back, Gluteal, Nerve Pain, Physiotherapy, Sciatica

The Secret to Sciatic Pain

Sciatica is a complex problem that many of us have either experienced, or know someone that has.  “Sciatic pain” however, is not just one problem but an umbrella term used to describe many sciatic-nervedifferent problems that cause the sensation of nerve pain in the area of the body controlled by the sciatic nerve.

Nerve pain can be caused by any irritation of a nerve either through compression, excessive or prolonged stretching, damage due to trauma, local chemical changes or even interference from scar tissue.

Nerve pain can feel different to different people and can be in different areas for different people, with either hot or cold feelings, pins and needles or numbness, sharp or shooting pains or even loss of power to muscles.  These differences are dependent sciatic painon which nerve has been affected and how significantly it has been affected.

The reason why sciatic pain can be caused by so many different problems is because the path of the sciatic nerve can be affected by multiple structures.
The four structures that are mostly responsible for sciatic pain are:

The Spine
When our nerves travel from the spinal cord and leave the spine, they must pass through small holes between vertebrae.  These holes (foramen) can be narrowed by different variables such as repetitive poor movement patterns, degeneration of joints, dehydration of spinal discs or disc protrusion.

The Pelvis
The lowest segment of the spine, the sacrum, also has small holes through which nerves emerge to service our legs.  If the sacrum is not gliding correctly through movement or there is poor alignment of the pelvis, these nerves can be affected.

The Buttockspiriformis syndrome
Within the buttock muscles, there is a singular muscle called the piriformis.  In most of the population, the sciatic nerve passes underneath this muscle, but 17% of people have this nerve pass through the piriformis.  Incorrect length or function of the piriformis muscle can aggravate the sciatic nerve in both populations but is more likely among the 17%.

The Muscles of the Leg
Scar tissue and a history of damage to muscles close to the sciatic nerve can cause adherence to the nerve itself and lead to pain.

Due to these multiple causes, there are multiple solutions to what seems as though it is the same problem.  What may be beneficial for your relative or friend with sciatica, may not be as effective, or may even be detrimental to your own situation.  This is why it is important to consult your physiotherapist, who will perform a thorough examination, to determine which problem is attributing to your nerve pain and create a program tailored specifically for you.

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Alarm Clock
Daily Exercises, Gluteal, Improving Movement, Injuries, Lifestyle, Physio's Personal Tips, Physiotherapy

Morning stretches!

Stretches in the morning:

Spinal stiffness and pain is a common complaint. This can be caused by inflammation, arthritis or muscular tightness as well as injuries such as bulging discs.

The impact of spinal symptoms can easily be reduced by doing a regular morning stretching session.

Generally, I advise my patients to wait 20-30 minutes after rising from bed before they commence spinal stretching. This is to allow the discs to compress slightly after they have been expanding during sleep. This reduces the risk of injury to the discs.

Following is a list of great exercises to do in the morning to get your spine moving!

Knees to chest rocking: bring the knees to the chest and tuck up in a gentle rocking motion 10 times.

CurlRock

Sciatic nerve stretches: using a long belt stretch the leg as shown by gently moving the ankle forward and back, keeping the leg straight.

HamstringAnim2

Piriformis and gluteal stretches: place the ankle of one leg on the knee of the other and lift both legs up toward you as shown, hold for 20-30 seconds as you pull the stretching leg toward the opposite shoulder and push into the ankle with the opposite knee.

GluteStretch

Open book stretch: lying on your side as shown, breathe in as you take your top arm across your body, allowing your head and shoulders to turn with it. Hold the stretch and breathe out. Repeat 10 times both sides.

Thoracic Open Book stretch

Gluteal, Hips, Improving Movement, Physiotherapy, Stability

Happy Hips

Whether you are a walker, a runner, footballer or even a belly-dancer, everyone needs good hip stability to be able to perform their sport (or their art) with optimum control.

Belly Dancers Hips

Poor stability around the hip joint can lead to problems such as trochanteric bursitis, lower back pain, sciatic pain and groin injuries. If you have one of these problems it is possible that you have weakness and poor control of the deep muscles of your hip joint.

Hip stability is achieved by having not only strength of the big gluteal muscles that make up the bulk of your buttocks but also good timing of activation and control of the deeper muscles of the hip joint. These deep muscles are responsible for stabilising the hip joint during movement to allow the larger gluteal muscles to move your hip with better joint alignment.

Hips Start

Knees bent, pelvis tilted

To test your deep hip stability simply follow these steps:

1) Stand in front of a mirror with your knees slightly bent (around 30 degrees) and your pelvis tilted forwards.

Now place your hands on your hips to feel the muscles just behind your hip with your thumbs and your abdomen with fingertips.

Hip exercise

Hips always level

2) Gently transfer your weight to one side, aiming to keep your knee, hip and shoulder aligned on the side that you are leaning toward e.g. your hips stay level with the ground.

Hold for a few seconds then transfer your weight to the other foot, again keeping your hips level.

If you have good stability you should be able to do this and maintain alignment of your hips, knees and shoulders, as shown in the animated image on the left, and you will feel the muscles activate strongly.

If you have poor stability you will find it hard to keep your balance and you may see your hips drop or your shoulders sway too far out to the side, as shown below.

Happy Hips Wrong

Left – hips crooked, Centre starting position. Right – hips crooked

Practicing this simple movement daily can help to improve the stability of your hip joint.

Keep it up! Remember; stable hips are happy hips!

Post by Angus Tadman B. App. Sc (Phty) Hons Class I