, but it doesn't feel a hundred percent, but it goes on for a week or two weeks. I would think after two weeks you should have it checked out. Bob: Yeah. Especially if it's new. Brad: Right, it's not improving. It's just kind of hanging out there. Bob: But if it's a gradual onset. You know, you might, you might go several months before you go to check it out. Brad: Yeah. Some people are that way. Bob: Yeah, like some people, (laughs) you and I are both that way. Brad: Well, well that's a different story. Bob: Well we diagnose ourselves is all. If the knee pain is affecting your daily activities, so you're having trouble doing the things that you've wanted to do in the past, obviously have it checked out. If it's affecting your sleep that’s usually a sign that it's pretty serious. I mean, not serious, but you need to get it checked out. Brad: Yeah. If it feels comfortable throughout the day and then, or not too bad throughout the day, but then at night is it really gets sore and it hurts in bed, get it. Get it checked out and make sure that you don't have something unusual going on. Bob: Yeah. Sometimes what that means is it could be as simple as that you overworked it during the day and that the swelling goes into the knee at night. Brad: Yeah. Bob: But again, pain at night is always kind of a red flag. You always want to pay attention to it. So number 11, redness or swelling around the joint. This is something obviously not to mess around with it. If you think you might have an infection, and you're tender to touch. Brad: It's warm. Bob: It's warm, very good, yes. You experience a high fever along with it. Brad: Yeah, you have to get that taken care of. Bob: Fast! That's not one you don’t mess around with, that's when you go in and have it checked out. And the final one if you have really high intensity knee pain. I'm sure that's going to cause you to want to go in any way. But don't tough it out. There's something wrong if it's really hurting quite seriously. Brad: You know, the other thing I don't think we mentioned with that redness or swelling, particularly if you had a knee replacement. Bob: Right. Brad: Definitely, because infections migrate to that artificial components in there. And that's really important. Bob: We've seen this quite often in our patients. And unfortunately I've seen it in my family. My mother-in-law, she had an infected knee. Bob: Oh yeah. She had a replacement? Brad: Yeah. She had a replacement. They had to take it out. Brad: Yeah. I've seen that too, over the years. Bob: It's more and more common unfortunately. Brad: I wonder why. There's more knee replacments? Bob: Well the bugs are getting stronger. Brad: Oh, sure. Bob: We're not able to fight them as much. Well, that's it folks. This video, by the way, is part of a series of videos on knee pain. If you want to check out the whole series, go to https://www.bobandbrad.com/programs You'll find our videos on knee pain. Now, if this is early on, they all might not be there yet. We're uploading. Brad: Yeah, because there's going to be, I don't know, 20 of these or more. Bob: 20, 30, 40, 50, probably. Brad: Depends on how ambitious Bob gets. Bob: Yeah, yeah, yeah exactly. Brad: But anyways, yeah, it'll say they're not ready yet. You'll just have to come back. And this is not a two or three-day process. Bob: Yeah, this takes a long time. Brad: Yeah, it takes a number of weeks. Bob: What else comes up with the video, Brad? Brad: Well, Bob, this is a great thing. You have a printout, PDF printout. Click the button print it out on your printer. You'll be able to read it and know exactly what the video says. You don't have to go over and look at it over and over and over and see our faces more than once. So it's a benefit. Bob: Again, no charge. Brad: Absolutely. Not even an email. Bob: Yeah. We don't ask for anything from you. Brad: That's right. Bob: All right. Just ask for your forgiveness. Brad: Be careful. Bob: Be careful. Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew 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 2021. For the original video go to https://www.youtube.com/watch?v=H6HpK2OHPPc&t=146s Brad: Hi folks, Brad Heineck, physical therapist. Chris: Hi, I'm Chris the Pharmacist. Brad: And today we're going to talk about, lowering your high blood pressure naturally, recently supported by science. Chris has done a lot of homework on this. Blood pressure is a big deal, you want to keep it intact, keep yourself healthy from now until you're 101 years old. So, what is high blood pressure? And we've got a nice chart here from the American Heart Association. So, should we start out with normal? Hopefully we're there. Chris: Yeah. So, basically the generalized number is going to be 120 over 80. So, that's considered normal blood pressure. And it can be a little bit lower, some people like me, my blood pressure is constantly like 100 over 60. That's still considered normal. So, even though it's lower than the norm, that's something that's very comfortable. Unless you're getting lightheaded or dizzy that's when your doctor begins to address those issues. Brad: Sure Chris: But for the purposes of today's conversation, we'll just deal these numbers. Brad: Yeah. Now, we're looking at elevated, it's like you're in the borderline, starting to get the high blood pressure, but you don't need meds yet. It’s a good place to change your diet, change your exercises. Chris: Exercise and diet. Brad: And that's exactly what I did about 20 years ago, I was in this range and with running consistently and other activities, I was able to drop it down within a few months. Chris: Yup. Now, that's huge. So, this elevated range (120-129/80-89) is where you're going to really focus on those lifestyle changes. And when you come to the doctor, they're going to start to talk to you about: how are you eating? what are you doing for your activities? And the key with activities, and that's probably the simplest natural way to, is to increase your aerobic output. It’s not to say that just aerobic is the only way to get exercise, weightlifting can be something that can be done. So, there's swimming, there's biking, there's dancing, there's gardening. Brad: Now, if you're not familiar with the term aerobic, that doesn't mean you have to go to aerobics class, where people are wearing everything and doing the jumping, and having fun. It's a good way to do it, but you may not feel comfortable, you can go for a walk. Chris: Yup a walk. A brisk walk, 30 minutes, five days a week. Brad: There you go. So, that's not a big deal. Well, if you're a sedentary person, that is a big deal. Chris: It is a big deal. Brad: You may want to start out walking five minutes. Chris: Yup, Rome was not built in a day. So, if you have a sedentary lifestyle, but you're ready to make these lifestyle changes so that hopefully we can keep you off from medication, it's just a little bit at a time. Baby steps, I think it's a real approach, because actually the last thing we want is an injury. And you always want to do this in accordance with what your doctor feels is safe for you. So, we can't stress that enough. Brad: Right. You don't want to overdo it. And that can be a big thing. If you've been diagnosed, you're maybe at stage one, you're at that borderline stage and your doctor has talked to you about it, it's like, I better get after this. You might think, well, my father died from high hypertension. Chris: Yeah. And he was 56 years old or something like that. Brad: Exactly. And I know this one guy, he wanted to run a half marathon and he started at age 60, hadn't run before. But he did it appropriately. He actually hired a trainer. Chris: All right. Brad: And it took him six to eight months, more like eight months. And he did it. Chris: That's a phenomenal goal. Brad: That's an option. He didn't have high blood pressure problems, but he knew that if he went after it too aggressively he's going to hurt himself. Chris: Yeah. And that's the last thing you want to do is put you back on the couch. I mean, other than they'll have to come and see you, or they’d have to come and see me for something for pain but I mean, from that standpoint. But basically when we get to those levels (130-139/80-89) up to stage one, and that's about when your doctor is going to start to say, "all right, how are we doing on the diet?" Brad: Sure Chris: So, we want to look at that too. So, they talk exercise and diet. So, one of the biggest guilty causes of blood pressure and a lot of us don't know about it, is just the amount of sodium we eat. Brad: Salt Chris: Salt. Yeah. So, we want to read packages. There’s your favorite saying, “don't buy anything out of the middle of the store,” and I say, “don't buy anything out of boxes.” For the most part, it's one of those things where that's a lot of the foods that are not natural, are packaged and prefabricated, and they're processed, highly processed. Processed food, they add salt in there and sugar for flavor. And so it's those dead calories and that sodium. And that sodium can make you retain water, which when you retain water that makes your heart work a little bit harder, more vascular resistance, higher blood pressure. Brad: I always think of it like a balloon, you know, you put more water or air in the balloon and it just gets more and more pressure built up. And that's really what's going on in your system, your vessels are taking in all that water and it's blowing up those vessels and the pressure goes up, heart has to work harder. And then also we have some arthrosclerosis. Chris: Yeah. So, the hardening of the arteries. We have to be careful, there's a lot of other things that once we get that word hypertension, there's a lot of other things can go sideways. So, it can affect our organs, like our kidneys, it can affect our eyes, obviously it's our heart, it's our circulation. So, there's a lot of things going on because there could be strokes, there can be heart attacks, vascular dementia, memory issues. So, there's lots of things that we have to be extremely cautious with, when we start to hear this and why we're going to make this commitment to ourselves, to help to naturally lower our blood pressure. Brad: Sure. So, and yeah, the thing is these problems you talked about, the vascular problems, well, the stroke too, but all these things kind of accumulate, over time. Chris: Over time. Exactly. Brad: So, and you could be up to 140 over 90, and feel perfectly healthy. And maybe you haven't seen a doctor for 5 or 10 years. It's like my grandmother, she never saw the doctor until she went into a nursing home. Luckily she was healthy, she didn't need to, but she wasn't going to anyways. She was stubborn, you know. Chris: Yup. Exactly. There's a lot of us like that though. Brad: If you have a problem like stage 2 (140+/90+), and then you find out after you've had it for 10 years, maybe your vessels are already hardened and you're having serious problems. Chris: Yeah think of your blood vessels as kind of like supple spaghetti. They're just kind of a very flexible tissue. And so basically when something's pushing hard against it, in a case of like an aneurysm it's stretches, in the case of just hardening the arteries, you've got all this resistance force, pounding against it because that pump is working so hard, that they just kind of harden. They aren't quite so supple. There's some debris building up in there. Brad: Which actually makes the blood pressure go up more. Chris: Go up more because it narrows the arteries and vessels. And that's what we have to be so careful with. Brad: So it's a compounding effect? Chris: Yes. It's not just one simple thing. Hypertension or high blood pressure is the word, but there's so many other things going on. And you know, for every 10 points in blood pressure, your risk for cardiovascular problems goes up like 20%, each time. And so many of us, because again it's the silent killer, we don't feel blood pressure, we just generally don't. Some people say they'll have a headache or they get a nosebleed. I guess they're the fortunate ones, not that it's fortunate to have a headache or a nosebleed but they actually have a symptom. It's a symptom that shows you that, hey I need to figure out what the heck's going on. But for those of us that are just walking around for 10, 15, 20 years, you know, are healthy as a horse, feel great, and all the sudden you go in for that doctor appointment because maybe it was an insurance thing or maybe your wife made you go or your husband or whatever. And all the sudden you get this number, like, oh my gosh what am I going to do? This is why we have to be careful a lot. Brad: So, it might not be a bad idea if you're going to a store, some have a blood pressure machine were you sit and put your arm in there and takes it that way. Chris: Absolutely. They're regulated, they're always very accurate. So, I think you can feel comfortable with that. We'll give you at least a good guideline or thumbnail sketch of where it is. But again, when we're taking our blood pressure even in a store or even at home, we want to make sure we're sitting in that proper posture. Both feet on the floor, relaxed. You want to give yourself about five minutes of sitting before you actually hit the trigger if you're in a store. Brad: So, you relax? Chris: Yup, because you want to get an accurate reading. Because if you just rush in and, boy, I don't feel really good, you get it set. You know, you'll just jump in all of a sudden, yeah, oh my gosh, I'm 170 over 110, oh my goodness, what am I going to do? Well, then all of a sudden if you rest for five minutes, and it comes down to somewhere like, 120 over 80. So, that’s not very accurate. You were in a hurry, driving and traffic, had a cup of coffee, I mean, there's a lot of factors. Brad: And then, you may want to take it a few times. Because there's a little red flag there. Well it's pretty high does it jump up there often? Chris: Yup, you want to wait another couple of minutes and repeat it. Brad: Yeah. So, let's say you've been diagnosed, you've know you've got high blood pressure or you know you're in the elevated stage, stage one, you're going to work with exercise and diet. We are not nutritionists, we're not dieticians, but we can give you some good, solid, basic introductory. And we talked about the salt already. Any other things besides looking at making sure there's not much salt? Chris: Yeah, you're going to want to go with lots of fruits and veggies, lean protein. You just don't want tons and tons of basically animal fat or if you're a vegetarian or vegan, obviously you want to get your protein sources through nuts and things of that nature, soy. So, there's a lot of good things that are actually heart-healthy in that. And like I said, vegetarians, I always kind of liked because you know, they generally are eating a lot of the right things. It's hard to meet somebody that's having a lot of health problems when they're vegetarian. Not that you can't have lean meats and protein. To me, I couldn't live without it. I need to have meat. I would not feel right. Maybe even be a crabby person. Brad: And that's a personal thing, Chris: Exactly. Brad: You can work around that. As far as exercise, we did mention walking. But start out slow. I mean, there are some people, they may be overweight already, very sedentary and they'll go of for a 10-minute walk, could just literally be exhaustive. So, you might start out with a two or three-minute walk. Chris: Exactly. Brad: And build it up week to week. My typical rule of thumb for people who are starting out exercising like that, is not more than 10% increase per week. Chris: Correct. Brad: So, if you walked, let's make it easy, 10 blocks week one, week two you're going to go 11 blocks. Chris: 11 blocks. Brad: That's 10%. And so it's like a slow and you know, you don't have to do the math, it doesn't need to be perfect. Chris: No. But you know its mental math, it might stimulate the brain too. So, that's always good. Brad: Well, there you go, exactly. So, start out slow, it can be walking, if you want to get into jogging, stationary bike, things of that nature, you can do inside the house are all acceptable. Chris: Yard work. I mean, raking leaves. This time of the year eventually we're going to be shoveling because we're up here in Wisconsin, or Minnesota. It's one of those things where anything that you find an activity that you can gravitate to, that you enjoy, I think that's really the most important thing. Brad: There you go. Chris: You can repeat it and do it day in and day out where you're not thinking it's a chore. You want to just say, hey I really look forward to getting my daily walk, hey, I look forward to getting out in the garden or I look forward to pushing my lawn mower. There's lots of things that people can do and it can be resistance training, it can be Pilates, it can be Yoga. I mean, there's a lot of good things that happen with different forms of exercise. Brad: So, you say resistance training, it can be weights, but you don't have to have weights, you can use stretch bands in your house. You don't have to go and spend a lot of money. It's just a matter of doing it. There's a lot of YouTube videos, just go to Bob and Brad we've got a lot of exercises. Chris: A couple of videos. Brad: Yeah. Mostly with stretch bands. We don't do much with weights. Just not what Bob and I have a history of doing personally as well as clinically. It's a great way to exercise with your balance, strength, a number of things there. I do want to talk a little bit more about because we didn't touch on like diet and far as specialty foods, not specialty, but flaxseed. We actually did a video. Bob's wife did some flaxseed diet; you can watch that video. They both say, boy, her blood pressure came down as a result of it. What's the science or what does the research say about things like that? Chris: Yeah, you know, it’s a little bit of a mixed review, but I think more positive than negative. I do think that with flaxseed and flaxseed oil, both products may be used, it's got Alpha-linolenic acid, that's the active ingredient and it's the big fancy term for your Omega-3s, the healthy fatty acids that kind of help to maybe keep blood vessels more supple. They may help to lower cholesterol. They may help to kind of lower your blood pressure. So, with these ingredients, there's a couple of different ways you can attack it. Some people like the oil, some people like capsules, some people can grind up the seeds and put it in their food. You can bake it; you can throw it in your oatmeal. So, there's a lot of healthy ways that you can add flax to your diet and actually get some really good positive benefits. With consistent use, that's where I think you might see the blood pressure lowering effects occur. Brad: And this is one of the things, if I understand this right, there's really no negative effect. Maybe the research shows it doesn't do anything, but is it going to do any bad thing, bad side effect? Chris: Generally, it sometimes can cause a little bit of GI side effects but that is so rare and so remote. And I mean you'd probably have to be throwing too much flax, you'd be taking a quarter of a cup. Brad: Shoveling it in. Chris: Yeah. So, a little too much. Brad: So, flaxseed is a healthy thing. Chris: I would call it a thumbs up. I don't think it can do anything wrong. It's no different than adding fish to our diets. So, if you're eating fish two to three days a week, that's another really good healthy protein to put in your diet, particularly fatty fish like salmon and mackerel. Those types of things actually have those good essential fatty acids, which are very cardio protective. Brad: Sure. Chris: And when you see diets around the world, the Americanized diet doesn't have fish as a staple, maybe on the East coast and West coast where it's a little bit easier to get to it. But when you go to some of the Island nations or Japan in particular, they have some of the lowest incidences of blood pressure as a whole because of their diet. Brad: Japan? Chris: Japan. Brad: But they say it's from diet? Chris: Diet. They’ve done some studies, these are older studies, but when they've come to the United States and they've moved here for a while and they get acclimated to our Americanized diet, blood pressure goes up. So, a lot of that's from the salt and things that we eat so. Although there's kind of an interesting study in Northern Japan, that actually when we talk about essential hypertension, which is when we get to this stage one, we don't know why it's caused, but it is. But the Northern region of Japan, eats the saltiest diet per capita in the world. And that's just a small population of people, but they have so much salt in their diet, and there's a large increase in blood pressure. And then when they studied the people that just don't like salt, none of those guys have the blood pressure issues like the people that are on the high salt diets. Brad: Oh, so, they do? They're in Japan but they love salt and their blood pressure is higher? Chris: Yup. So, even though they're eating the fish and the protein, that salt or sodium just seems to be that limiting factor. So, it's something to be real mindful of. And when you're actually looking for levels, as we talk about food, a lot of people like flavor, so, salt is an easy thing to put in there. The standardized measure that they say is about 2300 milligrams is what we want. And a low salt diet is considered 1500 milligrams. Brad: But what does that mean? Chris: Yeah. So, it's kind of hard to figure that out. So, basically a level teaspoon full, if you took a measuring spoon and you filled it with those white crystals of table salt, and you scrape it off the top, that's about 2300 milligrams. So, that's your daily allotment for salt. So, when we talk about reading boxes and food stores and what the sodium content is in say cereal and bread, bread is like a sneaky ingredient that has a lot of sodium in it to make it taste good. Brad: Ah! Chris: Yeah. You want to look for low sodium options, especially when we're starting to get up into these higher levels. So, look for low sodium on your packaging. We want to get used to reading stuff in the grocery store before you buy it. Brad: So, bread's got a lot of salt in it? Chris: Yeah, it does it's kind of tricky. And you know, things like lean meats like turkey and ham even they have a lot of sodium in there. So, you want to be careful. Brad: As part of the processing? Chris: Yeah, that's the deli meats, so you want to be really careful with that. So, you'd be probably better off, you know, bake some chicken and use that for your sandwiches and things. Brad: Then you control what you put into your diet. Chris: When you're controlling it, exactly. Brad: Yeah. So, there's a lot of things diet wise that you can do just by being observant and reading the labels, and you may be reading a book or doing a little research, watching some YouTube videos. It can go a long way to getting that blood pressure down in a nice, relaxed manner. And I'm feeling very relaxed now, Chris. Chris: Yeah. Well, there you go. That's the other thing, stress is actually one of the other contributing factors of hypertension and blood pressure. So, it's something that's a lifestyle change. So, it's something that we do want to be mindful of. So, whether it's meditation, reading, taking a walk which again is more on the exercise, but you want to find some time to relax. If you have a stressful job, stressful lifestyle, a lot of us with this COVID situation, our lifestyles are very different these days, and maybe we can't be as active as we want or we're trying to work the job, trying to get the kids through their virtual learning modules. I mean, so there's stress on people that may not necessarily recognize that they're approaching some of these levels. So, just taking a few minutes to try and relax is actually still very important. It goes a long way with trying to help to keep that blood pressure under control. Brad: Right, yeah. That's from the neck up mostly. -Chris: It is, but there's so many things that, in our Americanized society and actually I would say worldwide, I think everybody is tending to get busier and busier based on things that I read. Taking a little bit of me time is important. Even though maybe as a busy parent or a single parent, it's not always that easy. You know, if you can find 15 minutes for yourself just to relax. Whether it's finding a book, doing a puzzle, just something. Staying relaxed, seems to have a very positive effect on blood pressure. Brad: Makes sense to me. All right. Well, I'm feeling relaxed now, I'm feeling much better, my blood pressure is down a little bit, I think I'm going to relax for the rest of the afternoon. Chris: All right, well sounds good. Brad: All right. Well, thank you for watching. And once again, we can fix anything except for- Chris: A broken heart, but we're trying. Brad: Yeah this fits right in. We're going to put it in the archives and into that category. Chris: Yeah, well hopefully we'll help a couple of people. Brad: Yeah. It's nothing to joke around about seriously, but we're doing a little bit of it here. Chris: Absolutely. Brad: All right, take care. Chris: Have a great day guys. Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew 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.

How to Use a TENS Unit with Upper Back Pain. Correct Pad Placement. How to Use the TENS Unit: If you are using an iReliev TENS unit we provide step-by-step video instruction on how to use the following types: iReliev 1313 iReliev 5050 iReliev 8080 Just go to the program section at bobandbrad.com and click on the TENS series. Under the series look for the videos with the 1313, 5050, or 8080 TENS units. If you are using a TENS unit from another manufacturer you will need to follow the instructions provided with the product. Where to Place the Pads: There is NOT a specific right way to position or place the pads. The best approach is to place the pads wherever they relieve pain the most. Experiment and see what will work best for you. General Guidelines for Upper Back Pain (One Sided): Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad directly below the pad (at least a pad’s width apart). Use one channel and two pads. Place one pad directly above the pain and one pad directly below the pain or place one pad on each side of the pain. General Guidelines for Mid-Back Pain (Both Sides): In our examples channel one has yellow pads and channel two has green pads. One pad from channel one in the upper right corner of the area of pain and one pad from channel one in lower left corner of the area of pain. One pad from channel two in the upper left corner of the pain and one pad in the lower right corner of the pain. This arrangement forms an X pattern. Reminder: do not place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Upper Back Treatment: Use a tennis ball in a sock on the wall or on the floor. For more information on the TENS programs visit: https://www.bobandbrad.com/tens-program If interested in purchasing the TENS/EMS unit by iReliev visit: https://ireliev.com/bobandbrad/?uid=15&oid=1&affid=10 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.

What Is Oblique Lateral Lumbar Interbody Fusion? OLLIF is a new, highly effective surgery for spinal stenosis, scoliosis, spondylolisthesis, herniated disc and degenerative disc disease. “OLLIF” stands for “oblique lateral lumbar interbody fusion”. It is one of the most innovative back surgeries available for treating low back pain conditions. For patients considering lumbar fusion, the OLLIF offers significant advantages in the ease and speed of recovery. And unlike most other spinal fusion approaches, the OLLIF procedure can be used to effectively treat all lumbar levels of the spine. The OLLIF is one of Inspired Spine’s signature advanced minimally invasive spinal surgery procedure – a revolutionary advancement in minimally invasive spine surgery that our surgeons have perfected with years of research and practice. Inspired Spine’s OLLIF procedure is a demonstrably safer and more reliable outpatient surgery that delivers immediate and permanent pain relief. In fact, 96% of Inspired Spine OLLIF patients are walking without assistance within 24 hours after surgery and are back to performing normal daily activities in 2 to 4 weeks. OLLIF vs. Traditional Lumbar Fusion Compared to the OLLIF, traditional fusion surgeries to treat spinal conditions involve significantly more time in the operating room and a larger incision. For an open transforaminal lumbar fusion procedure (TLIF), the surgeon must cut through significant muscle tissue with a much longer incision than the OLLIF’s ½-inch incision. There is also more blood loss and bone removal. The diseased or damaged disc is accessed through Kambin’s triangle – a right triangle-shaped area over the disc, which is formed by the exiting nerve root at the top and the border of the vertebrae at the base (width). Traditional fusion surgeries are performed in a hospital operating room, take a lot longer, and typically require a hospital day of at least a few days. They can also make it much harder for patients to get back to normal life and activities with months of demanding rehab to compensate for damaged back muscles. This more invasive spine surgery technique is a high-risk inpatient procedure requiring 3 to 4 hours in the operating room, followed by a 3 to 5-day hospital stay and an 18 to 24-week recovery period. Inspired Spine’s OLLIF technique delivers commensurate to superior outcomes to those delivered by traditional approaches with a lower risk 40-minute outpatient procedure which enables most patients to be discharged the same day. The OLLIF procedure is the only truly minimally invasive alternative for lumbar fusion with clinically proven advantages in effectiveness, safety, and improved outcomes, reducing pain and recovery time while making the process simpler for both the patient and the surgeon. OLLIF Surgery Benefits for the Patient Patients with a High BMI A high body mass index (BMI) increases the risk of lower back pain, puts strain and pressure on the spine and often contributes to symptoms associated with degenerative disc disease, spondylolisthesis, spondylosis, herniation, stenosis, and scoliosis…all of which can make it more difficult to get relief. Many surgeons reject high BMI patients for traditional open back surgery because of the challenging nature of the procedure, the longer surgery times and possible tissue damage and infection complications that make it high risk, low reward. Unlike conventional treatment, the OLLIF procedure is low risk and high reward, whether your BMI is high or low. The OLLIF’s procedure duration (as displayed in the following chart) is not impacted by BMI, while TLIF and MITLIF both show considerable increases in surgery time as the BMI increases. The risk of complications increases 17% for every additional 30 minutes of surgery. Minimal Scarring As a result of our fluoroscopic minimally invasive surgery approach, you can expect less scarring, less pain from the operation and a faster recovery compared with open surgery. Often Doesn’t Require a Hospital Stay Because of its minimally invasive nature, the OLLIF is performed without an extended hospital stay and often without any overnight stay. The procedure itself can take as little as 45 minutes, compared to the hours spent on traditional spinal fusion procedures. In general, an OLLIF procedure takes about half the time or less as a comparable TLIF (transforaminal lumbar interbody fusion) surgery would. There is no need to cut through the muscles or ligaments surrounding the spine, so recovery is faster. Low Risk and Quick Recovery The OLLIF results in a very fast recovery period. Patients are frequently up and walking around within several hours and many go home the same day as surgery. In fact, the OLLIF does not need to be done in a hospital at all; it can be performed routinely in an outpatient surgery center instead. Blood loss is minimal, because of the very small incision and the risk of complications is significantly lower than that of traditional spinal fusions. But what most patients will appreciate is the speed of their recovery. Many can return to work and normal activities in a couple of weeks, as opposed to the lengthy and demanding rehabilitation process required with open fusions. Because of its short operating time, minimum rehab requirements, and high-safety profile, the OLLIF is often recommended for patients who have been denied surgery because of certain risk factors, such as age, obesity, or deformity. This is good news for elderly or frail patients with Adult Degenerative Scolosis, because several levels of the spine can be accessed from a single OLLIF incision, providing live-changing pain relief. Are You a Candidate for OLLIF? You may be a perfect candidate for the advanced minimally invasive OLLIF procedure if one or more of the following is true: You have suffered from low back and leg pain for 6 months or longer You have tried conservative treatments with no significant relief You have been recommended for lumbar fusion surgery *The information provided above has been provided by Inspired Spine

This article is a transcribed edited summary of a video Bob and Brad recorded in January of 2021. For the original video go to https://www.youtube.com/watch?v=_pIw4JC0tKY&t=19s Bob: Today we're going to show you how to treat a recent injury to your hip, it's a three step program. We thought this is a good topic that we want to cover all the bases in treating hip pain so this is the first part. Brad: Exactly, it's like, “oh, you fell down, bumped your hip, it hurts, it's painful, what am I supposed to do?” Bob: Yeah, now first off, you have to decide whether or not you're going to see the doctor. We did do a video called "Fifteen Signs You Need to See a Doctor Immediately". We're not going to go over that now, but you can look up that video on YouTube if you do have a question. Brad: Exactly. Bob: Now, let's say you've seen the doctor or you haven't seen the doctor, or you feel like you don't need to see him. The first thing you do, step one, in the first 24 to 48 hours you're going to apply ice to the hip because there's going to be pain and swelling and we want to try to get that to be under control. Brad: So typically a cold pack about this size and you really need to get a cold pack that's flexible, malleable, when it comes out of the freezer, not one of those cold packs that is hard as a rock or, ice cubes in a bag works okay. Bob: Eh, it works okay. Brad: But these really work better and in positioning, you need to get very comfortable so that your hip is not painful before you put it on or it’s irritating it. Bob: Yeah, Brad, you're bringing up a really good point. One, you don't want to lie on it, and two, you probably want to lie on your side with a pillow between your legs. That's probably the best position to be in. Brad: I would say if a recliner reclined back feels very comfortable and it's not irritating it, that would be another option, too, where you could wrap that around there and you're going to leave it on for 15 to 20 minutes. Bob: Yes, and you can do it every three hours if need be and you could use a bag of peas. Brad also has a recipe, the old Heineck recipe for making an icepack. Brad: Yeah, I wouldn't say that because I didn't invent it, but I've used it with myself, my mother, and many, many, I'd say thousands of patients over the last 20 years. One cup of Alcohol, rubbing alcohol. Four cups of water and a gallon freezer bag, see our video, Bob & Brad on YouTube, "How to Make a Cold Pack". Bob: Why don't you go ahead and do it right now, you just take the four cups of water, you take the one cup of rubbing alcohol, you put it in the freezer bag, the one-gallon freezer bag. Brad: One-gallon freezer bag, not a storage bag. Bob: Yeah, and then you get the air out, excess air out. Brad: Yeah, zip it up, put it into a second one just because it makes it a little more protected. Bob: So a second freezer bag. Brad: Yep, get the air out of that one, zip it up, lie it, lie it or lay it? Bob: Lay it down, that would be lay it down. Brad: Lay it flat in the freezer, don't let it get crumpled up and it'll come out and it'll be like a slush and you can move it around, get it there, never put it directly on your skin. That's a big never, you want to have some cloth, usually just a pair of pants or something thin is adequate, if it's still too cold you can put another towel. Bob: Yeah, I used to sometimes take a paper towel, even. Brad: Oh sure. Bob: It works sometimes, depending on the person. Brad: Right, it depends if your skin's fragile or not. Older people typically need more insulation, another towel or two. Bob: That's step number one, so you're going to put some ice on it, step number two, you're going to limit the activities that increase pain or swelling, so if you're walking and that increases pain or swelling, you're going to maybe want to use a cane or crutches. You're going to avoid hills and stairs. When you're using a cane, you're going to use it in the opposite hand. Brad: All right, so, if this is my sore hip on my left, it's going to be in my right hand. Some people naturally would think, "Well, you put it in the same side," but you don't and then as you walk, the cane in the right hand goes in sequence with the left foot and then as you put weight through your left foot, you're putting it through your right hand and the biggest thing Bob and I both find is, don't think about the sequence, your body will do it automatically because when you walk, your opposite hand goes with the opposite leg naturally. Bob: Now, here's a walking stick by Prime Stick. My wife when she hurt her knee, she used a walking stick and she really liked it. They're lightweight, they look a little bit less clinical, wouldn't you say, Brad. Some people don't want to be seen with a cane. Brad: If you're one of those but you need a little support, a stick is the next best thing. Bob: This cane, by the way, is called the Cyclone Cane, they sent it to us and it's a nice cane. It's got a nice handle, it's made well. it's actually made to grip this way, remember Brad? Brad: Oh that's right. It is a nice handle. Bob: The same company makes this, it's called the Prime Stick, but it's just lightweight, very good grip, we thought we'd put a little plug in for them. All right, so that's number two, you're going to limit the stress on that area and you're going to do that until it starts to feel a little better. Number three, the third step, you want to start some gentle movement as soon as possible. You really don't want it just to sit there and freeze up on you. It just makes pain worse. Brad: Yep, we need to get the circulation going, keep that from turning into a stiff joint. Bob: So, the one that we really, our go-to movement, is just gentle trunk rotations or hip rotations. You're going to lie on your back, you're going to bring your legs up like this, feet are flat on the bed or floor and you're just going to gently roll back and forth like this, and this is getting movement in the hip without putting a lot of stress on it. Brad: This would be a good thing to do if you've been sleeping all night, your hip will probably stiffen up. Before you even get out of bed, do this gently to get that hip moving before you step on it and put weight on it. Bob: Now let's say for instance, I do this, and it hurts this way, but it doesn't hurt this way. We're not going to move this way then, we're just going to go to the right now and after a while, we'll check the left again and see if it's any better, if it's not, we'll still keep going to the right. Brad: Typically, you get things moving in the pain-free range, it expands and it starts to go into the painful range. Bob: Yeah, it'll go back and forth further, Brad calls these, by the way, Windshield Wipers, and you can take the wipers farther and farther as time goes on, you can actually start going all the way to the end of the windshield. All right. Brad: I just do that because people can remember that well. Bob: Right, they relate to it, it's a good visual. The last thing, that's step number three, when the pain starts going down, you want to progress to one of our strength videos on how to strengthen the hip. Which reminds me, this video is part of a series of videos on hip pain. So if you go to bobandbrad.com, go to the Programs section and find the series on Hip, you'll find a lot of videos on strengthening the hip and you'll find other videos. You can watch any video you need, you don't have to watch all of them, each video has a print out along with it, including this one. Brad: Right, so it's got a PDF, you can print it out of your printer at home and then you have a reminder of everything we went through so you don't have to go back and watch the video every time if you couldn't remember something. Bob: And this is all free. Brad: Absolutely. Bob: We don't even ask for an e-mail. Brad: That's exactly right. Bob: Check it out. 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How to Use a TENS Unit with Mid-Back Pain. Correct Pad Placement. How to Use the TENS Unit: If you are using an iReliev TENS unit we provide step-by-step video instruction on how to use the following types: iReliev 1313 iReliev 5050 iReliev 8080 Just go to the program section at bobandbrad.com and click on the TENS series. Under the series look for the videos with the 1313, 5050, or 8080 TENS units. If you are using a TENS unit from another manufacturer you will need to follow the instructions provided with the product. Where to Place the Pads: There is NOT a specific right way to position or place the pads. The best approach is to place the pads wherever they relieve pain the most. Experiment and see what will work best for you. General Guidelines for Mid-Back Pain (One Sided): Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either directly above the other pad (at least a pad’s width apart) or directly below the pad (at least a pad’s width apart). Use one channel and two pads. Place one pad directly above the pain and one pad directly below the pain or place one pad on each side of the pain. General Guidelines for Mid-Back Pain (Both Sides): In our examples channel one has yellow pads and channel two has green pads. One pad from channel one in the upper right corner of the area of pain and one pad from channel one in the lower left corner of the area of pain. One pad from channel two in the upper left corner of the pain and one pad in the lower right corner of the pain. This arrangement forms an X pattern. Reminder: do not place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Mid-Back Treatment: Hallelujah Stretch Over Ball. For more information on the TENS programs visit: https://www.bobandbrad.com/tens-program If interested in purchasing the TENS/EMS unit by iReliev visit: https://ireliev.com/bobandbrad/?uid=15&oid=1&affid=10 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.