♪ Bob and Brad, the two most famous ♪ ♪ physical therapists on the internet.
♪ – Hi folks, I'm BobSchrupp, physical therapist.
– Brad Heineck, physical therapist.
– Together we're the mostfamous physical therapists on the internet.
– In our opinion of course, Bob.
– Okay this video's entitledhow to sit pain free in your vehicle when youhave back pain or sciatica.
Ideally when you haveback pain or sciatica you're gonna avoid sitting inthe car as much as possible.
This isn't the time togo on a long trip, Brad.
– This is the time to see if you can figure out an alternative.
'Cause even if you have ideal posture when you're in the car with sciatica, it's still gonna be hard on your back.
– When you're in the car, thisis gonna simulate the seat, by the way, of the carand this is the spine.
Let's see, Brad pointing that way, even if you have perfectposture like this, there's still lots of shock absorption and stress on the back.
– And unfortunately, a lotof people also tend to sit somewhat rounded here, so that's what we're gonna try to avoid and show you today how to get out of that.
– Even if you have perfect posture and you sit in the car foran hour, two three hours, it's not gonna be goodfor sciatica situation.
– Right and so that's, we're gonna talk about some, well what to do if you areforced to drive for a living.
– So, to get to work and back.
– Let's start, Brad.
I'll get in the chair here.
So the first thing with the seat is that you wanna make surethat you slide your butt all the way back, as far as possible.
– 'Cause that's, ifit's forward like this, you're gonna slouch.
– Yeah, there's just no way around it and you'll feel it.
When you push in, you can tellyou're getting good posture.
Now your seat might havea built in lumbar roll, lumbar support.
– If it does, make use of it.
– Because you don't needto use a different one 'cause that will also adjustto your particular curve.
– Right, and some cars, I've had patients that didn't even know they had it in their car with back pain so I'd literally go out intothe parking lot with 'em and show 'em how to use it.
Sometimes it's a mechanical one– – Sure.
– Where you turn.
Sometimes it's a button whereit's electric and it goes– – Those are really nice 'causeyou can actually adjust them throughout the trip then.
– As you're driving along.
All right, let's sayyou don't have anything.
The first thing you're gonna do is probably try a rolled towelbecause, wouldn't you say? – Right, except for the noteof changing the seat angle.
– We'll get into that.
– Yeah, we'll talk about that.
– All right.
– Well let's start withtowel if you don't mine.
– Sure, yup.
– If you're a thinner or slighter person you're probably gonnanot need as much support as if you were a largerperson with a larger buttock.
You can see there's gonnabe more of a gap there in that type of person.
– So I typically use a very thin foam that I put in my low back, actually almost, right by my belt line or even a little bit belowand that is plenty for me.
As you can see even this, starts to almost put toomuch of an arch in there.
– And you'll feel it.
It'll feel comfortablewhen you put it in there.
If it's too big, you're gonna feel it.
It's like, oh, you'll know.
It's very clear.
– Yeah, that's what'snice about the towel, you can adjust it to fitwhat is gonna work for you.
So then once you decidewhat size you need, you can then get something more permanent and these can actuallywrap around the seat so you don't have to keep adjusting it.
– And you don't haveto keep looking for it.
This one is actually fairly thick.
– So, and dense.
– Yup, so these areMckenzie lumbar supports.
They make a good support and they make a varietyof sizes, you'll see.
There'll be round ones.
That one's called the D shape.
– Yeah, look at this one.
Look how far I am with that one.
– Yeah, and if you havea really soft car seat or a old car seat where it's hollowed out, you're gonna need a thicker one even if you're a thinner person so there's a lot of variablesyou have to take account for.
– Yeah, this one's a littleless dense, isn't it Brad? – Yup.
– This one's gettingcloser to what I need.
This one actually doesn't feel bad.
Here's an air filled one, again another Mckenzie one.
Kind of nice becauseyou can adjust it a bit.
– My wife likes this one.
She uses one like this in the car.
– And it actually, I wouldlike this one too Brad.
It sits right on my sacrum nice and it gives me good support.
– Yup, it conforms nice.
– Let's show 'em yours.
– Yeah, I've tried all of these.
– You wanna sit down and show 'em? – Doesn't work for my back but I've got a different situation but this is the one I use.
It's memory foam and itsupports the whole back.
It does have a littlebit of a lumbar support and I put it in there likethat and it's very nice.
Oh, should we mention the dead pedal? – Yeah, why don't you goahead and jump on to that? – So Bob mentioned that youshould scoot your bottom all the way back in and in most cars in the left hand corner onthe floor there's a surface, it's not as big as this but it's where you can put your foot on.
– I call it a stationaryinclined foot rest and you called it a dead pedal.
– Dead pedal.
– Yeah, they both make sense to me.
– Right, so it's that little spot there on the left hand side, it'sthe angled platform solid.
You put your foot andpush your bottom back and you're gonna do that while you drive– – Exactly.
– Regularly, every 10 15 minutes, 'cause you'll slide down like this and you gotta get it back upin there and it'll feel good.
– A surprising thing again Brad on that is a lot of people don't knowthey have it in their vehicle.
– Right, or why it's there.
– Or why it's there, so what Brad was alluding to before is that you wanna havethe seat fairly upright.
– Because if it's back likethis, sit back like this, the thing you're gonna do is you're gonna reachfor the steering wheel and you're gonna round out, so you want to have itfairly straight upright.
You wanna be fairly closeto the steering wheel.
If you're not, if you're, for example if the steeringwheel is way over here, again, you're gonna round out.
– And also you wanna keepyour feet fairly bent.
If they are really straight like this, it's gonna be easier foryour seat to slide forward.
– Sure, sure.
– So that's a nice adjustment to make too.
The steering wheel, we're borrowing your imagination here now so here's the steering wheel.
Ideally they tell you to be at 10 and two.
– Yeah, that's gonna startcausing you to slump a little bit so we prefer nine and three.
– Yeah, bring it down.
– Or down to eight and four? Yeah, eight and four, right? – Right, that's goodfor your shoulders too.
– Yeah, it's gonna bebetter for your shoulders.
It's gonna be a lot less stress on them so you wanna do that also.
Let's see, we're also gonna talk about actually getting out of thecar and into the car correctly.
– So when you get out of the car, you don't wanna do, ifthe door is right here, we open it up, you don'twanna do what's typical where people, open this way, they don't wanna do this where you get the one leg out and then you start coming out, you know? – Right, one foot at a time.
– You wanna actually, yeah, you wanna putone foot, another foot, turn all the way around andthen get up straight like this as opposed to getting out like this where you're twistingand turning and bending.
– Right, right.
And sometimes if yourback is pretty sensitive, a lot of times there's a hand hold above.
– You might wanna usethat to help do the twist.
– So getting in to the seatwould be the same thing.
– You'd open the car door, you'd go ahead and sit down, again keeping a nice and straight back and then bringing in one leg and then bringing in the other leg.
– Right, taking your time.
– Do not try to reach to the back seat.
This is really bad onyour shoulders actually and it's really bad on your back to be reaching to the backseat and grabbing something.
I do this all the time, Brad.
This one thing, I gotta listen to myself.
(Brad laughing) I forgot something and Ineeded it in the front seat, I'm like, you know I'llbe back there like that.
– Yeah, reaching back, plus it's just not very safeparticularly if you're driving.
– No, well I don't do it when I'm driving but I am unfortunatelyguilty of that at times.
The other thing is afteryou drive for a while, you really don't wanna get out of the car and lift anything heavy for quite a while.
When you're sitting like this, the back ligaments are stretching out and your back is less stable, plus there's that pressure on the disc.
– So your discs are alittle more vulnerable to having a problem and I remember Brad, this happened to me specifically.
I went on a three hourtrip back home, got home and I grabbed a coolerout of my back trunk and I'm like, “Oh.
” I mean I felt it right away.
– Right, yeah.
– So it's a very vulnerable time.
– Get up, walk around and you'll probably noticeif you are having back pain, when you get out of a car, you've been sitting there for a while it takes a little walkingbefore you feel comfortable and straight up again.
– And Brad, yeah, brings up a good point.
As much as possible, you should try, if you have to go on a trip, break up the trip into increments.
– Try to stop every halfhour or every hour and walk.
– And also you can dostanding back extensions.
– So because you've beenflexing a long time, a lot of time if you take yourhand and bend back like this and do a repetition of 10 reps– – Sure.
– That can help offset thebending that you've been doing for quite a while.
– And if you're sore andthat's not tolerated, I hate to say it, but youshould lay down on your stomach and do some press ups.
– I didn't see it but Ihad an instructor of mine from a Mckenzie courseand one of his patients, out on the interstate– – Oh no kidding.
– Oh no, yeah, and he did his press ups, not on the road but wellin a safe area but– – Yeah, you could bring apiece of cardboard along.
I mean, we joke somewhat but really not.
I used to have patients thatwere in a factory setting that they got a piece of cardboard and they would lay on the cardboard and do press ups on the floor, so– – Right, and if you're not familiar with the press ups on this video, you'll see it a numberof times on our series.
– Yeah, it's one of the exercisevideos that we'll allude to so, remember you're tryingto stop the pain makers and sitting is a pain maker so you want to sit as correctly as you can but avoid it as much as possible too.
– Very good.
– All right, thanks for watching.
– Drive safely.