This article is a transcribed edited summary of a video Bob and Brad recorded in January of 2021 . For the original video go to https://www.youtube.com/watch?v=4tTCs-BAHwA&t=92s Bob: I am exactly one half of the Bob and Brad team, and I'll be your host today. I'm joined by Chris the pharmacist. Chris: Hi, guys. Bob: The smartest man I know. In fact, Brad and I were talking. We think he's a cyborg or something. So, anyway, we're going to talk about human growth hormone. Does it slow aging, increase height? And then we're going to talk about at least 10 ways to boost it naturally. So why don't we talk first about the possible benefits, Chris, of human growth hormones. What are some advantages? Chris: When you really look at growth hormone, from a prescriptive standpoint, it's really designed for about three generalized categories. If you're born of short stature, for a variety of different reasons, and there's multiple syndromes within that umbrella. Bob: Should be used with a child, right? Chris: Yeah, generally for childhood use. It's going to be used for the wasting of muscle in people that have HIV or AIDS, to help to kind of stimulate that and just kind of distribute some of the fat problems that are sometimes associated with HIV medications. And then really it's going to come down to people that have had tumors, things that mess up with the pituitary glands. So whether there's been some cancer or just something that's just simply not functioning properly. So those are really the real medical reasons why you would use growth hormone. Bob: That's as a prescription? Chris: Yes, as a prescription version. And there's a lot of non-prescription things and aspects that certainly go on. I mean, there's a reason why it's illegal in athletics and the Olympics. I mean, frankly, it works. Bob: And we talked about earlier how it's being used a lot in Hollywood? In fact, I read, nobody's coming out and telling you they're using it or anything. Chris: No, they're not going to tell you, but when you're 65 years old and you look like you're 45, something's going on. Bob: And you're ripped. So, I mean, there was some that admitted to it. It was Sylvester Stallone, well they caught him. Chris: Yeah, he got busted. Bob: Suzanne Somers did it in the book. Oliver Stone and Nick Nolte. And Nick Nolte, oh, my gosh, he looks like he should be using it. Chris: What a hard living. Bob: Yeah, hard living. But I had looked up a few too. I wanted to get your opinion on this. So advance loss of body fat. Chris: Yup. Bob: So enhanced muscle growth. Chris: Yes. It's interesting because growth hormone, that's the interesting thing when you look at athletes. A lot of times when athletes use it, they stack it with a steroid base. That's how they get the strength aspects. It creates more lean muscle mass, but it doesn't necessarily make you stronger. So it's kind of interesting. One of the reasons that drives that bus is they use insulin-like growth factor, and that's one of the things that helps with the development of muscle tissue. So it works, and it's a hormone. I mean, it's 191 free peptide chain of amino acids that's strung together. Bob: So an athlete probably wouldn't want to use it just purely alone. I mean, even illegally use it for strength. Chris: Not that we would ever recommend that an athlete would use that, Bob, but, I mean, if they were going to cheat, they would probably be using it with something else. Bob: Sure. So get your facts straight. Okay, next thing. Increased exercise capacity? Chris: Well, it's one of those things where growth hormone drives the bus in everything that we do, whether we're working out or whatever. It does so many other intrinsic things in our body. But for recovery rate, so, the Lance Armstrong's of the world. I mean, I think that's a pretty graphic example. Unfortunately, professional cycling has been wrought with, whether it's doping, whether it's HGH, whether it's steroids, and it really was all three, which is kind of interesting. Bob: You didn't have a chance, I don't think. Chris: You did not have a chance. Bob: You're leveling the field, unfortunately. Chris: And they had to be smart about it. But the reality of it is that it does speed up recovery and/or aspects of injury, it will help you to promote a faster recovery. But the weird thing is, and I couldn't find an exact reason, and I looked, it does increase, if you have more muscle mass, you would think intrinsically you'd be stronger, but they haven't been able to show that in laboratory studies. Bob: That's just so strange. Chris: A lot of these things, too, these studies were done mostly on short stature kids. So when we talk about some of the other things we're going to progress through to, they just noticed the good effects of the product on these children as they grew and aged and developed. And there are other doctors were making the extension of thought for people and other categories, as adults, as aging adults, as aging athletes. And so that's how a lot of these things ended up occurring. Bob: So I take it it's used fairly short term for children, or are these used for several years? Chris: Well, no. If you have a short stature child, whether it's premature birth, whether it was a tumor, whether it's one of the syndromes that they use it to treat for, they want to get it in there as quickly as possible, and then for as long as possible. At the end of the day for growth, you have a limited spectrum of activity, so when those bones fuse, you're pretty much done. But there's other superficial bones that grow, and then we can talk about, acromegaly and things like that which are side effects that can happen to adults when they're done growing, and you get the longer hands and fingers and feet. So those smaller bones definitely still continue to grow, which is unique and somewhat problematic. Bob: Yeah, I don't think it would be the desired effect you’re looking for. Chris: No, no. You don't want the elongated face, big jaw. Bob: So they also talked about possibly improved fracture healing and tougher bones? Chris: Yeah, again, it's a hormone, so we have receptor sites all over our bodies, and so it helps to stimulate bone growth. And so we know that for a fact. And when you're younger, and for obvious reasons, when we're growing, we want you to have more rapid bone turnover rate. Bob: So I wonder are they being used at all if they have someone that's not healing very well? And I wonder if it's used in that. Chris: I think probably more off label. I don't think you're going to see most physicians... Because they're dangerous, with growth hormones. So we'll touch on that as we go. Bob: We'll get into that, yeah. Chris: But, it's one of those things where, yes, it works. And so there's a reason why it's banned by the IOC. It's banned by MLB. It's banned by the NFL. It's banned NC2A. I mean, it's banned, but it does help. It does promote healing. It does help to enhance bone strength. It helps with the matrix. So it works with your body's natural systems. Bob: Now one thing we had in the title, does it slow down aging? And could you speak to that, Chris? Chris: Slowing down aging… Bob: Like living longer. Chris: Yeah, yeah, it does. It seems your appearance gets better. Your hair will be restored. You're going to have a better color. Bob: And that's why it's so popular in Hollywood. Chris: Yup, certainly for the aesthetic aspects. And then, actually, it's not just popular in Hollywood. It's one of the most abused things that they use it for, these youth spas in other countries. You can't get it in the United States, but you can get it elsewhere, or you can buy it online. But, I mean, it's one of these things. But you don't know what you're getting online, so you have to be really careful with that. And I can talk about a Chinese example if you want. But, nonetheless, it does seem to give you the appearance of youthfulness but it does not necessarily make you live longer because it can create a multitude of side effects, and it's quite unethical. Actually, it's technically illegal to use for that purpose. Bob: You have to tell us your good-looking corpse line. Chris: Well, yes. I thought we were going to talk about that side effects. Bob: Oh, okay. Sorry about that. Chris: But really, at the end of the day, a lot of people when their face is their business, looking good, looking young, looking well is kind of a key. But, with the risks that are associated with growth hormone use, it's going to end you faster. I mean, it's cancer, it's diabetes, it's thyroid problems. So you'll be a good-looking corpse. Bob: Live fast, die young. Leave a good-looking corpse. Chris: But look pretty. Bob: Yeah, so another one, restoration of erectile dysfunction. Chris: Yup, so because it's a hormone, it passes through the blood, and what they think that it does for that is the corpus callosum, which is what gives men an erection, it basically seems to allow the smooth muscle to function more effectively. That's the closest that we could find, inspires what they believe is why it works. But if you have more operational smooth muscle, blood gets in there better, and basically everything else works more effectively. Bob: And that, it's funny, they made references in one of those Hollywood articles that it's the love child of Viagra and Botox. It's working for both things. Chris: Yeah. I guess, whatever floats your boat, right? Bob: We'll talk about possible side effects coming up. But, yeah with everything, you pay a price. So how about stronger immune system? Chris: Yeah. It's strange. Growth hormone, again, it's wild. Our immune systems are very complex, so it's an aspect of immunity, but with all the other complexities that we have within there, we do show quite eloquently with growth hormone. Again, we find this with kids that were supplemented with it or adults that had some problem with their pituitary gland. We recognize fully that they're immune, they were not getting as sick. And so doctors are pretty, brought us a lot, and so they studied it. And lo and behold, it works within that immune functioning category, where it does help to minimize coughs, colds, and illnesses. But there's the downside. Bob: Interesting. But again, you're paying a price to get that. Chris: Correct. Bob: All right, decreased cardiovascular risk? Chris: Yeah, again, the hormonal aspects, and it has to do with the muscle functioning. Because growth hormone is something that's designed to, when we grow, it's what makes us get big and tall and strong and fast and develop from child to adult. Those muscles, I mean, you do kind of turn back the clock. So, I mean, that's one of the things that's so hard to argue against because you do see a lot of good positive benefits when we are supplementing with growth hormone. But the problem is, again, like I said, it's illegal. Bob: Well, let's go to the side effects. So let's talk about that. I mean, yeah, it's illegal unless it's prescribed for you. Chris: Unless it's prescribed by your doctor. Bob: In instances where you were talking about, HIV, or for a child. Chris: Well, it's muscle wasting, child short stature. But the downside of it is particularly with adults. So let's say you're a 50, 60, 70 year old, with some means, because it's expensive, so I always classify that as a side effect. There are very few insurance companies unless you have either a cancer or something, in fact, where it's a legitimate medical need. You got a pituitary gland that's not functioning properly, it's probably going to get covered by insurance. But for most of us that, let's say, you want to look better and then try and look a little bit more youthful, it's not going to be covered by insurance. Bob: What's the cost? Chris: Anywhere from $500 to $2,000 a month, so it's expensive. Bob: Yeah, there's a lot of people that pay that price. Chris: I would call that a side effect, but there's some people where money is simply just isn't an object. And so when we talk about the Hollywood crowd, I mean, they live in a different world than you or I probably will ever know. Bob: Right, right. Chris: But they have all sorts of fun toys and things that go along with that, I think. But the realistic issues that we see particularly in adults that are trying to gain advantages to look youthful when we use growth hormone is it can increase the risk for diabetes. It can increase, ironically, with the cardiovascular functioning, it can actually increase your risk for other heart abnormalities, so it's kind of a double-edged sword, and I think you see that more with the aging. Thyroid cancers are most common, but it can be other cancers, even skin cancers. So it's any type of, and, actually, to go back to children that are actually using it, let's say they had a cancer that initially caused the problem to begin with. Secondary neoplasms or secondary cancers are I don't want to say a common occurrence, but it definitely is more prevalent in the people that have to use growth hormone. And so when the doctor makes a very conscious decision to approach this, for any human being, they're trying to weigh out these risks and benefits. And no matter what drug I talk about, every drug on Earth is going to have the positive and the negative. Bob: Exactly. Chris: I mean; the good aspects of a drug are still side effects. They just happen to be good, so nobody really considers it. The bad aspects are bad, and obviously with things like growth hormone, like we're talking about today, you become... You're a healthy adult. Otherwise you want to look better, you use it, and all of a sudden become a Type 2 diabetic. Bob: And this is all enhanced by the fact of you buying an illegal version of it. Who knows the quality of it, correct? Chris: Correct, I mean, it comes down to, like anything else, is knowing your sources, reputable sources. And, again, it would be something that if people were to go down that avenue, you'd have to be very careful. If you're finding after you've made a purchase like this online, there's a pretty... I've looked at the FDA site, and actually there were several products that came through China, which seems like most things do, and they were just amino acids. They were lyophilized amino acids. You reconstitute it with whatever solvent they have in there, and you inject it. And so they're promoting it to be growth hormone when it was actually just arginine. Bob: We'll talk about that. It's actually one of the natural ways. Chris: We'll just talk about the amino acids. But it's something that certainly isn't going to give you that punch, so to speak, to get what you're looking for. But the reality of growth hormone, and, I mean, I've looked at the research for over 25, 30 years, is it works, but there's a cost, and then there's a pretty heavy cost at times. Bob: Yup, and you won't find out the cost sometimes till years later. Chris: Well, it's still too late. Bob: Yeah, it's too late. Chris: I guess if you have a doctor that's prescribing it, and you're paying for it, and they're watching for it. I mean, if you're an endocrinologist, and you're a specialist, I mean, clearly they know what they're doing, and maybe it's going to be used in cycles rather than just chronically using it all the time, giving your body a little bit of a break to kind of recuperate. So I think there's different ways that you can apply it, which is an injectable product. That's the other thing, too. Anything that you buy online that's not injected is not real human growth hormone. It's only injectable. Bob: Right there, that rules it out that if it's online. Chris: Yeah, if you're buying a tablet or a spray, it's not growth hormone. Bob: Yeah, it might be something that might help a little bit, boost it, but it's not. Chris: But, yeah, it's buyer beware, and it's the wild, wild West when it comes to that, and we'll touch on that as we go into it. Bob: Well, let's talk about some of the natural ways to boost them. Chris: Absolutely. Bob: So sleep. Chris: Yeah, it's going to be sleep, diet, and exercise, are really the big pillars. And I talk about this all the time. Bob: Can't get a waiver in that, can you? Chris: No, I can't. I'm a boring guy, Bob. I just am. I'm shallow. Bob: It's fine. It's just you want to lose weight; you have to exercise. Chris: You need to exercise. Bob: You need to diet. Chris: You need to eat well. Bob: You need to eat right. Chris: And you need to get your sleep. Bob: Sleep, yup. Chris: I mean, and those three things actually do all stimulate naturally your pituitary gland to produce more growth hormone. So if we want to just start with just sleep, which I think is... America, and we've talked about this in one of our last podcast, is that America doesn't get enough sleep. So if you aren't sleeping. Bob: Yeah, it used to be a badge of honor for a lot of people, like, "Oh, I only get three hours of sleep a night." Chris: Yup, and that's not something to be proud of. It's just some people can function that way, and some people can't, but it's one of those things where studies show, and they're right, and doctors know, and they're right, that seven to nine hours of sleep, seven to 10 hours of sleep, is where we really need to be. Bob: For the average person, and you could be one out of a thousand people that can get by with much less. And you really must not need it, Chris, because you'd crash. Chris: I have problems, just ask my wife. But no, I mean, the reality of it is it really is important to try and get as much rest as you can. It releases through the sleep cycle. So we have anywhere from four to six cycles of sleep that we go through, and the heaviest burst of growth hormone occurs at that first cycle of sleep. So when you get to that deep restorative stages, so they call it stage three, that's where your slow-wave sleep occurs. That's also when your pituitary gland starts to kick out that growth hormone, and that's where all of our healing processes occur. I mean, growth hormone, even though we're adults and even though the amount diminishes particularly after adolescence and really diminishes after 30, it's still important for all of our metabolic processes. It's why our muscles still remain firm and strong. It's why we tend to keep fat under control. It's why we try and keep our diabetes under control. It's why our bones regenerate. It's why our cognitive functioning is the way that it is. So there's a variety of different reasons, and it's all good. But as we age, our bodies are designed to accept lower amounts of growth hormone, and that's probably what, when somebody lives to be 90, 100, 105 years old, the reason that we're probably living longer without those problems, one, they have a genetic disposition. Let's face it, they probably did a few things right throughout their lives, whether they focused on their diet and exercise or not, or they're just naturally, they just gravitate towards it. But, I mean, endocrinologists are going to tell you that when we supplement with growth hormone and the reason that we end up with Type 2 diabetes or we end up with thyroid conditions, I mean, these are all things that are very, very important for other processes in our bodies, and when we inject the growth hormone into our body, not your hand, really, it's going to go in your muscle, but you're going to ruin that whole process. So as you're gaining certain things, so you're going to look more youthful, your collagen kind of fills, and your muscles fill out, so all those good things happen, but there is an operational cost, and so we have to be super careful with that. Bob: So how does melatonin play a role in this? I was reading about bright light and melatonin. Chris: Yeah, well, melatonin's a unique substance that our bodies make. It's a different gland in our body, the penal gland, another lower-base brain. Yeah, so next door to the pituitary, really. There's not that much space in there. So but the reality of it is, is that melatonin is what governs our sleep and wake cycle. And what they've found is that when your melatonin levels are up, we get tired, so we get some sleep. So it all goes back to that first sleep wave. So sleep, again, the pillar of fitness really is sleeping. Bob: But when you have plenty of melatonin, you're going to sleep well. Chris: Yeah, and even taking melatonin you have to be careful with too, long term it creates problems. Bob: Yeah, you take it, and your body stops making that, right? Chris: It doesn't work as efficiently, yeah, about two weeks. And really all melatonin, by all medical standpoints, should really only be used for a couple of weeks and be for people that for example travel for a living. Let's say you're going from the United States to Europe, although they're probably not right now. Bob: Shift work, maybe. Chris: shift work. I mean, those are going to be the things where you have those approaches, where you have to kind of get your body reset back and forth, back and forth. Beyond that, it has its own side effects. But we know that when you take melatonin, it's a hormone itself, and it also helps to stimulate the production of growth hormone by a pretty large margin, and in some studies they say even 45 to 150%. So that's a large amount of growth hormone depending upon the tracers and indicators that they're looking at. It's dose dependent as well. But, again, it's probably something, when we look at this ethically, I mean, how much do we, I mean, do you want to live longer or do you want to look better? Or is it somewhere in between? Bob: Well, you touched on earlier, too, before the podcast that people possibly could get too much growth hormone. We don't know. Chris: Well, we don't know, but you see examples. I mean, there is a set dose that doctors have researched. I mean, it's been around. We've been using synthetic growth hormones since the '80s. And so the reality of it is we know the dose one was required. It's just the negative aspects of it when we're going off the rails is what you have to watch for because there are very real, very serious risks. So melatonin for before bedtime. One of the best foods on Earth to stimulate melatonin is pineapple. And it also stimulates growth hormone. Bob: We talked about that. Chris: So and then raspberries are right there. Cherries are right there. Bob: So you need to eat it right before bedtime, though. Chris: That's what they say, which is funny because one of the biggest killjoys for growth hormone production is sugar. And when we're talking about the glycemic index, which is going to make people yawn and go to sleep, but it's a medium range, and the sugar, it's not high, but it's still more sugar, and every article I've ever said is that sugar cuts down the production of growth hormone. So it was interesting to me. So it has something to do, I think, more or less with how it stimulates melatonin, which probably then in turn within that cycle stimulates the growth hormone. So for whatever reason, I mean, getting your sleep, pineapple seems to be a trick. I don't think I would eat an entire pineapple before bed but you could probably try a little bit. Bob: Awesome. This is probably not going to be very helpful to people, but one way to increase growth hormone, isn't it you decrease body fat? You can manage your insulin, decrease sugar. Like, all the things you'd want to do anyway. Chris: Correct. Bob: And so it's not really helpful advice for increasing your growth hormone. Chris: No, but it's really one of those things that you always think of food as a way to stimulate things. Well, intermittent fasting is another way to consider, and actually it's one of the bigger drivers of the bus, and it's a pretty simple procedure. So there's different ways to do intermittent fasting, and I think there's several ways on the internet you can certainly look at. It seems to be relatively trendy. So depending upon which way you want to do it, but, I mean, you sleep overnight, you're in a fastest state to begin with, so if you push back your meal. Bob: That's a fasting in itself. Chris: Exactly, and so your body is like, "Well, gosh, I need energy," so it goes into those fat cells, it breaks them down. And fats are the best energy source, so it breaks it down, like polycysts, and so basically at that point, your body's breaking down fat, and you're getting energy, and off you go. Bob: I think it’s a good point to be brought up because my first thought with fasting was like, "I'm not going to eat for two days." And I wouldn't do that. Chris: I think that's what we need, and I couldn't do it either. Bob: So I don't know the guidelines or I haven't seen them, but what are they talking about, like eating your last meal at four or five o'clock, something like that? Chris: Well, to make sure you maximize growth hormone production, you don't want to eat within two to three hours of going to bed. Everything that I've read, that's kind of seems to be the big thing. But there's different ways to fast. So, I mean, there's ways where you can just have two days a week where you just have like a five to 600-calorie-a-day diet, and all the other days you eat normally. So you just space them out. So let's say Monday and Thursday are the days you're not going to eat as well. Bob: So you cut it down. Chris: Otherwise, it's pushing back, you just eat just in a window. So there's eight hours, and you eat all within those eight hours. Bob: Oh, sure, eight-hour window. Chris: But, I mean, you become satiated after you eat, so, I mean, you're not necessarily going to eat three hours after that. There was some study, there's the small, tiny meals. So there's a lot of different ways that people can try it. Like I said, I guess if you're interested in fasting, I would talk with your doctor because you just want to make sure that it's right for you. I always stress that. But the reality of it is, because your body doesn't like being hungry, we have reserves. I have plenty of reserves right around the middle, so I'm sure that if I were to fast, it's going to definitely help to improve and drive the fat burning, and that's what creates the lean mass, and that's one of the, again, one of the attractive aspects of abusing growth hormone. Bob: Do you want to mention, there are a bunch of amino acids. You can get through food, ideally. Chris: Yup, arginine, glutamine, ornithine. There's 20 amino acids, but, there are some that it seemed to be better than others. Usually when we stack them together, this seems like arginine and ornithine seemed to be the best two in so far as what we've seen with synergy together to help stimulate more growth hormone production. Bob: Arginine found in red meat, seeds, nuts, chicken, brown rice. Chris: Yeah, it's in a variety of different things that we eat. Bob: You can look it up. Chris: So the reality of it is, is that when we're eating naturally, you're going to gain these things. Actually, and if you eat lean red meat, and specifically grass-fed beef versus, I guess, when they're eating more of the grains and other things to fortify and fatten them and make them taste better. But I think, honestly, I prefer to tend towards lean cuts myself. I do like grass-fed beef, it's just a leaner cut of meat, but it's really can be even classified as a superfood because of all the other health benefits that you get from it. There's not a lot of fat. You get an excellent protein quantity because of the amino acids that are in there. It's because of arginine and ornithine. They are the ones that are going to help to stimulate that growth hormone surge to help to replenish and heal those muscles and help with all those cellular processes that they work to improve on. Bob: Now even the vegans or vegetarians, you can get through seeds and nuts. Chris: Well, seeds and nuts. No, I mean, they can do this too. Bob: All right, I completely understand that too. And ornithine is about the same thing, right? Chris: Yeah, I mean, you can get supplements that are purified. You can just go onto amazon.com. You can go to health food stores. So you're going to find these type of amino acid pairings. I mean, there's glutamine and there's other things too besides amino acids that you can use. And then it seems like the amino acids are the big thing, but I mean, if you think about an amino acid, they're the building blocks of life. They're proteins that help us to develop other proteins and other cellular processes. So the growth hormone is driving the bus and everything. Even as we age, we just don't use as much, but it's still helping with our bone turnover. It's helping with our muscles, fat distribution. It's what's actually, believe it or not, if we eating a healthy diet and staying active, it's what's preventing Type 2 diabetes from developing. So they're all critical. Bob: Well, I guess if you were going to summarize here, you definitely would never want to use the illegal substance because you don't know what you're getting. Chris: Well, no. Bob: If you need it for some medical reason, you're going to go through your doctor, and otherwise you're going to try these natural ways to boost it. Chris: Yeah, well, and the other thing we didn't really touch on really was high-intensity exercise training. Bob: Oh, yes. Yeah. I missed that too. Chris: So exercise is that other pillars. So we're talking about food and supplementation. We're talking about sleep. We have to talk about exercise, and specifically interval training. And so probably one to two days a week, not any more than that because obviously when we're doing these very high efforts, and these are efforts when you're very uncomfortable, where you can't hold a conversation, that's the level that you need to be getting your heart rate up to. Bob: It's short length. Chris: Short bursts. Bob: Oh, yeah. Short bursts. Chris: You're talking 30 seconds to a minute, five to 10 times throughout a workout. Bob: And the rests can vary. Chris: Yeah, so whether it's Tabata intervals, whether it's skipping rope, which I just did that actually yesterday, and it just, it hurts. Bob: Yeah, it does. Chris: It's a fatiguing burn. But those studies show that your body does go into a, because of the way that it's metabolizing things, it's that anabolic effect and breakdown, it's helping to release that growth hormone to heal, get more lean mass, and try and pack on some muscle density. So, I mean, it does naturally induce that so that we can become stronger and more lean, more fit. Bob: Definitely going to help you lose weight too. Chris: Yup, and be healthier. I mean, actually, I mean, HIIT training to me is the way to go. Brad and I, your other dynamic duo person that's not here with us right now, every Saturday, whether it's in the pool or on the bike, depending, weather dependent, we do a series of intervals that, I guess if you ask me, I would call it brutal. But Brad has fun, but he has fun with everything. Bob: He's only got one gear. Chris: Yes, he does, and he's got the burst, I'll tell you. Bob: It think you're along with him though, too. Chris: Well, we're both kind of crazy. Bob: I think we'll bring it to an end there, Chris. Really good information again. You just always amaze me with your knowledge, so thanks again for being on the show. Chris: Absolutely. Enjoy it. Bob: And we'll keep her rolling. Chris: See you next time. Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

How to Use the TENS Unit: If you are using an iReliev TENS unit we provide step-by-step video instruction on how to use the following types: iReliev 1313 iReliev 5050 iReliev 8080 Just go to the program section at bobandbrad.com and click on the TENS series. Under the series look for the videos with the 1313, 5050, or 8080 TENS units. If you are using a TENS unit from another manufacturer you will need to follow the instructions provided with the product. Where to Place the Pads for Hip Pain: There is NOT a specific right way to position or place the pads. The best approach is to place the pads wherever they relieve pain the most. Experiment and see what will work best for you. General Guidelines for Side or Lateral Hip Pain (Greater Trochanteric Hip Bursitis, Hip Arthritis, IT Band Syndrome, Tensor Fascia Lata TFL Pain): Option One: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either in front of the other pad or behind the other pad (at least a pad’s width apart). Option Two: Use one channel and two pads. Place one pad (either one) in front of the pain and one pad behind the pain or place one pad on each side of the pain. Use of two channels and four pads for side hip pain. In our examples, channel one has yellow pads and channel two has green pads. Option one: place one pad from channel one behind the area of pain and place one pad in front of the area of pain. Place one pad from channel two on the right side of the pain and another pad from channel two placed on the left side of the area of pain. This arrangement forms a cross pattern. Option two: one pad from channel one in the upper right corner of the area of pain and one pad from channel one in the lower left corner of the area of pain. One pad from channel two in the upper left corner of the pain and one pad in the lower right corner of the pain. This arrangement forms an X pattern. General Guidelines for Front Hip Pain (Hip Arthritis, Hip Flexor Pain): Precaution: If you place an electrode pad directly in the groin it may be disrupted with sitting, walking, movement, etc. Option One: use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either in front of the other pad or behind the other pad (at least a pad’s width apart). Option Two: use one channel and two pads. Place one pad (either one) in front of the pain and one pad behind the pain. Or place one pad on each side of the pain. Use of two channels and four pads for front hip pain. In our examples, channel one has yellow pads and channel two has green pads. Option one: place one pad from channel one behind the area of pain and place one pad in front of the area of pain. Place one pad from channel two on the right side of the pain and another pad from channel two placed on the left side of the area of pain. This arrangement forms a cross pattern. See Photo for Example Option two: place one pad from channel one in the upper right corner of the area of pain and one pad from channel one in the lower left corner of the area of pain. One pad from channel two in the upper left corner of the pain and one pad in the lower right corner of the pain. This arrangement forms an X pattern. See Photo for Example General Guidelines for Pain Referred from Another Area: An example would be hip pain that is coming (referred) from the back. Using channel one, place the two pads along the nerve pathway. See Photo for Example Reminder: do not place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Side Hip Treatment: Hip Flexor Stretch, Figure 4 Stretch For more information on the TENS programs visit: https://www.bobandbrad.com/tens-program If interested in purchasing the TENS/EMS unit by iReliev visit: https://ireliev.com/bobandbrad/?uid=15&oid=1&affid=10 DISCLAIMER We insist that you see a physician before starting this video series. Furthermore, this video series is not designed to replace the treatment of a professional: physician, osteopath, physical therapist, orthopedic surgeon, or chiropractor. It may however serve as an adjunct. Do not go against the advice of your health care professional. When under the care of a professional make certain that they approve of all that you try. This information is not intended as a substitute for medical treatment. Any information given about back-related conditions, treatments, and products is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this publication. Before starting an exercise program, consult a physician. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in January of 2021. For the original video go to https://www.youtube.com/watch?v=l2aIKP-aWWQ&t=107s Bob: Today we're going to show you some easy exercises to help hemorrhoids. Yes, believe it. This helps hemorrhoids and I'm going to actually sacrifice myself here, Brad. I'm going to admit that I had hemorrhoids, and this has helped my hemorrhoids. Brad: Say no more, Bob. Bob: Now I'm going to just go and warn you right away. The language is going to be a little bit graphic at times on here. We're not using blasphemy. We're just using descriptive words. So we're going to be talking about the genitalia and stuff like that. Brad: It's all professional. Bob: It's all professional, yeah. So what we're talking about here is Kegel's exercises. Arnold Kegel. He invented this in the fifties and it was really done mostly for urinary incontinence but I saw a bunch of articles, Brad that it does help hemorrhoids. It gets more blood flow to the area. But in my case, I'm going to get a little graphic here but it firms things up so things don't droop as much. Brad: Around the anus. Bob: Well yes, because you're strengthening the muscle of the pelvic floor. Brad: Sure. Bob: And the pelvic floor is made up of the superficial level and a deep level. But when you do this exercise you're strengthening both levels. Brad: Sure. The pelvic floor, I envision them kind of flat like a pancake or like a diaphragm. And it literally is the pelvis floor that keeps things supported so that your visceral organs stay where the need to be. Bob: Exactly. It's like a netting down there. And you know, it's horizontal just like the diaphragm. In fact, I think it's called, there's a name where they call it something like the diaphragm. Brad: The bottom diaphragm? Bob: Yeah, something like that. Seriously. Brad: Inferior diaphragm? Bob: Well, if not, we just made that up. So if you want to strengthen these or we're going to give you hints on how to do it. What you're going to feel is like a gentle gathering of the pelvic floor muscles. You're going to contract and lift them up. You should feel like you're including the anal sphincter. Like that should be moving up. With ladies and men too, in fact, we're going to talk about this later, you want to feel like the perineal body is lifting up. The perineal body. What is it, Brad? You want me to tell them? Brad: Yeah, go ahead. Bob: It's the area between the anus and the vagina for women and the anus and the scrotum for men. So it's really, we'll talk to it later how you can actually palpate that and feel it moving up. Brad: So I'm assuming this is preferred in the seated position. Bob: You could do it lying down. You could do it seated. In fact, it's a good thing to progress. Like start lying down. Then you could even do it in a quadruped position. Brad: On your hands and hands and knees. Bob: Hand and knees. You could do it in a seated position and they should do it standing. The whole thing with this, you should continue to breathe normally while you're doing this. People should not be able to tell that you're doing this. Brad and I could be doing it right now and you'd have no idea. Brad: Assuming you've practiced it. Bob: Practice, and you know what you're doing. With men, you may actually feel the base of your penis lift up and possibly your testicles as well. You know, we'll get into all the cuing that goes on. What you shouldn’t feel is you shouldn’t feel other muscles contracted, like the glutes. Brad: You should or you should not? Bob: Should not. They should not. You're trying to focus on the pelvic floor. You shouldn't feel the inner thigh. You shouldn't feel the abdominal muscles contract. Brad: So if you're straining and tightening everything? Bob: Yeah. You know and I've seen some other channels where they were actually promoting that. And I was like, you know, I don't think that's right. Brad: That's not along with this? Bob: Kegel's, yeah. Brad: It came out of a book or two books, you said? Bob: I've read a couple of books on it. Brad: Sure. Bob: Don't hold your breath. You should be able to talk. Don't tense, anything up in your face either, your eyebrows or shoulders, biceps. Brad: It's just one of those things on isolating muscles. I mean, we do this with people, with your abdominal muscles try to isolate that for pelvic position. A lot of these areas of the body are very difficult to isolate or it's just not a normal thing. It's not like moving a finger, you know? Bob: Yeah, I think that's a good point to be made, Brad. You can voluntarily control the pelvic floor muscles. But it's also got an added automatic component to it. It's going to automatically work at times when you're lifting or you're carrying something, you know. Brad: I compare it to your breathing muscles. I mean, you can voluntary control your diaphragm and your breathing. But at the same time you don't have to think about it and you continue to breathe. Bob: It's going to keep going. Hopefully, thankfully. So these are the common cues, and this is probably the most important part of this, is for women, you're going to squeeze and lift the pelvic floor. They tell you, you want to tighten up like you would like to stop the stream of urine. But they don't want you doing that. They don't want you to just start going and then stop. Brad: Not literally? Bob: Not literally because you could develop a urinary tract infection and it can mess with your reflexes, I guess a little bit, your urinary reflexes. So yeah, you want the feeling like you're stopping urine but not actually doing it. And another cue is you can make it feel like you're lifting and holding something in your vagina. You can also squeeze, like you're trying to hold in gas, which Brad and I know quite well. You know you're afraid to let one go, you're among company so you tighten up. Brad: Flatulence, Bob. Bob: Flatulence. There you go. Brad: I got to put some professionalism in there. Bob: That's right. So the other thing you can do, and you can't see this on a podcast, but you can actually take your sit bones. That's the bones that you're sitting on. You can feel right when you're palpating. Brad: Or if you're sitting on a hard surface… Bob: Like bleachers. Brad: Yeah, you rock back and forth, you'll feel those sit point bones are making contact. Bob: Yeah, now with those sit bones, what you want to feel is like you're pulling them together. That also helps raise it up. So now this is interesting, Brad, they only had one cue for men and they did a study on this. They had a bunch of cues for men, but the one that worked was this one. So you're supposed to shorten your penis. Brad: Bring it in like a turtle. Bob: There you go. Like a scared turtle. Brad: I think most guys could relate. Bob: So, it's funny. People, men really seem to latch onto that and it worked for me. Brad: So the whole idea is we're contracting those muscles and you said, it's going to increase blood flow for the hemorrhoid. Bob: So they can heal better. The other thing, a lot of people with hemorrhoids they sit on the toilet too long. You know what I mean? And everything starts to get slack. This is year after year. Do you know what I mean? Brad: So you shouldn't be reading or looking at your cell phone. Bob: You really shouldn't. You really shouldn't. Brad: Get on there, get your business done, and go. Bob: That's what you're supposed to do. Otherwise you’re just stretching things out. You know, you're letting things sag. And so this helps tighten things up here. So... What are you laughing at now? So we're trying to keep this as serious subject because you know, hemorrhoids are an issue. Brad: Oh right. I've never had them. Bob: Well I had them, and it's not fun. Let me tell you, so. Brad: You know, this is one of those things that there are therapists who have taken courses on this and become certified, and they have actually some tools that are specifically made for this. Bob: Yeah. Feedback tools. So if you are having trouble, seek out a therapist that has expertise in this area. Some of the larger hospitals generally have someone dedicated towards that. But I think what we're doing here, I think for some people, it's going to help. Bob: Oh! My wife picked up right on it. I mean, she was able to do it right away. In fact, she hardly even listened to me, I think. Because she was doing it. But this is how you can actually feel it, Brad. If you want to try to feel it. You can actually take a piece of toilet paper, small piece and put it by your anal sphincter, do the exercise, and it actually kind of picks it up a little bit. So, I mean you got to put your finger on the anal sphincter. Brad: Sure. Oh. Yeah. Bob: All right, Brad, keep serious here now. Next one, the perineal body, which we already recommended. I think this is the best cue of all, Brad. So again, the perineal body. It's the area between the anus and vagina or the anus and the scrotum. Put your hands there. Obviously you do this in private. You could be lying on your back and you put your hands there for feedback and if you're doing it right you're just going to feel it gently lifted inward. Brad: Feel some motion going inward. Bob: Up, yep. Brad: I can see where lying down would be a good place to start that. Bob: And men, one more one, you might actually see the penis lift up a little bit when you're doing this. If you're doing it right. Brad: Not if you got your pants on. Bob: Not if you got your pants on. No. You know, you'd have to check it out. You know, one of those things where, and don't send us any phone videos of this stuff. All right. So repetitions, you start off probably like eight to 12 reps. You're going to hold it for 10 seconds. Brad: Boy, that is a long hold. That's work. I mean, especially to get started. Bob: Yeah. Brad: But that's what they recommend. Bob: It's not really hard to hold it. I didn't think so. Yeah. You can do that three times a day. Eventually, they said you want to work up until like a hundred reps in a day. Brad: So how many reps? Hold it for 10 and do it 10 times? Bob: Yeah. Eventually, over the day. And the other thing is, it is a fast twitch and a slow twitch muscle. So you can do the hold one, that's slow twitch. But if you want to do fast twitch, you can actually tighten and then relax, tighten, relax just for a second. Brad: So did they give any statistics on people who do this on success rate? Because I mean, you don't have to do this for the rest of your life, do you? Bob: No, no, but I'm sure you know for women and incontinence and for men and incontinence you might have to do it in the rest of your life. It's not like it's a big burden, Brad. Brad: Sure, once you get used to it, but I mean a hundred times a day, or do you get to relax often? Bob: Yeah. I don't know on that. I find it can be very helpful with urinary incontinence. It can be the difference between you having trouble and not having trouble. I mean, there's a reason it's been around since the fifties. I mean, it works. Give it a try! Brad: Good luck. Bob: Thanks everybody. Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in February of 2021. For the original video go to https://www.youtube.com/watch?v=rCcznN6FHqQ Bob: Today we're going to talk about, I did, that's me, The Wim Hof method for Stress Reduction, for two months. And this is what I found. I'm going to reveal today what it has done for me. Brad: Wim Hof is a name of a person? Bob: He’s Dutch, and he’s known as The Iceman. We'll tell you some of his accomplishments, it’s pretty amazing. He's got many Guinness World Records Brad. Brad: Yeah, I actually saw a video of this guy. I've read a little bit about him. Bob: It's amazing. Brad: Yeah. Bob: I mean, it seems impossible. Some of the things he did, so he's got the record for swimming under ice. 188 feet. Brad: Without a wetsuit? Bob: Without a wetsuit. Brad: No dry suit. Bob: No. He had the camera on the first time, he was just trying it, and his eyes froze over, his eyelids. He was blind. He couldn't find his way out and he had to be rescued. And then the next time he did it, the same day yet, he still went 188 feet. Brad: So the water is what? 40 degrees or something like that. Bob: I think its freezing. Brad: Or was it 32 or was it salt water. If its salt water, it could be even colder without freezing. Bob: Yeah, I'm not sure. Brad: We didn't get in that into detail. Well one way or another that guy is amazing or he's got some issues. Bob: I'll give you a few more Brad. He’s got the fastest half marathon. He did this up in Antarctic, I believe with no shoes, no shirt he wore shorts. I mean. Brad: What was the temperature? Bob: You know, what is in Antarctica? Brad: Maybe they have a summer that gets a little warmer. Bob: No, no. He was in snow. It took him two hours and 16 minutes and 34 seconds. Brad: Wow. Bob: But yeah, nothing but shorts. Brad: Just shoes. Bob: No shoes. Brad: No shoes? Bob: Yeah. Brad: I'd like to see what his feet look like. Bob: This seems impossible, doesn't it? Brad: I bet we could look, someone could probably Google this and they'll see pictures and maybe some video footage. Bob: Yeah. There's a documentary out him. So you can watch that. There's the longest time that he had direct full body contact with ice. And that was an hour and 53 minutes. I guess it's been broken now by other people now. But could you imagine sitting the ice bath for an hour and 53 minutes? Brad: Like water filled with ice cubes and you submerge yourself? Bob: Yeah. Brad: Like to the neck. Bob: Yeah, to the neck. He can keep his body temperature the same. He just has that ability. Brad: So they're measuring it sublingually. Bob: Yeah, they actually did test it on him. So this is the one that's pretty amazing about his immune system. So he purposely injected an endotoxin that normally makes you sick. It will cause nausea, headaches, inflammation, vomiting and nothing happened to him. He just, with his mind pretty much controlled it. He didn't get sick at all. Brad: Why would you do that to someone anyways? Bob: Well, they wanted to show... He wanted to prove that as immune system and they did it. So you think, okay this guy's a freak of nature, he's got, but no. So he can teach people how to do this stuff. Brad: And it has a lot to do with breathing techniques. Bob: Breathing technique and yeah, they do mindfulness. He's got a three system, three pillar system. But these are the things that his website says it’s supposed to do: it's supposed to boost your immune system, increase your energy, relieves stress, improve sleep, increased willpower, relieve some symptoms of depression, increases concentration, improves your overall mental wellbeing. So again, there's three ways to do this. Brad: Wait. So if you get into this, does this mean you’re jumping into water or you're going to jump in an ice bath and you're going to do all these things? Bob: Well, you know, this is how he recommends it. First he's got the breathing part of it and these are breathing exercises and they last... You can probably do it about 15 minutes and you can go right to his YouTube channel and he's got great videos. Great visuals on how to breathe. And you breathe in and out for like 30 times then you hold your breath for a minute. And right when you're done, you hold it for another 15 seconds. Brad: Did you do this? Bob: I didn't it. Brad: Did you get dizzy? Bob: I never got dizzy but people can get dizzy. And he warns you not to do it in the shower, not to do it anywhere if you're not lying down or sitting down because you could get dizzy and fall over. Brad: And he actually learned this technique from some people? Bob: I think it's a mishmash of things over time. I don't think its specifically in one place. Brad: Cause in that book, Breathe, they referenced him and that he did with these with people from, I'm thinking over by India. Bob: Yeah, I think it was India. Brad: The Buddhists? Anyways, that's a side note. Bob: So the breathing, he does have a program you can purchase but I'm thinking you don't need to do it. I didn't. Brad: You maybe that's why... Bob: Yeah, yeah. We'll find out. The only thing I was missing, he's got some yoga stretches and stuff like that. I do a lot of stretching already. Brad: You know how you would do with yoga sometimes. Bob: Yeah. So anyway, the breathing exercises, definitely had that down. I was doing that. The cold exposure. What he does is he has you start with cold showers. So you start with a warm shower and then you finish with a cold shower. And the first time he made me only 10 seconds or 30 seconds and I was up to a minute and a half. Brad: Of cold? Bob: Of cold. Yeah. Brad: But you started warm. Bob: I started warm and I'd go with that last minute and a half. I just say, this is just the shower, tough it out. Brad: Did you have a little timer or what? Bob: I had a little timer. Brad: Right in the shower with it? Bob: Right in the shower. Brad: A waterproof one? Bob: Yeah a waterproof one. And you know, it's funny when I'd get out of the shower, you know, normally if I get all the shower, now I'm cold. But if you get out of the shower after you had a cold shower, you actually feel pretty good. So it definitely wakes you up. Brad: Yeah, I believe it. Bob: And then he had a mindfulness meditation which he kind of just did with the breathing. The same breathing state. Brad: Mindfulness? What do you mean mindful? Bob: That's all meditation. You're trying to be in the moment. Brad: Its the mind. Bob: And I know a lot of you have problems with this. You know, I do transcendental meditation and a lot of people were upset about that that I was leaving the devil in. And believe me, the last thing I'm thinking about is the devil. So anyway, so I did the breathing, the cold exposure like I said, it was up to a minute and a half. I think he actually has you eventually go up to like five minutes but I get a lot of outdoor cold too. In fact, one day I ran out. I ran in shorts to see what it's like. It was 30 degrees or less than 30. Brad: Did you have short sleeves? Bob: I had a short sleeve shirt on. You know, I get hot when I run. So first I should say I am the least person that likes the cold on earth. I hate cold. I hated it all my whole life. My hands get really cold easy, my feet. So that has improved without a doubt I can handle the cold better. Brad: Sure. Bo: Without a doubt. But as far as my immune system, who knows. I don't know if my immune system's better. I mean, I've not been exposed to anybody. Brad: Oh, you're healthy, right Bob? Bob: Yeah, I'm healthy. Brad: It's probably better than... Let's be optimistic. Bob: The breathing, the sleeping, you know I felt like the transcendental meditation helped me more than anything else right now. So I'm going to continue doing that. Brad: I think you have to take the program. Bob: Maybe you do. Brad: Sometimes you take a program, they explain it better. But maybe not, I don't know. Bob: He's got a lot of information on his channel. I think you get a pretty good sense of whether or not the program would work for you. Brad: Well, Bob let's look at it this way. If someone watches our shoulder program through the video, we do a pretty good job. But if they come to us directly, it’s probably better. Bob: But our shoulder program is free. I thought you were comparing our shoulder program to just one video? Brad: Well, no, it just a video in general. You're going to learn a lot but in person you might get more out of it. Bob: I'm not going over to the Netherlands or whatever. Brad: Oh, you have to actually go over there. Bob: If you want the program. There is an online program too. Brad: I'd like to go over there and maybe take it. Because otherwise I'm not doing all that stuff. That's cold. Bob: I mean, you start off and then you finish off by climbing up this mountain with your shirt off and shorts. Brad: Well maybe if I had shoes on. I'm thinking, I don't know anymore but at one time in my life, I'd say yeah, let's do it. Now I'm thinking maybe not. I've swam in very cold water without a wetsuit. Bob: Oh yeah. Brad: I had to for a triathlon, you either swim or you can't go. And it's dang cold. You got an ice cream headache because the water is hitting you in the forehead. By the time you get done, you're so numb. It doesn't feel so bad. You get out and like you say, you feel pretty darn good. Bob: You feel good when you come out. Brad: It’s like, Whoa, it’s not so bad. Bob: I'm getting so much cold exposure. I ran this morning out in the cold, but I had plenty of clothes on. It was it was -10, -15, below with the wind chill. And I felt good. I mean, I felt, I wouldn't want to be any colder. It was probably at the limit of where I'd run outside. But I just don't want to do the cold showers. You know what? I only have so much motivation. And if I deplete my motivation on that cold shower, I'm not going to be able to do something else during the day that I should do. Brad: We might have some people watching that are experienced with this and actually are really successful with that maybe. Bob: There are people that love him and I don't disagree. Brad: But they could maybe give you some hints on maybe what they've discovered. Bob: Sure. Brad: Maybe there was something that you missed. Bob: That I missed out on. Brad: You never know. I think it's one of those things that could be different between individuals, how you experience it. Bob: It can and there's some talk about people with rheumatoid arthritis and AMS. Brad: And they got better? Bob: They were on meds and they got off the meds. So there's a lot of stories. There's no doubt, I think it does boost your immune system too. I really do well. Brad: There's got to be something to it if this gentleman could climb a mountain and run and go under water. It’s amazing how he could not have hypothermia. Bob: I know it's crazy. Brad: Unbelievable. Bob: It's nuts. So, check it out. He's got a website. He's got videos on YouTube. He's got a book. So I have nothing against Wim Hof. I think he's a great guy. I just... I'm not going to do cold showers anymore. Sorry. Thanks. Interested in learning about the products mentioned in today's video: 1)The Wim Hof Method: https://amzn.to/3amDTiT Visit us on our other social media platforms: YouTube:https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

How to Use the TENS Unit: If you are using an iReliev TENS unit we provide step-by-step video instruction on how to use the following types: iReliev 1313 iReliev 5050 iReliev 8080 Just go to the program section at BobandBrad.com and click on the TENS series. Under the series look for the videos with the 1313, 5050, or 8080 TENS units. If you are using a TENS unit from another manufacturer you will need to follow the instructions provided with the product. Where to Place the Pads: There is NOT a specific right way to position or place the pads. The best approach is to place the pads wherever they relieve pain the most. Experiment and see what will work best for you. General Guidelines for Top of Foot: Use of one channel and two pads for top of foot Option One: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either in front of the other pad or behind the other pad (at least a pad’s width apart). Option Two: Use one channel and two pads. Place one pad (either one) in front of the pain and one pad behind the pain or place one pad on each side of the pain. Use of two channels and four pads for top of foot In our demonstration channel, one has yellow pads and channel two has green pads. Option one: place one pad from channel one placed behind the area of pain and one pad placed in front of the area of pain. Place one pad from channel two placed on the right side of the pain and another pad from channel two placed on the left side of the area of pain. This arrangement forms a cross pattern. Option two: place one pad from channel one in the upper right corner of the area of pain and one pad from channel one in the lower left corner of the area of pain. Place one pad from channel two in the upper left corner of the pain and one pad in the lower right corner of the pain. This arrangement forms an X pattern. General Guidelines for Bottom of Foot: Caution: If you place a pad over a calloused area on your foot, the conduction of electricity may be affected (diminished). Experiment and see. Option One: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either in front of the other pad or behind the other pad (at least a pad’s width apart). Option Two: Use one channel and two pads. Place one pad (either one) in front of the pain and one pad behind the pain or place one pad on each side of the pain. Use of two channels and four pads for bottom of foot. In our examples channel one has yellow pads and channel two has green pads. Option one: place one pad from channel one behind the area of pain and place one pad in front of the area of pain. Place one pad from channel two on the right side of the pain and another pad from channel two on the left side of the area of pain. This arrangement forms a cross pattern. Option two: one pad from channel one in the upper right corner of the area of pain and one pad from channel one in the lower left corner of the area of pain. One pad from channel two in the upper left corner of the pain and one pad in the lower right corner of the pain. This arrangement forms an X pattern. General Guidelines for Pain Referred from Another Area: An example would be foot pain that is coming (referred) from the back. Using channel one, place the two pads along the nerve pathway. The two pads from channel two could be placed on the foot. See Photo for Example Reminder: do not place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Treatment before or after TENS: Circular and splaying massage. See video for demonstration. For more information on the TENS programs visit: https://www.bobandbrad.com/tens-program If interested in purchasing the TENS/EMS unit by iReliev visit: https://ireliev.com/bobandbrad/?uid=15&oid=1&affid=10 DISCLAIMER We insist that you see a physician before starting this video series. Furthermore, this video series is not designed to replace the treatment of a professional: physician, osteopath, physical therapist, orthopedic surgeon, or chiropractor. It may however serve as an adjunct. Do not go against the advice of your health care professional. When under the care of a professional make certain that they approve of all that you try. This information is not intended as a substitute for medical treatment. Any information given about back-related conditions, treatments, and products is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this publication. Before starting an exercise program, consult a physician. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in May of 2021. For the original video go to https://www.youtube.com/watch?v=WlmF9PM3Kg0 Bob: Today, we’re going to talk about the dominant exercise for great health, including weight loss, cardio, and back pain. Brad: It’s got to be one good exercise, Bob. And we’ve got it all raveled out in here. We are going to show you exactly. Bob: Exactly. Brad: I’m excited about this one. What does it take to be the best, the dominant exercise? Number one, it has to be something that the majority of people can do. Bob: Right, what good would it be if it’s the dominant exercise if only 10% of the population can do it. Brad: Or just high-level athletes or whatever. We want it for the masses. Number two, good compliance. It has to be something that most people will be willing to do. It’s not like, you know nobody wants to do crunches. Laying down and doing abdominal work. Most people don’t. Bob: Well, some of the really high intensity workouts too. People have trouble sticking with them. Brad: Yeah, you get sore muscles. Bob: They do it for a while and they burn out on it. Brad: And number three, something low cost. You don’t have to go out and purchase a large piece of equipment or something. The next thing for this exercise, there’s 7 benefits that are really important. Number one it should burn some calories. We want some weight loss. Lower blood pressure. It’s going to lower blood pressure, which is wonderful. Improved digestion. It’s a broad exercise. This is great. It’s going to help joint and back pain. Also, good for osteoporosis, osteopenia, bone loss and improve your sleep. Then just simply make you live long. Bob: I know you like seven, Brad, but I’m going to add a number eight. Brad: Oh, the bonus. What’s number eight? Bob: Number eight is it’s going to help your mental health, without a doubt. Brad: Yeah, you’re right, you’re right. Bob: Exercise in general helps mental health. Brad: But there’s been studies on this particular exercise. Bob: Especially when done in a certain way. Brad: So, everyone’s wondering what is the exercise? The answer is so simple. Many people have already guessed, I’m sure. It’s simply walking. Get out and walk. Dr. Steven Blair has done a lot of research on exercise for the general population back in the eighties and nineties. This was his go-to exercise. We talk about back pain, Stuart McGill, leading back expert. Bob: What Stuart recommends Brad, is actually if you’re having back pain, he recommends getting out four times a day with walking for even just 5 minutes each time. He said even up to 20 minutes, four times a day. Probably the number one thing you can do for your back pain. Brad: And if you are doing it with back pain, walking on the flat is going to be much preferred because it keeps that pelvis stable. Bob: In regards to mental health, Brad, we’ve also seen this, they had done studies that it's so much better to walk out in nature. Brad: Yep, get away from the hustle and bustle if that opportunity exists, some people may not have that. But if you can jump in the car and take a 10-minute ride to get to the park, that kind of thing. Bob: Well, it’s an hour ride, ha-ha. Brad: Duration, well how long should we walk? People are going to want it. 20-30 minutes is typically recommended. And then, 5-7 days a week. If you’re just starting out and you have not walked much, start out on five-minute walks, maybe 10 minutes and then do it every other day so your body gets used to it. Bob: If you’re really not fit, go to the end of the driveway and back. I mean, just a couple times a day. Start off in a manageable bite. Brad: You know, I was just listening to Sara Meeks, and she was talking, if you’ve been in bed, let’s say you’ve maybe had COVID and your bed-ridden for a week. That just takes your whole cardiovascular system down to an incredibly low level. So, you’re going to go out and walk, short distances. Like you said, maybe to your mailbox and back. Bob: I got pneumonia when I was a sophomore in high school, and I was in track at the time. I came back mid-season, and it wasn’t until the end of the season that I stopped getting last in the mile because it just took so much out of me. Brad: And that’s as a young person. Bob: Right. Brad: If you’re older, it’s way worse. Let’s talk about anything else with back pain. Bob: So, this was recommended by Dr. Stuart McGill. I found this fascinating. I tried it on some patients, and it worked. What he recommended is that you actually pick up your pace when you walk. Brad: That sounds weird. Bob: It does sound weird because it seems like it might hurt your back more. It does, you actually take less weight on a spine if you are walking at a faster pace. I had a guy come in. He was limping like you wouldn’t believe. He looked like he was walking through a desert on a hot day. I said, we’re going to try walking at a faster speed. He looked at me like I was crazy. But by the end of the session, he was walking around, and he looked normal. Brad: Was he smiling? Bob: He was smiling. I was the Messiah after that. I mean, I knew everything, ha-ha. Brad: It is fun to be a therapist when that happens. Bob: Yeah, once in a while that happens. Brad: I do want to mention though, if you’ve been walking for a while, you’re up to 20-30 minutes and you’re starting to get bored and you need something to break it up, do some interval walking. Or actually kind of a modified HIIT, high intensity interval training. You can do this very easily. Walk for one minute or pick a distance out. Maybe if you’re walking in a city, you could go one block where you walk very quickly and briskly and the next block you take your time and slow down. So, you go fast then slow then fast. You can break that up, two minutes, one minute. Bob: Whatever interval you want to go with. Brad: With these cell phones you can actually put a little beeper timer there, so it beeps after one minute. If you’re that kind of person. Bob: Which you are. Brad: Well, sometimes I swear at the phone because it doesn’t do what I want it to. Then I have issues. Bob: It’s a great thing because you can actually get your heart rate up. Brad: Yes. That’s where that cardio comes in. You do not have to go out and run to get cardiovascular benefits, but you do have to walk briskly. Bob: Even if it gets to the point, you’re still able to talk. Only one sentence, but that’s getting your heart rate up high enough. Brad: That’s one of the common tests I use with cardio rehab after a heart surgery. Bob: Remember, we can fix just about everything, Brad: Except for, Bob: A broken heart. But we’ll help relationships. Give us your relationship problems and we’ll solve it. Brad: Well, we haven’t really proved that we’ve helped any yet, but we think we are. Bob: Yeah. Brad: In our minds, we’re helping. Bob: Right, that’s all that matters. Brad: Just go home and enjoy your life. Bob: Thanks. Visit us on our other social media platforms: YouTube: https://www.youtube.com/user/physicaltherapyvideo Website: https://bobandbrad.com/ Facebook: https://www.facebook.com/BobandBrad/ Instagram: https://www.instagram.com/officialbobandbrad/ Twitter: https://twitter.com/ptfamous Pinterest: https://www.pinterest.com/mostfamousPTs LinkedIn: https://www.linkedin.com/company/bob-and-brad TikTok: https://www.tiktok.com/@bobandbrad Wimkin: https://wimkin.com/BobandBrad Mewe: https://mewe.com/i/bobandbrad Minds: https://www.minds.com/bobandbrad/ Vero: vero.co/bobandbrad SteemIt: https://steemit.com/@bobandbrad Peakd: https://peakd.com/@bobandbrad For this week’s Giveaway visit: https://bobandbrad.com/giveaways Bob and Brad’s Products Pain Management: C2 Massage Gun US: https://amzn.to/36pMekg Now available in EU: https://amzn.to/3eiruwV Now available in Canada: http://amzla.com/t4qn7uniltfb Q2 Mini Massage Gun US: https://amzn.to/3oSMBu9 Now available in UK: http://amzla.com/qe4bmn3puczb Now available in EU: https://www.amazon.de/Massagepistole-Muskelentlastung-Handmassageger%C3%83%C2%A4t-Muskelkater-Entspannen/dp/B08M8YSFC7/ref=mp_s_a_1_2?dchild=1&keywords=bob+and+brad&qid=1620323625&sr=8-2 Handheld Massager: https://amzn.to/2TxZBqU X6 Massage Gun with Stainless Steel Head: https://amzn.to/38zRLEv T2 Massage Gun: https://amzn.to/3GfflX1 Foot Massager: https://amzn.to/3pH2R2n Knee Glide: https://store.bobandbrad.com Fit Glide: https://store.bobandbrad.com​ Fitness: Resistance Bands: https://amzn.to/36uqnbr​ Pull Up Bands: https://amzn.to/3qmI4Rv​ Resistance Bands for Legs and Butt: https://amzn.to/2G5mXkp​ Hanging Handles: https://amzn.to/2RXLVFF​ Grip and Forearm Strengthener: https://store.bobandbrad.com​ Wall Anchor: https://store.bobandbrad.com​ Exercise Ball: https://amzn.to/3cdMMMu​ Pull-Up System: https://www.optp.com/Pull-Up-system-by-Bob-and-Brad Stretching: Booyah Stik: https://store.bobandbrad.com​ Stretch Strap: https://amzn.to/3muStbi Wellness: Bob and Brad Blood Pressure Monitor: https://amzn.to/3hm721f Bob & Brad Amazon Store: https://amzn.to/2RTSLLh Check out other products Bob and Brad Love: https://www.amazon.com/shop/physicaltherapyvideo?listId=3581Z1XUVFAFY Check out our shirts, mugs, bags and more in our Bob and Brad merchandise shop here: https://shop.spreadshirt.com/bob-brad​ Check out The Bob & Brad Crew on YouTube by clicking here: https://www.youtube.com/c/thebobbradcrew Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded June in of 2021. For the original video go to https://www.youtube.com/watch?v=x-gCo08Kjo8&t=404s Brad: Today, Bob is on a little hiatus, he’s taking the day off. Chris: Attaboy. Brad: So, we are going to do this, Chris and I. You’ve seen Chris before. He has excellent information and presents himself well, much better than Bob or I. Today’s topic is “Understanding Cramps Stopping and Preventing Them.” We’ve got some updated science and we’ve got some good information on how you can stop cramps when they start and perhaps on how you can prevent them. Really interesting information. Pretty much everyone has experienced painful cramps, I think I’m safe in saying that. Some people more than others. Often times they are induced by exercise or excessive fatigue. Other times they come on for no apparent reason. So, Chris got his desk out and he commenced on researching this to the nth degree and we’re going to come up with what he has to tell us. I’m going to tell you some things I’ve worked with my patients on over the years, what’s been the best solution to prevent and stop them once they start. So, cramp: it’s when a muscle contracts into tetany; tetanus. That’s when a muscle contracts to maximum potential. Very painful. Chris: It’s awful. Brad: It’s not done volitionally. In other words, your brain isn’t telling that muscle to cramp. It just happens. Chris, can you explain a little more on that, technically? Chris: Cramps are awful. We’ve all experienced them at one level or another. Young or old, you can get them, it doesn’t make a difference. What we do know, cramps are a by-product seemingly of fatigue and dehydration. These are probably the two most prominent causes that we are going to see. Brad: So, not enough water. Chris: Not enough water, not enough electrolytes. You could throw diet in there to a lesser degree probably. It can be age related; you’re going to see it. As we get older, we lose some muscle mass. So, if we were standing all day, working all day in the yard, we don’t have as much muscle mass to support our bodies so as a result it just creates more fatigue on the muscle. When you’re sitting in the chair at night, watching TV, reading a book or when you’re sleeping, all of a sudden, boom. You got that cramp and it’ll wake you up in the dead of night. It’s miserable. Brad: You kind of holler a little bit. Chris: Yeah, you might say some magical words. It’s different from magical thinking, but either way it’s not fun stuff. So, what do we do? It’s one of those things where there’s not a lot that really happens. There’s not a lot of preventative maintenance but what we can do is light stretching, maybe before bed. Brad: So, really the bottom line is the research has no definitive answer. Chris: No, it’s really a by-product of fatigue. It’s a by-product of hydration. There can be a couple other things, maybe some hypothyroidism. Brad: Maybe eat a lot of bananas, get that potassium in your system. Chris: Yes, potassium definitely seems to be something that’s beneficial. There are some correlative studies that talk about magnesium supplementation, because you’re going to have your electrolytes, sodium, potassium, magnesium, and calcium. They’re all part of the action potential of the muscle to make the muscles contract and relax, contract and relax. The muscle is just in a hyper contracted state when we get there. It seems like if we’re not getting enough fluids and maybe we have sweated out too much of our own salts or our electrolytes, it becomes an operative problem. If we can supplement that through our daily diets, and there’s a couple of things we’ll go through as we go further into this about what to do to prevent it as much as we can. Brad: So, as far as my experience in the clinic, the biggest muscle groups that cramp are in the legs. The toe, the muscles in the toe and the bottom of the foot that make her toes curls is pretty common. The calf muscles and the hamstrings and the quads as well, but probably the hamstrings are more on the top of that list. We are going to focus more on those because I think we’re safe on saying that is covering the majority. What I’ve had with elderly people in particular, the people who come to me in the clinic and say, “I get these night cramps,” and say your calf cramps. What happens is, your toes are going to plantar flex or go down cause those muscles to cramp. When you get that, it’s very painful. The first thing you have to do is dorsiflex or pull that foot back up. Now, this is very awkward in bed to reach up, especially if you’re older, to reach your toe and pull back. Chris: Especially when you're in the dead asleep. Brad: Yeah, so, I suggest when you need to get out of bed safely; if your balance is off, have something there. If you have a walker possibly or the wall, would depend on your situation. Be safe but get up and put your body weight through that to stretch it. It seems to work the best. It’s easier than pulling on it and you’re going to stretch out. In other words, a foot from plantar flexion to the neutral position, the pain should start to lessen. Then you can bring your foot behind you. Hold onto the dresser or whatever to dorsiflex or bring the ankle up even further. You can push your knee forward to stretch it more. By that time, the pain should be gone. It may be painful, but you won’t have that severe cramp pain. You’re going to hold it there. Don’t let it go back and cramp right away. Try and hold it. Give it a stretch. Walk around a little bit before you go back to bed. And so, you’ve had it stretched. Brad: One thing that can trigger a cramp is if you stretch and yawn in bed and you kind of like think you’re stretching your legs because it feels better. Those are times where you can get those quadriceps, those calf muscles and the toe cramp where your toes curl under. I’ll talk about toe cramps because they’re very painful. I usually get them swimming. When you push off the floor, not many people swim laps. Anyways, swimmers get them a lot. If you get them and your toes curl down, this is one of those things where it’s, I think it’s easiest. As long as you can get to your foot, if you can reach it, to get on those toes and just stretch them the opposite direction the best you can and work on that. Brad: This includes a family member; anybody around can help you if they know what to do. I thought it interesting, I got certified in scuba diving last year. You have to learn how to stretch someone’s legs in the water with your gear on. Chris: I bet that's kind of tricky. Brad: It’s not so bad once you get used to it and how to work your BC but that’d be another video. Chris: Maybe underwater filming. Brad: Yeah. So, you need to stretch that. And the hamstrings; the tendency is it’s going to want to pull your knee up and flex it. You’ve got to do whatever you can. If you’ve got someone there to help if you can lay on your bed. On your stomach. So, if this cramp is pulling and if the person can lay on their stomach and someone else can go here and push, push, push this leg down. When you get this out to here (all the way straight), that cramp should relieve. Brad: If you don’t have someone to help you, then you’re going to need to do what you can to straighten that leg. Can you lay on your back, Chris? Chris: Yeah. Brad: You get these don't you Chris? What do you do to relieve yours? Chris: Scream, ha-ha. Actually, I try to stretch as quickly as I can. Brad: What techniques do you do in bed? Chris: Well, I get out of bed as quickly as I can. For me, whether it’s my calf or my hamstrings, those are my two most common cramping points. But, with my hamstring, actually what I’ve found is that I’ll get my foot up on my bed and then I’ll just lean into it. So, if you can imagine me standing, I’d have my foot on the bed and just gently stretch. Then I’ll walk. Brad: So, if you’re doing this, just from my point of view, think about keeping your back straight and leaning forward. You’ll get a more aggressive stretch a little quicker as opposed to rounding. When you’re in this kind of pain, you’re probably not going to think about that. Just get over and stretch it out the best you can. Again, balance is an issue. If you’re not stable on your feet, this is not going to be an option. If you’re lying-in bed, go do this stretch where you go underneath and then straighten the knee. If you can do this and straighten that knee out and do the best you can and get that cramp relieved. Brad: Is there anything else that you wanted to cover? Chris: I think that one of the things is, we’re in summertime now so a lot of people are out there in the heat and enjoying exercising, being more active and certainly doing things. So, a lot of times one thing that is overlooked is hydration. We want to make sure we are drinking plenty of fluids. Brad: Plenty of fluids. Chris: Water is ideal but some people like sports drinks and it’s debatable about what’s best and what isn’t. I will tell you that many of them have lots and lots of sugar. Some of them use high fructose corn syrup which is a natural sweetener. It’s a natural carbohydrate source. Brad: Can you give an example? I think we can mention that. Chris: I mean, like Gatorade. I think actually their a better choice, if you can get to it, is the Gatorade Bolt that actually uses sea salt. I think it’s much better than the traditional Gatorade. Brad: Because it has less sugar? Chris: It’s considerably less sugar. I mean, you need the carbs, but you don’t need as much carbs as was in a traditional can or bottle of Gatorade. At that point, the powder Gatorade does use sugar for sweetener, but the bottle pre-made is always made out of high fructose corn syrup. I honestly think that natural sugar is something your body processes better. But the Bolts specifically use a sea salt and actually sweetener from watermelon specifically. It’s about as natural a sugar as you can get. The less calories but plenty of water in there because it’s a very watery drink but it gives you the sea salt and it gives you the other electrolytes. With those electrolytes in there, it’s going to help to minimize that. Further than that, from a drink, people don’t think of this, but you see a lot of marathoners and a lot of runners going to Pedialyte. Brad: Pedialyte, which is for kids. Chris: It’s for kids. Brad: Babies. Chris: Babies all the time when Mom and Dad come in and baby’s dehydrated, for whatever reason, it’s my go-to choice. There’s not a lot of excess sugar in there and it’s got all the good and none of the bad, so inexpensive stuff. It works very very effectively. Brad: Pedialyte for the adult for electrolytes and hopefully they start marketing it towards adults and athletes now. Chris: They’re just kind of starting to tap into that. Brad: They better change the name. Chris: Maybe they’re going to have to but nonetheless, it’s actually really affordable stuff. Sometimes you buy them in like cases of these sports drinks that can actually get expensive on the pocket books. So, you know, fruits and veggies. Honeydew, the melon actually works really well. It’s got a perfect blend of carbohydrates, potassium and sodium. It’s excellent. Brad: And it tastes good. Chris: Tastes great. It’s excellent, after a run or a workout. Brad: You have to cut it up with a big knife and work out that way. Chris: Or you just scoop up the seeds, get a spoon. It works great as a post exercise or post activity or even a snack in the middle of the day. Let’s say you’re at work and you’re working a construction site where you’re sweating because it’s hot, go for some melon. It works very effectively for you. And don’t forget the water. Brad: Right, plenty of water. As far as preventing cramps from stretches, I’ll have a lot of people that cramp at night. I’ll do the exact same stretch as we talked about once you get a cramp, but you do them preventatively. Chris: Right before bed. Brad: Right. You could be laying or lying. I’m sorry. I’m sorry, Karen about that. Karen, she’s our English major. When you lay in bed, you can stretch out your hamstrings if standing. Doing the standing stretch on the bed isn’t good. Make sure you do pull your ankle back dorsiflex it. You should do that lying down with your knees straight. You’ll get a better stretch on those calf muscles there. That covers all of it. Chris: That’s pretty much it. Brad: There’s one thing I want to say. If you have a lot of calf cramps, get yourself an inclined board. If you do a lot of walking, a lot of running. It just makes calf stretches easier and it’s more effective, I think. Chris: There’s a better balance to it. Brad: This is about a 25 degree. You can buy them. 25 degrees is what I feel will fit most people. They’ll tell you what the degree is. You put your foot on there and boy does that work while you can just relax. You should do it with a shoe on, works a lot better, in my opinion; you get a better stretch. Hold that for 20-30 seconds once or twice before you go to bed or before you run or after you run or walk. Actually, I made this one. If you’re handy, you can make these. Chris: Heck, you made me one. Brad: Oh yeah. Made Bob one, my wife one, Bob’s son got one. They were Christmas gifts. Chris: One thing I didn’t touch on with the supplements, salt tablets actually. There’s a variety of different ones. Hammer makes Thermotabs. There’s a variety of different ones that also work well. The key to making those work well is make sure you have plenty of hydration with it too, but they get rid all the sugars and things but they’re just putting the electrolytes in a tablet or capsule. Brad: One thing that always kind of confused me about this and I think other people might wonder, what if there’s a little high blood pressure. Chris: That’s an interesting point you bring up because you know, one of the other causes that people that maybe take diuretics so that which can make you lose fluid, and you lose electrolytes when you’re on a diuretic. Brad: Water pills. Chris: We have to be careful. Why don’t you check in with your doctor with just about anything just to make sure or talk with your pharmacist. If they know your profile to make sure that it’s going to be safe and effective for you. But with respect to a salt tablet, the number one, when you look at the studies, the by-product of cramping is usually lack of sodium but what do we say to people that have hypertension? “Don’t use salt.” Brad: Yeah! So, it’s a double-edged sword. Chris: So, I would say work with your physician to make sure that it’s appropriate for you to maybe use either a little bit of table salt on your food or let’s say you have a big yard work project that you’re going to get done and you’re going to be perspiring quite a bit. When we sweat, we lose a lot of our electrolytes. So, we want to make sure we’re keeping you safe. We still want you drinking water. If you can get most of your electrolytes for your diet, it’s certainly appropriate. Some people can certainly use the salt table or the sports drinks. Brad: So, if they don’t have high blood pressure. Chris: Yeah, no hypertension issues, it’s not going to be a big issue. If it’s well controlled and on certain medications, it can be appropriate in certain situations. Being more careful around diuretics, so the water pill, so to speak, and there’s several of those out there. It’s something to always work with your doctor, work with your pharmacist. Make sure it’s appropriate for you. Brad: That always made sense to me once I thought about when you’re sweating a lot out in the heat and the sweat goes down your face. You can just taste the salt in it. Then it’s like, oh, yeah, maybe we should replace that. Chris: There’s a balance with everything we do. Brad: Alright, Chris, I think we pretty much hammered everything we needed to. Chris: I think so. It’s a lot about cramping. Brad: Don’t cramp your style, or my style. Whatever. Chris: Thanks guys. Brad: Take care, be careful. 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How to Use the TENS Unit: If you are using an iReliev TENS unit we provide step-by-step video instruction on how to use the following types: iReliev 1313 iReliev 5050 iReliev 8080 Just go to the program section at bobandbrad.com and click on the TENS series. Under the series look for the videos with the 1313, 5050, or 8080 TENS units. If you are using a TENS unit from another manufacturer you will need to follow the instructions provided with the product. Where to Place the Pads: There is NOT a specific right way to position or place the pads. The best approach is to place the pads wherever they relieve pain the most. Experiment and see what will work best for you. General Guidelines for One Channel and Two Pads on Outer Ankle Pain: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either above the first pad (at least a pad’s width apart) or below the first pad. Another option with two pads: place one pad directly above the pain and one pad directly below the pain or place one pad on each side of the pain. General Guidelines for One Channel and Two Pads on Inner Ankle Pain: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either above the first pad (at least a pad’s width apart) or below the first pad. Another option with two pads is to place one pad directly above the pain and one pad directly below the pain or place one pad on each side of the pain. General Guidelines for Using Pads on General Ankle Pain: Use one channel and two pads. Place one pad (either one) directly on the pain. Place the other pad either above the first pad (at least a pad’s width apart) or below the first pad. In our examples channel one has yellow pads and channel two has green pads. Option one: One pad from channel one is placed above the area of pain and one pad is placed below the area of pain. One pad from channel two is placed in front of the area of pain and another pad from channel two is placed behind the area of pain. This arrangement forms a cross pattern. Option two: Place one pad from channel one in the upper right corner of the area of pain and one pad from channel one in the lower left corner of the area of pain. Place one pad from channel two in the upper left corner of the pain and one pad in the lower right corner of the pain. This arrangement forms an X pattern. General Guidelines for Pain Referred from Another Area: An example would be ankle pain that is coming (referred) from the back. Using channel one, place the two pads along the nerve pathway. The two pads from channel two could be placed on the ankle. Reminder: do not place pads over open wounds or areas with excessive hair. Clean the area with soap and water prior to placement of the pads. Ankle treatment: Movement- ABCs For more information on the TENS programs visit: https://www.bobandbrad.com/tens-program If interested in purchasing the TENS/EMS unit by iReliev visit: https://ireliev.com/bobandbrad/?uid=15&oid=1&affid=10 DISCLAIMER We insist that you see a physician before starting this video series. Furthermore, this video series is not designed to replace the treatment of a professional: physician, osteopath, physical therapist, orthopedic surgeon, or chiropractor. It may however serve as an adjunct. Do not go against the advice of your health care professional. When under the care of a professional make certain that they approve of all that you try. This information is not intended as a substitute for medical treatment. Any information given about back-related conditions, treatments, and products is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this publication. Before starting an exercise program, consult a physician. Medical Disclaimer All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We are highly selective in our products and try our best to keep things fair and balanced in order to help you make the best choice for you.

This article is a transcribed edited summary of a video Bob and Brad recorded in January of 2021. For the original video go to https://www.youtube.com/watch?v=JeLyt67rMak&t=60s Bob: Today we're going to show you how to cure urinary incontinence with Kegel exercises. I was asked by a family member a ling time ago to show her how to do these. I really didn't have much experience with them though. So now, I've read a couple books on it and I've been doing them myself, but I'll talk about that some other time. Brad: You read some self help books then? Bob: Yep. So, what is urinary incontinence? It is an involuntary loss of urine. Brad: It's embarrassing. Bob: It is embarrassing. You could be laughing, you could be getting off the floor, you might be jumping. It's really common among young women in sports. You might be on a trampoline, obviously. And as you know, you have to rush to the bathroom if you don't make it. I had an older family member that really had trouble with this, and it really socially isolated him. It's not a laughing matter at all. Brad: No it isn't. Bob: It causes depression and loneliness. It's going to effect your social life. It's hard to date someone if your afraid or it. Brad: Or your spouse might not want to be with you. I mean they do, but it's awkward. Bob: So a lot more common in women, some reports, I saw one out of three women have it. And over 65, one out of two women. Brad: Yeah. Bob: So that's very common. Actually, believe it or not, one out of 20 men also have it. My wife made the observation, she goes, you go into the store and there is all these male Depends diapers there. Brad: Which are made for incontinence. Bob: So it may be a bigger problem than we're letting on. Brad: I think men just won't admit it. Bob: Men won't admit it. They'll, let it go. Brad: Not me though, I wouldn't. Bob: Yeah. All right. So what we're talking about here for Kegels exercises is we're trying to strengthen the muscles on the bottom of the pelvic floor. So the pelvic floor is attached to the coccyx or tailbone, and up to the pubis. So it's right in this area here where my hand is. Brad: It is, that's why they call it the pelvic floor. It's literally on the bottom of the pelvis. Bob: Right, it supports everything. It supports all those structures down there. You've got two layers of muscles a superficial and deep layer, but you don't have to worry about that because you can't work them separately. If you're working one, you're working on both. So it was developed by Dr. Arnold Kegel in the fifties, very popular now. So the pelvic floor, you can control voluntarily, which is an intentional muscle contraction but it is also an automatic type of muscle that's working when you're not even thinking about it. Brad: Right, it'll automatically contracts to take care of business. Bob: Yeah. So like when you're lifting something or carrying something it's kicking in so that you don't go to the bathroom while you're doing it. Brad: Yep, it closes those sphincters off and you're sealed. Bob: So, what should happen when you feel a pelvic floor contraction? You know, you're going to have like a gathering of the pelvic floor muscles, and it's going to contract and lift up a little bit. That muscle is actually going to lift up. And also we are going to apologize ahead of time here. We're going to use some graphic language here. I mean, it's appropriate. Brad: We'll be professional. Bob: Yeah. But your anal sphincter it should also be lifting up. Now with the ladies and the men too, you're going to feel the perineal body lift up. Now the perineal body is the area between the vagina and the anus. And for the men, that's between the scrotum and the anus. So that you and you we'll talk about that. That you can actually feel that with your hand, you won't do it in public, but you know, when you're trying to learn them. Brad: So you want to feel that movement and you want to be able to do it on command, your mind is telling you and you feel like you have good control. Bob: Yep, you should continue to breath normal. People should not be able to know that you're even doing it. My wife and I are joking that we've been doing these and you could be talking to each other and doing it. I mean, we could be doing it right now. What should not happen when you're doing the pelvic floor, Brad is you don't want to contract outside muscles. I've seen this on some other channels. Like you don't want to tighten up the glutes, the inner thigh, or the abdominals. You don't. The muscle that you want is working down there. Brad: You want to isolate it. Bob: Isolate it. Don't hold your breath. You should be able to talk, don't tense your eyebrows, or your shoulders, or your body parts. Brad: I would think that this is going to require initially some practice by yourself. Bob: Practice by yourself get used to it and becomes easier. And if you have trouble, there's therapists that specialize in this area, we had a couple of therapists that's all they did. See our experts page for those therapists. Brad: Right. Sure. Bob: So these are the common cues and these are the ones that tend to help. We'll talk about it for women and for men. So women, they tell you to squeeze lift the pelvic floor. They've told you the contract like you're trying to stop the stream of urine from happening, but they don't recommend doing that because it can actually result in a urinary tract infections. I guess you can screw up your urinary reflex. So you don't want to actually start going to the bathroom and then stop it. Brad: Oh, sure. Mid stream. Bob: Yeah. You want to think about how that feels and then apply it. You can, again I'm going to get a little graphic here, Brad but you're supposed to imagine lifting and holding something in your vagina. That's another one, you're supposed to squeeze like you're trying to hold in gas. I think we've all done that. Or imagine pulling your sit bones together. So these are the sit bones. I first misstated at first, that's these two bones. They're the bones you can feel when you're sitting down. Brad: If you're on a hard surface, you can feel those bones. Bob: Yeah. You're supposed to feel like you're pulling those together. Brad: Sure. Bob: And that'll help lift that area up. Now for men, this is kind of interesting. They did a study on this Brad, and they had all these cues and the best cue that worked for men was you're supposed to feel like you're shortening your penis. Don't make a joke. Brad: It's like a turtle. Bob: Like a turtle right. Brad: Guys understand that. Bob: Yeah. But it's funny, when I do that it feels like, one it works, and at two, it's an easy cue to understand. So I don't know why? Brad: I bet your wife knows when you're practicing that. Bob: Yeah. (laughing) Brad: I mean, she knows you. Bob: Okay for positioning, you can lie on your back propped up on a pillow or you can have your knees up. You can be in a quadrupedal position, Brad. And if you don't start that way you might want to progress that way to doing it that way, to do it sitting, to do it standing so you can apply it to all. Brad: So you would start lying on your back. Bob: You'll start lying down, yes. That's what I would do. Brad: How many repetitions? Bob: They have different ways of doing this. One, you can start with eight to 12 reps and do a ten second hold. So hold for 10 seconds. Do another one, do eight to 12 of those. Brad: And then rest for 10 or? Bob: Then you can do it like three times a day. Brad: So you're going to hold it for the contraction and then rest for whatever. Bob: Yeah, whatever. Brad: And then do it again. Bob: They said, you want to get up to like a hundred reps a day. Brad: Not in a row. Bob: Not in a row. And there's also, it's a slow Twitch and a fast Twitch muscle fiber. So you can actually do some where you do one second hold, one second release, one second hold one second release. Brad: Sure. Bob: So you want to throw both of them in there Brad. So, these are the ways to feel it. This is a little bit, I don't know if you want to say grotesque, but one way you can tell whether or not it's working is you could take a small piece of tissue paper and put it over your anal sphincter. And if you're doing it right, it's actually gonna kind of suck that paper up a little bit. Brad: Really? Bob: Yeah. It's going to grab onto it and pull it up. Brad: Well, it's like therapists, when we talk about working your gluten muscles. Since I started therapy back in the eighties as the teacher would say, well pretend you have a quarter between your butt cheeks and you're trying to squeeze that quarter, so it doesn't fall out. And it's like, boy that works. Bob: It works. Brad: Patients really respond to it. And they do it right. Bob: You won't want to do that now because you're not trying to move the butt cheeks. But this is the one that I thought worked the best for me. And for people, it seemed like. So again, the perineal body is that area between the vagina and anus or the scrotum and the anus. That area right there. If you put your hand on that, again you won't want to do it in public, but you just put your hand there when you do it, you'll feel it lift up. I think that's the best cue you have. It seems like it works really well. Brad: Basically biofeedback here. You're feeling what's going on with the muscles. Bob: Speaking of biofeedback and we can laugh because we're men. You can actually see your penis lift a little bit if you're doing it right so. Brad: I have to laugh. Bob: I should have said, see if you cannot laugh. We're laughing but we know this is a serious problem. We really do. Brad: You have to have fun with life, don't you Bob? Bob: I know. Because it's a terrible thing. So you wouldn't be doing this after surgery unless you're doctor has okayed that. And you don't do it with a urinary catheter either. Brad: Sure. Bob: So that's it, Brad. I know we're not experts on this but it's definitely, it's helped me with some issues and we'll talk about that in another video. 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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=FP4gka-BQ0o Bob: Today, we’re going to talk about the seven most important questions to ask your shoulder surgeon. We actually have more than seven, but we have kind of seven categories of questions. Let’s start right into them. In any surgery that you have, has to be taken very seriously. You want to give it much consideration. Brad: And I think this is really important, I can’t tell you how many times I’ve had patients or myself go to the doctor, and you leave, and you say, “I forgot to ask him that question. It was a really important question.” It could give other feedback that would be helpful for the therapist or for you and your family. Bob: If you’re watching this program, if you go to Bob and Brad, our website, and go to the program section, find the shoulder program and look for this video. There is a printout that you can actually do that has all these questions listed for you. Brad: Yeah, which is really nice. You can just highlight the ones that you want to ask your surgeon and just carry this with you to the doctor. Bob: Right, and make sure they answer all your questions. Let’s start off with the first one. Now this isn’t self-promotional here, but can you try physical therapy first? That’s really the first question you should ask. Brad: Right, it is. Bob: Yes, if you can avoid surgery obviously you want to avoid surgery. Brad: Some surgeons, that’s what they do. They will skip the physical therapy option, unless you ask for it. Then they’ll say, “Oh sure, we’ll give it a try.” So don’t be shy about it. Bob: This second one kind of ties into that. You’d ask, “What is the risk to not performing surgery now? What would happen if you waited six months or a year?” Because in some cases, let’s say, the tendon was actually ripped away from the bone. Maybe the muscle is going atrophy so much, it’s not going to heal. That’s why we’re going to ask the surgeon. Can I wait at all? If you have an impingement and it’s the shoulder tear going to actually get worse, if you wait? These are all things to keep in mind. This is a good question also for people who are under the age of 30 who are considering surgery due to shoulder dislocation. Quite often when you’re younger than 30 and you have shoulder dislocations, they want to do surgery because it’s most likely to happen again. They don’t want to have you experience the damage that occurs with dislocations. Brad: Sure, right, that unstable joint. Bob: Yeah, I always hate to tell people that but if you’re younger than 30 and your shoulder has been popping out quite often, my recommendation is you have the surgery. Brad: Get it tightened up and be done with it. Bob: So, number three kind of ties into all the other ones. What are the alternatives to shoulder surgery? So besides physical therapy, there’s injection, taking anti-inflammatories. Sometimes just the education. Sometimes you need to avoid it. Let’s say, you’re an older person, has shoulder dislocations, don’t be doing stuff like grabbing back or grabbing behind the seat. Brad: Like, when you’re driving, you need your bag and then, "ahhh", that can really cause pain sometimes. Bob: You want to avoid shoulder dislocations, bring in the arm back beyond this plain. Brad: That’s where it can really get unstable and cause some pain when it pops out. Bob: Number four is a general question. Then there’s some sub-questions here. Brad: Sure. Bob: It’s basically about the length of recovery off from the surgery. How many days will you be in the hospital after surgery? The norm seems like now, it’s in and out, right? Brad: Right. Same day. Maybe one night for observation depending on the person’s other medical conditions if they have any. Bob: I just want to state this. So, the first time I worked in a hospital as a physical therapy student, the first four patients I had, had rotator cuff surgery. They were all men, and they were all, I hate to say it, but they were all the biggest babies I’ve even seen. They were having so much pain. Maybe I’m just being judgmental after I found out how bad it is after. But I had some women after that and they acted like they didn’t have surgery. Brad: They typically are tougher. Bob: They are tougher. Alright, some sub-questions here. Will you need full time or part time care? You might. You can’t, if you’re down to one arm, you have to plan ahead and know this. Brad: Sometimes after surgery, your arm is going to be completely immobilized for so many days where you can’t move it. Other times it’s going to be in a sling when there is some mobilization. Bob: Yeah, and that’s the next question, Brad. How long will you be in a sling? Maybe 4-6 weeks. Your restrictions may be continual for up to six months. Again, your family has to plan from a functional and from a mental standpoint. Brad: Right, or can you work? If you have a job, you have to have that arm, it’s a disability. If you’re going to have some kind of insurance so you have coverage financially during that time, if it’s available. Bob: Absolutely. Ask the surgeon. When can you expect the shoulder to be pain-free? When can you lay on the operative side? When can you drive? Somebody could be driving around for a long time. When can you return to work? When can you return to sporting activities, if that’s your thing right now. And how soon can you resume housework and gardening and so on? That one for me, if I can’t ever get back to it, okay! Brad: Yeah, no housework, no gardening. Let’s go. Maybe you can emphasize that to the doctor. Bob: That’s right. Give me a note. Number five, okay, we’re back to the main questions now. This is kind of determining the competence of your surgeon and you shouldn’t be afraid to find this information out. You don’t want to ask the surgeon, maybe ask his nurse. Or get the information from the hospital. How many procedures do you perform every year? How many surgeries of this type have you done? Not surprisingly, they found out that the more times a person does a surgery, the better they are at it. Not shocking there. Brad: Right, it’s a pretty basic thing and practice makes perfect sort of thing. Bob: If they’re a general surgeon and they rarely do this surgery, I’m sorry, I’d go find someone else that’s done 100 of these last year. Brad: There’s one thing, I have a friend who was going to get the ankle surgery and he said, “Oh, I want to go to Rochester, go to Mayo and have the guy who does all the athletic, the top people.” And I’m sorry, he was not an athlete. He just wanted to walk. So, I don’t now if that’s the best fit because he’s working with athletes. There may be a difference in treatment afterwards. Bob: I understand completely. Brad: All that, people need to understand that. Bob: Just because they’re the best at treating athletes, doesn’t mean it’s good for you who are not an athlete. Brad: If you’re a standard person, like us. Bob: Right. Number six, what are the risks of complications? And what is your complication rate? Again, you don’t necessarily have to ask the surgeon, but you want to find this out. I remember this was a different doctor, he was a radiologist, but they do the test where they stick the catheter up through your femoral artery. Brad: Right, up into the heart. Bob: There’s actually generally a high percentage of problems with that. And at the time I’m just throwing a number out there, I don’t remember what it was. It was like 5% of people have problems. And he was one that would be like less than 1%. He’s like, I am meticulous at everything I do. So that’s the kind of person you want. It’s funny how I had a test done and I could just tell by meeting the guy, he was one of those guys that was really particular. I’m like, good, he’s, my guy. Alright, number seven, the final question. If you’re going to have a shoulder joint replacement surgery, you should ask these specific questions. Brad, do you want to throw one out there? Brad: What is the implant made of? Bob: Yeah, you want to know if you’re going to set off metal detectors in the airport. Brad: You know it’s amazing because there’s the plastic component, there’s the metal, there’s ceramic. I’m trying to think of some of the other things they use. Bob: I don’t know how long shoulders are suppose to last. I know knees are like 15-20 years. Brad: Yeah, and they get better. I’m not sure of shoulders because really shoulder replacements have just really gotten popular in the last 5-10 years, I think. Bob: When you think about it, a shoulder there’s not as much stress on it as a knee. Brad: Yeah, the weight bearing. Bob: No weight bearing. So, I don’t know with shoulder replacements, we have to find this out, we don’t know. And that’s one of the questions. How long will your shoulder replacement last? Number 3, Brad, what’s that? Brad: What can you do to make the new joint last as long as possible? Bob: What do you want to do? What you want to avoid. The Do’s and don’ts. Brad: There’s different types of replacements. There’s the reverse in placement. So, that’ll all be informed. They’ll probably give you some literature to read on your own as well. Bob: The last one ties right into that. What activities or factors could make your joint replacement wear out more quickly? So, you want to avoid these things obviously. That’s it. If you just happened to stumble upon this video, this video is a part of a series of videos on shoulder pain and rehab. Just go to bobandbrad.com and go to the program section and you’ll see all these different programs we have. We have one on shoulders. There’s a printout with each one as well. This one will have all these questions. You don’t have to write them down. Brad: Okay, take care. Bob: Thank you so much. 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