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.

Advertisements
abdominals, back, Core stability, Feet, Gymn Dangers, Physiotherapy, Pilates, Shoulder

What is Core Stability?

Power and Strength are useless without Stability and Control

muscles

Big flashy muscles might be attractive but as any physio will tell you, they are next to useless without core stability.

Thankfully the health and fitness industry has now started to embrace the need for core stability, but still few people really understand the concept and what it means.

Essentially our bodies have hundreds of different muscles that all perform important tasks and the very conspicuous Abs, Glutes, Pecs, Delts and Biceps (amongst others) are there to provide strength but they are supported by a plethora of smaller, less conspicuous muscles that provide stability.

shock absorbersThese are generically referred to as the ‘Core Muscles’ and the best comparison we can think of is with automotive suspension systems.

If the ‘Strength’ muscles are the springs then the ‘Core’ muscles would be the shock absorbers.  They are usually less conspicuous, sometimes even hidden within the springs but without them your car would fall apart in no time.

The same goes for humans.  Good strength muscles alone won’t keep you running smoothly. Without good core stability you’ll be in for lube and servicing (physio) all too often and eventually you’ll be off to the scrap yard before your time!

inner_core_musclesWhen it comes to spinal stability, the most important muscles are the multifidus, pelvic floor and transversus abdominis. As shown in the image to the right, these muscles form a supportive cylinder around the spine. The transversus abdominis is like a corset around your abdomen and it sits deep underneath all the “six-pack” muscles.  It attaches the lower ribs, diaphragm and lumbar spine to the pelvis.

This ‘core’ stabilises the spine and allows the load of movement to be evenly distributed between all the intricate joints of the spine. Just like a car suspension system, it reduces the shock through the joints and thus reduces wear and tear which would, over time, lead to conditions such as arthritis or bulging discs.

personaltrainerDoing exercises like sit ups is useful to strengthen the big “six-pack” muscles, but doing this exercise without good core stability will lead to excessive load through the joints of the spine and can lead to injury of the spine.

So in that respect it is important to activate and strengthen the core before you start on a regime of strength building.

 

Muscles of the posterior shoulderAnother example is the shoulder. The “delts”, “lats”, “pecs” and “biceps” look fabulous but they are not the stabilisers of the shoulder.

Over training of these without attention to the deeper, core stabilisers of the shoulder can result in injury as a result of an increased load being put through the system without the appropriate “suspension”, so to speak.

See our blog on ‘Shoulder Stability’ for a series of simple exercises to build core shoulder stability.

Each area of the body  has a “core” component.

Feet have intrinsic muscles that operate in balancing.

Ankles rely on hip and foot stabilisers for control.

Knees similarly need good hips and feet to be protected.

and even Necks have a deep system of muscles that control movement.

In essence, the core muscles play a crucial a role in overall well being and strength. Without the stability and control provided by the deeper core muscles, the power and strength gained from training is useless!!

Stay tuned as our series of CORE STABILITY blogs will introduce the specifics of core training for different parts of the body and the common areas of overloading we see in fitness regimes!

Post by Catherine Stephens (B.App.Sc Physio) and Angus Tadman (B.App.Sc Physio Hons I)

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