Taking Care of Your TENS Pads. Make Sticky Again & Last Longer. Are They Worn Out? Every TENS unit comes with adhesive pads or electrodes. The pads deliver the electrical current or impulses from the unit into the skin. Your TENS pads should last for 20 to 30 uses. A sign the pads are starting to wear out include if your pads are no longer sticky or if you are feeling excessive pins and needles sensation upon using the pad. If this is the case, first try cleaning the pad with a moist cloth as there may be dirt and oil on the pad. Do not use a paper towel which could leave a residue. Also, before each use, clean your skin with gentle soap and water. This helps remove any of the natural oils that may take away some of the stickiness on the electrode pads. After each use, the pads should be placed back on the plastic piece from which you originally got it. Once the pads wear out you can purchase new ones separately. You can replace the old pads by simply detaching them from the leads (wires). If you find you are purchasing a lot of pads you may want to consider joining the iReliev Dollar Electrode Pad Club to help you save money. 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 August of 2019. For the original video go to https://www.youtube.com/watch?v=EO0Z6YB51ek&t=119s Bob: Alright today, Brad, we’re going to talk about five big mistakes people with bad back pain make. Brad and I have been working in the therapy business way longer than we want to admit. That’s the gray hair and wrinkles. But over this period of time, these are the mistakes that we see people commonly make, especially when they have severe back pain. So, we’ll go over those. Number one, people think their back cannot heal. Let’s talk about when people come in, especially if they’ve had back pain for a long time, Brad, they have it in their head that their back is very delicate. Basically, they also believe that it’s unable to heal. Now, the body has an amazing ability to heal itself. We’ve seen this again and again. All you need to do, is create an environment, so it wants to heal and you’re not making it worse. Two, you may want to do some other things like exercise in order to promote the healing, and you get more blood flow to it. Brad: So, sometimes it's one way where people aren’t moving enough, and other times, people are moving too much in the wrong manner. Bob: Doing the wrong stuff and they’re not holding back. That’s basically on personality types there. I had one guy, Brad and I were talking about this before, he had it in his head that his back was broken and there was nothing he could do about it. I have to be honest; I don’t have good luck with patients like that because they have to buy into the belief that it can get better. I want to give Brad some kudos here. Brad is a prime example. He has grade two, you can say it, Brad, Brad: Spondylolisthesis. The vertebra actually shifted about two centimeters and I have no disc in that particular one. My lower discs are both gone basically. The bones, I believe, are fused together, but when I saw the X-rays, it looks like my back is broken. Bob: Yes, one bone is completely shifted forward. It’s very noticeable. Brad: Right. It’s, wow! Bob: If you’re the layperson, and you’re thinking, “oh my God, I better not even move this back.” The fusion shows you again here’s nature’s way of trying to protect the back by fusing it. I always say this as an example too, if you were the average layperson, Brad, I believe that you would be disabled. And here you are, you do triathlons, bike-a-thons, what do you call them? Bike-things. Brad: Bike races. But I cannot do it like I could otherwise. But I can still do it. Bob: Yeah, you’re 100 years old. What do you expect? Brad: Oh, Bob. Bob: Well what do you think, you can do it like when you were younger? Anyway, you need to get that out of your head. You need to have the right way of thinking and try some of these things. Brad: But you need to treat your back right, by the way. Get educated on how to do it, see a therapist, see our videos, things like that. Bob: Good point, Brad. Number two mistake we see people do is; they stop moving. One thing they might do is go on bed rest right away. They don’t recommend that hardly at all now. Maybe one day but really, you want to get it moving as fast as possible. Figure out something that you can do without increased pain. Quite often, is simply walking. Maybe it’s walking with a walking stick or a cane, or something, but get some walking going. We don’t want you to increase the pain by doing it, but quite often, by walking, it actually starts to feel a little bit better. Brad: Get things moving. You know, you need to walk on the flat. If you’re walking uphill, downhill or on an incline, one way or another, that’s probably going to tilt the pelvis and irritate it. Bob: Avoid stairs, avoid going up and down hills, yes. Swimming you might try. Maybe biking for some people might feel better, but get moving. Brad: We’ve got some really good videos on simple exercises you can do in bed. Bob: We’re going to do that next, Brad. Number three, people are doing the wrong exercises. Generally, we have the best luck with one of the three versions, really. I’m going to show these very quickly because that’s not what this video is about. I’m just going to show that there are exercises. If you just want to stand up Brad. The first one is rotations. Here you’ve got one where you lay on your back, you put your feet together and bring your legs back and forth like this. Brad likes to call it the windshield wipers. If this doesn’t hurt, keep doing it. If it hurts going in one direction, don’t do it in that direction; go in the other direction instead. If that feels good, just work it in that direction. Brad: I mean; you’re not going to do them for an hour. You do them maybe 3-5 minutes. Bob: And you might do it a bunch of times during the day if it feels good. Brad: Sure. Bob: Flexion is another one. This feels good. A lot of arthritis patients, you might start with just single leg like this, and then work into double leg and just do pressure on, pressure off. Bob: The final one, Brad, is the one for a lot of people. They actually do well with extension. Arms underneath, pelvis stays on the bed or on the floor. They’re not lifting this up like this, and they’re working their body into extension. Generally, one of those three is going to help. Brad: Right. Bob: I don’t know which one, but it often dependent on whether or not you have a disk problem or arthritis or stenosis or whatever. Brad: One way or another, this video’s not to figure that out. Bob: Number four, you start on opioid medications and you stay on them. You need to find some alternatives. Your back is not going to get better if you become addicted to the opioids or dependent upon them. Brad: Right. There are so many stories of bad things that happen like overuse. Bob: It’s very easy to do that. It happened to my mother-in-law. It’s funny because she said, “I’m not going to become an addict or anything.” I said, “No, you become dependent upon it,” and she did. It was a really terrible thing. She had a personality change, and she would get angry at everything. Brad: It wasn’t just around you? Bob: No, it wasn’t! I was wondering If my wife was on opioids. Ha-ha Brad: BOB! You better hope she doesn’t watch this one. Bob: I hope not because she’ll get madder even yet. Alright, so, an alternative is you might try things to help manage the pain throughout the day. You might take an icepack, people like that. You use icepacks. Brad: If I do something silly throughout the day, like do some yard work because I enjoy doing it, sore back, that night, I have to get a cold pack. Lay on the floor or my bed with the leg wedge, which we don’t have it here. That’s too bad we didn’t bring that over. Bob: Yeah, we should have. Brad: We’ve got a number of videos on that. Bob: Another thing is, we really like the Thermotex. Going in the other direction is infrared heat. If you’re wondering why Brad is wearing this thing, it’s because this is the platinum Thermotex model. What’s nice about this, we’ll talk about how infrared heat works in a minute, but it’s got two straps and the straps especially if you’re having trouble with the upper back but even lower back, it will actually pull you into good posture. Brad: So, they’re gently pulling back, and posture is very critical with back pain. If you have poor posture, it’s going to contribute to it, so we want to get the posture better and that’s what the straps do. Plus, it’s got that deep infrared heat pack that goes up to 2.36 inches deep. Bob: A lot of people don’t realize this, Brad. Brad: Just a normal heat pack, you go buy it for $20 off the shelf. Bob: Normal heating pad or heat pack, will only go like a millimeter, very surface orientated. Brad: It heats up the skin. Bob: Basically, that’s all you’re doing. The Thermotex goes 2.36 inches. That’s starting to get into the muscles, that’s starting to get into the joint themselves of the back. Brad: And it’s a gentle heat. You’re not going to feel it right away. It takes a few minutes, but it goes deep. Bob: It takes about 10 minutes to really almost heat up and then you lay on it for like a half hour. Brad and I have it sitting in our chairs. Brad: Right in our recliner in the evening. Bob: Not our chair. My chair at home and your chair at home. People are going to think we have our chair. Brad: I’m glad you clarified that. We can afford to have different chairs. Bob: It’s kind of my treat at night especially during the winter, I have it on. I just leave mine on now. You probably turn yours off. Brad: Sometimes if I fall asleep and then I wake up, I go to bed and I forget. It’s just an off/on button. You don’t need to have variable temperatures on this one. Very simple. It does have a cord too. Bob: It’s got a nice long cord. Brad: Which is actually pretty handy if you’ve got it strapped around her back, if you want to go get a glass of water, you can do that while it’s around your back. Bob: That’s what I quite often do, I'll work with this on if I’m having pain. Number 5, they have surgery before even trying any therapy or something like that. Brad: That is one thing that really irritates me, Bob. The doctor will say you need surgery. There may be cases where therapy is not even an option, but not many. Bob: Yeah, it’s hard for me to even imagine one. The case of maybe a severe automobile accident where you need to put some rods in there or something. It’s unstable or something. In most cases, you’re really going to want to try some therapy. There are stories out there that are abundant on people that they had them already for surgery and they tried some therapy, and they didn’t need surgery at all. You’ll find a lot of surgeries that don’t help, or they help for a while. There’s a doctor who thinks the reason it helps for a while is because you’re resting your back for so long. Brad: Oh sure, after surgery, you have that time to recover. Bob: Right. This is the kind of person where we were talking about under step one, where they’re going overboard all the time. They’re working their back too much. Brad: Well, they have work to get done, they don’t have time to wait around. Bob: Right, they can’t wait around. Make sure you try therapy. Also, try not to do a multilevel fusion, because they have about a 40% failure rate, where things have to be redone again because you’re getting pressure above and below the fusion. Brad: Right, it’s kind of hard to get into detail right now. Bob: So, those are the mistakes we see people commonly make. Hopefully you’ll avoid these. Brad: I think it’ll go well Bob. Bob: Thanks for watching. Interested in learning about the products mentioned: 1) Thermotex Platinum Infrared: http://www.thermotex.com/bobandbrad/ Use code: FAMOUSPTX for $30.50 off plus free shipping- a total of $55.50 off the purchase of a Platinum 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 For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun: https://amzn.to/36pMekg​ Q2 Mini Massage Gun: https://amzn.to/3oSMBu9​ Handheld Massager: https://amzn.to/2TxZBqU​ 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​ Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY

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=6c6fespwUMk&t=9s Bob: Today we are going to talk about 8 morning habits that help you lose weight. Brad: It’s that time of year, Bob. Bob: It is that time of year. I ran outside this morning, by the way. Brad: You did not. Bob: I did, it was 20 something below out. Brad: What were you chasing? Bob: I had to run fast, LOL. Brad: I’d have to do that just to give me some motivation. Good for you. Bob: Let’s get started. Number one, the first thing you want to do is, and I don’t know if you do this, Brad, but I do. Weigh yourself every day. Brad: No, I don’t. I think I do once a week. Bob: Several studies have shown, if you weigh yourself every day, you’re going to have increased weight loss. I don’t know how you can’t because I right away see if I ate too much the day before. You can adjust right away. If you don’t, it might be like 5 days and all of a sudden, you’re 10 lbs. up already and you didn’t even realize it. Brad: Sometimes you eat something, or you don’t void and, I’m 2 lbs. up. It doesn’t make sense. I shouldn’t be. Bob: I don’t worry about that. If you eat a lot of carbs or pasta, it seems like my weight goes up. You retain water and salt. Brad: Yeah. I could see that. I’ve read that before, take it every day. I can see that, but it’d be like me looking at my retirement account every day. The stocks are going up and down and it would drive me nuts. Bob: Oh sure! Number two, drink lots of water, especially in the a.m. This increases your energy expenditure and increases the number of calories burned. I don’t know the physiology behind it. Brad: I’m reading a book on nutrition and diet and he said exactly the same thing. Bob: You concur? Brad: Yeah, I concur! It was Shawn Stevenson. He has a really nice book. He does a really nice job. Anyways, it’s exactly what you said. Get up and you have to drink a good 24 ounces or so. Bob: You should see what I drink. Brad: I don’t have a problem doing that. Bob: No, because I try not to drink a lot at night so that I don’t have to get up and go to the bathroom. I counted this morning. I get up and I drank 5 big glasses, like over a period of a half an hour. Brad: Really skinny or just tall? Bob: No, they’re big and tall. Brad: It didn’t say ounces on them? Bob: I probably should be able to figure it out. I bet they were like 16 ounces. Brad: 16 times 5, that’s a lot. Then you don’t have to drink for the rest of the day. Bob: Right. Alright, number three, this is going to sound stupid, but you have to make sure you’re getting enough sleep. Actually, if you’re pain-free, you can sleep well. That’s why we want a SleepOvation mattress. If you have sleep deprivation, it actually can cause weight gain. You’ll have decreased leptin. That’s the thing that makes you feel full. But you’re going to have increased ghrelin. This sounds like Gremlins. And they make you feel hungry. Brad: Don’t want to have them! Bob: So, you know, both of those things are going on at the wrong rate when you don’t get enough sleep. Brad: Well, sleeping is your fasting time. You go 12 hours without eating and you can lose a lot of weight overnight. I was amazed, I lost two pounds once. I thought, this cannot be right. Bob: Just from sleeping? Brad: Yeah. But you know the breakfast. That’s why they call it breakfast because you break the fast. Bob: Gotcha! Hey, wow. You’re sounding intelligent. Okay, number four, we’re going to talk about is going to sound like a small trick. But it actually works. If you use a smaller bowl or smaller plate or smaller cup, you do eat less. The bowl I like to eat cereal out of broke, so I started using a smaller bowl. I found I started eating less. Brad: How do you break a bowl? You drop it? Bob: Yeah. It cracked somehow. So, it sounds like a stupid little trick, but it really does work. Brad: I tried it with ice cream when I used to eat more ice cream. Bob: Then you ate two bowls. Brad: Right. The second bowl tastes better than the first, I tell you. So, we just get rid of the ice cream. Bob: Doesn’t always work. Brad: No, I agree. That’s an easy, easy thing to try. Bob: Number five, and I’m terrible at this. I’m just not that type of person. Tracking your intake. Brad: Your calories? Bob: Yeah. If you actually track how much you’re eating, you’re going to be surprised. You’re eating more a lot of the time than you think you are. Especially if you start weighing your food. You’re suppose to have six ounces and you look at it and think, “Yeah, that looks like six ounces to me.” Then you weigh it and it’s twelve ounces. If you’re serious about losing weight, I think that alone can really help you. Brad: Sure. That’s kind of a personality thing too. If it doesn’t make you feel comfortable, it may not be the best for you. I can see where it would be very effective, and scientific. Bob: I don’t think you have to track it forever. Just track it for a while and then you can start to get a sense of what you can eat. Brad: Right, why don’t you plop that steak down, there’s a six ounce, there’s a seven ounce. That’s a four and a half ouncer. Bob: Right. My wife and I played that game for a while where she’d like, how much is this? Brad: Did you weigh it? Bob: Yep. Brad: What do you have, a scale? Bob: Yeah, a little food scale. Brad: Oh, a food scale!? Kind of like a scale for your envelopes. Bob: Yeah, it’s pretty sensitive. Number six: Morning exercise is the best time to exercise because to me, you have the greatest amount of motivation in the morning. If you wait until you get home at night, there may be nothing left in the gas tank. It’s really easy to put it off. But if you exercise right away in the morning; that’s why I get out in the cold weather, Brad. Brad: That’s a good idea. Bob: It makes you feel good. It sets the tone for the day. A lot of times now, my wife and I are going for walks in the afternoon, and you get a little bonus. A little extra already. Brad: Yeah, you get it out of the way. Especially if you have kids. You have to do it before they get up. Bob: You have to put you first. Brad: Then you come home, and all kinds of stuff pops up and then you can’t, or you don’t because you don’t have any time. Bob: All H-E-L-L breaks loose, right? Brad: Ooo, it’s a family show. I’m glad you kept it that way. Bob: Alright, number seven: We found this really helps if you plan your meals. Like, I’ll make a bunch of salmon, together, right away. That way, one, it’s healthy. And two, you don’t grab some junk food because you’re really hungry. It’s all ready to go already. Bob: Yeah, those are good. Brad: Put it in in the morning, your vegetables, your meat. You get home, the house smells good, you’re ready to eat and you don’t have to deal with all those potential chips and other fun things you happen to have in your house for when you’re going to have that social. Bob: Yeah, we watched the Superbowl yesterday, or two days ago? Brad: Well, a lot of people watched it Sunday. Bob: Yeah, Sunday. Well, anyway, my wife just had a chip craving the whole time. She fought it. Brad: She did!? Bob: She was going to make me go out at halftime. I go, “But it’s the halftime show!” Anyways, she fought it off. Number eight, the final one! This is if you eat a breakfast that is more saturating, it satisfies your hunger. You’re going to last longer throughout the day. A high protein meal can often last longer and I’m sorry for the vegans and vegetarians out there. If you can, oh, I guess you can get protein other things. Brad: I don’t know. I’ve been eating avocados and I’m telling you they kind of fill me up. They are just fun. I’m having a good time with the avocado. Bob: Good for you. Brad: I like the color of them and then cut open. I learned how to break them. Bob: You’re a grapefruit guy too, aren’t you? Brad: Every morning, at least a half a grapefruit. At least from November to April. Bob: Remember, they used to have the grapefruit diet? I don’t know what it was, but you had to eat a lot of grapefruit. Brad: Was that Atkins? Except with grapefruit? Bob: It was a diet. Brad: They say they burn calories just eating it, you know? I just know I feel better. Bob: Alright, I’m glad you feel better, Brad. Brad: I think that everyone’s going to have success with this if they just take it seriously. But with a sense of humor! You know, you just can’t get all wound up. You’ll get your stomach all bound up and tightened up like that. You get ornery and you’re hungry and you’re taking it out on the kids, the wife, so have fun with it. Bob: That’s called hangry. When you get that hungry and you’re grumpy. It’s like when you’re tired and you get all angry. Brad: Like a hangover. Bob: No, you’re hangry, you’re hungry and you’re angry. Brad: Oh, sure. Bob: Because you didn’t get food. Brad: We have to quit babbling, Bob. Bob: Remember, Brad and I can fix just about anything, Brad: Except for, Bob: A broken heart. But we’ll work on it. Just like you guys can work on your diet. Brad: Hopefully you’ll have better success with your diet then this heart thing. Bob: LOL, thanks for watching. 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 For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun: https://amzn.to/36pMekg​ Q2 Mini Massage Gun: https://amzn.to/3oSMBu9​ Handheld Massager: https://amzn.to/2TxZBqU​ 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​ Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi 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.

What Type of TENS Units Should You Get for Controlling Your Pain? Electrical Stimulation Units? As stated in an earlier video we (Bob and Brad) have tried dozens of TENS units. Most units work fine but many are very confusing and have very poor instructions. In the end we decided that we were going to choose one company to provide TENS units to our patients. The company is iReliev. The following is a list of things to consider when purchasing a TENS unit: The first decision to make is do you want just TENS, or do you want a machine that has both TENS and EMS? You may recall there is one simple difference between TENS (Transcutaneous Electrical Nerve Stimulation) and EMS (Electrical Muscle Stimulation). When using a TENS unit, you are trying to reduce your pain. When using an EMS unit, you are trying to strengthen a muscle. If your muscle is no longer working at all, you may also use an EMS unit to try and retrain the muscle to start working. You cannot substitute one for the other. Many units contain both but if you do not need EMS you can just get TENS. Does the unit have a rechargeable battery? We remember very clearly several years ago when none of the units had rechargeable batteries. It was a pain to have to replace the batteries. However, if you are not certain whether TENS will be helpful to you, you might try a non-chargeable unit because they are less expensive. Do you want a unit with wires or without (wireless)? The wireless units are more expensive. Also, the wireless units have separate pods that need to be charged and used with the adhesive pads. But, of course, when you own a wireless model you do not have to deal with wires. Some units are very simple with just a few buttons, others have many added features (such as being able to control the TENS from your smart phone, or even pulsating to the beat of the music on your phone). Electrodes (pads) come in many sizes and shapes. Large sizes work better for larger areas, like the low back. Smaller sizes can direct the current easier to smaller areas like the knee or elbow. The pads generally attach Bob and Brad TENS Program: What Type of TENS Units Should You Get for Controlling Your Pain? Electrical Stimulation Units? 2 through one of two means: pigtail type with a prong connection, or button type snaps. Be sure to get pads that are compatible with your TENS unit. Price. As a comparison iReliev has the 1313 Tens unit model that has wires and uses (3) AAA Batteries for about $49 (if you use our link). On the higher end they have the Premium TENS + EMS Therapeutic Wearable System. This unit is wireless and rechargeable and runs about $189 if you use our link. These prices may have changed since this publication. 7. One of our favorite units is the iReliev 8080 TENS unit. It costs about $129 if you use our link. It is a TENS and EMS unit combined and it has wires, but it is rechargeable. 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 February of 2021. For the original video go to https://www.youtube.com/watch?v=erVegtjpDwU Bob: Today we're going to talk about how to avoid hungry water, question mark. It's the number one key for weight loss, and a robust active life. All experts concur. Brad: Absolutely, Bob. And hungry water, if you haven't heard of that, don't worry we're going to explain it in detail. It's a very fitting term that you should be familiar with. This is not going to be a five-minute discussion. If you really want to know about water, and if you're drinking what you want for water, it's going to be more than 10 minutes. Bob: A lot of things to keep in mind here. Brad: Yeah, good information. Bob: A lot of controversial information. Brad: Actually, it is. We'll clear some of it up, and some maybe not. So keep that in mind. Bob, are we ready to go on? Bob: Let's go, let's roll. Brad: And we concur on this. Now this is one thing that we all feel, everything we have read, and I think everyone will agree: doctors, nutrition gurus, weight loss gurus, they all agree that people need to have ample amount of water to stay healthy. If you're losing weight, you really need to get water in to keep the system moving. It makes you feel full a little bit that way, but just the system to get things moving. Bob: There are exceptions. There are people who are trying to watch their blood pressure or whatever. You know, if they're on certain meds and stuff. But yeah for the average person they are probably not drinking enough water. Brad: Exactly. I know my brother's an ER nurse, and everyone that comes in, they always are dehydrated. Bob: Brad and I have worked in nursing homes, and that is such a common diagnosis. It's almost like a daily occurrence. Brad: Right. So I think we kicked that horse enough. So let's go on. How much water should we drink? Let's go to the extremes, Bob. We know that if you don't drink any water for three to five days, it results in death. On the other hand, you can drink too much. As a matter of fact, I found a case, a woman drank 1.6 gallons, or six liters of water within a three-hour time period. Within a day, she passed away from too much water. The body cannot take it. And you mentioned someone locally that it happened to. Bob: Yeah, it was a really unfortunate situation, a college student got sick and they told them to drink lots of water, and he went nuts over it. The sickness combined with the water, he actually passed away from it. I mean it was tragic. Brad: So, we're going to come up with some good rules of thumb from the information I found out. Again, this varies on your body size, how much water you should drink a day. Like the climate, the weather, how active you are. Bob: Yeah, it's really hard to give a general rule of thumb. Brad: Right, so we're going to give you some ideas here. Bob: Yeah, a starting point anyway. Brad: Yep. The average person, if you're just living your average day-to-day life, I think the eight times eight rule. Eight glasses of eight ounces of water, 64 ounces a day, is a pretty good rule of thumb. Bob: You can try it, and see how you feel with it. How you're doing with it. Brad: If you're more active, one ounce per one pound of body weight. So I weigh about 175 pounds. That's a lot of water, because I keep track of it. Bob: 175 ounces, but you are very active. You work out a lot. Brad: In the summer that would be no problem. Now, in the winter, not so much. This next rule, males averaging 125 ounces a day. Females, it was kind of unusual, 91 ounces. Bob: You know, there is another way, Brad. You can actually go ahead and drink some water, and see how long before you go to the bathroom. If you go to the bathroom almost immediately, you already had enough water in you. And if you don't, you actually don't go to the bathroom for a couple hours, you still probably need more water. Brad: Sure, is that homeostasis? It might vary if you have some caffeine in your system. That might play a role. Bob: A lot of things can play a role. Brad: Exactly right. So Bob, now that we've cleared all that information, We've got to get on, so drinking water. If it's so important to drink water, we should know what kind of water to drink. Do you just go to the store and drink some water from the bottle at the convenience store? Do you go to the tap? Get it right out of the tap, or do you need to do something special? So we're going to talk about that. Now this, these four things I kind of did this for myself, because I got a filter at home. I've been looking into this stuff to figure out what's best for myself and my family. I grew up in a rural area, we had our own well. It was about 40 feet deep. Not a very deep well, but it was in the middle of the country. There were no farms around, there was no nothing. Everybody loved our water. People would come from the city. "Oh, it tastes great." And it was well water, so it had a lot of minerals in it. Bob: You didn't have to worry about fertilizer or chemicals. Brad: No, we did not. And I swear, we had the best water around. That is he best, in my mind and I think most people agree. The water that filters through the earth, collects minerals from the stone and the earth, and you get your calcium and magnesium and all those things. Bob: Iron? Brad: Iron, exactly right. You get that, that your body needs to stay healthy. So that's very good, well water, that's the best thing. Bob: Hard to get, though. Brad: Right, because I have a well right now, but there's like 140 acres of corn that's been there for 40 years, and every year they put in nitrogen. They put atrazine, and all these chemicals. And eventually, it probably will get down into that well. I got 130 feet well, I'm thinking, you know, it might be down there. So I started thinking, what do I need to do? I need a filter, but a carbon filter is going to take out some odor, little bit of iron, but it's not going to do iron either. You got to get an iron filter. We put that in. We liked the iron, but it was so bad that it was turning red. You get red hair, you know, you have to do something. Bob: Yeah, that was Linda's parent's house. Brad: So I went with a reverse osmosis system. Which is, takes out everything. And that's where the hungry water term comes in. Bob: So if you take out everything, the water becomes hungry. Brad: Right, if you have distilled water, or reverse osmosis. You have nothing in the water but water, which is good. But what they say now, this is a controversial subject. You drink this hungry water; it's got nothing in it, and it's too pure, and it can actually perform a reverse osmosis from the electrolytes in your cells. And this is theory now. I've found different arguments that no it doesn't happen, your stomach is so acidic, it has enough things that if your diet is good and healthy, you're going to be fine. I took my reverse filter out actually, there's five filters, I took that one out about two weeks ago. I think I'm going to put it back in after doing more research. That's up to you. I did put a remineralizer in the system, which is supposed to add in minerals to the water. I don't know if it's a marketing thing, or if it really works. I would have to do some more research. Bob: I don't know if this is a good time to mention this, but like, I sweat a lot, especially in the summer. I might get drenched like three times during the day, cutting lawn and stuff. I drink a lot of water of course, but then it does wash out my electrolytes. I start getting dizzy. Brad: Particularly sodium. Bob: Yeah, sodium. So, I do take Nuun tablets. They make all the difference. When I take those, I don't have any problems. But when I don't, I get dizzy. Brad: Oh yeah, you need those electrolytes. Now, one thing you can do if you're drinking distilled, or RO water is, they make tablets you can put in specifically for that, mineral tablets. You can also, I've heard people say, use honey, or some natural syrup. Pure maple syrup. Because that's coming up from the earth. Bob: Oh, sure. That it has some of the same stuff. Brad: That doesn't mean you can put a cup of pure maple syrup in the water. Lol. Bob: Just a spoon full of sugar. Brad: So just a little bit of those to get some minerals in your water to reverse that reverse osmosis syndrome, if you will. Let's go to the next one. Bottled or processed water, which we have right here. Got this at the convenience store. This is pretty common now. The BPA, in other words, it's bisphenol A, and the A, I'm not sure what that stands for. But there's three bisphenol products. There's A, there's F, and there's S. Bob: So they're BPA, BPF, BPS. Brad: Right, the BPA is pretty well known as a possible carcinogen. Bob: So people do not want the BPA. Obviously you hear that quite often. Brad: So what do you do? Do you drink it, or do you not drink it? So, probably not the best choice. And a lot of people will say, absolutely not. But one thing, like my water bottle that I drink from, I have about three or four of them. This says it has no BPA in it, but it's plastic. But I believe it does have BPF and BPS. But I fill this up from my own water in the morning, and it lasts maybe three hours. Actually, I bring two to work. So, I drink them up within an hour and a half. But four hours is the longest it's ever going to be in there. And you don't have the time for the plastics to go into the water. Bob: Although sun would enhance that, probably. Brad: I don't keep it out in the sun, but that's a good point. Think about this: bottled water you buy could have been on a shelf in a storage room for months. And then, if you get it out in the sun, or it gets hot in the summer and it warms up, that all enhances the amount of BPA, or the other chemicals to get into the water. And that's why some people call bottled water, plastic tea. If that makes you think. Bob: And that's not a good tea to have. Brad: Yeah. So people are just going to be trembling after watching when they're drinking it. I still drink out of them, but not as much. Bob: I'm bad about it, because it’s convenient. At our cabin we're not really supposed to drink the water there, the city water's, not good, and so I get plastic bottled water. I leave it in my golf bag, and it heats up. So, I have to stick with the other water bottles. Brad: Now what do we got here? Bob: Well, this is Aluminum. Brad: It's not stainless steel? I think they recommend stainless steel as a step ahead of aluminum. Bob: It is stainless steel; it says on the bottom. Brad: Having your water in a stainless steel or glass bottle is what I’ve found to be the most recommended. Aluminum, I wouldn't have aluminum because it oxidizes pretty easily. And that’s no good. So number four, municipal or tap water right from your house. It's been treated by the by the city or whoever, you know. They put the chlorine in there to kill the bacteria. They put the fluoride, to keep your teeth from getting cavities. But then there's controversy on that. Some people say that fluoride might be good for your teeth, but not so good for the system. If you do take too much of it, that can kill you too. Bob: Wow, interesting. Brad: I don't know what the volume is, you don't have to worry about that with your tap water by any means. But anyways, another thing I found out, what's in your tap water? You can go to the website, ewg.org, Environmental Working Group. I found it without any problem. Look under EWG’s National Tap Water Database. You put your zip code in there and they have done tests on all the zip codes. You know, if this is in the United States, and I looked at the water from the village where I live. I don't get it, because I live outside the village. It didn't look real clean, but it's acceptable to drink. The volumes of chemicals that are in there are not high enough to worry about, so they say. Bob: Well what's shocking, and this has become more and more of an issue, is how many prescription medications are found. Brad: I was just going to bring that up. Bob: Yeah, a high percentage. Brad: There were studies done from California to New York, and up to 52 different pharmaceuticals or medications were found. They're talking about trace amounts. It's probably not enough that it’s going to affect you. But if you do drink a lot of water, you know, you've got all these things to think about. Do you feel comfortable drinking your tap water? Usually tap water, to me, doesn't taste that good in most places. Bob: Right. But you grew up with the best water in the world, Brad. Brad: Well, I don't know what it comes from, but anyways, for me I'm going to go with my RO water. I have the remineralizer on it too. I may put a little bit of maple syrup in there just because it might taste good. It’s got all that from the earth. If you think about the water in the ground that the tree brings up? You boil out all the water, and that's all you have is that purity. Bob: Can't you put some on your RO machine that puts it in automatically for you? Brad: Well, I got to look into that. I might be able to make something like that, a drip. Lol. Anyways, we want to joke a little bit. Bob: You're a drip. Brad: Yeah, but this is something to consider when you're drinking water. If you're drinking a lot of it. Bob: Trying to be healthy. And I don't know what to do, Brad. Now that you got me so confused. Brad: Yeah, it is a can of worms, actually, when you start getting into how important water is, the volume you need to drink. But then, what kind do you drink? You want to be healthy, you want to keep your children healthy. So, good luck with it. Bob: Right. Good luck out there. Brad: Yeah, if we come up with some more concrete information we’ll let you know. Go find a good well. Bob: And we want your comments below, share your opinion. Brad: Yeah, absolutely, because there's going to be a lot of people with opinions. It's going to be like a diet or, you know, a nutritional thing. Bob: Well I want to hear them; I want to hear both sides of it. Brad: Yeah, absolutely. Good luck. 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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.

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=LS8uzSBkPqE&t=18s Brad: I'm Brad Heineck and I'm exactly one half of the Bob and Brad show. We have Chris the pharmacist here. We're excited to have him here. He did a lot of research and he just knows this information on this topic, which is heartburn, acid reflux and GERD capital G-E-R-D best relief options. Whether it's diet, over-the-counter or prescription meds, also known as PPI. I guess we're going to get into that. You need to know this information. If you have this or a family member it's going to be a complete education. You are going to feel so much better about how to deal with this. So, Chris, heartburn, acid reflux, GERD, or G-E-R-D. Are they all the same or is that three different diagnoses? Chris: They're all the same. Basically, it is that awful feeling you get in your chest, you just feel like it's kind of burning. It just doesn't feel right. You're just uncomfortable, whether it's after you eat or maybe when you lay down at night. Your symptoms can come at different times of the day or at all times of the day. So, it just kind of depends on how severe your case is. Brad: So from personal experience, I do want to say one thing, if you have not had acid reflux or this problem and you're getting chest pain, don't guess and think, “Oh, I've got heartburn,” because you could be having a heart attack. You've got to get in and get it checked out. Confirm what the problem is. Chris: Yeah, you want to make sure that you have a professional look you over, because there are symptoms that are indiscernible to a doctor, even in an ER setting until they actually do blood work and look at your levels and all the things there. Brad: So you're saying, they don't know what it is? Chris: They don't know until they do some testing. So, sometimes people can have what they think is heartburn and it's actually a heart attack. Some people think they're having a heart attack and its only heartburn. So if it's an emergent situation, don't just guess “I'm going to take a couple of Tums and see what happens,” get it taken care of properly. Brad: There's another diagnosis with similar symptoms which I have, it’s costochondritis, which, has to do with the ribs and the cartilage in your chest. But I know I get that pain in the chest area. I've gone to the emergency room three times. So I feel confident if I ever get it again that I know it's my costochondritis, but I'm thinking, boy I bet you heartburn is similar, because my mother had it in the same location. Chris: It’s the same nerve plexus, from that standpoint. So yeah, it's nothing to mess around with guys. If you don't know, get it checked out by the pros. Those doctors are there to help you, and make sure. And if it is just heartburn, there's a lot of things that we can do to help treat people. Brad: Yeah, that's the good news about this, the more educated you are, the more you can self-treat or work with your doctor and have a team effort that really does that prime way to work. So you feel part of the team. What are the stats as far as, is it just an older person thing or? When I was looking this up, there was a diagram and this really helped me. If you think of, here we've got the stomach, on the left, so the food goes down, goes over into the stomach, and then from there into the intestine, or the duodenum. So we've got the stomach. And here are the food's going down and there's a sphincter that keeps the food going one direction if everything is working right, and down in here, that's why I use red, we've got stomach acid, and evidently that's pretty potent. Chris: Very potent, one molar, one molar hydrochloric acid. Brad: Now we're talking chemistry, we've got a pharmacist. So if you compare that to other like acidic food, stomach acid is… Chris: Much stronger. A tomato is not going to withstand that. Brad: So we've got all this acid down here, which is healthy. We use it to digest, but we want to keep it there. So with GERD or acid reflux, somehow this stuff gets up and goes this way. And that burns, which is why you get the pain in the chest. Chris: Yes. You're describing it really well. Brad: I feel like that's my contribution to the this all. Chris: That’s a definite improvement over my artwork, that's for sure. No two ways about it, but yes. When you get those symptoms, there's certain foods that can trigger it. In the old days, we used to tell people that, if you have reflux or GERD, you have to go to this bland diet where you're just eating like white bread and crackers and chicken noodle soup. Brad: How about milk? Chris: Milk actually is weakly acidic. And some people can actually get irritated by it. Not always. But that way of thinking is wrong. So that's the old news. The good news is, you can eat a lot, just about anything you want, minus garlic, tomatoes, citrusy fruits, onions, those types of things. Brad: I’m dead in the water. I can’t eat grapefruit? Chris: Well, if you have heartburn, no. But there's medicines, we're going to get to better living through chemistry shortly. It's one of those things that if we can avoid some of the foods that are triggers, we can kind of naturally bypass some of this. A lot of times, we may overeat, we have a high fatty meal. It's just, this little muscle the sphincter here, can get stretched and all of a sudden acid will just kind of leak right through it. And what do you do after dinner? You kind of lay around, you watch TV. I mean, you're not necessarily sitting with perfect posture. If you can sit upright after you eat for a good hour, this is going to help because gravity is going to keep things going down in the right direction. But if you're in the lazy boy and you're flipping through channels or you're reading a book, and your stomach is a little bulged because you maybe had the old 96er or something to that effect, you can get some seepage and you're going to get that heartburn. Brad: 96er? Chris: Did you ever see “The Great Outdoors” John candy movie? 96-ounce steak. Brad: I don't get out much Chris: A very big piece of meat. Brad: I quit watching movies after 86. Anyways... Chris: That's about when it was made. Brad: I was on the borderline. So anyways also, so if you lay flat, you're even more prone. Chris: More prone to probably suffering. And so there's things that people can use like bed wedges, prop their bed up. So there's a lot of non-drug things you can do but what it comes down to and really the title today is, the proton pump inhibitors have really revolutionized how we treat these types of acids. Brad: Protons Pump Inhibitors. So they put up a pump in your system? Chris: Basically the easiest way to think about how we make too much stomach acid. We have pumps and they're basically in the lining of our stomach and their actually what kicks out the stomach acid. Brad: You don't mean... Surgically putting the pump in there. It’s not like the pump for morphine or anything. So the pump is just a natural thing that goes on. Chris: No we're not pumping it in. Brad: That was a little scary for me. You said the pump and I thought, what are we going to promote here? Chris: There is no little robots in us or anything like that? Brad: I thought they're going to put them in there. I didn’t know. Chris: No, but ultimately it's what our stomachs do to break down food. So we need that. The business end in the stomach is the surface area, then it gets into some of the intestines, from there nutrients go into the body. I mean, that's the quick and dirty answer but the reality of it is, there’s a lot going on. For a lot of people that have reflux or even other stomach kind of conditions your body is making too much stomach acid and as a result, it's seeping out in the wrong direction, we're getting the heartburn, we're getting the discomfort. So if we take these types of medications like Omeprazole or pantoprazole, like Prilosec or Protonix these are drugs that suppress that acid pump. So your body doesn't make as much acid. Realistically, when you take a tablet within about 20 minutes of taking that, like with Omeprazole specifically, your stomach acid has been reduced by 80%. It’s very thorough. Brad: So what about, I heard people take Tums, over-the-counter. Chris: Yeah, that's a neutralizer, so it works differently. That's calcium carbonate. So if you've had acid in a little cup and you threw some Tums in there, it neutralizes it. So it's not as damaging. So that works a lot faster than say a proton pump inhibitor. It takes about five to seven days to notice a difference with the PPIs. If you have a lot of reflux and discomfort there's irritation going on and it takes time, it's just like any other wound at that point. So if the mucus is kind of irritated. Brad: So the tissues in the throat or the esophagus are actually physically irritated with little lesions. Chris: Irritated, correct. And there can be lesions, and if untreated, it can go to a myriad of very serious diseases, as bad as cancer. So yeah, you can get to ulceration and if ulcers are left untreated, it can become stomach cancer, esophageal cancer bleeding varices. There's a lot of things out there that you want to make sure you see your doctor and you get treatment for this. Brad: So the first step I'm thinking, I don't want to take the pills, maybe diet. Like I know my mother, we had to take citrus out of her diet and it seemed to help. And actually she did get, she was taking, I don't remember. You remember? Chris: Yep, she was on Ranitidine at one point, we switched and I think she’s on Omeprazole now. Brad: I'm supposed to know that, it's my job. I got it written down. Chris: That’s what you have me for. Brad: Yeah, that's exactly right. So anyways, you may be able to modify it or maybe be able to control it by diet. If it's a mild case. Chris: You can, diet and exercise are huge. Brad: Exercise has something to do with this? Chris: Well, keeping a healthy body weight. Because, if we have too much body weight we're carrying around, the things that kind of keep everything in place kind of gets stretched and displaced. And then, all of a sudden, your stomach's not sitting quite right and then you can get reflux. So healthy body weight is important. Brad: So, we work with our diet a little bit, and maybe it's not going well, and you talk to your doctor and it's like a time for meds. So this means we have to do prescription meds or is there over the counter meds? Chris: No, many of these drugs are all over the counter as well. And so that's, one of the problems that we're facing in this country is, maybe the over utilization of some of these drugs. So we have to be careful with that. The reason that you see a lot of these packages over-the-counter, they're only for 14 days. We only want you to use it for two weeks. If your symptoms aren't gone, by that point, you should be discussing this with your doctor because we want to make sure that there isn’t something more serious going on that could be easily hidden by just simply taking months and months and months of over-the-counter proton pump inhibitors. Brad: So, yeah, you're just kind of masking. Chris: You can mask the symptoms. It could be a variety of different things. But I mean, worst case scenario is let's say you had some severe erosive esophagitis. I mean, that esophagus is just raw and irritated. Sometimes it can be to the point where they have to do special procedures or it could be triggering things like very bad disease states like cancer. Brad: So at that point, if you've got that esophagitis, it's probably going to be painful to swallow. Chris: It is, but some people are so tough. I mean, actually a buddy of mine's a gastroenterologist, it'd be fun to have him on here. But, a lot of these people just don't even recognize it and it almost speaks silent in some cases. Some people have tremendous pain. So it varies from person to person, condition to condition, and where along the GI track it is. So there's a lot of different things that go into these factors, but the medications that we use to help to try and cut down acid are game-changing. And so it can be life changing as a result of that. But, we still have to be judicious with it. There can be some consequences of over utilization of some of these medications as well. Brad: You mean some side effects that take on other problems? Chris: Yeah, so, you think about your stomach acid it's one of your best immune defenders. So I mean, it helps to protect you against things like pneumonia and other respiratory infections. Brad: Because it goes up into the esophagus? Chris: No, it's not even the esophagus, it could be on your food or whatever, but it's bacteria. And it can't stand up to that acid. Although we do have bacteria that do stand up to those acids too, we'll talk about. Brad: There's good bacteria? Chris: There's good bacteria, yep. Brad: That's another video. Chris: A couple of videos, probably. When we have people with symptoms, we have to treat them and we want to treat them and usually it takes about three months to get everything to heal up. And if you are three months and you're like, I feel great. I'm not having symptoms. At that point, your doctor may even suggest that maybe you can try and cut down or try and discontinue the product. But there's a double-edged sword with proton pump inhibitors specifically is that they can cause a rebound in your acid production for about 14 days after you discontinue a product. So depending upon the dose level that your doctor puts you on for your particular condition some people have to take it up to twice a day. Some people only take it once a day, usually like to half that dose for a couple of weeks and then stop it. And like I said, recognize that you will probably have a little bit of rebound reflux. So you have to kind of muscle through that or maybe use something like a Tums or maybe something like a Pepcid, which is an over-the-counter supplement to help to try and cut that down and bridge the gap. Brad: I think once you see your doctor, hopefully you're listening to him, you got him as your quarterback or your coach. But if you're in that phase where I want to see if I can do this with over-the-counter meds, and you said they're typically 14 days, and then if that doesn't work then you better stop. Chris: You should see your doctor after 14 days. Brad: Is there an acceptable and wise way to go in to get an over-the-counter medication that you could suggest to people. Chris: When people come and see me, we're going to talk, I'm going to try and get a gauge as to how long they've been suffering. What makes it worse? We're going to see if it's always after meals. Is it when they lay down at bedtime? Is it all day? Brad: So you're saying like, if I'm a customer, I come in and have not seen my doctor, I could go ask the pharmacist, "I've got heartburn can you recommend anything?" Chris: Yep, and so we could see how long it’s been going on. If you’re like” Yeah, it's been like two months and I've been feeling horrible every time I eat. I just get this horrible pain up in my chest. It just doesn't feel right.” We can try a couple of different things, and then I would give them options. Pepcid is one, it's a little bit faster acting than the proton pump inhibitors but the proton pump inhibitors are more thorough and they're more effective. Brad: You can get that over the counter? Chris: Yeah, they're all over the counter. These are all over the counter at this point, this is my arena. We always say, "Hey, I'd like you to just try this for about two weeks. And if this isn't better, or if you see symptoms worsening while you're doing this, don't mess around with this and wait for something to happen in a positive direction. Talk to your doctor because you're going to need the help. We have to figure out what's going on directly.” And there's ton of incidences, where they go in and all of a sudden it was a big deal. Brad: Do you have many people come in for advice like that? Chris: Yeah, all the time. We want to talk to people. That's what we're there for. So hopefully we can give them some temporary help unless they need more thorough help from their doctors. Brad: Which is something I didn't know. I don’t go to the pharmacy very often because I've been pretty healthy. I didn't know that you could go ask them questions. I just get a lot of my advice from Chris. I talk to him about something and he tells me. I remember I had a skin thing, I said, “I have to go to the doctor to get something for this.” And he gave me a little over-the-counter advice, I got it, it was gone, it's like, a pharmacist, they work. I mean, a pharmacist and a doctor really need to work hand in hand. But, you can eliminate doctor visits by doing some of it? Chris: I don't think we can eliminate the doctor’s visits; we can help out when it's something simple. Brad: Well, in my case, it was a simple thing. It's like, I don't want to go to a doctor because of a rash. I just need something to put on it. And you helped me. And like this topic of acid reflux, this could possibly stop a doctor visit. Chris: Yeah, I think the use of over-the-counter medications, is very, very effective and I think it has its place in therapy. But again, we have to be careful because, if we're older, I mean, if they're a smokers, there's a lot of things that could be triggers that your doctor really needs to address these things. And long-term, as we age and we take these things for long, long periods of time, we found that there is a higher risk for osteoporosis. So you might want to maybe be taking a calcium supplement if you're on it, specifically calcium citrate versus calcium carbonate because the carbonate needs the acid to break down. So if you're reducing the acid environment you want to use something that's bioavailable. Brad: These things overlap and we don't want to cause another problem. Chris: Exactly. So, we have to be mindful, of other things, like I said, it's disease state management too. We can see, and if you're at higher risks of what they call Clostridium difficile which is another very bad intestinal bug, there is a correlation with long-term use of these medications. So we have to be really careful. And that's why your doctor has to be involved with your treatment plan. So coming in and seeing me is nice and I enjoy it, but a lot of times, we have to make sure we do the professional punt and hand it off to the pros. So whether it's your regular physician or a gastroenterologist, I mean these guys are the ones that really know and they'll turn you back to me and we'll talk about proton pump inhibitors at length. Particularly if you end up on a prescription to make sure you use it long enough, What's the best tapering strategy? And you should always, when you're talking with your doctors, figure out what's going to be the end game here. I mean, am I going to have to take this forever? And we're finding that about 27% of the people do. And your doctor has to mitigate those risks for you. Brad: You're saying almost three-fourths of the people eventually can get off? Chris: Yes, they can get off. So if they're eating well losing a little bit of weight, watching what they eat, minding the type of things that they eat. Brad: Maybe get a wedge to sleep on. Chris: Wedge to sleep on, smaller meals multiple times a day sometimes; grazing versus gorging kind of thing. So there's a lot of things that can be done that do not require medicine, but a lot of times they're there for you if you need it. But just realize that long-term use does have some consequences. So we have to be mindful of that. And you want to work with your doctor, to do the safest, most effective plan. See if there is an exit strategy for you. So we don't have to succumb to some of these risks that could be associated with long-term use of these medications. So I'm going to be very, very careful. Brad: I'm feeling better already. Chris: All right, well, there you go, no reflux for Brad. Brad: Thank you for listening and watching. I know we'll be back with another exciting episode with Chris. Chris: Have a good day guys. Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun: https://amzn.to/36pMekg​ Q2 Mini Massage Gun: https://amzn.to/3oSMBu9​ Handheld Massager: https://amzn.to/2TxZBqU​ 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​ Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi 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. * More info on Chris the Pharmacist can be found on his Bob and Brad's Experts Page here

How Do I Obtain a TENS Unit for Pain? Do I Need A Prescription? Will Insurance or Medicare Pay for It? You do NOT need a prescription to obtain a TENS unit. If you are trying to get your insurance or Medicare to pay for a unit, you will need to check their guidelines. Their requirements frequently change, and many have different rules. You might need documentation from your doctor stating that the treatment is medically necessary. You might also need a prescription from your doctor. Some insurers require that you rent a unit for a month. Medicare used to require that you try other treatments first. They also required that you have pain longer than three months. Medicare may also not cover certain types of pain such as chronic low back pain. Having said all that we honestly do not know of any equipment providers that will process an insurance or Medicare claim for TENS. Leave a comment below if you know of one. The cost of units has come down so much we believe there is not enough money in it for equipment providers to go through the difficulty of dealing with insurance and/or Medicare. iReliev’s has a TENS unit (order number 1313) that is around $49. We remember when these units were hundreds of dollars. Despite the low cost, the $49 unit is just as powerful and effective as the units that used to cost 10X to 20X more. 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 2019. For the original video go to https://www.youtube.com/watch?v=0wByGAdkV44 Bob: Hi folks, I’m Bob Schrupp, physical therapist. Brad: Brad Heineck, physical therapist. Bob: I think we are well qualified to talk about this one, Brad. 7 secrets to running without injuries from head to toe. Both Brad and I, are well into our 50’s, unfortunately, and yet we are still running. We’ve dealt with injuries over the years and we’ve figure out what works and what doesn’t work. Brad: And we are going to help you out, whether you’re just starting or getting into it or your body’s changing, after you hit 50s, you’re wondering why things are changing and we can help you out. Bob: Little clue, it’s not for the good either. It’s not changing for the good. Brad: So, Bob, it’s springtime right here, right now, it’s beautiful. We came off of a beautiful April. Bob: We’re about to have a snowstorm. Brad: Right, but it was nice over the weekend. You were golfing and I did go running. I started running when I was in my late 20s, so I have about 30 years in consistent running. I really still enjoy it, but I have run into injuries. A lot of them over the years. From calf muscles to groin to hip abductor muscles to hamstrings. Bob: Yeah, didn’t you just have a hamstring injury? Brad: Yes, I just dealt with a hamstring injury. I feel pretty comfortable now taking care of it so I can get back at it, because it can be really a psychological issue if you’re a runner and you have an injury and you really want to get back out there. Or if you want to start running and you want to learn how you can run without hurting yourself. You have people who say, “Why are you running? You’re just going to hurt your body; you’re going to bang up your knees. You’re never going to last.” Bob: I remember, my brother, he picked up running at one point. He just went out without stretching and tore his calf muscle. That was it! Brad: Right. Let’s talk about the first thing. I’ve got 7 things here. You know, Bob, how I am about seven. Bob: You love seven. Brad: Seven is complete, Bob. Bob: Seven is heaven. Brad: There you go. So, number one, shoes. Let’s start out with shoes. These are not necessarily in order of importance but they are all important. The type of shoe you’re going to pick out is going to vary depending on how you run. Most people that start out are heel strikers, where they go heel-toe strike. You’re probably a heel-toe striker. You might be a forefoot runner. My wife’s a natural forefoot runner without even training. If you’re a heel-toe striker, like most people, then it gets a little complicated depending on if you have a high arch, a medium arch or you’re flat-footed. You want to make sure you get the shoe that fits you. I don’t have time here to go through that whole thing, because that takes a lot of time. Bob: We’ve had videos on this. You may want to check out those, because that’s a whole video, which shoe is correct for your type of foot. Brad: Right, so get the right shoe. If you want to see that video, just check out How to Choose Proper Running or Walking Shoes. Bob: I think the point that we are trying to make today, Brad, is that you need to spend the time to get the right shoe. It’ll make all the difference. I mean, you can run into problems very quickly. Brad: Yes, so, take some time and it’s probably likely that you’ll get a pair of shoes and they might not be the right ones, but then your second pair will be. Runners have all kinds of stories about shoes. Bob: Well, generally, what you do as a runner, once you find one that works, I buy a bunch of them and when I go back in I ask what the latest one on that kind is. They change it but they keep it fairly similar. Brad: Anyways, we don’t want to discourage them about the shoe issue. If you are a forefoot runner, that’s a different story. I’ll get into that later. Number two, warm-up. There’s some controversy about warm-up. There’s been some studies in the last few years where warm-up is not necessary, why do you warm-up, it doesn’t do anything anyways. I personally, disagree with that. Bob: I do too. As you get older, I definitely disagree with that. Brad: As far as warm-ups, I don’t personally go through an extensive warm-up before I run because I’m not going out sprinting. I usually start out walking, maybe around the block. Bob: That’s what I do too. Brad: Yeah, maybe about a block and then I go to a jog and as my body feels warmed up, I will start running. Bob: I do stretch before too. Which is the next one. Brad: Sure. That’s kind of an individual thing, I think. In wintertime, or if I’ve got the elliptical in my house, that’s a really good way for me to warm-up. Bob: It gets all the body parts going. Brad: Exactly. Jumping jacks is a really nice way before you get running. You know, if you’re a sprinter, that’s a whole different story. We are talking about people who are going out jogging or running, that type of exercise. Number three, the stretch. Now a stretch is another thing that some people will do or will not do. I think the two major muscle groups that you really should pay attention to and stretch are the calf muscles and the hamstrings. Bob: I agree. Brad: They’re the most commonly injured muscles, in my opinion, with runners. So, I would do a warm-up, the jumping jacks, maybe some walking, and then do some stretching with your heel cords. You can just do a wall stretch, where you stretch like this. If you want to get something that’s more made for it and it really works well, what do we have here, Bob? Bob: We have the ProStretch. I have to tell you a real quick story. So, I was on Reader’s Digest, so one lady was doing that against her car, that stretch. Another man thought she needed help pushing her car, so he came up and started helping. She asked him what he was doing, and he said, “Well, you need help pushing your car?” She says, “No, I’m just stretching. Ha-ha.” So anyway, this is the ProStretch. They sent us one of these and I was like, well, who cares about this? But actually, I use it every morning. It’s a great one to do because what’s nice about it, it actually stretches the toes too. Which helps prevent plantar fasciitis. I get up on it like this, Brad, and I stretch like this and I rock it back and forth. It works out really well and then you can actually pop it off that way because it sticks on you. Brad: Sure. Wouldn’t be fun running with that. And then the hamstrings. If you’re a runner, I’m assuming you’re pretty able and have good balance. I like to just bring my foot up on a stair or an object like this and straighten the knee out and stretch. You can hold it for that 30 seconds, a couple three times. Bob: Keep your back straight. Brad: Yep. I don‘t like to do the whole 30 seconds. I like to just relax, pressure on, pressure off. I’ll do that like 5-10 times. Of course, on both legs. Make sure you stretch both legs on both of these. So those are the two primary groups we’re going to talk about. Then, let’s talk the more technicalities of running. Number four, strike placement. I mentioned forefoot versus heel strike and if this is new to you, when you walk, your heel hits first and you roll through your foot to your forefoot. When you run, you do the same thing if you’re a heel striker. That puts a lot more impact to your ankle, your knee, and your hip as well as your back. Bob: Your heal hits and the force comes right up through the body, through your lower leg and into your leg. Brad: That can be up to 10 times as much as your body weight if they put a force gage on there. Bob: Both Brad and I have evolved from heel strikers to forefoot runners because it seems like it disperses the force more so when we run now, we’re hitting forefoot first. Taking more stress on the calf muscles now. Brad: As well as the quads too. Bob: But you’re taking less stress on the joints of the body that can’t handle it. Brad: So, if you’re a heel striker and you want to convert to forefoot runner, don’t expect to do it within a week or two. It took me two seasons, two summers, before I could do it. I started getting strains in my calf muscles. Bob: It’s a lot more strain on your calf muscles. Brad: And I strained my hip abductor muscle too. So, I just kept at it and eventually I took a running course for physical therapy. They also said, you know, one to two seasons, it’s going to take you to convert from a heel striker to a forefoot runner. Bob: There’s a book, The Pose Method. They go into great detail on how to convert to become a forefoot runner. Brad: And the popular book that’s come out in the last few years, Born to Run, it's all about forefoot running as well. And that forefoot, I want to step back into shoes. If you’re a forefoot runner, it’s easier to pick out shoes. You usually pick out a minimalist. A real light shoe and you’re just striking on your forefoot, so you don’t need that cushion in the shoe. The arch support issue is not near as important. Bob: I found, once I became a forefoot runner, I could run with my shoes longer. They lasted longer because I didn’t rely on the cushion as much so when the cushioning started going down. I didn’t care really. Brad: Supposedly, your speed will greatly increase when you become a forefoot runner. Bob: That didn’t happen to me. I thought it would, but it didn’t. Brad: Number five, cadence, how often you strike. Bob: Cadence means the number of foot strikes per minute. Brad: The location where your foot touches the ground, now this is for more advanced runners, I used to think if I stretched out in front of me that I’m going to run faster and more efficiently but that's not the case. Bob: I heard people say this at cross country meets all the time. They'd say he’s a good runner because he’s tall, he’s got those long legs. Brad: Oh yeah, stretch it out. Bob: The key is really to get a lot of foot strikes in a rapid succession. Brad: To do that, your foot should not strike the ground, if you draw a vertical line over your hips, it should not land in front of that. It should be right below it so you’re pushing as opposed to going out and pulling and coming through and there’s some other biomechanics with the knee mechanics that reaching out in front of you can give you knee problems with hyperextension, etc. I started doing this, and I think my time is going to be faster. Bob: I had a friend that was talking about this. He’s quite a good runner and he goes, “I’m running behind this older person and I can’t keep up with them. I’m watching them, it’s like, they’re striking their feet so often compared to what I was, so I started doing that and I pulled up to them." Give it a try. A higher rate. Brad: Right, so, I think the books we’ve mentioned, The Pose Method and Born to Run are two good reference books that you could read if you’re wanting to step up you’re running. Reducing injuries as well as increase your speed. Number six is very simple, very basic. If you can run on a non-pavement or concrete surface, you know get on a trail or anything that’s grass or dirt or gravel. Any of that, takes off stress. Bob: Number seven, you also want to watch the camber of the road . The road always has a slant, and if you always go down the same slant, you’re going to develop injuries. I know for safety-wise, you’re supposed to kind of always go against the traffic so you can see it coming. But, I actually go down one side and come back the same side so I’m varying the angles that my ankles and feett are dealing with. Brad: Right, because the road does curve so the water runs off instead of into the center so that’s a good consideration. Bob: If you’re on a trail that doesn’t have that consideration. Then you don’t have to worry about it. There’s lake trails and stuff like that. Brad: Just watch out for rocks and roots so you don’t sprain your ankle. Bob: Sounds good. Thanks. Interested in learning about the products mentioned: ProStretch Plus Calf Stretcher and Foot Rocker: https://amzn.to/2Gfv9ea​ Dr. Nicholas Romanov's Pose Method of Running (Dr. Romanov's Sport Education): https://amzn.to/2Ifw0yS​ Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen: https://amzn.to/2Z02Toa 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 For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun: https://amzn.to/36pMekg​ Q2 Mini Massage Gun: https://amzn.to/3oSMBu9​ Handheld Massager: https://amzn.to/2TxZBqU​ 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​ Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi 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 November of 2020. For the original video go to https://www.youtube.com/watch?v=SVDsfgI7KAw&t=76s. Brad: Hi folks, Brad Heineck, Physical Therapist. Chris: Hey, I'm Chris the Pharmacist. Brad: And today topic: Are you injured? Heal faster while you sleep. Simple inflammation management is the key. This is science-based, we have Chris the Pharmacist here, he's going to fill us in on all the science so we can understand it and go through the whole three pronged approach to get this goal completed. All right, so Chris, heal faster while you sleep. That's a pretty cool thing, but is it true? And if it is true, can you explain what the key is? Chris: Yeah, well, it's kind of interesting. We do seem to heal faster when we sleep. And there was a pretty cool study that came out this last January. The study specifically is called, "Chronotherapy of NSAIDs May Enhance Post-Operative Recovery." Brad: I don't know what the heck you're talking about! Chris: All right, all right. Brad: Can you shorten that up to something that I can understand? Chris: Basically what it's saying is timing is everything. And so the key is, when you take an anti-inflammatory drug, like Ibuprofen. Brad: Okay, across the counter? Chris: We'll use that as our example. And that's what the study used, was Ibuprofen. Just plain old Ibuprofen like you get, Advil, Motrin, Ibuprofen at any local pharmacy or online source. Brad: So you look on the box, it says, "Main ingredient: Ibuprofen 200mg"? Chris: 200mg, yup, you betcha. So, always check with your doctor, make sure it's right for you. Those of us that have kidney problems, heart problems, we have to be really careful with it. But for the purposes of this study, and making sure that we're going to get the best possible healing, this was some interesting stuff. Basically, the subjects were divided into an active group and resting group. They all had an injury that they had to study. Basically what happened was, we know a lot of things about anti-inflammatories. Since the 70's we have known that anti-inflammatories, like Ibuprofen, actually can delay healing. Particularly from a post-operative standpoint. Brad: Actually delay, slow healing down? Chris: Slow healing down. Brad: We know that, but everyone takes it? Chris: Everyone takes it. So it's kind of a conundrum. We've gotten a lot more advanced in our understanding of how our bodies work. What the authors of this particular study looked at very clearly, is they noticed we have genes that govern our circadian rhythm. That cycle that tells us when to sleep, and when to get up, and what we do throughout our day. Brad: Yeah, that is kind of been, not a buzzword, but something people are more familiar with. Chris: Yeah, so they found that we have these clock genes that kind of govern that, and it seems to work hand in hand with the inflammatory process. So it was really interesting. Like I said, we know that NSAIDs may delay healing, but at the same time we know that they help with pain relief, they help reduce inflammation, so we feel better. So it creates kind of a conundrum. Brad: So the inflammation, you're saying the swelling is good? It actually helps us heal? Chris: Swelling is actually a good thing. It's our body's natural way of getting all those little chemotactic factors, these healing factors that come in to try and help us to kind of calm things down, and allow new tissue growth, whether it's a broken bone, a torn ligament, a strained muscle, tears. So our body has a unique way of understanding what injury it is, and how to heal it. Brad: So it inflames, it swells up, and all of the fluid, the inflammation, is actually full of good things to help it heal faster? Chris: Correct. Brad: So we take Ibuprofen to do what? Chris: Reduce the inflammation. Brad: See, I always kind of thought that, you do it, there's that good stuff in there, but it gets to be too much, and it swells up, and the actual pressure creates pain, so the Ibuprofen actually just releases it enough so it doesn't hurt. Like it takes the air out of the balloon, a little. Chris: It takes the edge off. And for most of us, for comfort, humane use, that's kind of what we use it for. But Ibuprofen not only is an anti-inflammatory, it's also analgesic, so it helps with pain relief. So we'll kind of touch on that, to a degree, with the example in the study, as well. What they did with the subjects is they kind of grouped them up. Because we know that our cycles, again the circadian rhythm, so we're trying to figure out: When's the best time to take Ibuprofen, so we can get the best possible healing? We don't want to inhibit it. So what they've kind of postulated is that when we're asleep at night, that's when our best tissue recovery occurs. Brad: So it's healing the best while you sleep. And I think that's pretty easy to accept. Chris: Yup, exactly. But during the day, that's when your pain is highest, because our bodies are active. So let's say you sprained your ankle. You're going to kind of guard that joint, or you're going to limp a little bit, or you're going to keep pressure off of it. Brad: Crutches. Chris: You're not going to necessarily have your full range of motion. So with respect to that, they found that these painful mediators go up and same with some of the tissue tear-down factors also go up during the day, in our active phase. So what they postulated was, we're going to give Ibuprofen to this group of subjects in their active period, and we're going to give Ibuprofen to the other group of subjects in their resting period. And what they found was pretty interesting. So when they compared them, across the board they found, exclusively, that the active group that was taking Ibuprofen healed much better. Their bone volume was better, because it was on broken bones, was what the study was. And so the bone volume was better, they had better union, where the bones come together. They had less guarding during the day with pain relief, so meaning that they had a more, I guess better gait. Brad: Oh, quality of walk. Right. Chris: So when they noticed those, and then they compared it to the resting group. The subjects slept really well, and they were much more comfortable, and they also see that rest is healing. But, when they actually examined the bones at the end point of the study, they showed less healing. Delayed and even very diminished healing. Brad: So the bottom line is, if you take the Ibuprofen before you go to bed, with the idea "I will sleep better, I'm going to have less pain, less pain when I get up." That may be true, but the healing is actually slowed down as a result. So you want to take the Ibuprofen two hours before you go to bed, six hours? Chris: They didn't really identify that. Basically what they did, they equated to a 500mg dose of Ibuprofen for the subject matter. So from that standpoint, they didn't actually, like how people take it, it's two tablets every four to six hours apart. So they didn't really examine that. They gave it as a dose, equivalent to the subjects. What we know is that if you take Ibuprofen through the day, you'll take it a couple times, two-three times during the day. We probably wouldn't want you to, based on this study, it almost seems like you probably wouldn't want to take it past 6:00 at night. So that if you're going to bed around 10:00. But they also showed, with the gene expression, that our pain factors actually are, probably from let's say you were a typical person gets up at 6:00 in the morning. And kind of the evening they kind of rest, relax, wind down. By bed time, the pain's not so bad, simply because they've begun to relax. And then sleep is when all these other factors kind of come into play. There's other inflammatory factors that come in. The fluids that we're having. What they found is that if you cut that supply off using the anti-inflammatory, you're prolonging the healing stage. So it's going to take longer to get better. And maybe inhibit some of the healing. Brad: Sure. So, the bottom line is, if you're going to do a three... Chris: Three times a day. Brad: Three times a day, maybe in the morning when you get up, between 6:00 and 8:00. Lunchtime, dinnertime, but don't take it before you go to bed. Chris: Yeah, it seems like if you need something for pain relief, you might want to go with Acetaminophen or something like that. But not an anti-inflammatory. Brad: Sure, okay. So if you're going to take the ibuprofen, take it those times, take it with some food, at least some milk. Is that correct? Chris: Definitely want to take it with some food. But, you know, the big thing too, to take away on this, is this is a theoretical study, and it's not done on people. It was done on animals. So we want to be really careful with that. Talk with your doctor to make sure of it. But I mean, the logic and science is really sound. I think it might unlock a lot of possibilities. Because the problem is, with pain relief, rest is healing, and if we got pain we don't rest well. And if we're not resting well, we're not healing well. So we've got to come up with a way that's going to do a better job. And we know that anti-inflammatories are a good pain killer. We know that opioids are a good pain killer. Probably the combination is something that, at least post-surgically, that most doctors will always do. But they don't want to put people on opioids too long, because obviously there's addiction and other side effects that occur. But the same thing with NSAIDs. If we take NSAIDs all the time, we run the risk with our kidneys having some trouble with that. People that have bad hearts... Brad: NSAIDs? Chris: Non-Steroidals, like Ibuprofen. So Naproxen, and then there's several prescriptions as well. We want to make sure that our doctors are aware, the doctors are going to be acutely aware, but talk it over with your doctor if you've got kind of a game plan. Like, "Hey I heard this study, it said that maybe it's better to take this during the day time, and lay off the anti-inflammatories at night." Just see if it's right for you. You know, we don't want to steer you in the wrong direction. But the study seems pretty overwhelmingly positive that daytime use does a better job for you. Better healing while you sleep. Brad: Then we did say three-pronged, so you go onto the next phase and this is more where a therapist comes in. And its basic information. Elevate. If you got a swollen ankle, elevate it. Don't leave it hang down where you're sitting, get it up in a chair in front of you. Or on a couch, above the level of your heart. Get gravity working with it. You can wrap it with an ACE wrap. Not too tight! That's the biggest mistake people make, is they wrap too tight. You should be able to easily slip two to three fingers underneath the ACE wrap and easily pull them out. It should not be too tight, otherwise it acts like a tourniquet, things do not flow. And then cold packs. I'm a big fan of cold packs. Not for everyone, they only use them if they feel good and you get good results while you use them and afterwards, the next two to three hours. But there are some studies coming out that are showing cold packs may not be the way to go. But, I tell you what, I'm going to have to really examine those, because I've had really good luck, personally, as well as with patients over the last 20 years. So I think you're pretty safe using a cold pack. Those are the three points. Ibuprofen, don't take it right before bed. Take the proper amounts. Compression, elevate, and cold packs. So, wow, I'd say Chris you gave a full and detailed explanation of the recent studies, and I don't know what else to say. But one thing's for sure, I don't think it's going to help with a broken heart. Chris: Nope, we can't figure out how to fix that, yet. Brad: And we're working on that. Very good. Take care until the next time. Chris: Thanks guys. Visit us on our other social media platforms: YouTube: https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun: https://amzn.to/36pMekg​ Q2 Mini Massage Gun: https://amzn.to/3oSMBu9​ Handheld Massager: https://amzn.to/2TxZBqU​ 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​ Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi 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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What is the Difference Between TENS (Transcutaneous Electrical Nerve Stimulation) and EMS (Electrical Muscle Stimulation)? There is one simple difference between TENS (Transcutaneous Electrical Nerve Stimulation) and EMS (Electrical Muscle Stimulation). When using a TENS unit, you are trying to reduce your pain. When using an EMS unit, you are trying to strengthen a muscle. If your muscle is no longer working at all, you may also use an EMS unit to try and retrain the muscle to start working. An example where you might use a TENS unit would be if you have chronic pain and knots (trigger points) in your upper back, shoulders, and traps and are taking daily pain medication to help control the pain. Using a TENS unit, you may be able to decrease pain AND decrease or eliminate your medication use. The following is an example where you might use an EMS unit. AN EMS unit is commonly used after knee surgery on the quadriceps muscle. The quadriceps muscle is a set of four muscles that are designed to help straighten the knee. Sometimes after knee surgery, your brain will tell your quadriceps muscles to go into protection mode by not working or not working well. Your brain believes they are protecting the knee by stopping those muscles from contracting (working). If this continues for a while, it is as though the quadriceps muscles have forgotten how to do their job. The EMS can help retrain the muscles and help them perform the job they are designed to do. The EMS is not designed to bulk up the muscle but rather retrain the muscles and get them to activate. 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 March of 2021. For the original video go to https://www.youtube.com/watch?v=oSLUgFLPpY8 Bob: Today, we're going to talk about five bad habits that are killing your joints and what to do instead. We have a lot of these. Brad: Yeah, you don't even think about a lot of these things. Bob: No, we have a lot of experience with this, because we're old and we're starting to kill our joints. All right. So number one, you're going to avoid wearing high heels. I mean, you can wear them for special events. Brad, you can wear them on special events. Brad: LOL. Whew. Bob: But don't be wearing them every day. You know, around the house. Brad: You know, it's really hard on those metatarsals the weight going down and the bunions. Bob: Yes, they can cause bunions, hammertoes. The weight is tipped forward and you're getting more weigh on your toes. So, it's just not good. There's no way about it there. Brad: They look good, though. Bob: They look good. Brad: On some women, they look really good. Bob: What does that mean? Brad: I'm just sayin', it's a fashion statement. You know, that's why you wear them. Bob: Number two, too much texting. We're talking about stress on the CMC joint, in the thumb, especially. Brad actually did a video on that. The carpometacarpal joint, at the base of the thumb. It's being very active when you're texting. Brad: It can be confused with wrist pain. People think it's the wrist and it actually is their thumb, the base of their thumb. Bob: Pretty easy to fire that up. In that case, one, you're going to maybe do more of the texting through audio, right? Or you can also get a brace for your thumb. Brad: Yep. There's some nice massages. We got a video on that too. Bob: Yep. Number three, sleeping on your stomach. That's a bad habit. What it’s doing is you're putting your head all the way to the left or all the way to the right, which is putting your neck, the joints, at end range. As a rule of thumb, our joints don't like to be at end range. Brad: For any length of time. Bob: For any length of time, right. And that goes for closed back or open, it really doesn't like it. So, number four, you're not stretching enough. This is one Brad and I probably see. The number one thing that you can do to improve your joint pain, is to stretch that joint. The muscles above it and the muscles below it. And if you're not stretching enough, we have a million videos on this. So, whatever the problem you have, if you have knee pain, we show you how to stretch your knee, so that you can decrease that pain levels. Brad: And for this, stretching, you do want to go to end range but we're not going to hold it there very long. Bob: Right. Brad: But, there is an exception there. Bob: Yeah, you don't want to hold it for a half hour. Brad: No, we're just doing some short stretches, end range good for it. Bob: Number five, not getting enough sleep. Now, people wouldn't think that had anything to do with your joints, but they actually did a study, Brad. And people, if they felt like they had a restless night, their arthritis felt worse. The joints felt worse. The question is, they don't really know, it might be that it triggers inflammation, when you don't sleep well. Sleeping is always really important. Number six, if you want another reason to stop smoking this is it. Blood flow to the bones, and also the discs, which are between the bones, is decreased with smoking. It limits the calcium the body can take in. So lots of bad things. I always like tell the story, Brad. I had a lady that worked for me and her nephew actually cut off one of his fingers at a sawmill. Brad: What's it got to do with this? Bob: Because, he was only 17 or something like that, at the time, and they had trouble reattaching it because his arteries were so bad because he was a smoker. Brad: Oh it was a smoking effect, yeah, yeah. Bob: So just to throw a little fear in you. Number seven, you're not strengthening enough. Same thing as with the stretching. If you don't keep the muscles around the joint strong, the joint itself has to take more weight bearing. The other thing that happens, Brad is Wolff's law. When you strengthen the bone actually reacts and thickens on you. Brad: Right. Right. That's how you prevent osteoporosis. Bob: Right. So, strengthening exercises are a big part of osteoporosis prevention. Actually, on our podcast, we're having someone this coming Friday. It won't be aired this Friday, but it'll be soon after. Brad: Sure. I just wanted to mention, when you do strengthen, it's typically moderate weights. You're not doing these max heavyweights. For younger people, you can get away with that. But especially if you haven't lifted weights, moderate weights are good for the joints. Good for that bone growth but we don't want to overdo it. Bob: All right. Number eight, is probably the most obvious statement I'm going to make today is, that if you're overweight that's going to put more stress on your joints. So you all know that and I guess it's just another reminder. Brad: That's a challenging one. It’s like, stopping smoking, if you've done that for a while. But, there's ways to get by. And we have videos on that. Bob: Sure. On weight loss. Brad: There's a lot of good information to help you out and good friends and family. Bob: Yep. Number nine, if you're carrying a bag, especially, I carry a bag for my paperwork and stuff. I always carry it on one same side. I know you're not supposed to do that, but you carry the bag on the same side, it’s stressing the joints on one side. If you don't have a roller for when you go on vacation. You're going on vacation, Brad. Do you have a roller suitcase? Brad: No. My wife carries them. (LOL) No, we roll them. Bob: It's like he loads up a pack mule there. Brad: She is strong, Bob. Bob: Well, good. She'll handle you. Brad: I hope she doesn't see this. Bob: Number ten, poor back posture. That just really puts pressure on the joints. You know, if you have that rounded out posture. You want to stack the bones like when you were born. They were made to have a S-curve in your back. Brad: Everything there is designed in our body exceptionally well. Bob: To be the strongest. Brad: As long as we use it properly. Bob: Yeah. Number eleven, Brad, you were going to talk about this. Brad: Oh yeah. If you're using hand tools, for those of you who work in the trades or at home, garden tools, but particularly tools that vibrate, sanders, that kind of thing. Or if you're using tools where you're putting a lot of stress temporarily, and if you have arthritis, you know what we're talking about? Because you'll get done with the task and those especially those finger joints and wrist joints, they just ache afterwards. You know, you're beating those joints up. So, do something, if you cannot do it as long, have someone else do it because you want to keep those joints and make them last. Bob: I felt, what helped me, Brad, is I have a weed trimmer that I actually push. But it really vibrates. It really vibrates and I did get one of those gloves. That seems to help. Brad: The gloves with the cushion in it? Bob: Yeah, got the cushion in it. It seems to make a big difference. Brad: They come up with a lot of good ergonomic gloves, tools, shapes and things like that. So it's worth paying a little extra to have a better grip, if you're looking at that. Bob: Okay, number twelve. Being on the computer too much. If you're watching Bob and Brad, that's fine. You can also put us on TV. Brad: Absolutely. You just keep watching. Bob: But otherwise, especially if you have poor posture, you can have increased stress on your elbows, your wrists, your back, your shoulders, everything. You have to have it aligned correctly. And we have videos on that for you. Brad: Right. Just Google "Bob and Brad posture" with the computer and we'll show you all the ins and outs. Bob: Number thirteen. If you've got poor form, throughout the day. I'm going to give a couple examples, Brad. There's people who stand on one leg. They stand, for example, if you picture a woman maybe with a baby on her hip. Brad: What about a guy? Bob: Well, yeah, but women seem to do it because they have better hips, you know? So, they can rest that baby on their hip but then they're putting stress all on one side. So you want to even it out. Brad: It's one of those things that's a habit. If you're right-handed, you know, I was carrying my granddaughter yesterday. She's a year and a half and I had her on my right side. I don't even think about it. I'm not going to carry with the left hand unless I actually cognitively think to do it. Bob: You'd probably drop her. Brad: Well, it's possible. I did have my daughter when she was a year old on the left side, and it was five o'clock in the morning and I was falling asleep and I almost did drop her. But I caught her. Bob: You caught her. Brad: Yeah, I could probably tell her that now she's 24 now. Bob: She made it through the Brad years. LOL. So you can also be sitting wrong. That's the one I like to do. Brad: Let me give you an example. Brad: If you have a habit of doing this, when you're younger and you keep doing it and you're older, you'll probably pay the price at the hip, the knee, the ankle sooner or later. Bob: - The chains of habit. They form and they're hard to break them. Brad: Say no more, Bob. Bob: But I have to think it every time, Brad. I don't know why, but when I eat at our island, I want to lean forward and I want a lean on one side. I don't know why but I have to consciously, sit up straight. All right. Number fourteen, just simply not moving enough. Joints love movement. Even arthritic joints, if the arthritis isn't too far along. But one thing that we suggest, if you're sitting, just every so often you're going to bend and straighten your knees. Let them swing back and forth. It lubricates the joint. Brad: Ankle pumps. Knee kicks, marching, all these things you can do seated, you know. Bob: And it doesn't take much. It gets that synovial fluid moving, which is kind of like the lubrication oil. And you're going to be in like Jake. That's an old saying. Number fifteen, the final one you'll want to avoid, especially if you're having arthritis in the hands. You want to avoid using the smaller joints, whenever possible. So if you have a coffee cup and if you're grabbing the handle, you're using the small joints of the hand. You actually want to grab it with the palm, like this and drink it like this. It warms up your hands then too. Brad: Right and in the wintertime it's a pleasure. Bob: The same with picking up a box. It's better to do with your palms, instead of the fingers. Even opening a jar, Brad, rather than using your fingers to grip the lid, if you can you want to use your palm. Brad: Sure. You can get those sticky pads on there. That makes a big difference. For the coffee cup, here's the easy fix, Bob. You pull your drawer with a little hammer in it and you hit it, you just break the handle right off and then you don’t use the handle. Bob: There you go. Brad: Or you buy one without a handle. Bob: What a genius. Brad: I'm just sayin'. Bob: All right. More great ideas from Brad Heineck. Brad: Well, and it's cheap. It doesn't cost you anymore. Bob: All right. 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 For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun: https://amzn.to/36pMekg​ Q2 Mini Massage Gun: https://amzn.to/3oSMBu9​ Handheld Massager: https://amzn.to/2TxZBqU​ 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​ Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi 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 December of 2019 . For the original video go to https://www.youtube.com/watch?v=6avLYAHa3zA Bob: Hi Folks, I’m Bob Schrupp, physical therapist. Brad: Brad Heineck, physical therapist. Bob: Together we are the most famous physical therapists on the internet. Brad: In our opinion of course, Bob. Bob: Today we’re going to show you how science shows inversion table decompression reduces surgery by 55%. This is quite a claim, Brad. Brad: Right. Well, that’s in the study. Bob: We'll try to back it up. Brad: We’re going to talk about how they did this. We have this study, as well as personal and patient experience that also supports this. So, Bob, if you have a herniated disc, Bob: Bulging or herniated disc, Brad: That’s what the study was done on. All the patients had just one herniated or bulging disc. Bob: At one level. Brad: Correct. At one level with symptoms down the leg, the typical sciatica symptoms. They start out with 22 patients, actually three of them did drop out for various reasons. That’s pretty typical in studies; they don’t get a 100% follow through. But that’s normal, like I said. So, they went through this and each group had therapy, physical therapy exercises they did, and the one group had the inversion table protocol in addition to the physical therapy exercises. Bob: This was at New Castle University. New Zealand or Australia? Brad: No, I think it was in the UK. Bob: United Kingdom. Brad: There you go. The group that didn’t use the inversion table, 78% of them did have surgery. You have to remember that all these people were going to have surgery to begin with. Bob: Oh, all of them were slated to have surgery. Headed down that path. Brad: Right, so 78% of them did that didn’t use the inversion table and the people that did use the inversion table, only 23% of them had surgery. Bob: So that’s quite a difference. Brad: That’s 55% difference. Bob: Right, and I’m going to give you an anecdotal story. My neighbor, I saw him almost a year ago and he was having sciatica. I had showed him some things and recommended to him to try to tough it out if he could and not have surgery because I said the discs often get reabsorbed. There’s a mechanism in a way that happens. He listened to me to some extent and he actually went and got a Teeter. Not on my advice, but he went and got one. I was just talking to him at the Christmas party and he said, “I got a Teeter and my doctor had said the same thing, the disc could get reabsorbed, and I’ve been using the Teeter.” He uses it a couple times a day. He’s got a little bit of pain in the low back yet but it’s almost all gone. Brad: I’ve had patients that use them regularly too. I used one when I had sciatica. Bob: It’s a big part of your pain management. Brad: Right, exactly for my spondylolisthesis. We do want to go on to one thing. If you’re going to use one and you haven’t used one, make sure you talk to your doctor about it. There are some conditions, for example, if you have glaucoma. Bob: Right, you can’t have an increased eye pressure. Brad: Blood pressure could be a variable in it as well. There may be a few other things too so it’s not good for everyone so make sure that it will fit for you. Bob: Get it cleared with your doctor. Brad: The next thing is using a good product. I really like these Teeter’s. Roger Teeter’s the founder of it. Bob: Alright, we have to bring this point up, because his name is Teeter. Like teeter-totter. Which seems like the perfect name for this and are you telling me that he was born with the name Teeter and then he invented this product? Or did he change his name? Brad: I have a feeling he was born with it. He just seems like that kind of guy. He wouldn’t do that. Bob: He’s 80 years old, still surfing. Brad: Water skiing. Bob: Water skiing, oh, I thought it was surfing. Brad: Maybe he’s doing that too, I don’t know. So, it’s a good product. What we do want to talk about is adjustment. If you’re going to use it, do not think you’re going to just buy one of these, get on it and start doing your treatment right away. Take some time to put it together properly, look at the videos, the instructions, and make sure you adjust it properly. I’m not going to go through it very detailed here. This one’s already adjusted for me, one more click, there we go. Bob: Alex put this together. It was pretty easy, he said. Brad: Yes, it’s preassembled for a good part of it. You should be able to for sure be very comfortable in the control of where your incline is. Bob: So, basically you just lean back, and that started pushing you back into the inverted position. Brad: Right, so just by moving your hands. This way, I’m starting to tilt more, if I bring my arms up, say I’m not ready for it, I just bring my arms down to my side. You should feel in complete control, because if you’re not relaxed doing this, it’s not going to be near as effective. Bob: You have to have the muscles relaxed so they can come apart. Brad: So, let’s talk a little about the mechanics, why this works for sciatica. What I’m doing is, I’m going back. Now, the weight of my trunk and my arms and my head are going to slide on the smooth table of this inversion table, which is another good benefit to this table, and that’s going to put traction through my lumbar spine. I don’t know, Bob, if you wanted to show that on the spine. Do we have a spine? Bob: Yeah, we have a spine, right here. Brad: So, you’re going to go ahead, and this is where the decompression part of the title or of inversion comes in. Bob: So, Brad would be in this position right here. If you look at maybe these two bones, can you see how they are pulling apart a little bit? That’s basically what’s happening there on an anatomical level. Those are pulling apart and sometimes they say there’s almost a centrifugal force on the disc helping to suck it back in. So almost like a vacuum cleaner. Brad: Right, well that’s what I would refer to it like a vacuum, bringing that disc back in where it belongs. The key part is when you’re actually doing this, learn to relax your core. I’m going to go back now. I’ve got this locked out at 60 degrees. I like to keep it at 60 degrees when I’m inverted. Some people will go to a complete inversion. I’m not a big proponent of that. Bob: If you wanted to set it for less than that, you can set it for less than that, and go back. Brad: You can start out at 20 to 30. If you invert the first day lat 60 for five minutes like I did, I ended up with a headache all night that night, and then I realized, too much too soon. Bob: Yeah, you went full inversion. Brad: Well, I didn’t go full, I was about 60 degrees. Bob: 20 to 30 degrees is what he’s saying not 20-30 minutes. Brad: Right, oh I’m sorry, did I say minutes? Bob: No, you said 20 to 30. Brad: Oh, okay, I’m sorry. Bob: One to two minutes. I’d start off with. Brad: I’ll go back to 60 and I’m going to relax those core muscles, and you’ll feel the traction on your spine. Now, if you have sciatica, you got the numbness, you have the pain going down the leg. When you are inverted, you want to monitor the location of your symptoms closely. If the symptoms and the pain seem like they are going away in your foot, but they’re a little worse maybe in the thigh or butt, that’s a good sign. We want the symptoms or the pain to come back in a manner that it goes away from the foot or distally we call it, and it works its way back up towards the back, the buttock first and then to the center of the back. Bob: So, the pain kind of retreats but it starts on the furthest most point first. If you have symptoms in the toes and feet, you want that to go away first, calf pain to go away, then knee and thigh and so on and finally it would all go away. Brad: The other extreme is let’s say the back pain gets notably better, it’s like, oh wow, that back pain is better, but your foot starts getting more numb and more symptoms there, that is not a good situation. Bob: Right, that’s a bad sign. Brad: You do not want to continue. You’re either going too much or you need to reposition or just do something different. It’s not good. Bob: Yeah, that’s not what you want to see. Brad: In my case, I went on it and my legs started feeling better clearly, although I did invert too long too fast, but I eventually got back, usually I went around three minutes. I’m comfortable here. I don’t know how many minutes I’ve been here so far. Bob: Quite a few. Brad: I’m going to gently bring myself up. When you get done inverting, you’re not going to want to get up and just bounce out of this thing. I like to go to the middle position for a minute or so, and then work yourself up. Bob: You want the blood pressure to equalize and that you’re not going to get a little hypertensive episode where your blood rushes down. Brad: Then you get dizzy and have a problem with that. Also, this is really critical, how your leg and your back feels while you’re inverting, then you come back to an upright position, and then see if that numbness and tingling comes back in your leg. If it does, well, that was doing good when it’s back but it’s not maintaining, hopefully it doesn’t. Also, if you get up and then walk around and you really know it’s really setting in is when the leg feels better when you’re in it as well as for the next half hour as you’re walking around. If it stays good for two or three hours and its starts to come back, you may want to get back in that inversion table again and do this repeatedly until it gets better. Bob: One thing I like is if it gives you an hour of relief, then use that time to go for a walk then, because walking will help your disc heal as well. Brad: Don’t walk up a hill though. Bob: Keep it flat. Flat surfaces. If you normally have trouble walking, and after you teeter it goes away, that’s a great time to walk. It can be used advantageously. Brad: I did want to mention, they also have an adjustable and removable lumbar support, which in the case of a disc problem, you may want to use it. That’ll support the lumbar area. It’s adjustable, you can have it at different levels. In my case, if I use this, it’s very uncomfortable. I will not use it. Bob: You have spondylothesis Brad: Yes, I have a different diagnosis. But anyways, that’s a nice little option that comes along with this, you may or may not use. If you use it, you should feel good comfort with it. Bob: There you go. Thanks. 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