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.