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=mHG1YDaTgg4&t=17s Bob: Today we want to talk about the six big lies about hip pain, hip arthritis, and surgery. These are common statements that Brad and I have heard over what, 50 some years of treatment? Brad: Combined. Bob: Combined, yeah not 50 alone. But we hear these commonly occurring themes and so we're going to address that. So hip pain obviously can occur at any age, you know if you had like a sporting injury, or you have trauma. But, as we age, it can actually can show up for no reason whatsoever. I mean, all of a sudden, you know, you're 50, 60, 70 years old. All of a sudden it pops up one day. Brad: Right, right. But you know, it can go away too. Bob: Yeah, it can go away too. Brad: And so that's what we're going to address a little bit. Bob: Yeah, so we're going to talk about the typical scenarios. So someone goes in they're 50, 60, 70, they go into the doctor, because they're having hip pain. It just started on its own. First thing the doctor's going to do maybe an X-ray, MRI, CAT scan not the first thing, but depending on the doctor. Brad: Right. Bob: But eventually what they're going to show, you're going to see these results of your scans, and it's going to say, there's degeneration and osteoarthritis in your hip. It might be bone on bone, even. Brad: Right. Bob: And you're going to say,” oh my gosh now I know what's causing my pain (arthritis is causing your hip pain).” So they're going to do medications, injections and maybe even surgery. Brad: Sure. Bob: But what we have found is, and study after study has shown this, that really osteoarthritis degeneration is just part of the normal aging process. Brad: It's like getting gray hair. There are some things that may increase it. For example, maybe some muscle tightness around the joint is making it worse and if we can loosen those muscles up, the pain can decrease and actually improve things. Bob: Exactly. So it's not necessarily what you're seeing is the problem, because the studies they've done is they looked at people with no hip pain, did X-rays or MRIs on them and they found lots of these same things. Brad: Right. Bob: They found, and the other thing, Brad, I'm sure you've seen this a million times. Somebody comes in and they're going to need surgery on both knees, but they're doing it on the one that looks better to start off because that one hurts more. Brad: As far as, X-rays? Bob: Yeah, X-rays of both knees. They're both bad, but one really, really hurts and that's the one they're going to do surgery on and that one doesn't look as bad as the other one. Brad: Right, so the X-rays and the pain level, they don't always match. Bob: I bet you right now, we could do an X-ray of our hip Brad and I bet you they find stuff. Brad: Oh yeah. Bob: I know they would. Brad: All right. I want to say that, I had two episodes and I worked with you on both of them. I had severe hip pain where I had to use crutches and I thought, well maybe I better go in and get this X-rayed. And I didn't and both times within three days, the hip pain got better and actually it went back to completely normal. Bob: And it probably helps that Brad's a therapist, because he knew what you know, what to do as far as calming the pain down. And also, this by the way, is a part of a series of videos on hip pain. If you go to bobandbrad.com go to the program section look for the one on hip pain and we've got a whole series of videos and you can look through them, pick out the ones you want to watch, but they're going to tell you what to do to calm your hip down and possibly take the pain away. Brad: Sometimes it's stretches, sometimes heat or ice or strengthening and, they're all about 10 minutes long. Bob: Yeah, it might be poor daily habits. And hip inactivity too, if you're not moving your hip enough. Brad: And another big one here, I don't know if we have on the list, Bob, oftentimes you can get pain in the hip here, and we find out it's from the back, a referral pain, which, you know even doctors can get that mixed up. It can be tricky. The human body with referral pain can be tough. Bob: All right. The second lie, if you have arthritis it's going to just get progressively worse. That's not necessarily true. They've done studies and they've done scans of people a couple of years later, and sometimes it's not worse and sometimes it even gets slightly better. Brad: Right and maybe if your activity level improves and the pain goes down, that's what we're looking for even if the X-rays didn't show it got better but you can move better and you're feeling better. You know, that's what we’re looking for, that's the bread and butter. Bob: My wife doesn't like when I mentioned her, but she is an example here. I'm even going to tell her age, 56. When she was 54, her knee fired up and it got so bad she was on crutches. She thought she was going in for surgery. She couldn't even walk. I mean, and not even thinking about running. Brad: She was using a cane or a crutch. Bob: She was using two crutches first, then she went to one crutch. Brad: Sure. Bob: But we worked on it and she's back. She ran like three, four miles this morning. Brad: Really? Bob: Yup, she's been running, no pain. It's just awesome. Brad: I suppose, running away from you. Bob: Yeah, it's a motivation. Number three lie is” I wore out my hip because all my life I've been running or hiking or roofing.” I hear farmers say, “ I wore out my knees because of milking.” Brad: Right, right. Bob: And in that case, it might be actually true. Brad: Well, especially on those concrete surfaces as well. Bob: But actually it's not true as far as running or hiking because active people have better joints. Brad: Right. Bob: If you're using a joint, it's going to be actually healthier for you. You increase that synovial fluid, increase the blood flow to the area. It's the inactive people or sedentary people that start having the hip problems and arthritis that doesn't go away easily. Brad: And there's always exceptions. But as a rule. Bob: As a rule. Brad: People who move more within reason, of course and not doing excessive, extreme things, the body likes it, it adapts to it, it's healthier, all the way around. Bob: Number four. “I don't want to make it worse, so I'm going to rest it.” Now, that is okay to some extent, but people rest it too long or they like, we like the fact that if you can take some of the weight off the hip. It can actually maybe decrease the pain for a while and calm it down. Brad: So a good example is, if you have hip pain when you walk or when you stand, your body's telling you, don't stand, don't walk so what you can do alternatively is swimming, which may not be a good alternative or not very practical for a lot of people. Also, a stationary bike maybe a nice non-weight bearing motion. Bob: You're still moving the hip. Brad: Yep. Bob: You can even lie on your back and bring your knees up and rotate them back and forth. That even gets a little movement in your hip. Brad: Right, and we do have a number of these videos where we show motions you can do without stressing the hip with weight bearing. Bob: Number five lie. “My mom had arthritis so I'm pretty much destined to have it too.” And the fact is. Brad: That's a possibility. Bob: There's a possibility but. Brad: When you do that, it kind of pre-programs you. Bob: You think, I'm destined to have arthritis, no matter what I do. And the fact is almost everybody gets some arthritis at some point. Your lifestyle and exercise are more important than the heredity factor. So if you can go ahead and do the things that we're going to recommend in these upcoming videos, you can help knock the pain down or keep it down. Brad: Exactly. I'm reading a book right now about a woman who teaches Pilates and other motions, and she focuses it around, works with people specifically with pain in their joints. Bob: Oh, sure. Brad: And the whole concept of keeping moving, doing the right motions that don't irritate it. Bob: We're reading some of the same books Brad because I'm doing the same thing right now, two of them, it's always about motion. -Brad: Right, keeping things moving with proper motion that doesn't irritate it, which isn't always easy to find for some people, but you have to look for it and that's why therapists are here and that's why she's there. That's why we have our videos that help you all to find those. Bob: Yeah, because it can make a big difference in your life especially if you're having some chronic pain. Brad: Yeah, exactly. Bob: Number six, the final, big lie. “I'm going to need a hip replacement anyway so I might as well have it now.” Now first off, it may not be true that you're going to need a hip replacement. And again, we talked about the arthritis possibly could stall out and not get worse. And if you do some of the exercises and stretches and the strengthening and proper habits, you may never need one. Brad: Right. I do want to mention, you know, they may say, well I saw my orthopedic surgeon, and he says that hip needs a replacement. And that may be, however if you go to another orthopedic doctor, he might say, well I've seen a number of hips like this and had some therapy and they're able to get away without it. So a second opinion can also be very helpful. Bob: And you know, if you have a hip replacement when you're two young, obviously they wear out. Brad: Right, the replacement does. Bob: And you could end up having to have another one, you know, in 15, 20 years and so you want to delay it as much as you can, if you can. And as long as you're healthy. Brad: Because if you get one at 45 years old and say if it lasts 20 years, you're 65 and that's called a revision when they redo it. Any surgeon will tell you that it's much harder to do a revision because you’ve got the old hardware you have to remove. It’s a big challenge and they like to avoid that. Bob: When you're 45, 65 seems like a long time away but it's not. Brad: It comes around pretty quick. Bob: So yeah, again, check out the program on hip pain and each program, or each video has a PDF. Brad: PDF printout and it prints out the highlights of the exercises, so that you can review that and then you don't have to go back and look at our faces. You can actually just, you know, see if. Bob: Well if you want to come back and look at our faces. Brad: Well, yeah, you can, but you know I understand if you don't. Bob: All right, that's why podcasts are nice, you don't have to look at it us. All right, thanks. 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 March of 2021. For the original video go to https://www.youtube.com/watch?v=GlBJZfFl3YI&t=64s Bob: Today we are going to talk about the signs you should have an osteoporosis screening. So, we're going to do this for both women and men, and for women, they are at a higher risk. So you're going to find out that we're a little more stringent on them. Brad: And we'll explain it. There's a very, very good reason for it. Bob: Alright, let's get started, Brad. Brad: Let's find out about osteoporosis. So, osteoporosis it's about bone density? Bob: Bone density, but also, I found out from Sarah Meeks, one of our experts, that the structure of the bone is just as important. So like the trabeculae and how they're put together, is almost more important than if your bone is soft, or not. Brad: So, the trabeculae is that the outside of the bone? Bob: No, the inside. Brad: Oh! Bob: It's like the engineering. Brad: Oh, sure. Bob: Does that make sense to you? Brad: Yeah, the part of the bone that actually looks like a sponge, if you cut through it. Bob: Right, right! Exactly. And if that's designed to be strong, you're less likely to break bones than if you have let's say, one that's designed weak, but you have strong bones. Does that make sense? Brad: So, uh this is a genetic factor? Bob: Yeah, I think so. I don't know there's much you can do for that. Maybe Wolff's law would work with that? That means the more stress you put on the bone, the more that it reacts to it. Brad: Right, right, right. So your activity level. Bob: Right, right. Alright well, we'll have another video that we're going to show you exercises to do. So number one, all women who are over 65, you should have a screening, just out right, do it. Brad: Right. Bob: If you're post-menopausal women 60 to 65 and you have one risk. So, if you're over 60, you're post-menopausal, plus you had a fracture after age 45, you've had a hip fracture in a parent because there is a genetic factor. Brad: Oh yeah, the genetic component. Bob: If you've abuse tobacco. You smoke. Brad: Oh, so that's going to increase your risk? Bob: Right. Brad: Okay. Bob: Always does. Unfortunately, tobacco's bad for everything. If your BMI, your body mass index… Brad: So, if you're a little heavier? Bob: No! If you're lighter. Brad: Lighter? Bob: Yeah. If you're less than 22 kilograms/ Brad: That's right, because your bones adapt to that weight so they're stronger in heavier people. Bob: Can you do the calculation for me, Brad? It's less than 22 kilograms. Brad: What? In pounds? Bob: Yeah! Brad: Yeah, I can do that. (scoffs) Where's my phone? Bob: Yeah, yeah. Alright, if you've been using Prednisone for like three months... I had a patient, Brad. She was in her twenties, and she had really severe asthma and she had to be on Prednisone. We just take her for a walk, she'd break a bone. It was just, it was terrible. It actually ended up killing her. Brad: Yeah, I had a patient similar, she was in her fifties and she was on Prednisone and it’s really hard on you. It's a long story, but yeah, you don't want to get on that for too long. Bob: Well, she would die without it. You know, she couldn't breathe, so. Alright number three, if they found, if they found osteopenia when they did an x-ray on you, then you should have a screening for osteoporosis too, because that's the stage before osteoporosis. Brad: So, the x-rays will show signs of a bone weakening. Bob: Right. Thinness Brad: Yeah, thinness. Bob: Hypogonadism, that's a medical term that you'd know if you have it. Hyperparathyroidism, same thing. Here's the risk calculator, some other things that could be giving you trouble. For example, if you have heavy alcohol use, two or more drinks a day. If you're female. If you're white or Asian, you're at higher risk. Brad: Oh, really? Bob: Did you know that? Brad: No, this is statistically shown. Bob: Yes. If you're Black or Hispanic, you have lower risk. Brad: Okay. They don't know why they just know the statistics reveals this? Bob: Well, I think a lot of the Asians you see they are fine boned. Brad: Sure. Bob: Would you say that? Smaller as an overall rule of thumb. Okay, here we go, weight below 128 pounds. Brad: Oh, so we have a number? Bob: Yeah. We have a number. If you have kyphosis, if you're bent forward and your spine is rounded out. Brad: And kyphosis is the mid-section of the back. Right between the shoulder blades, and that area is rounded. And you know, this is not uncommon with older people. Bob: Yeah, if you're really sedentary, that's not good either. You want to be moving, and you just aren't doing any bone loading exercises. Brad: Right. Bob: You know where you're at least walking and trying to get some exercise. Number 8, you have a physical disability, you know, if you're in a wheelchair, you're not getting bone loading. Brad: Right, it's again, an activity level with things that are putting weight through your bones. Bob: Too much caffeine. If you're drinking more than 2.5 cups a day. Do you drink coffee; you don't do you? Brad: Yeah, I do now! I just started in the last year or so, but yeah. Bob: You're not drinking that much? Brad: Well 3 or 4 cups. No, I'm just kidding. I just, I find that just in the morning, if I drink it after that, it doesn't taste good anymore, actually. So that's good. I'm glad I don't have to fight that off. Bob: Low vitamin D, which we're in trouble for, because during the winter we just don't get much of that sun. Brad: Yeah, yeah. You tried to the thing with that one guy that goes out and freezes himself. Bob: Wim Hof. Brad: Yeah, Wim Hof. But yeah, I'm not going to do that. Bob: Okay, low calcium intake or absorption if you're not taking the calcium in very well. If you have diabetes, if you're diabetic, DM. Believe it or not, if you haven't had any children, you're at a higher risk. Brad: Oh really? Bob: They call it nulliparity. You're going to learn a new word. I think it's multiparity, if you have multiple children. Brad: Oh, really? Bob: This is kind a big indicator, if you lost over 1.5 inches of height. There's a reason for that. Since age 25, you should probably have that done. Sarah Meeks said, that the numbers are all over the place. And she said 1.5 wasn't necessarily true, but start thinking about it. That's for sure. Brad: And if you don't know, Sarah Meeks is an expert that has spent great deal of her professional life dedicated to this topic. Bob: And the last one if you do have what appears to be a spine deformity. You're rounded out. You may have already had a compression fracture. Brad: Sure. Bob: Sarah called it a silent fracture. Brad: Oh, without symptoms? Bob: She said very common. In fact, that was the most common fracture, actually is silent fractures. Brad: Interesting. Bob: Yeah, alright. So, men we have forgot about you either. So we'll talk about the men now. If you're over 70 for men you're supposed to have it done. Not 65 Like women. Brad: Okay. Bob: If you're over 50, and you've had any of the following, then you should have it a done. If you've had a non-traumatic fracture. So, it just fractured like a hip fracture or a vertebra, without a fall or obvious reason. Brad: Just got a fracture. Bob: Same thing, if they find osteopenia on an x-ray. Brad: Evidence of bone, not decay, but thinning, yes. Bob: Same thing about prednisone use. If you've taken more than five milligrams a day for three months, you're at higher risk. Brad: Now, I don't know if we cleared this up with the women. Maybe there's some men wondering, well why do men in general have less chance? It's because of going through menopause. Bob: I don't know what it all is, Brad. I think, men tend to have bigger builds maybe too, larger bones? I really don't know. I don't know the answer. We need Sarah Meeks on that one. Brad: Yeah. Bob: Same as women, hypogonadism, and hyperparathyroidism puts you at higher risk. And there's other risks that can you have. Again, if your parents had a history of a fracture. It’s interesting, isn't it? Brad: So genetics. Bob: Yep. If you've had the test in your femoral neck bone, a mineral density test, you know obviously you're a higher risk. Brad: Yeah, we're talking about the hip there. That's where our common fractures are in older people. Bob: Heavy alcohol use. Now for men, you can go up to four drinks a day. Brad: That's probably because of generally they're larger, heavier and more muscle mass possibly. Bob: BMI, or if they weigh less than 128 pounds. A slighter build. If they've had a prostate cancer, and they had an orchiectomy. Remember from anatomy what that was? Brad: Orchiectomy? No, I do not. Bob: Oh, well it's not something you want when you're a man. You're losing something vital, part of it anyway. Brad: Say no more, Bob. Bob: A loss of height also in men, 2.4 inches since age 25, is the one I read. Brad: I've lost about an inch, so far. Bob: I've lost about an inch I would say. And I had an inch to give. Brad: Yeah, you know, proportionally, you're taller. So maybe you can go a little bit more than that. You're really good I figure. Bob: Again, low calcium intake, low vitamin D intake. Again, we talked about that, the sun. Brad: So, really those, if you're not in the sun, or just getting a good diet of leafy greens, and that kind of thing. Bob: I do take a supplement, for vitamin D. Just during the winter. Brad: Okay. Bob: Again, if you're diabetic and again if you have high caffeine in takes. Greater than 2.5 cups. You know the thing is, it can be treated to some extent. You can't reverse it, but you can certainly stop it from getting worse. Brad: Sure. Bob: And, so it's better to know if you are osteoporotic, and they can put you on meds, or you can maybe become more active. Brad: More active. Your diet. Get out in the sun. It really kind of boils down to a lot of the common things. As we get older, you have to clean up your act. Bob: Yeah. Brad: You know, treat yourself well. Bob: And so finally though, let's remember Brad, we can fix just about anything. Brad: Except for... Bob: A broken heart. Brad: Right, but by the time you're this age and you have a little more experience with it. Usually, they don't need as much help. Bob: That's right. Brad: I hope, I don't know, whatever Bob: 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 Low 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 Low 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 Low Back Pain (Both Sides): In our examples channel one has yellow pads and channel two has green pads. One pad from channel one is placed in the upper right corner of the area of pain and one pad from channel one is placed 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: don’t place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Low Back Treatment: Prone Extensions or Gentle Trunk Rotations 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 April of 2021. For the original video go to https://www.youtube.com/watch?v=2YDmdrYbsd4&t=516s Brad: Today the subject is, OTC or over the counter Voltaren gel. Pain reliever, versus the traditional Motrin, Advil, Aleve, or Tylenol. We're going to give you information on how to decide if Voltaren, the new over the counter pain med, is for you or not. And today we have an expert here that's going to help us out with the facts. Chris, the pharmacist. Chris: Hey guys. Brad: I'm looking at this from a therapist’s point of view. Pain management can be absolutely critical, whether therapy is successful or not. Particularly, an example is like a knee surgery. You have to get the knee moving. Chris: Oh yeah. Brad: You have break up scar tissue, and I think times like that, it's okay to have pain. So if we can decrease the pain, we can get more motion and get the therapy going on. But for the general public, if you just want to control a headache, or you want to control joint pain, arthritic pain, maybe a sprained ankle, or whatever it may be. This Voltaren gel is now over the counter, so anybody can use it, but let's get to the basics. Chris: Sure. Brad: Is it really new? Is Voltaren gel something that has been used or not? Chris: Well, yeah. Voltaren gel has been around. It's diclofenac 1%. It's a topical gel. Diclofenac is the generic name of it. Brad: Okay. Chris: It's been around, as a prescription for quite a while. I mean. Brad: For like a decade or more? Chris: Yeah, I think 2009 is when it came out. So it's been around. It's definitely had its place in the orthopedic circles. I mean, it really goes right to your arena. Brad: So when you say orthopedic, some people, you know, it's for joints. Chris: Yeah. It's widely used for osteoarthritis, but it can be used for joint pain, muscle aches, you know there's just certain joints, you can't use it on real effectively. The hip joint. The hip is just too thick. I mean, it's too deep. You can't get this to penetrate into the hip directly. So it's going to be more for your, you know, your ankles, your elbows, hands, you had a back pain, sore ribs. I mean, people have used it for a little cartilage tear. Brad: So, in the past doctors would prescribe the exact same thing? Chris: Exact same thing. There is no difference between this and the prescription. Brad: Why was it prescription, and then all of a sudden, now it's over the counter? Chris: I think really what it comes down to is safety. And so they've had decades’ worth of experience showing that it was very safe and effective product. The biggest complaint for this, for patients that have side effects, is going to be kind of a rash or some itchy skin. So that's about it. The no-no’s are if you're on blood thinners, or if you were allergic to NSAIDs or aspirin. Those would be the things that you would not use it for. And of course, patients talking to the doctors, you know. It's very important to give them all that information, so they're imbibed with that, so that they can get you the right choices. When you walk into the pharmacy and you're like, “gosh I'm just looking for some pain relief, I've got a sore knee. It's just bugging me.” Voltaren gel is actually a really good thing that people can certainly try in the arena of pain relief. So whether it's going to be ibuprofen, whether it's going to be naproxen sodium, or acetaminophen. Brad: I always get this confused. So naproxen sodium is the same as Aleve? Chris: Yeah. Aleve. Yeah, we are talking ibuprofen would be Motrin or Advil. Aleve is going to be neproxin sodium, or acetaminophen is Tylenol. Brad: Okay. Chris: And then Voltaren is diclofenac. Brad: Ok. Yep. So, it's whether, it's the manufacturer or the generic term. Chris: Correct. Brad: But it's the same active ingredient? Chris: Yeah. Exact same thing. That's the business end. Brad: Sure. So for diclofenac, is there other manufacturers that have it? Chris: Well, GSK owns the patent that was on diclofenac gel. They actually, havea 3% prescription one also for a different process, or problem. So, but yeah, that's been around for years, and you know, it's effective good stuff. We've been using as a generic medication. So it's a lot more cost effective alternative for patients. And now, this is just really affordable stuff over the counter. So it's just nice because now it gives access to many. So you don't necessarily need to see a doctor. So if you have, you know, weekend wear kind of stuff. You were out in the yard, and you were raking, and you hurt your back, or you pulled something, or did something to your shoulder. You were playing catch with your kid and just did something to your rotator cuff, or labrum, or something silly, that maybe is minor. You know, maybe it doesn't need a doctor, or physical therapist yet. Now let's try and use something like this, you know, 3-4 times a day and see if it helps to relieve it and provide the pain relief that the patient needs. Brad: So I'm thinking in my head trying to separate all these different avenues out for pain relief, because, in my case I do best with ibuprofen. Chris: Sure. Yeah. Brad: Okay. I've tried Tylenol, doesn't seem to work, and everyone’s bodies have their own preferences. Chris: Correct. Brad: So if you know that I'm thinking, well, what about this? Now my understanding is, say I have a sore knee. If I take my ibuprofen, it goes throughout my whole system and it gets to that knee. Chris: Yep Brad: So if I take this, if I'm thinking right, and I put it directly on my skin, does that medication go through the skin to the point of the irritation? Chris: It depends on the depth, but I mean that's why the hip joint is not the best place to put it. Brad: Sure. Chris: But let's say, we're talking to knee and ankle, you know people use it for arthritic hands all the time. And so, you know, it's important to get the correct product. So basically below the waist, we use 4 grams as the measuring tool. There's a measuring guide that's actually included within the box. Well, basically upper joint is going to be 2 inches, lower joint is going to be 4 inches. And so basically, it's just like squirting out toothpaste. So you just put it on the spreading blade, let's just pretend that I've got a sprained wrist. So we're going to put 2 grams on the wrist, and then you're just going to rub it in really well. Just wash your hands down. You don't really want to wash off the spot, but maybe wash the other hand with soap and water, just so it doesn't irritate the skin. I mean, there's no point to it. The biggest complaint can be a little bit of skin irritation, but it's going to penetrate through the dermis, into the joint. It's not going to get all the way, deep into the joint, but it's going to help to where those pain receptors are, and hopefully help to kind of control some of the inflammation, that's creating some of the pain. Brad: Sure. Chris: So, then you'll apply every 6 hours, or 4 times a day max, 3-4 times a day. For lot of people it's going to be hard to go on a 24-hour schedule because we sleep somewhere in there, or we get busy, but 3-4 times a day, 4 to 6 hours apart, is a reasonable usage pattern for this particular product. Brad: So upper body? So like Chris says, it's just so nice, because you can just squirt it out on there about that size. So you get an accurate dosage. Chris: Exactly. And that's important. Brad: You don't have to get a measuring cup. Chris: No, you are not guessing. No. You'll get an idea, and then you just basically, let's say your elbow, you just kind of rub it in. Do that 4 times a day, and hopefully we're going to help to control the pain and inflammation, so you're more functional. Brad: Have you heard a lot of people allergic, or break out from this or is that pretty weird? Chris: No. I mean the biggest common side effect is a little bit of itchy, irritated skin. If you have an allergy to NSAIDs, which would be your ibuprofen, your Aleve, those types of things. Aspirin. You would want to avoid using the product because there's a higher chance, you know this is diclofenac, it is an NSAID. So it's, it's certainly something that is within that family, that umbrella. So you could see an allergic reaction. We don't want to tip the balance in the wrong direction. Brad: Sure. Chris: So if you know you're allergic to an NSAID, you should avoid it. And that's when we go to Tylenol. Brad: Sure. And the other hand, if you have problems taking some of the other oral meds, because it upsets your stomach. Chris: Yeah. And that's one of the advantages but while we're on it we'll just keep talking about it. So, when you take a traditional anti-inflammatory, so ibuprofen, naproxen sodium, aspirin, those products are going to have an increased risk of causing some stomach ulceration or some kidney damage. So, NSAIDS do have a risk. They can raise blood pressure, that can be damaging to the heart and kidneys. So there's a lot of things, that even though they do very good things for us and for many of us, we have to use it appropriately, under the doctor's guidance or at least make sure, you talk in your pharmacy about safe use, length of use, those types of things, because we don't want to create a new problem, in a different area of the body. Brad: Right. Chris: One of the distinct issues, that drives the bus with NSAIDs is stomach ulceration or irritated gut. So when you use something topical, like Voltaren gel or diclofenac gel, what that's going to do is you're not going to get, that whole amount of systemic absorption. So when we take the tablet, like you said it kind of goes all over. This acts right in the area. And so you're going to get some, that goes into the bloodstream. So you can see some prostaglandin inhibition. So there is still the remote, and I do mean remote possibility, that even though this is a topical gel, that it could cause stomach ulcerations, which is why we don't stack in on said NSAIDs. So if you're already taking a regimen of, let's just say, 600 milligrams of ibuprofen, 4 times a day. You're not going to use this, on top of that. Brad: I see. Chris: Because there is a synergistic or additive effect, that when we're talking about swinging things to the negative. So kidneys, stomach, heart. So we need to be careful with all of those things. Brad: All right. So if you've got arthritis and I'm thinking of my mother right now, she's got a knee that bothers her, on and off, it's an arthritic problem. She's not a good candidate for surgery, so to manage the pain, she could put this on that knee. Say there's no skin irritation. She could put that dosage on there. Chris: Yep, that should be a 4 inch. So yeah. And then, it's really neat for your mom. I mean, you know, one of the easiest ways, you know, a lot of times it's like, are you really looking at your clock? Has it been six hours? I'll tell people just go breakfast, lunch, dinner, bed. Those are intervals that are somewhat, just through our lives, we've kind of naturally spaced those apart. Brad: Right. So let's say you put it on there to. Do you notice the effect? Is it typically within an hour? Or is it kind of take a day? Chris: Yeah, it's going to take a day or 2 with some consistent use. I mean, you might get some pain relief right out of the gates, but it needs to be kind of an additive effect, because there's a lot of things going on with inflammation, that's causing pain. Brad: Sure. Chris: And so we have to calm down all those chemotaxis, and healing factors, to give the relief to the patient. So it does require repeated dosing, to get adequate drug response. Brad: So a typical scenario, my mom's got knee pain. She uses this for a couple of days. The knee pains getting better, or maybe it's back to normal again. Then you can stop? Chris: Yeah. Usually we're not going to want people to use this longer than 7 days, without at least discussing with their doctor. Just because there could be something more potentially wrong with that knee. Let's say she tore some cartilage, or you know, and there's a litany of things that you're going to see in there. So we want to make sure, that we're not overlooking something. So, 7 days is kind of the max, unless your doctor says, “Oh yeah, you can use, as long as you need to kind of thing,” but make sure your doctor's involved. I mean, that's, the quarterback of the team. I mean, you're very important with your own healthcare, but your doctor should be involved or at least ask a pharmacist or one of the other healthcare professionals. Brad: To make sure there's no red flags. Chris: Exactly. Brad: If you're on other medications. Chris: Yeah, blood thinners would be the big no-no. Brad: Okay. So any other side effects or things to be? Chris: No, it's actually some pretty slick innocuous stuff. I mean, not much bad with that, simply because it acts locally, so you don't get as much into the system. Brad: Yeah. Chris: So it doesn't create all the systemic onset side effects. It's pretty impressive stuff. There's a lot of orthopedic surgeons and doctors out there, that routinely prescribe it still, even though it is over the counter because sometimes your co-payment might be a little bit cheaper. Brad: Sure. Chris: But I mean, you can get a tube of that for about 9 bucks, over the counter. It's affordable stuff Brad: And that'll last you the 7 days? Chris: Oh yeah, easily. I mean the, depending upon the size of the tube. They actually make a larger tube too, so it's a little bit more economical, I just grabbed a small one. Brad: It depends on what size area you're covering. Chris: Exactly. And how frequently, hopefully it's just going to be kind of a short-term thing anyways, but it's available to you if you need it. Brad: Yeah. Well, that's great. I think it's a great alternative, especially when you don't have to take pills, if you've got digestive irritants. Chris: Yeah. Just remember guys, it takes about 5 minutes for this to absorb. So let's say you're treating a shoulder, while you rub it in, give it about 5 minutes to dry, otherwise you’ll put it on your shirt, your shirt kind of stick to it. Brad: Oh, I see. Chris: I'll get a little slimy, so. Just, that'd be just one of the other negative things. That's not really an overt side effect, but it's definitely a cause and effect kind of scenario. You want to keep your clothing looking nice. Brad Yes, exactly. All right. That answered a lot of information for me. I'm thinking this is going to be a go to. I'm going to at least try it with my mother's knee. Chris: Yeah. Give it a go. Brad: See how she responds. Chris: I bet she'd appreciate it. Brad: All right. Very good. Take care and enjoy your pain-free way of life. All right. Chris: Thanks guys. 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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://www.youtube.com/watch?v=ntWElqA4LFU&t=276s Bob: Today we're going to talk about common "pain makers" causing pain in your neck and arm and how to get rid of them. So our goal is you want to, of course, decrease the amount of neck and arm pain you're having. So to do that, we're going to show you exercises and all sorts of other things, positioning but it's also important for you to decrease the things that are causing the pain in your life. Brad: And you might say, well, it hurts all the time everything irritates it, but we're going to talk about how you can find a few things out. Because we've heard those comments many times from patients, and after a little discussion, we find out, “Oh well, they say it really hurts when I do this.” And then we go into that area and it becomes very much clearer than. Bob: It becomes clear as you stop doing some of these things, you start finding out that things are causing my pain. Like, let's say you, you sit in a chair with your head bent down, you know? And after a while, you fall asleep in a chair, and your neck falls down and your head falls down and that causes increased pain. And that pain goes on for a couple of hours because of that. Brad: Sure. Bob: And, you stop doing that all of a sudden, you maybe have two, three hours of pain free moving. So, you know, it could be pain in your neck or even referred pain down your arm. If you perform a task and it increases your pain, it's a pain maker in our book. If you move a certain way and it increases pain, it's a pain maker. If you're lying in bed and that causes pain, it's a pain maker. Brad: It may be something as simple as just posture you're not aware of. And it's, you have poor posture you have no idea, until someone takes a picture of you, and you look at it from a certain angle. Bob: Or like the bed example, you think, well, I'm lying in bed. Why am I having pain? And then, maybe you're lying with too many pillows Brad: Sure Bob: You know so, the other problem with the pain is that the more pain you have often the more sensitive your nerves get. So now rather than taking a large event to cause your pain, it only takes a small trigger. You know what I mean? Brad: Right. Bob: The nerves become so much more sensitive that the what used to cause a lot of pain hardly takes anything now to set it off. Brad: And you can think of that. You know it's going to be painful when you move this direction or when you're going to do this activity, so even before you get to it because you're starting to feel anxiety and that can all trigger into the whole pain cycle. Bob: Right. So the cycle is hitting the wrong way. It's getting worse and worse. Now you can also hit it the right way by taking the pain makers out of your life you can see that you can control the pain. Brad: That's a big deal. When you find out you can control it. You know, that's, that's huge. Bob: Yeah. It doesn't have to control you. So, what Brad and I thought was that we’d go over some things that you probably should do right now. And Brad, and I 'll go back and forth. And now, number one I would not look down continuously, right now when you're having neck pain while reading, knitting or performing desk duties. You want to try to get things. That's how we often talk about setting up your office or home computer, making sure the screen's high enough so that you don't have to look down. Brad: In our society, these are challenges that Yeah, they are challenges. Bob: Yep, they are challenges. Brad: And number two, we're looking at continuously looking at a phone or a laptop. You know phones are, you know pretty much phones are the new TV. Bob: Yes, it is. Brad: You know? So we're down looking at the phone, putting stress on the neck. And it's one of those things. When you do it immediately, it doesn't cause pain, but over 20 minutes, it gets it that fired up mode, and then you don't really realize that, that was the problem. Bob: You don't even realize it that it's sneaking up on you. So bring that phone up by your face. This is what you need to do. So I just a generalize one is putting the neck in what we call putting the head in the forward head posture. So you know, that neck is geeking forward. This is such a common position that we see with sitting and working and, and even lying down sometimes. Brad: Yeah, the pillow issue again. Bob: All right, Brad, what else we got? Brad: Ooh sleeping on your stomach or your head is turned to one direction as far as it can go. And that's fine. But if you lie there for any period of time, that's end-range on the joints, which is a common therapist term that we use. We know we don't like to put our joints at end range for prolonged periods, that irritates them. So, no more sleeping on the stomach. Bob: Yeah. If you do it, do it for a very brief time. Brad: Hopefully if you do, when people that do sleep on their stomach that don't have any pain, they've probably got pretty normal motion. They probably turn their head right to left frequently, without even knowing that. Bob: Sure. All right. Like we alluded to a number of times as sleeping on your back with the wrong number of pillows. Generally, when you sleep on your back, and we'll go into this in another video, you want to have a thinner pillow so it doesn't move your head and neck forward. Brad: And the same thing with sleeping on your side you've got a different posture you need to accommodate so that your neck is not stressed. And we'll cover that probably in the same video. Bob: The other one, number seven don't sit in a slumped rounded position. What does this have to do with neck? Well, if you're like mid back is rounded out, there's no way you can have the neck in good posture. It just, it just follows suit. So you got to have the entire spine in good posture or your necks going to be in a bad position. Brad: And this is one of those things where it comes into play with our next thing, watching TV, you know it's all that slumped posture, sitting in your car or sitting anywhere. And you know, Bob, we both know that particularly with younger kids, you ask them to sit up tall and straight with good posture and a lot of times they'll say “it just feels so weird and it’s not even comfortable.” Bob: I know they say, “who sits like this.” They don't realize how bad they look the other way and how good they actually look sitting up straight. But the other thing with that, Brad from that same point is that you don't want to have your computer screen off to the one side either or TV off to one side. If you're constantly looking, let's say to the right, you're going to develop pain on that right side of the neck possibly. So you want to have the things right in front of you, even if it's slightly off, it's not a good thing. Brad: This is one of those things that, the older you get the more you realize it. Bob: Yeah, it becomes very evident with you as you get older because these things crop up and you’ll know. Brad: Particularly over the age of 50. I just had a physical and the doctor said “Once you get over 50 things kind of start changing.” It's like, wow, that, that was my experience. Bob: Well, Brad jokes, something new crops up pretty much every day, Brad: Nothing major, but you know things that you used to be able to do. Bob: Next, cycling with your head down posture, Brad you're a big biker. I do some biking. Rad: Yeah. And it depends on the type of bike you have. If you've got a bike that is more normal it keeps you upright. you're going to have less stress on your neck. Bob: You’re just not going to go very fast. Brad: I have the bike that you lean forward and go in the arrow bars, and it's not that comfortable. I've got to sit up every now and then stretch my neck because it's a little uncomfortable. Bob: Yeah. And you know what I do? My bike is upright but I often like take my arms behind my back and stretch it. Brad: You can let go of the handlebars? Bob: I can let go of the handlebars. But I started thinking maybe I shouldn't do that anymore because if I go down, I'll go down. So, all right. Number 10, Brad, you’ve got number 10, right? Bob: Oh yeah. Driving with incorrect posture, same concepts that we aren't talking about. The thing in a car is you can adjust your lumbar support, hopefully. If your lumbar support is good it makes it much easier to have good posture in your neck. So make sure you're got that adjusted properly. Bob: This next recommendation is with a caveat because if you can run without pain, I absolutely recommend that you run. But if it's increasing your pain one might be that you have bad posture while you're running and then it's actually the shock absorption is making it worse. But generally, running is good for you as far as increasing the oxygen to the area, and the healing power but you have to have good posture while you're doing it. We have a neighbor lady, I want to put my knee between her and back, pull her shoulders back Brad: Go out there and do it and see what happens. She’ll probably thank you for it. There are a small percentage of people that actually run, I think overall, but yeah. It's something good to point out. Oh, here we go. Next one sporting activities. Bob: Don't do them if they increase your pain. Brad: Or change how you're doing them. Maybe it is a postural thing or something of that nature. Bob: We’re not saying that you can't go back to it, but we want to calm things down. We want to calm the pain down. So let's say you're having pain while you're playing tennis. Cause you're turning your head a lot, wait until we get the pain knocked down again. Then you can gradually go back into town Brad: Boy, that sport just with the abrupt changes in directions, that can cause pain. Bob: I think the big one now is pickle ball. Brad: Oh yeah. That is becoming very popular. Do they eat pickles? Bob: I don't know. I haven't got into it. So, lifting weights am I'm going to tell you it’s fine to lift weights, as long as it doesn't increase your pain but if it increases your pain, you can't do it. It’s that simple. Brad: Well, body mechanics is so critical at lifting weights and there's a lot of people that lift that aren't aware of their poor biomechanics. So make sure you get some proper instructions. Bob: Yeah. You want to bring up pretty much you, one of your spine nice and upright and completely erect when you’re lifting. Brad: And that's why a lot of gyms have mirrors. So you can actually see what's going on with your posture. Bob: Not just to look at yourself and see how big you're getting or toned you're getting. So number 14, Brad that's you. Brad: Oh, working in a cramped or awkward space. That's very typical with a lot of computer work stations. You put everything into one area so you can work. Especially now with COVID people are trying to convert things into their house. Bob: What about a car mechanic or a painter? You know, they're really in confined spaces a lot. Brad: Yeah. It depends. I mean, when I was working on equipment for service calls where I'd be almost upside down and trying to reach under something. You need three elbows just to get your arm around. If you're a mechanic, you know exactly what I'm talking about. Bob: Unfortunately, with that, if it’s your livelihood, there's nothing you can do right now. We'll try to show you some things to do in between. Brad: The elevating work bench can be a really handy tool for something of that nature. Bob: If you tilt your head out of habit in the same directions, a lot of you don't know you even do this. I do this when I'm doing notes, I'm always tilting my head to the left. So as an exercise, actually I have to tilt my head to the right, the opposite direction. We'll go into that later. But you want to try to avoid those, you know especially if it's a daily habit you're doing hour upon hour, day upon day, years upon years. Brad: Yeah. Bob: All of a sudden it will start giving you pain. Brad: So shoppers tilt? Bob: Well, is that referring to the same as the shopping cart and a shopper's tilt is when you just carry something on just one side. Brad: Oh. So if you've got a big purse or something of that nature or backpack. Bob: Or if you bought something and you're carrying it all in one hand you're supposed to have spread out the load. Brad: So you should buy two of them? Bob: That's right. Lol Brad: Carry one in each arm. Bob: That’s what you can tell your spouse. I was supposed to buy two of these Bob and Brad said. So, keep the weight evenly distributed. Number 17, it's kind of a repeat there but what they're talking about is if you're carrying a heavy suitcase at the airport. You, want to get a rolling one. Brad: I don’t even think they make them the other way anymore Bob: I know my, my niece just was having trouble with this. She, she flies a lot, was flying a lot. And she was getting like thoracic outlet syndrome. I don't know why she didn't have a roller. What I think it was, you know there's times you have to lift it up to go upstairs or something. You know what I mean? And she was always using one arm and she has a purse over her neck. Brad: Did you straighten her out? Bob: I straighten her out. Brad: Oh good. Bob: So anyway, again, decrease the pain. So you decrease the sensitivity of the nerves. We're going to show you some exercises to help you also along with this but the pain does not have to be permanent. You know, we're going to help you get rid of it. By the way this is a part of a series of videos on neck pain. So you go to https://www.bobandbrad.com/ go to the program section and look for neck pain. And you'll see a whole series of videos. Brad: Go to the one that fits you. Don't worry. They're not all just talking like this. We're actually going to show you some exercises that we've had great success with patients and you can work with them yourself. And there's a PDF printout to show you the exercises. Once you turn the video off so that you can refer to it, a little review of the video, it's a great thing. There's no email or anything. It's all free and rate ready for you. Bob: Like this one week, for example we got a list of the 17 things you should do right now. Brad: Oh so they can read it all. Yeah. They'll probably print it and not watch the video. 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.

Additional information on the Intracept procedure video with Bob and Dr. Ekstrom

How to Use a TENS Unit with Inner Thigh 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 a Smaller Area of Inner Thigh Pain (Hip Arthritis, Hip Adductor Strain): 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 a Larger Area of Inner Thigh Pain: In our examples channel one has yellow pads and channel two has green pads. Option one: one pad from channel one placed above the area of pain and one pad placed below the area. One pad from channel two placed in front of the area of pain and another pad from channel two placed behind the area of pain. This arrangement forms a cross pattern. Option two: 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. See Photo for Example General Guidelines for Pain Referred from Another Area: An example of this would be inner thigh pain that is coming (referred) from the back. Using channel one, place the two pads along the nerve pathway. Reminder: Don’t place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Buttock Treatment: Adductor Massage with Cordless Massager. *Update Bob & Brad have come out with their own line of massage guns: https://amzn.to/36pMekg 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 May of 2021. For the original video go to https://www.youtube.com/watch?v=4F6MP0l50uU Bob: Today, we're going to talk about how to finally stop your back pain. We're going to have you answer 10 questions. All right, let's get started, Brad. Brad: All right. Bob: So, these questions were developed by Stuart McGill. He is probably the world's foremost expert on back pain. Brad: That's right. Bob: It's in his book. It's an excellent book. These questions are from his book called "The Back Mechanic." I think it's the best book out there right now. Brad: Sure. Bob: So, the most important thing you need to do when you're trying to get rid of back pain is you got to stop the cause. Brad: Stop the irritating component, right. Bob: A lot of people think like, “oh, I hurt my back. It's going to stay hurt.” That's not true. You've got something that's irritating you during the day, and if you stop those irritating things, the pain will calm down eventually. The nerves will calm down. Everything will calm down. Brad: And you might think, I had a lot of patients say, "What irritates it," and the first response is everything. Bob: Everything, exactly. Brad: And then I talked to them some more, and finally we can figure out where the primary causes are, or maybe two different causes. Bob: Yeah, we start off this process by basically doing the questions, but we're going to do another video that's going to show you some tests you can do on your own, to try to help narrow down what is the cause. Brad: Right. Bob: So you want to watch both of these videos, or all of our videos, you want to watch. So number one question, does the pain change in intensity? I like to see that it does, like there'll be times where maybe you have no pain or a little pain. Brad: Right. Bob: And then times where you have severe pain. That usually means you can control it then. Brad: Sure. Bob: I mean, if you can have times where there's no pain, well we're going to increase those. Brad: Right, try and associate that with your activity then or just prior to that. Bob: Yeah try to make note. It's not the worst thing to even have a log book. Brad: Yes. Bob: Okay, When you roll in bed, do you feel any catches? This is a really good sign of instability in the spine, and I'm going to explain that one Brad. Brad: Right because that might not be clear. Bob: So let's say you have a disc problem at one level. You have all of these vertebrae that stack up to make your back. If you are unstable at just one level, when you move, all of the movement's going to occur at that one level instead of all spread out among the other levels. Brad: Sure. Bob: It's hard to explain this without showing it, and we don't have a good model to show it. But, you just have to take our word for it. It's usually the sign of a disc problem, and it's a sign of instability in the back, and so what you're going to want to do is you're going to, when you try to get out of bed, you actually tighten your abdomen. Brad: Right. Bob: Like a corset. Brad: Yep, like you're putting on a back belt, you just tighten up those core muscles and really try and keep your whole trunk, we call it log rolling. Bob: Right. Brad: So it's everything stabilized together by using those abdominal and back, or you know, core muscles we'll call it. Bob: What a difference it makes. I've seen it with patients, like they were very skeptical. They thought it's not going to make any difference, and they're like, "Wow, I got out of bed without pain." Brad: Sure. Bob: And that's the first step, then. You start realizing hey, maybe I can control this pain. Maybe I do have control over it. Brad: That's a big step, feeling confident that you can deal with this. Bob: Right, exactly. So this is probably the most obvious question. What makes your pain worse? I mean, you start writing down. Generally, we find is that people are going to maybe have worse pain with bending forward. Which is a really common way, or maybe it's bending up straight and backward. Brad: Yes, sir. You're not even bending forward. Sometimes it's bending over a bench while you're doing something perhaps at work or in the kitchen, and you don't even realize that you're bending forward, and a little bit can make a big difference. Bob: Why don't you show twisting too, Brad? It might be with twisting, just turning. Brad: Yeah, so when you turn, especially the low back pain, ooo. And just a little bit. Bob: And maybe it might be in one direction. Might be mostly to the right, and when you go to the left, you're fine. And of course, we have to throw in things like load and fatigue. Brad: So lifting, pushing, pulling heavier objects. Bob: Or some things you might be fine with until you've done it for a long time. You might be fine sitting for 10 minutes, but at 15 minutes, it starts to hurt. You don't go to 15 minutes then. You have to stop at 10 minutes, and do something else in between. So there's ways around this. We brought this one in, too. Any history of osteoporosis, osteopenia? The reason we ask that is it's very common with osteoporosis or osteopenia, by the way. In some ways, they're not that much different. People think osteopenia, they're fine. You could be a higher risk for fracture with an osteopenia. Brad: So we're talking about bone density loss. Your bones are becoming weaker. Typically, with older people, it's common. Bob: So the problem is there's about 300,000 patients who go to the doctor each year, because of a fracture. Brad: In their spine? Bob: In their spine, yeah. Brad: Compression fracture, whatever. Those are common. Bob: Yeah, the bones squeeze together. But they estimate another 600,000 don't go to the doctor and don't even know that they have a compression fracture. It's called the silent fracture, and it's very, very common. So if you have osteoporosis, you probably want to have that checked out. A bone density test and also probably you might, if you're having pain, you should have an x-ray. Brad: Of your spine. Bob: Yep, of your spine. Brad: Yeah, it's not a major fracture. It's something that has to be read oftentimes by a radiologist. The MD may not be able to see it. You have to get an expert, which is very common. They almost always do it. Bob: They always do it anyway. Number five, Any trauma involved? If there was trauma involved like you're in a motor vehicle accident or if you fell, you should be seeing your medical provider just to make sure that no fractures occurred. Or nothing untoward happened. All right. Is your pain worse thing in the morning? If it is, this could be your sleeping posture. Brad: Sure. Bob: And quite often, that's what we point to. If you're sleeping in a good position and you're moving a little bit, you really shouldn't have increased pain at night, you know what I mean? Unless you irritate it during the day. Brad: Right, right. Well, yeah, and we have videos on how to readjust your body or use some supports to help eliminate that. Bob: Exactly, you might be putting pressure on that back all night long if you have, for example, if you have kind of a large buttock, and you sleep on your back. Actually, the back is going into flexion all night long. Brad: Or side lying. Bob: Or side lying, if you have a little bit wider hips, you could have your back sagging all night. Bob: Or wide shoulders. Bob: Right, right. Absolutely. All right, Does your pain worsen throughout the day? This usually indicates that you're putting your back into some poor positions. Or maybe too much load. I mean, maybe you're fine at a lighter load, but as soon as you start putting some stresses on the back, it can't handle it. Brad: So if you have to move boxes throughout the day, and the lighter ones are, you're doing fine, and that's kind of a common sense one, I think. But just when you say load, I just wanted to clarify that. Bob: Well, I think Brad, what we're trying to hammer home here is that something is causing your pain, and look for it, and if you can't find it, you aren't looking hard enough. I mean, really. Brad: Right. It's one of those things as a therapist, we're trained and we have this experience. A lot of times, it's just sitting, you feel fine, but that sitting long-term sitting with poor posture kind of sneaks up on you, and it feels fine until you get up, and then it's like, oh, what was that, what did I do? And it was actually the seated posture that you're completely unaware of. Bob: Or it might be you're seated in a perfectly fine position, but you sit too long. I mean, there's lengths of time, too, so you should get up and walk. Brad: Which can be a problem depending on your job. Bob: Well usually, you can walk to the bathroom anyway. All right, Is your back pain more concentrated in the middle back? This is for people, a lot of people Brad, they've developed poor positioning and movement patterns where they actually tend to, instead of bending at their hips and keeping their back straight, they bend at the mid back. They call it a hinging right where the ribs meet the low back. Brad: Right. Below the shoulder blades, but above the low back, just right in the middle there kind of. Bob: But they get into this movement pattern of going like this, and that's almost always causing the mid back pain. Brad: And that's one of those things you're certainly almost certainly not aware of. It's a habit that's been going on for years and developed, and so that is one of, like a lot of these things, you're just not aware of what you're doing. Bob: Yeah, I think back to a couple of patients I had who had mid back pain, and they had to lean over a fence to do something, and I'm like I knew right away what they were doing. They were doing that. They were bending at the mid back and hinging, and you want all the movement to occur at the hips, not the mid back. Brad: Right. Bob: All right. Does your pain also radiate into your buttocks and feet? If it goes all the way down into your feet, it's more likely a disc problem. Brad: If it's past the knee, disc, if it's to the knee, then it could be SI. It's still a back thing, but then it's a little bit more challenging to fix it. Bob: You're getting a pinched nerve somewhere. It could be piriformis, too, but somehow, you're getting that nerve pinched. You're definitely going to want to see the doctor in this case. Does your pain increase with fast walking, or does it decrease? Usually if it decreases with fast walking, it's often a disc problem because a disc problem will increase when you're walking slow. It just puts a little more load on the spine. Brad: Stuart McGill, he talks about that as well. Bob: But then, what case? Does it increase, Brad, when you're walking? That would be spinal stenosis, and that's such a common thing that they call it shopping cart syndrome, like you lean on a shopping cart, and it feels better, and if you have spinal stenosis, you may be only walk a hundred yards, and you have to sit down and give yourself relief. Brad: And then when you sit, it feels good. Typically, right away, and that's more with the older population, 60 and over. It's not an uncommon diagnosis to have, but it's certainly nothing to get too excited about. There's some exercises that can help you out. Bob: And you know, you deal with it, too. You manage it like Brad bandages his spondy. You figure things out, and Brad runs and bikes and swims. Brad: Right, I just got to be careful. Bob: And irritates people, so he does all those things. Brad: I don't bike too far, Bob. It's still uncomfortable getting off the bike. Bob: You don't let it bite too far. Brad: You learn your limitations. Bob: Yup, and that's the whole summary of this video, is let's find out what's bothering you. Let's calm it down. Let's not let it irritate you, and it can flare up to the point where you can't do anything. Brad: So you need to either modify the irritant, maybe use a back support, change your body mechanics, or if you can avoid doing that activity which can be challenging. Bob: You may have to avoid it for a while, but then we can eventually get you back into it, maybe with modifications. Brad: Sure, yeah. Bob: All right, remember, Brad and I can fix it about anything. Brad: Except for. Bob: A broken heart. Brad: Right. Bob: And I think I've been working on it harder than Brad to be honest with you. Brad: Well, that's true. I kind of, you know. Bob: I hate to be catty about it. Brad: What's a guy going to do about it? Sometimes you have to take a break from the old heart thing. Bob: All right, thanks. For more information on Dr. Stuart McGill visit: https://www.bobandbrad.com/experts/stuart-mcgill 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 January of 2021 . For the original video go to https://www.youtube.com/watch?v=4tTCs-BAHwA&t=92s Bob: I am exactly one half of the Bob and Brad team, and I'll be your host today. I'm joined by Chris the pharmacist. Chris: Hi, guys. Bob: The smartest man I know. In fact, Brad and I were talking. We think he's a cyborg or something. So, anyway, we're going to talk about human growth hormone. Does it slow aging, increase height? And then we're going to talk about at least 10 ways to boost it naturally. So why don't we talk first about the possible benefits, Chris, of human growth hormones. What are some advantages? Chris: When you really look at growth hormone, from a prescriptive standpoint, it's really designed for about three generalized categories. If you're born of short stature, for a variety of different reasons, and there's multiple syndromes within that umbrella. Bob: Should be used with a child, right? Chris: Yeah, generally for childhood use. It's going to be used for the wasting of muscle in people that have HIV or AIDS, to help to kind of stimulate that and just kind of distribute some of the fat problems that are sometimes associated with HIV medications. And then really it's going to come down to people that have had tumors, things that mess up with the pituitary glands. So whether there's been some cancer or just something that's just simply not functioning properly. So those are really the real medical reasons why you would use growth hormone. Bob: That's as a prescription? Chris: Yes, as a prescription version. And there's a lot of non-prescription things and aspects that certainly go on. I mean, there's a reason why it's illegal in athletics and the Olympics. I mean, frankly, it works. Bob: And we talked about earlier how it's being used a lot in Hollywood? In fact, I read, nobody's coming out and telling you they're using it or anything. Chris: No, they're not going to tell you, but when you're 65 years old and you look like you're 45, something's going on. Bob: And you're ripped. So, I mean, there was some that admitted to it. It was Sylvester Stallone, well they caught him. Chris: Yeah, he got busted. Bob: Suzanne Somers did it in the book. Oliver Stone and Nick Nolte. And Nick Nolte, oh, my gosh, he looks like he should be using it. Chris: What a hard living. Bob: Yeah, hard living. But I had looked up a few too. I wanted to get your opinion on this. So advance loss of body fat. Chris: Yup. Bob: So enhanced muscle growth. Chris: Yes. It's interesting because growth hormone, that's the interesting thing when you look at athletes. A lot of times when athletes use it, they stack it with a steroid base. That's how they get the strength aspects. It creates more lean muscle mass, but it doesn't necessarily make you stronger. So it's kind of interesting. One of the reasons that drives that bus is they use insulin-like growth factor, and that's one of the things that helps with the development of muscle tissue. So it works, and it's a hormone. I mean, it's 191 free peptide chain of amino acids that's strung together. Bob: So an athlete probably wouldn't want to use it just purely alone. I mean, even illegally use it for strength. Chris: Not that we would ever recommend that an athlete would use that, Bob, but, I mean, if they were going to cheat, they would probably be using it with something else. Bob: Sure. So get your facts straight. Okay, next thing. Increased exercise capacity? Chris: Well, it's one of those things where growth hormone drives the bus in everything that we do, whether we're working out or whatever. It does so many other intrinsic things in our body. But for recovery rate, so, the Lance Armstrong's of the world. I mean, I think that's a pretty graphic example. Unfortunately, professional cycling has been wrought with, whether it's doping, whether it's HGH, whether it's steroids, and it really was all three, which is kind of interesting. Bob: You didn't have a chance, I don't think. Chris: You did not have a chance. Bob: You're leveling the field, unfortunately. Chris: And they had to be smart about it. But the reality of it is that it does speed up recovery and/or aspects of injury, it will help you to promote a faster recovery. But the weird thing is, and I couldn't find an exact reason, and I looked, it does increase, if you have more muscle mass, you would think intrinsically you'd be stronger, but they haven't been able to show that in laboratory studies. Bob: That's just so strange. Chris: A lot of these things, too, these studies were done mostly on short stature kids. So when we talk about some of the other things we're going to progress through to, they just noticed the good effects of the product on these children as they grew and aged and developed. And there are other doctors were making the extension of thought for people and other categories, as adults, as aging adults, as aging athletes. And so that's how a lot of these things ended up occurring. Bob: So I take it it's used fairly short term for children, or are these used for several years? Chris: Well, no. If you have a short stature child, whether it's premature birth, whether it was a tumor, whether it's one of the syndromes that they use it to treat for, they want to get it in there as quickly as possible, and then for as long as possible. At the end of the day for growth, you have a limited spectrum of activity, so when those bones fuse, you're pretty much done. But there's other superficial bones that grow, and then we can talk about, acromegaly and things like that which are side effects that can happen to adults when they're done growing, and you get the longer hands and fingers and feet. So those smaller bones definitely still continue to grow, which is unique and somewhat problematic. Bob: Yeah, I don't think it would be the desired effect you’re looking for. Chris: No, no. You don't want the elongated face, big jaw. Bob: So they also talked about possibly improved fracture healing and tougher bones? Chris: Yeah, again, it's a hormone, so we have receptor sites all over our bodies, and so it helps to stimulate bone growth. And so we know that for a fact. And when you're younger, and for obvious reasons, when we're growing, we want you to have more rapid bone turnover rate. Bob: So I wonder are they being used at all if they have someone that's not healing very well? And I wonder if it's used in that. Chris: I think probably more off label. I don't think you're going to see most physicians... Because they're dangerous, with growth hormones. So we'll touch on that as we go. Bob: We'll get into that, yeah. Chris: But, it's one of those things where, yes, it works. And so there's a reason why it's banned by the IOC. It's banned by MLB. It's banned by the NFL. It's banned NC2A. I mean, it's banned, but it does help. It does promote healing. It does help to enhance bone strength. It helps with the matrix. So it works with your body's natural systems. Bob: Now one thing we had in the title, does it slow down aging? And could you speak to that, Chris? Chris: Slowing down aging… Bob: Like living longer. Chris: Yeah, yeah, it does. It seems your appearance gets better. Your hair will be restored. You're going to have a better color. Bob: And that's why it's so popular in Hollywood. Chris: Yup, certainly for the aesthetic aspects. And then, actually, it's not just popular in Hollywood. It's one of the most abused things that they use it for, these youth spas in other countries. You can't get it in the United States, but you can get it elsewhere, or you can buy it online. But, I mean, it's one of these things. But you don't know what you're getting online, so you have to be really careful with that. And I can talk about a Chinese example if you want. But, nonetheless, it does seem to give you the appearance of youthfulness but it does not necessarily make you live longer because it can create a multitude of side effects, and it's quite unethical. Actually, it's technically illegal to use for that purpose. Bob: You have to tell us your good-looking corpse line. Chris: Well, yes. I thought we were going to talk about that side effects. Bob: Oh, okay. Sorry about that. Chris: But really, at the end of the day, a lot of people when their face is their business, looking good, looking young, looking well is kind of a key. But, with the risks that are associated with growth hormone use, it's going to end you faster. I mean, it's cancer, it's diabetes, it's thyroid problems. So you'll be a good-looking corpse. Bob: Live fast, die young. Leave a good-looking corpse. Chris: But look pretty. Bob: Yeah, so another one, restoration of erectile dysfunction. Chris: Yup, so because it's a hormone, it passes through the blood, and what they think that it does for that is the corpus callosum, which is what gives men an erection, it basically seems to allow the smooth muscle to function more effectively. That's the closest that we could find, inspires what they believe is why it works. But if you have more operational smooth muscle, blood gets in there better, and basically everything else works more effectively. Bob: And that, it's funny, they made references in one of those Hollywood articles that it's the love child of Viagra and Botox. It's working for both things. Chris: Yeah. I guess, whatever floats your boat, right? Bob: We'll talk about possible side effects coming up. But, yeah with everything, you pay a price. So how about stronger immune system? Chris: Yeah. It's strange. Growth hormone, again, it's wild. Our immune systems are very complex, so it's an aspect of immunity, but with all the other complexities that we have within there, we do show quite eloquently with growth hormone. Again, we find this with kids that were supplemented with it or adults that had some problem with their pituitary gland. We recognize fully that they're immune, they were not getting as sick. And so doctors are pretty, brought us a lot, and so they studied it. And lo and behold, it works within that immune functioning category, where it does help to minimize coughs, colds, and illnesses. But there's the downside. Bob: Interesting. But again, you're paying a price to get that. Chris: Correct. Bob: All right, decreased cardiovascular risk? Chris: Yeah, again, the hormonal aspects, and it has to do with the muscle functioning. Because growth hormone is something that's designed to, when we grow, it's what makes us get big and tall and strong and fast and develop from child to adult. Those muscles, I mean, you do kind of turn back the clock. So, I mean, that's one of the things that's so hard to argue against because you do see a lot of good positive benefits when we are supplementing with growth hormone. But the problem is, again, like I said, it's illegal. Bob: Well, let's go to the side effects. So let's talk about that. I mean, yeah, it's illegal unless it's prescribed for you. Chris: Unless it's prescribed by your doctor. Bob: In instances where you were talking about, HIV, or for a child. Chris: Well, it's muscle wasting, child short stature. But the downside of it is particularly with adults. So let's say you're a 50, 60, 70 year old, with some means, because it's expensive, so I always classify that as a side effect. There are very few insurance companies unless you have either a cancer or something, in fact, where it's a legitimate medical need. You got a pituitary gland that's not functioning properly, it's probably going to get covered by insurance. But for most of us that, let's say, you want to look better and then try and look a little bit more youthful, it's not going to be covered by insurance. Bob: What's the cost? Chris: Anywhere from $500 to $2,000 a month, so it's expensive. Bob: Yeah, there's a lot of people that pay that price. Chris: I would call that a side effect, but there's some people where money is simply just isn't an object. And so when we talk about the Hollywood crowd, I mean, they live in a different world than you or I probably will ever know. Bob: Right, right. Chris: But they have all sorts of fun toys and things that go along with that, I think. But the realistic issues that we see particularly in adults that are trying to gain advantages to look youthful when we use growth hormone is it can increase the risk for diabetes. It can increase, ironically, with the cardiovascular functioning, it can actually increase your risk for other heart abnormalities, so it's kind of a double-edged sword, and I think you see that more with the aging. Thyroid cancers are most common, but it can be other cancers, even skin cancers. So it's any type of, and, actually, to go back to children that are actually using it, let's say they had a cancer that initially caused the problem to begin with. Secondary neoplasms or secondary cancers are I don't want to say a common occurrence, but it definitely is more prevalent in the people that have to use growth hormone. And so when the doctor makes a very conscious decision to approach this, for any human being, they're trying to weigh out these risks and benefits. And no matter what drug I talk about, every drug on Earth is going to have the positive and the negative. Bob: Exactly. Chris: I mean; the good aspects of a drug are still side effects. They just happen to be good, so nobody really considers it. The bad aspects are bad, and obviously with things like growth hormone, like we're talking about today, you become... You're a healthy adult. Otherwise you want to look better, you use it, and all of a sudden become a Type 2 diabetic. Bob: And this is all enhanced by the fact of you buying an illegal version of it. Who knows the quality of it, correct? Chris: Correct, I mean, it comes down to, like anything else, is knowing your sources, reputable sources. And, again, it would be something that if people were to go down that avenue, you'd have to be very careful. If you're finding after you've made a purchase like this online, there's a pretty... I've looked at the FDA site, and actually there were several products that came through China, which seems like most things do, and they were just amino acids. They were lyophilized amino acids. You reconstitute it with whatever solvent they have in there, and you inject it. And so they're promoting it to be growth hormone when it was actually just arginine. Bob: We'll talk about that. It's actually one of the natural ways. Chris: We'll just talk about the amino acids. But it's something that certainly isn't going to give you that punch, so to speak, to get what you're looking for. But the reality of growth hormone, and, I mean, I've looked at the research for over 25, 30 years, is it works, but there's a cost, and then there's a pretty heavy cost at times. Bob: Yup, and you won't find out the cost sometimes till years later. Chris: Well, it's still too late. Bob: Yeah, it's too late. Chris: I guess if you have a doctor that's prescribing it, and you're paying for it, and they're watching for it. I mean, if you're an endocrinologist, and you're a specialist, I mean, clearly they know what they're doing, and maybe it's going to be used in cycles rather than just chronically using it all the time, giving your body a little bit of a break to kind of recuperate. So I think there's different ways that you can apply it, which is an injectable product. That's the other thing, too. Anything that you buy online that's not injected is not real human growth hormone. It's only injectable. Bob: Right there, that rules it out that if it's online. Chris: Yeah, if you're buying a tablet or a spray, it's not growth hormone. Bob: Yeah, it might be something that might help a little bit, boost it, but it's not. Chris: But, yeah, it's buyer beware, and it's the wild, wild West when it comes to that, and we'll touch on that as we go into it. Bob: Well, let's talk about some of the natural ways to boost them. Chris: Absolutely. Bob: So sleep. Chris: Yeah, it's going to be sleep, diet, and exercise, are really the big pillars. And I talk about this all the time. Bob: Can't get a waiver in that, can you? Chris: No, I can't. I'm a boring guy, Bob. I just am. I'm shallow. Bob: It's fine. It's just you want to lose weight; you have to exercise. Chris: You need to exercise. Bob: You need to diet. Chris: You need to eat well. Bob: You need to eat right. Chris: And you need to get your sleep. Bob: Sleep, yup. Chris: I mean, and those three things actually do all stimulate naturally your pituitary gland to produce more growth hormone. So if we want to just start with just sleep, which I think is... America, and we've talked about this in one of our last podcast, is that America doesn't get enough sleep. So if you aren't sleeping. Bob: Yeah, it used to be a badge of honor for a lot of people, like, "Oh, I only get three hours of sleep a night." Chris: Yup, and that's not something to be proud of. It's just some people can function that way, and some people can't, but it's one of those things where studies show, and they're right, and doctors know, and they're right, that seven to nine hours of sleep, seven to 10 hours of sleep, is where we really need to be. Bob: For the average person, and you could be one out of a thousand people that can get by with much less. And you really must not need it, Chris, because you'd crash. Chris: I have problems, just ask my wife. But no, I mean, the reality of it is it really is important to try and get as much rest as you can. It releases through the sleep cycle. So we have anywhere from four to six cycles of sleep that we go through, and the heaviest burst of growth hormone occurs at that first cycle of sleep. So when you get to that deep restorative stages, so they call it stage three, that's where your slow-wave sleep occurs. That's also when your pituitary gland starts to kick out that growth hormone, and that's where all of our healing processes occur. I mean, growth hormone, even though we're adults and even though the amount diminishes particularly after adolescence and really diminishes after 30, it's still important for all of our metabolic processes. It's why our muscles still remain firm and strong. It's why we tend to keep fat under control. It's why we try and keep our diabetes under control. It's why our bones regenerate. It's why our cognitive functioning is the way that it is. So there's a variety of different reasons, and it's all good. But as we age, our bodies are designed to accept lower amounts of growth hormone, and that's probably what, when somebody lives to be 90, 100, 105 years old, the reason that we're probably living longer without those problems, one, they have a genetic disposition. Let's face it, they probably did a few things right throughout their lives, whether they focused on their diet and exercise or not, or they're just naturally, they just gravitate towards it. But, I mean, endocrinologists are going to tell you that when we supplement with growth hormone and the reason that we end up with Type 2 diabetes or we end up with thyroid conditions, I mean, these are all things that are very, very important for other processes in our bodies, and when we inject the growth hormone into our body, not your hand, really, it's going to go in your muscle, but you're going to ruin that whole process. So as you're gaining certain things, so you're going to look more youthful, your collagen kind of fills, and your muscles fill out, so all those good things happen, but there is an operational cost, and so we have to be super careful with that. Bob: So how does melatonin play a role in this? I was reading about bright light and melatonin. Chris: Yeah, well, melatonin's a unique substance that our bodies make. It's a different gland in our body, the penal gland, another lower-base brain. Yeah, so next door to the pituitary, really. There's not that much space in there. So but the reality of it is, is that melatonin is what governs our sleep and wake cycle. And what they've found is that when your melatonin levels are up, we get tired, so we get some sleep. So it all goes back to that first sleep wave. So sleep, again, the pillar of fitness really is sleeping. Bob: But when you have plenty of melatonin, you're going to sleep well. Chris: Yeah, and even taking melatonin you have to be careful with too, long term it creates problems. Bob: Yeah, you take it, and your body stops making that, right? Chris: It doesn't work as efficiently, yeah, about two weeks. And really all melatonin, by all medical standpoints, should really only be used for a couple of weeks and be for people that for example travel for a living. Let's say you're going from the United States to Europe, although they're probably not right now. Bob: Shift work, maybe. Chris: shift work. I mean, those are going to be the things where you have those approaches, where you have to kind of get your body reset back and forth, back and forth. Beyond that, it has its own side effects. But we know that when you take melatonin, it's a hormone itself, and it also helps to stimulate the production of growth hormone by a pretty large margin, and in some studies they say even 45 to 150%. So that's a large amount of growth hormone depending upon the tracers and indicators that they're looking at. It's dose dependent as well. But, again, it's probably something, when we look at this ethically, I mean, how much do we, I mean, do you want to live longer or do you want to look better? Or is it somewhere in between? Bob: Well, you touched on earlier, too, before the podcast that people possibly could get too much growth hormone. We don't know. Chris: Well, we don't know, but you see examples. I mean, there is a set dose that doctors have researched. I mean, it's been around. We've been using synthetic growth hormones since the '80s. And so the reality of it is we know the dose one was required. It's just the negative aspects of it when we're going off the rails is what you have to watch for because there are very real, very serious risks. So melatonin for before bedtime. One of the best foods on Earth to stimulate melatonin is pineapple. And it also stimulates growth hormone. Bob: We talked about that. Chris: So and then raspberries are right there. Cherries are right there. Bob: So you need to eat it right before bedtime, though. Chris: That's what they say, which is funny because one of the biggest killjoys for growth hormone production is sugar. And when we're talking about the glycemic index, which is going to make people yawn and go to sleep, but it's a medium range, and the sugar, it's not high, but it's still more sugar, and every article I've ever said is that sugar cuts down the production of growth hormone. So it was interesting to me. So it has something to do, I think, more or less with how it stimulates melatonin, which probably then in turn within that cycle stimulates the growth hormone. So for whatever reason, I mean, getting your sleep, pineapple seems to be a trick. I don't think I would eat an entire pineapple before bed but you could probably try a little bit. Bob: Awesome. This is probably not going to be very helpful to people, but one way to increase growth hormone, isn't it you decrease body fat? You can manage your insulin, decrease sugar. Like, all the things you'd want to do anyway. Chris: Correct. Bob: And so it's not really helpful advice for increasing your growth hormone. Chris: No, but it's really one of those things that you always think of food as a way to stimulate things. Well, intermittent fasting is another way to consider, and actually it's one of the bigger drivers of the bus, and it's a pretty simple procedure. So there's different ways to do intermittent fasting, and I think there's several ways on the internet you can certainly look at. It seems to be relatively trendy. So depending upon which way you want to do it, but, I mean, you sleep overnight, you're in a fastest state to begin with, so if you push back your meal. Bob: That's a fasting in itself. Chris: Exactly, and so your body is like, "Well, gosh, I need energy," so it goes into those fat cells, it breaks them down. And fats are the best energy source, so it breaks it down, like polycysts, and so basically at that point, your body's breaking down fat, and you're getting energy, and off you go. Bob: I think it’s a good point to be brought up because my first thought with fasting was like, "I'm not going to eat for two days." And I wouldn't do that. Chris: I think that's what we need, and I couldn't do it either. Bob: So I don't know the guidelines or I haven't seen them, but what are they talking about, like eating your last meal at four or five o'clock, something like that? Chris: Well, to make sure you maximize growth hormone production, you don't want to eat within two to three hours of going to bed. Everything that I've read, that's kind of seems to be the big thing. But there's different ways to fast. So, I mean, there's ways where you can just have two days a week where you just have like a five to 600-calorie-a-day diet, and all the other days you eat normally. So you just space them out. So let's say Monday and Thursday are the days you're not going to eat as well. Bob: So you cut it down. Chris: Otherwise, it's pushing back, you just eat just in a window. So there's eight hours, and you eat all within those eight hours. Bob: Oh, sure, eight-hour window. Chris: But, I mean, you become satiated after you eat, so, I mean, you're not necessarily going to eat three hours after that. There was some study, there's the small, tiny meals. So there's a lot of different ways that people can try it. Like I said, I guess if you're interested in fasting, I would talk with your doctor because you just want to make sure that it's right for you. I always stress that. But the reality of it is, because your body doesn't like being hungry, we have reserves. I have plenty of reserves right around the middle, so I'm sure that if I were to fast, it's going to definitely help to improve and drive the fat burning, and that's what creates the lean mass, and that's one of the, again, one of the attractive aspects of abusing growth hormone. Bob: Do you want to mention, there are a bunch of amino acids. You can get through food, ideally. Chris: Yup, arginine, glutamine, ornithine. There's 20 amino acids, but, there are some that it seemed to be better than others. Usually when we stack them together, this seems like arginine and ornithine seemed to be the best two in so far as what we've seen with synergy together to help stimulate more growth hormone production. Bob: Arginine found in red meat, seeds, nuts, chicken, brown rice. Chris: Yeah, it's in a variety of different things that we eat. Bob: You can look it up. Chris: So the reality of it is, is that when we're eating naturally, you're going to gain these things. Actually, and if you eat lean red meat, and specifically grass-fed beef versus, I guess, when they're eating more of the grains and other things to fortify and fatten them and make them taste better. But I think, honestly, I prefer to tend towards lean cuts myself. I do like grass-fed beef, it's just a leaner cut of meat, but it's really can be even classified as a superfood because of all the other health benefits that you get from it. There's not a lot of fat. You get an excellent protein quantity because of the amino acids that are in there. It's because of arginine and ornithine. They are the ones that are going to help to stimulate that growth hormone surge to help to replenish and heal those muscles and help with all those cellular processes that they work to improve on. Bob: Now even the vegans or vegetarians, you can get through seeds and nuts. Chris: Well, seeds and nuts. No, I mean, they can do this too. Bob: All right, I completely understand that too. And ornithine is about the same thing, right? Chris: Yeah, I mean, you can get supplements that are purified. You can just go onto amazon.com. You can go to health food stores. So you're going to find these type of amino acid pairings. I mean, there's glutamine and there's other things too besides amino acids that you can use. And then it seems like the amino acids are the big thing, but I mean, if you think about an amino acid, they're the building blocks of life. They're proteins that help us to develop other proteins and other cellular processes. So the growth hormone is driving the bus and everything. Even as we age, we just don't use as much, but it's still helping with our bone turnover. It's helping with our muscles, fat distribution. It's what's actually, believe it or not, if we eating a healthy diet and staying active, it's what's preventing Type 2 diabetes from developing. So they're all critical. Bob: Well, I guess if you were going to summarize here, you definitely would never want to use the illegal substance because you don't know what you're getting. Chris: Well, no. Bob: If you need it for some medical reason, you're going to go through your doctor, and otherwise you're going to try these natural ways to boost it. Chris: Yeah, well, and the other thing we didn't really touch on really was high-intensity exercise training. Bob: Oh, yes. Yeah. I missed that too. Chris: So exercise is that other pillars. So we're talking about food and supplementation. We're talking about sleep. We have to talk about exercise, and specifically interval training. And so probably one to two days a week, not any more than that because obviously when we're doing these very high efforts, and these are efforts when you're very uncomfortable, where you can't hold a conversation, that's the level that you need to be getting your heart rate up to. Bob: It's short length. Chris: Short bursts. Bob: Oh, yeah. Short bursts. Chris: You're talking 30 seconds to a minute, five to 10 times throughout a workout. Bob: And the rests can vary. Chris: Yeah, so whether it's Tabata intervals, whether it's skipping rope, which I just did that actually yesterday, and it just, it hurts. Bob: Yeah, it does. Chris: It's a fatiguing burn. But those studies show that your body does go into a, because of the way that it's metabolizing things, it's that anabolic effect and breakdown, it's helping to release that growth hormone to heal, get more lean mass, and try and pack on some muscle density. So, I mean, it does naturally induce that so that we can become stronger and more lean, more fit. Bob: Definitely going to help you lose weight too. Chris: Yup, and be healthier. I mean, actually, I mean, HIIT training to me is the way to go. Brad and I, your other dynamic duo person that's not here with us right now, every Saturday, whether it's in the pool or on the bike, depending, weather dependent, we do a series of intervals that, I guess if you ask me, I would call it brutal. But Brad has fun, but he has fun with everything. Bob: He's only got one gear. Chris: Yes, he does, and he's got the burst, I'll tell you. Bob: It think you're along with him though, too. Chris: Well, we're both kind of crazy. Bob: I think we'll bring it to an end there, Chris. Really good information again. You just always amaze me with your knowledge, so thanks again for being on the show. Chris: Absolutely. Enjoy it. Bob: And we'll keep her rolling. Chris: See you next time. 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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 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 for Hip Pain: 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 Side or Lateral Hip Pain (Greater Trochanteric Hip Bursitis, Hip Arthritis, IT Band Syndrome, Tensor Fascia Lata TFL Pain): Option One: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either in front of the other pad or behind the other pad (at least a pad’s width apart). Option Two: Use one channel and two pads. Place one pad (either one) in front of the pain and one pad behind the pain or place one pad on each side of the pain. Use of two channels and four pads for side hip pain. In our examples, channel one has yellow pads and channel two has green pads. Option one: place one pad from channel one behind the area of pain and place one pad in front of the area of pain. Place one pad from channel two on the right side of the pain and another pad from channel two placed on the left side of the area of pain. This arrangement forms a cross pattern. Option two: 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. General Guidelines for Front Hip Pain (Hip Arthritis, Hip Flexor Pain): Precaution: If you place an electrode pad directly in the groin it may be disrupted with sitting, walking, movement, etc. Option One: use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either in front of the other pad or behind the other pad (at least a pad’s width apart). Option Two: use one channel and two pads. Place one pad (either one) in front of the pain and one pad behind the pain. Or place one pad on each side of the pain. Use of two channels and four pads for front hip pain. In our examples, channel one has yellow pads and channel two has green pads. Option one: place one pad from channel one behind the area of pain and place one pad in front of the area of pain. Place one pad from channel two on the right side of the pain and another pad from channel two placed on the left side of the area of pain. This arrangement forms a cross pattern. See Photo for Example Option two: place 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. See Photo for Example General Guidelines for Pain Referred from Another Area: An example would be hip pain that is coming (referred) from the back. Using channel one, place the two pads along the nerve pathway. See Photo for Example 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. Side Hip Treatment: Hip Flexor Stretch, Figure 4 Stretch 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 January of 2021. For the original video go to https://www.youtube.com/watch?v=l2aIKP-aWWQ&t=107s Bob: Today we're going to show you some easy exercises to help hemorrhoids. Yes, believe it. This helps hemorrhoids and I'm going to actually sacrifice myself here, Brad. I'm going to admit that I had hemorrhoids, and this has helped my hemorrhoids. Brad: Say no more, Bob. Bob: Now I'm going to just go and warn you right away. The language is going to be a little bit graphic at times on here. We're not using blasphemy. We're just using descriptive words. So we're going to be talking about the genitalia and stuff like that. Brad: It's all professional. Bob: It's all professional, yeah. So what we're talking about here is Kegel's exercises. Arnold Kegel. He invented this in the fifties and it was really done mostly for urinary incontinence but I saw a bunch of articles, Brad that it does help hemorrhoids. It gets more blood flow to the area. But in my case, I'm going to get a little graphic here but it firms things up so things don't droop as much. Brad: Around the anus. Bob: Well yes, because you're strengthening the muscle of the pelvic floor. Brad: Sure. Bob: And the pelvic floor is made up of the superficial level and a deep level. But when you do this exercise you're strengthening both levels. Brad: Sure. The pelvic floor, I envision them kind of flat like a pancake or like a diaphragm. And it literally is the pelvis floor that keeps things supported so that your visceral organs stay where the need to be. Bob: Exactly. It's like a netting down there. And you know, it's horizontal just like the diaphragm. In fact, I think it's called, there's a name where they call it something like the diaphragm. Brad: The bottom diaphragm? Bob: Yeah, something like that. Seriously. Brad: Inferior diaphragm? Bob: Well, if not, we just made that up. So if you want to strengthen these or we're going to give you hints on how to do it. What you're going to feel is like a gentle gathering of the pelvic floor muscles. You're going to contract and lift them up. You should feel like you're including the anal sphincter. Like that should be moving up. With ladies and men too, in fact, we're going to talk about this later, you want to feel like the perineal body is lifting up. The perineal body. What is it, Brad? You want me to tell them? Brad: Yeah, go ahead. Bob: It's the area between the anus and the vagina for women and the anus and the scrotum for men. So it's really, we'll talk to it later how you can actually palpate that and feel it moving up. Brad: So I'm assuming this is preferred in the seated position. Bob: You could do it lying down. You could do it seated. In fact, it's a good thing to progress. Like start lying down. Then you could even do it in a quadruped position. Brad: On your hands and hands and knees. Bob: Hand and knees. You could do it in a seated position and they should do it standing. The whole thing with this, you should continue to breathe normally while you're doing this. People should not be able to tell that you're doing this. Brad and I could be doing it right now and you'd have no idea. Brad: Assuming you've practiced it. Bob: Practice, and you know what you're doing. With men, you may actually feel the base of your penis lift up and possibly your testicles as well. You know, we'll get into all the cuing that goes on. What you shouldn’t feel is you shouldn’t feel other muscles contracted, like the glutes. Brad: You should or you should not? Bob: Should not. They should not. You're trying to focus on the pelvic floor. You shouldn't feel the inner thigh. You shouldn't feel the abdominal muscles contract. Brad: So if you're straining and tightening everything? Bob: Yeah. You know and I've seen some other channels where they were actually promoting that. And I was like, you know, I don't think that's right. Brad: That's not along with this? Bob: Kegel's, yeah. Brad: It came out of a book or two books, you said? Bob: I've read a couple of books on it. Brad: Sure. Bob: Don't hold your breath. You should be able to talk. Don't tense, anything up in your face either, your eyebrows or shoulders, biceps. Brad: It's just one of those things on isolating muscles. I mean, we do this with people, with your abdominal muscles try to isolate that for pelvic position. A lot of these areas of the body are very difficult to isolate or it's just not a normal thing. It's not like moving a finger, you know? Bob: Yeah, I think that's a good point to be made, Brad. You can voluntarily control the pelvic floor muscles. But it's also got an added automatic component to it. It's going to automatically work at times when you're lifting or you're carrying something, you know. Brad: I compare it to your breathing muscles. I mean, you can voluntary control your diaphragm and your breathing. But at the same time you don't have to think about it and you continue to breathe. Bob: It's going to keep going. Hopefully, thankfully. So these are the common cues, and this is probably the most important part of this, is for women, you're going to squeeze and lift the pelvic floor. They tell you, you want to tighten up like you would like to stop the stream of urine. But they don't want you doing that. They don't want you to just start going and then stop. Brad: Not literally? Bob: Not literally because you could develop a urinary tract infection and it can mess with your reflexes, I guess a little bit, your urinary reflexes. So yeah, you want the feeling like you're stopping urine but not actually doing it. And another cue is you can make it feel like you're lifting and holding something in your vagina. You can also squeeze, like you're trying to hold in gas, which Brad and I know quite well. You know you're afraid to let one go, you're among company so you tighten up. Brad: Flatulence, Bob. Bob: Flatulence. There you go. Brad: I got to put some professionalism in there. Bob: That's right. So the other thing you can do, and you can't see this on a podcast, but you can actually take your sit bones. That's the bones that you're sitting on. You can feel right when you're palpating. Brad: Or if you're sitting on a hard surface… Bob: Like bleachers. Brad: Yeah, you rock back and forth, you'll feel those sit point bones are making contact. Bob: Yeah, now with those sit bones, what you want to feel is like you're pulling them together. That also helps raise it up. So now this is interesting, Brad, they only had one cue for men and they did a study on this. They had a bunch of cues for men, but the one that worked was this one. So you're supposed to shorten your penis. Brad: Bring it in like a turtle. Bob: There you go. Like a scared turtle. Brad: I think most guys could relate. Bob: So, it's funny. People, men really seem to latch onto that and it worked for me. Brad: So the whole idea is we're contracting those muscles and you said, it's going to increase blood flow for the hemorrhoid. Bob: So they can heal better. The other thing, a lot of people with hemorrhoids they sit on the toilet too long. You know what I mean? And everything starts to get slack. This is year after year. Do you know what I mean? Brad: So you shouldn't be reading or looking at your cell phone. Bob: You really shouldn't. You really shouldn't. Brad: Get on there, get your business done, and go. Bob: That's what you're supposed to do. Otherwise you’re just stretching things out. You know, you're letting things sag. And so this helps tighten things up here. So... What are you laughing at now? So we're trying to keep this as serious subject because you know, hemorrhoids are an issue. Brad: Oh right. I've never had them. Bob: Well I had them, and it's not fun. Let me tell you, so. Brad: You know, this is one of those things that there are therapists who have taken courses on this and become certified, and they have actually some tools that are specifically made for this. Bob: Yeah. Feedback tools. So if you are having trouble, seek out a therapist that has expertise in this area. Some of the larger hospitals generally have someone dedicated towards that. But I think what we're doing here, I think for some people, it's going to help. Bob: Oh! My wife picked up right on it. I mean, she was able to do it right away. In fact, she hardly even listened to me, I think. Because she was doing it. But this is how you can actually feel it, Brad. If you want to try to feel it. You can actually take a piece of toilet paper, small piece and put it by your anal sphincter, do the exercise, and it actually kind of picks it up a little bit. So, I mean you got to put your finger on the anal sphincter. Brad: Sure. Oh. Yeah. Bob: All right, Brad, keep serious here now. Next one, the perineal body, which we already recommended. I think this is the best cue of all, Brad. So again, the perineal body. It's the area between the anus and vagina or the anus and the scrotum. Put your hands there. Obviously you do this in private. You could be lying on your back and you put your hands there for feedback and if you're doing it right you're just going to feel it gently lifted inward. Brad: Feel some motion going inward. Bob: Up, yep. Brad: I can see where lying down would be a good place to start that. Bob: And men, one more one, you might actually see the penis lift up a little bit when you're doing this. If you're doing it right. Brad: Not if you got your pants on. Bob: Not if you got your pants on. No. You know, you'd have to check it out. You know, one of those things where, and don't send us any phone videos of this stuff. All right. So repetitions, you start off probably like eight to 12 reps. You're going to hold it for 10 seconds. Brad: Boy, that is a long hold. That's work. I mean, especially to get started. Bob: Yeah. Brad: But that's what they recommend. Bob: It's not really hard to hold it. I didn't think so. Yeah. You can do that three times a day. Eventually, they said you want to work up until like a hundred reps in a day. Brad: So how many reps? Hold it for 10 and do it 10 times? Bob: Yeah. Eventually, over the day. And the other thing is, it is a fast twitch and a slow twitch muscle. So you can do the hold one, that's slow twitch. But if you want to do fast twitch, you can actually tighten and then relax, tighten, relax just for a second. Brad: So did they give any statistics on people who do this on success rate? Because I mean, you don't have to do this for the rest of your life, do you? Bob: No, no, but I'm sure you know for women and incontinence and for men and incontinence you might have to do it in the rest of your life. It's not like it's a big burden, Brad. Brad: Sure, once you get used to it, but I mean a hundred times a day, or do you get to relax often? Bob: Yeah. I don't know on that. I find it can be very helpful with urinary incontinence. It can be the difference between you having trouble and not having trouble. I mean, there's a reason it's been around since the fifties. I mean, it works. Give it a try! Brad: Good luck. Bob: Thanks everybody. 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 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=rCcznN6FHqQ Bob: Today we're going to talk about, I did, that's me, The Wim Hof method for Stress Reduction, for two months. And this is what I found. I'm going to reveal today what it has done for me. Brad: Wim Hof is a name of a person? Bob: He’s Dutch, and he’s known as The Iceman. We'll tell you some of his accomplishments, it’s pretty amazing. He's got many Guinness World Records Brad. Brad: Yeah, I actually saw a video of this guy. I've read a little bit about him. Bob: It's amazing. Brad: Yeah. Bob: I mean, it seems impossible. Some of the things he did, so he's got the record for swimming under ice. 188 feet. Brad: Without a wetsuit? Bob: Without a wetsuit. Brad: No dry suit. Bob: No. He had the camera on the first time, he was just trying it, and his eyes froze over, his eyelids. He was blind. He couldn't find his way out and he had to be rescued. And then the next time he did it, the same day yet, he still went 188 feet. Brad: So the water is what? 40 degrees or something like that. Bob: I think its freezing. Brad: Or was it 32 or was it salt water. If its salt water, it could be even colder without freezing. Bob: Yeah, I'm not sure. Brad: We didn't get in that into detail. Well one way or another that guy is amazing or he's got some issues. Bob: I'll give you a few more Brad. He’s got the fastest half marathon. He did this up in Antarctic, I believe with no shoes, no shirt he wore shorts. I mean. Brad: What was the temperature? Bob: You know, what is in Antarctica? Brad: Maybe they have a summer that gets a little warmer. Bob: No, no. He was in snow. It took him two hours and 16 minutes and 34 seconds. Brad: Wow. Bob: But yeah, nothing but shorts. Brad: Just shoes. Bob: No shoes. Brad: No shoes? Bob: Yeah. Brad: I'd like to see what his feet look like. Bob: This seems impossible, doesn't it? Brad: I bet we could look, someone could probably Google this and they'll see pictures and maybe some video footage. Bob: Yeah. There's a documentary out him. So you can watch that. There's the longest time that he had direct full body contact with ice. And that was an hour and 53 minutes. I guess it's been broken now by other people now. But could you imagine sitting the ice bath for an hour and 53 minutes? Brad: Like water filled with ice cubes and you submerge yourself? Bob: Yeah. Brad: Like to the neck. Bob: Yeah, to the neck. He can keep his body temperature the same. He just has that ability. Brad: So they're measuring it sublingually. Bob: Yeah, they actually did test it on him. So this is the one that's pretty amazing about his immune system. So he purposely injected an endotoxin that normally makes you sick. It will cause nausea, headaches, inflammation, vomiting and nothing happened to him. He just, with his mind pretty much controlled it. He didn't get sick at all. Brad: Why would you do that to someone anyways? Bob: Well, they wanted to show... He wanted to prove that as immune system and they did it. So you think, okay this guy's a freak of nature, he's got, but no. So he can teach people how to do this stuff. Brad: And it has a lot to do with breathing techniques. Bob: Breathing technique and yeah, they do mindfulness. He's got a three system, three pillar system. But these are the things that his website says it’s supposed to do: it's supposed to boost your immune system, increase your energy, relieves stress, improve sleep, increased willpower, relieve some symptoms of depression, increases concentration, improves your overall mental wellbeing. So again, there's three ways to do this. Brad: Wait. So if you get into this, does this mean you’re jumping into water or you're going to jump in an ice bath and you're going to do all these things? Bob: Well, you know, this is how he recommends it. First he's got the breathing part of it and these are breathing exercises and they last... You can probably do it about 15 minutes and you can go right to his YouTube channel and he's got great videos. Great visuals on how to breathe. And you breathe in and out for like 30 times then you hold your breath for a minute. And right when you're done, you hold it for another 15 seconds. Brad: Did you do this? Bob: I didn't it. Brad: Did you get dizzy? Bob: I never got dizzy but people can get dizzy. And he warns you not to do it in the shower, not to do it anywhere if you're not lying down or sitting down because you could get dizzy and fall over. Brad: And he actually learned this technique from some people? Bob: I think it's a mishmash of things over time. I don't think its specifically in one place. Brad: Cause in that book, Breathe, they referenced him and that he did with these with people from, I'm thinking over by India. Bob: Yeah, I think it was India. Brad: The Buddhists? Anyways, that's a side note. Bob: So the breathing, he does have a program you can purchase but I'm thinking you don't need to do it. I didn't. Brad: You maybe that's why... Bob: Yeah, yeah. We'll find out. The only thing I was missing, he's got some yoga stretches and stuff like that. I do a lot of stretching already. Brad: You know how you would do with yoga sometimes. Bob: Yeah. So anyway, the breathing exercises, definitely had that down. I was doing that. The cold exposure. What he does is he has you start with cold showers. So you start with a warm shower and then you finish with a cold shower. And the first time he made me only 10 seconds or 30 seconds and I was up to a minute and a half. Brad: Of cold? Bob: Of cold. Yeah. Brad: But you started warm. Bob: I started warm and I'd go with that last minute and a half. I just say, this is just the shower, tough it out. Brad: Did you have a little timer or what? Bob: I had a little timer. Brad: Right in the shower with it? Bob: Right in the shower. Brad: A waterproof one? Bob: Yeah a waterproof one. And you know, it's funny when I'd get out of the shower, you know, normally if I get all the shower, now I'm cold. But if you get out of the shower after you had a cold shower, you actually feel pretty good. So it definitely wakes you up. Brad: Yeah, I believe it. Bob: And then he had a mindfulness meditation which he kind of just did with the breathing. The same breathing state. Brad: Mindfulness? What do you mean mindful? Bob: That's all meditation. You're trying to be in the moment. Brad: Its the mind. Bob: And I know a lot of you have problems with this. You know, I do transcendental meditation and a lot of people were upset about that that I was leaving the devil in. And believe me, the last thing I'm thinking about is the devil. So anyway, so I did the breathing, the cold exposure like I said, it was up to a minute and a half. I think he actually has you eventually go up to like five minutes but I get a lot of outdoor cold too. In fact, one day I ran out. I ran in shorts to see what it's like. It was 30 degrees or less than 30. Brad: Did you have short sleeves? Bob: I had a short sleeve shirt on. You know, I get hot when I run. So first I should say I am the least person that likes the cold on earth. I hate cold. I hated it all my whole life. My hands get really cold easy, my feet. So that has improved without a doubt I can handle the cold better. Brad: Sure. Bo: Without a doubt. But as far as my immune system, who knows. I don't know if my immune system's better. I mean, I've not been exposed to anybody. Brad: Oh, you're healthy, right Bob? Bob: Yeah, I'm healthy. Brad: It's probably better than... Let's be optimistic. Bob: The breathing, the sleeping, you know I felt like the transcendental meditation helped me more than anything else right now. So I'm going to continue doing that. Brad: I think you have to take the program. Bob: Maybe you do. Brad: Sometimes you take a program, they explain it better. But maybe not, I don't know. Bob: He's got a lot of information on his channel. I think you get a pretty good sense of whether or not the program would work for you. Brad: Well, Bob let's look at it this way. If someone watches our shoulder program through the video, we do a pretty good job. But if they come to us directly, it’s probably better. Bob: But our shoulder program is free. I thought you were comparing our shoulder program to just one video? Brad: Well, no, it just a video in general. You're going to learn a lot but in person you might get more out of it. Bob: I'm not going over to the Netherlands or whatever. Brad: Oh, you have to actually go over there. Bob: If you want the program. There is an online program too. Brad: I'd like to go over there and maybe take it. Because otherwise I'm not doing all that stuff. That's cold. Bob: I mean, you start off and then you finish off by climbing up this mountain with your shirt off and shorts. Brad: Well maybe if I had shoes on. I'm thinking, I don't know anymore but at one time in my life, I'd say yeah, let's do it. Now I'm thinking maybe not. I've swam in very cold water without a wetsuit. Bob: Oh yeah. Brad: I had to for a triathlon, you either swim or you can't go. And it's dang cold. You got an ice cream headache because the water is hitting you in the forehead. By the time you get done, you're so numb. It doesn't feel so bad. You get out and like you say, you feel pretty darn good. Bob: You feel good when you come out. Brad: It’s like, Whoa, it’s not so bad. Bob: I'm getting so much cold exposure. I ran this morning out in the cold, but I had plenty of clothes on. It was it was -10, -15, below with the wind chill. And I felt good. I mean, I felt, I wouldn't want to be any colder. It was probably at the limit of where I'd run outside. But I just don't want to do the cold showers. You know what? I only have so much motivation. And if I deplete my motivation on that cold shower, I'm not going to be able to do something else during the day that I should do. Brad: We might have some people watching that are experienced with this and actually are really successful with that maybe. Bob: There are people that love him and I don't disagree. Brad: But they could maybe give you some hints on maybe what they've discovered. Bob: Sure. Brad: Maybe there was something that you missed. Bob: That I missed out on. Brad: You never know. I think it's one of those things that could be different between individuals, how you experience it. Bob: It can and there's some talk about people with rheumatoid arthritis and AMS. Brad: And they got better? Bob: They were on meds and they got off the meds. So there's a lot of stories. There's no doubt, I think it does boost your immune system too. I really do well. Brad: There's got to be something to it if this gentleman could climb a mountain and run and go under water. It’s amazing how he could not have hypothermia. Bob: I know it's crazy. Brad: Unbelievable. Bob: It's nuts. So, check it out. He's got a website. He's got videos on YouTube. He's got a book. So I have nothing against Wim Hof. I think he's a great guy. I just... I'm not going to do cold showers anymore. Sorry. Thanks. 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