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
Ankles, Feet, Physiotherapy, Sports

Ankle Sprains – Putting your Best Foot Forward

 

Musts following any ankle sprain.

Ankle sprains are very common among young and old  alike.  There are many different types and vary depending on the type and severity of the mechanism of injury. Most commonly ankleswollen-ankle sprains occur when we roll our foot inwards, stressing the ligaments that attach from the bone in our leg to the bone in our foot.  They are usually characterised by immediate swelling, pain and reduced range of movement.

After an ankle sprain, it is important to begin on the road to recovery as soon as possible and you can get started by using these simple tips.

RICER Tryptich

Rest – give the structures in your ankle time to heal and minimise the amount that you aggravate the injury.

Ice – place ice, a cold pack or frozen peas over the injured area for 20minutes every 2 hours for the first 72 hours to minimise swelling and reduce pain.

Compression – make use of an elastic bandage or compression sock to apply light compression to the area to reduce swelling.

Elevation – try to keep your ankle elevated with a foot stool when sitting and propping on pillows when lying down or sleeping.

Range of Motion – move your foot and ankle through light and pain-free movements to keep the blood flowing and prevent stiffening of the joint.

Support – if a crutch or stick is required because you cannot weight bear, use it correctly as shown in the video clip below and try to continue your walking pattern as similar to pre-injury as possible.

Always hold the support on the opposite side to the injury, put injured leg forward first accompanied by the support – this will provide you with a wider and more stable base of support.

 


Referral – book in to see your physiotherapist ASAP for treatment, further advice and redirection of care as an X-ray, MRI or specialist appointment may be necessary.

These tips are just some of the steps required immediately after a sprain to allow a return to full functional capacity.  Physiotherapists have a much broader range of tools and strategies at their disposal and their consultation could prevent long-term issues and promote faster recovery.

Post by Mitchell Sandvoss (B. Physiotherapy)

Lifestyle, Physio's Personal Tips, Physiotherapy, Stability, Work

Avoiding a Pain in the Neck

The link between neck pain and technology use.

laptop-postureNeck pain is becoming more prevalent in recent times and much of it is linked to the poor postures we adopt when using technology.

On average, we spend 15 hours a week in front of a screen (almost 1 month of the year), and up to 50 hours a week if it is required for work. When using technology, our eyes need to be in an optimal position to focus on the screen. For most of us, it is easiest to poke our chin out to get closer to the screen.

For each inch that your head sits forward of its normal position, the head adds 4.5kg of force onto the small and fragile structures within your neck.  All of this added pressure can cause neck pain, shoulder pain, arm pain and headaches from the muscles in your neck having to work harder and the added pressure placed on the discs, nerves and vertebrae.

ForwardHdEv

If you are someone who spends a lot of your hours in front of the screen, behind the wheel or on the couch, there are some strategies that you can adopt to ease the pressure on your poor neck!

Activation of your Deep Neck Flexors

Your deep neck flexors are muscles in front of the spine responsible for neck stability (similar to the role of the deep abdominals in your lumbar spine) and supporting the head directly over the spine.  When your neck is over your spine, the pressure on other parts of your neck and body will be reduced.

Activating them can be difficult if you are doing so for the first time, so follow these simple steps:

Step 1 – Lie down on your back with a pillow underneath your head and neck, legs bent up and muscles relaxed.

Feeling Neck FlexorsStep 2 – Tuck your chin in so it feels as though it is lightly blocking your windpipe and push the back of your skull into the pillow.  Do NOT activate the muscles at the front of your neck.  Place your fingers on these muscles if necessary to stop them from activating.

Step 3 – Hold this position for 5 seconds before relaxing.  Repeat 10 times before having a rest, then complete 1-4 more sets of 10 until fatigued.

Chin Retraction

Chin Retraction – make a double chin, hold for 5 secs, then relax

Constant awareness of your neck position

When in the car, use the head rest and tuck your chin in.  When at your desk or when using technology, make sure you are not protruding your chin to see the screen.  And, when you are sitting on the couch make sure your head is in a good position and is supported appropriately.

Set up your environment correctly

Move the items in your environment (screen, mouse, keyboard, chair) so that you can maintain a good posture and still work efficiently.   Laptops and tablets force poor posture as looking down at the screen and typing so close prevents good posture. Purchasing a wireless keyboard to use with your tablet to separate hands and screen, increase the font size on your smartphone, correct the angle of your screen on your laptop and position pillows properly when sitting on the couch to provide low back support..

Ergonomics1

Take regular breaks

Increasing the amount of time that the structures in your neck are under pressure will increase the likelihood of developing pain.  Scheduling regular breaks will allow your neck to have a rest and to relieve the strain.

____________________________________________________________________________

If you do suffer from neck pain due to poor posture, these strategies will help you.  Poor posture, however, is not the only cause of neck pain and if pain persists we do recommend consulting your physiotherapist for a full assessment.

Post by Mitchell Sandvoss (B. Physiotherapy)

abdominals, back, Core stability, Daily Exercises, Gymn Dangers, Hips, Improving Movement, Injuries, Physio's Personal Tips, Physiotherapy, Pilates, Stability

How stable is your core?? Here’s how to check!

personaltrainerOften, people spend hours doing “core training” in the gym such as sit-ups, planks and the like only to find that they still experience symptoms of instability such as low back pain during training or, they get injured regularly doing exercise. The problem? This kind of “core training” addresses the strength of your abdominal and oblique muscles which are responsible for providing movement but does not train the deeper, stabilising muscles that are responsible for maintaining good alignment of the spine.

Here is a little exercise to introduce the feeling and the essence of stability in you torso. The true “core”:

1. Lie on your back, knees up, feet flat on the ground.

2. Breath, and feel how your ribs move and the shape of your spine changes.

3. Place your index fingers on the bones at the top of your pelvis at the front.

4. Feel what happens when you lift one foot from the floor REALLY SLOWLY!!! No jumping it up!!!

5. Try again and try to not allow any movement in your pelvis or lumbar spine.

Did you hold your breath? Did your pelvis roll toward the side you lifted? Did your back arch away from the floor? Did you get a “ping” of back  pain?

If YES was an answer to any of these questions you have room for improvement in you core stabilisation.

Practicing this exercise is actually a great way to begin the reactivation of your deeper, stabilising muscles.  Breathing as you move and load the spine is essential to prevent rigidity. Our bodies are designed to be fluid and coordinated when moving and breath holding can stifle this and cause us to become to stiff when moving! If you don’t breath while you do anything you won’t do it for very long!!

Mullumbimby-Pilates

For detailed explanation of core stability refer to our previous blog “What is core stability?”. You can find it here: https://northernbeachesphysio.com/2014/03/28/what-is-core-stability/.

Also, watch this video of one of physiotherapists, Angus, walking through the above exercise and explaining how to activate your core!

Gardening, Lifestyle, Physiotherapy, Stretching

Keeping the ‘Ache’ out of Gardening

GardeningGardening can be the most restorative of activities – unless we overdo it, and most people will be guilty of that at some time or other.

The key is to not go at it like a bull at a gate, but to pace yourself (regardless of your age) and pause during repetitive tasks to let joints and muscles rest. Every fifteen minutes is a good target but don’t leave it more than half an hour before RESTING and performing the OPPOSITE movement for a short while.

Hands & Wrists:

Extended pruning with secateurs is a classic cause of RSI (repetitive strain injury).

Secateur-Hand-StretchJust pause now and then to stretch your fingers, hands and wrists in the opposite direction to the pruning action.  Joints will recover, muscles will shed their fatigue and you’ll be more efficient.

Shoulders:

While pruning or clipping overhead your shoulders will take most of the strain.  Just pause for a few moments and roll your shoulders down and back in a circular motion for one minute. Apart from providing rest for the muscles, you’ll also relieve those joints and tendons temporarily.  Remain standing tall during the exercise and keep your chin in.

Clipping-Shoulder-Roll

Back:

While digging, raking or bending to weed, stop and arch your spine and shoulders backwards with hands pushing your pelvis forwards.  It’s a classic for very good reason as it allows the gelatinous content of squashed discs to revert to balance again.

I see so many patients suffering from lower back pain from gardening, yet this small exercise can prevent so much discomfort.

Digging-Back-Arch

Knees:
Many gardening tasks involve kneeling and even if you’re wearing kneepads to protect the front of your knees, the knee joint and surrounding tendons needs rest and opposite action too.  So stand up and give them a rub and a wiggle (that’s a technical term for repetitive re-traction by the way).

Weeding-Knees-stretch

Painful Joints:

Many mature gardeners will suffer some occasional joint pain, whether it be arthritic or rheumatic and many will avoid outdoor activities at these times.  But all joints benefit from movement as it stimulates joint lubrication which in turn provides the nutrition for the joint linings and cuffs.

People who immobilise tetchy joints do themselves no favours as the joint will become stiff and produce even more pain. If you have painful joints and decide to do some gardening then warming up first is all the more important as this will minimise the initial discomfort.

But, as with all things to do with health, all movements should be performed in moderation. Stop if sharp pain persists and consult a doctor.

Post by Catherine Stephens B. App Sc (Physio) MAPA.  This article appeared originally on www.gardensonline.com.au

Improving Movement, Physiotherapy, Stability

5 exercises to keep your shoulder stable and healthy

The key to a healthy, pain free and strong shoulder is a stable scapula (or shoulder blade) which is the base from which all shoulder movement occurs. It is the bone where the “socket” of your shoulder is found and to which the “ball” of your upper arm (humerus) connects.

Losing scapula stability is often the first step toward developing painful injuries such as rotator cuff tears, subacromial bursitis and arthritis.

The following exercises are very effective for improving scapula stability and therefore improving shoulder function. Please keep in mind that you should never have pain during or after doing these exercises. If you do, please consult a physiotherapist before continuing.

scapulaScapula Clock#1.Scapula clock: Stand close to a wall with your elbow bent. Place your hand on a small ball on the wall just below shoulder height. Roll your shoulder blade back and down and hold it set in this position.

Make circles alternating from clockwise to counterclockwise with your hand on the ball while maintaining your shoulder set. Repeat 10 times each way.

Pull Downs#2. Pull downs: Using a cable or theratube secured above you.

Pull down with straight arms to the side of body and simultaneously draw your shoulder blades back and down to feel muscular squeeze in the middle part of your back just below the shoulder blades.

Repeat 10-20 times.

Wall Push Ups#3. Wall push ups: Place hands on wall below shoulder height and slightly wider than shoulder width.

Stand with feet together and away from wall so you are weight bearing through your arms and hands.

Do slow push ups on the wall being mindful to keep the shoulders back and down as you press toward wall.

As you press away from the wall roll the shoulder blades around the ribcage to arch the upper spine.  Repeat 10 times.

4 Point Kneeling#4. Four point kneeling: Assume four point kneeling position.

Take weight forward so your nose is in front of your fingertips. Bend elbows and take shoulders down away from your ears.

Keep shoulders back and down and maintain stability on one arm as you lift the other out in front.  Repeat on the other side and do 5-10 repetitions.

Ball Roll#5. Roll out on ball: Assume start position as pictured.

Ensure shoulders, hips and knees are aligned and support weight on hands.

Slowly roll the ball out in front of you, keeping your body aligned and extend the arms away from the body to allow the elbows and forearms to rest on the ball.

Maintain shoulder blades down and back. Repeat 10 times.

Post by Angus Tadman

Improving Movement, Physiotherapy, Stretching

4 Tips for Effective Calf Stretching

Stretching the calf muscleImportant after any extended walking, running, golf or weight bearing sport!

1)    Ensure the foot is directly in line with the leg. Toes not turned out as is often the case.

2)    To get an effective stretch you need more pressure than just stepping backwards so press into a wall or bench with hands or forearms.

3)    Roll the heel backwards so the very back of the heel is on the ground and lift the toes just a little.

4)    Straighten the knee completely feeling tightness in the muscles above the knee, lifting the knee cap.

Hold the stretch for at least 30 seconds to get effective lengthening through the entire length of the calf muscles.

Note : in the case of Achilles tendonitis this is not suggested as it tends to aggravate the tendon.