Yes, it’s true Sciatica is a pain in the butt! Literally. However, the sciatic nerves are not confined to the gluteus maximus, the body’s largest nerves; sciatic nerves extend from the low back to your toes. The nerves exit the spine between two vertebrae in the lower back, travel behind the hip joint on both sides, down the buttock, and back each leg into the foot.

One of the most important things about Sciatica is first identifying you have it and then determining what is causing it, in order to treat it effectively. If you don’t seek help for sciatic problems, over time, the condition may only continue to get worse and cause lasting damage to the lower back and hips.

Dr. Elijah Chiang PT, DPT from Foothills Sports Medicine Physical Therapy (Tempe Location), shows us his top 4 exercises to relieve sciatic nerve pain.

What causes Sciatic nerve pain?

Sciatic pain can be caused by numerous reasons, such as a herniated disc or a narrowing of your spine. However, the most common reason is a pinching of the sciatic nerve as it passes through/around the lower limbs’ gluteal region. This is often caused by a rotation in the pelvis and/or weakness in the glutes. In the most extreme cases, when the nerve is pinched between the disc and the adjacent bone, the symptoms may involve pain and numbness and muscle weakness in the leg because of interrupted nerve signaling.

What are the most common symptoms of Sciatica?

Some of the most common symptoms are radiating pain down the backside of the leg. Symptoms will usually run north to south. If the symptoms are on the outside of your leg or down the front, it is usually a different issue.

Other common symptoms of Sciatica include:

  • General lower back pain
  • A pain in the rear or leg that is worse when sitting
  • Hip pain
  • Burning or tingling down the leg
  • Weakness, numbness, or a hard time moving the leg or foot
  • Constant pain on one side of the rear
  • A shooting pain that makes it hard to stand up

How soon can you find relief after physical therapy?

It takes approximately four weeks to build new muscle, and the change in symptoms usually corresponds to the building of new muscles to decrease compensations. Temporary relief can generally be achieved within a few visits, but lasting changes are highly variable with factors such as how long you have had the sciatic pain.

What is the best treatment for Sciatica pain?

Massages to the hips and lower back are usually a great way to manage symptoms. Icing the hip and lower back when radiating symptoms are severe can generally decrease the symptoms. Acupuncture and dry needling are also suitable alternative treatments. In most cases, Sciatica resolves in a few weeks with conservative treatment such as exercise and physical therapy. However, for some patients, pain can last much longer, and treatment should be individualized.

 

Foothills Sports Medicine Physical Therapy is a group of locally-owned Phoenix Area physical therapy clinics that provide quality, hands-on care to all of our patients, ensuring optimal results with our Full RecoveryFocus™. We offer a free assessment of any injuries you might have; if you would like to be evaluated for sciatic or back pain issues, schedule online today.

If you watch football, you’ve seen it.

An individual running across the middle for a ball when out of nowhere, a missile in the shape of a man pummels the unsuspecting individual. You see the player lying on the ground writhing in pain and then getting to his feet visibly shaken.

Yet somehow, in a couple plays up to a few weeks, they’re right back at it again.

Despite the way concussions may be downplayed in professional sports, it is a serious condition that requires immediate attention and sports rehabilitation.

But how do I know I have a concussion?

It doesn’t require bone-jarring hits for an individual to sustain a concussion. In fact, it’s possible to sustain a concussion without hitting your head.

For example, imagine an unsecured purse or bag placed in the passenger seat. When you suddenly slam on the brakes, you stop — but what does the bag do? It continues to fly forward and smashes into your dashboard or flops onto the floor. A concussion occurs when your brain suddenly and rapidly hits the inside of your skull. Similar to the illustration, when your head suddenly changes in direction, your brain can fly into the inside of your skull when enough force is applied.

What do I do it I think I may have a concussion?

It is our professional recommendation that you contact your doctor immediately if you suspect that you may have suffered a concussion. Unlike the professional world, most of us don’t have immediate access to a doctor, nor have we taken a baseline test for our balance and cognitive functioning that is commonly used for the 1-minute and 2-minute concussion tests.

So how can we test it ourselves?

Test Procedure Positive indicator
Memory Give the individual 3 random words to memorize before you begin testing – Failure to recall after 5 minutes
Vision Have an individual track the eraser or cap of a pen/pencil while you move it up/down/side-to-side – Eyes begin to skip

– Difficulty following your movements

– Dizziness or nausea

Sensitivity Monitor the individual and ask them if they feel sensitive to loud noises or light – Sensitive to loud noises

– Sensitive to light

Reflex Use a light to check the pupil’s reflex responses – Poor pupil response to light changes
Balance Have the individual balance on a single leg while performing a cognitive task (adding 7s up to 100, listing a category of objects, etc.) – Consistent loss of balance
Cognitive Have the individual perform moderate cognitive tasks that would be easy for them normally (recite the months backward, multiplication tables, etc.) – Inability to perform the task correctly
Speech Converse with the individual and ask them many questions about the day, the time, interests, things that they were doing – Incoherent or incorrect answers due to confusion
General signs You should also look for nausea, vomiting, and loss of consciousness – Nausea

– Vomiting

– Loss of consciousness

Now, by no means is this an exhaustive list of tests but it is a good baseline and can provide valuable information to the doctor when you are able to see them.

It is my recommendation to perform these tests multiple times throughout the first 12-24 hours to see if there is a drastic change. It is my strong recommendation to seek emergency care if symptoms continue to worsen or if there is a drastic change in symptoms after, establishing a baseline for the individual.

What exercises can I perform for a concussion?

One of the most important things after a concussion is to get proper care through your MD which will often result in referral to a physical therapy clinic for neurological retraining. This is often done to restore proper function of the eyes and vestibular system which are major proponents of balance and daily function.

Below is a list of exercises that are great starters to help visual issues. Please perform them while sitting down as this may increase fall risk. If you don’t feel that you can perform all of these exercises, please only perform as many as you’re comfortable doing. These exercises may cause some discomfort and dizziness. Stop if you become excessively dizzy and nauseated. This is by no means an exhaustive list, as balance and cognitive therapy with a physical therapist are also recommended.

Eye Movement

·      Keep head still

·      Move eyes up/down, then side to side.

·      Repeat 5 times

Head Movement

·      Move head up and down, then side to side, then diagonally right to left

·      Repeat 5 times

Eye-Head Movement

·      Hold your thumb directly out in front of you and focus on your thumbnail

·      Move the thumb up, down, and side to side and follow with your eyes and head

·      Repeat 5 times

Gaze Stabilization

·      Place a sticky note or an object on the wall at eye level.

·      Write a capital letter on the object and stand about 3_5 feet away from the wall (usually around one large step backward)

·      While keeping your eyes steady on the target, rotate your body side to side for 1 minute

Saccades

·      Place two sticky notes/objects about 12 inches apart on a wall, at about eye level

·      Take a large step backward from the wall

·      Start the exercise by looking back and forth between the two objects quickly

·      Objects can be placed horizontally and vertically

Convergence

·      With your thumbs up, fully outstretch one arm and bring one thumb close to your face

·      Focus your eye on the farthest thumb and hold for 10 seconds

·      Then switch your focus to the closer thumb and hold for 10 seconds

·      Repeat 5 times and slowly increase the repetitions as you increase tolerance

If you think you have a concussion, it’s important to see a health professional. You can safely get back on the field with sports rehabilitation. Find a physical therapy clinic near you.

One of the main problems physical therapists face is their patients not performing their exercises at home or not continuing their exercises after they’ve been discharged. If you’re like most of the United States, we always have the best intentions at the start of the New Year to be more active and to eat healthier. If you’re like me, it stays just like that: as an intention. Unfortunately, intentions never solve anything and they definitely don’t build muscles.

Recently, I spent 15 minutes with an elderly patient as we tried to devise a strategy for him to motivate himself to perform his exercises at home. Like many of us, he knows that it’s good for him and that he needs to exercise to manage pain and become healthier. But, let’s be honest: it’s difficult. So, I’ve devised a list of easy “life-hacks” that will help you remember to do your exercises.

1. Utilize Time During Mindless Activities

One of my favorite recommendations to give patients is to use the time from mundane and repetitive tasks to exercise. When we take the time to think about it, we spend a significant amount of time doing nothing (physically).

Before you grab your pitchforks and argue that you’re always busy, let me use an example. How do you brush your teeth? If you’re like the vast majority, you might be walking around or just standing around staring at yourself in the mirror. What if you spent that entire time working on your balance and standing on a single leg? Or, how about some leg lifts or squats? I use the 2 minutes brushing my teeth to perform balance and leg strengthening exercises.

Here are just some ways I’ve taken the initiative with my exercise routine:

ACTIVITY EXERCISE
Commercial breaks → Squats, lunges, pushups
Brushing my teeth → Single leg balance, hip abduction
Flossing → Supine marches, posterior pelvic tilts, bicycles
Dishwashing → Single leg balance, calf raises
Microwaving or waiting activities → Wall slides, shoulder squeezes

 

2. Modify Daily Activities

This is probably the most common and easiest thing to change to increase physical activity. Some changes that you can easily make could be as simple as parking farther instead of driving around looking for the closest parking spot.

Other ideas include:

  • Taking the stairs at work.
  • Choosing to use the basket at the supermarket instead of the cart.
  • Walking to get the mail.
  • Placing your treadmill or another cardio machine next to your television.
  • Standing and walking at your child’s sports game.
  • Playing with your family instead of spending time on your phone or watching television.
  • Taking walking breaks at work with your coworkers.

My personal favorites are what I call “exercise taxes.” I installed a pull-up bar at the doorway leading to my bathroom. In order to pass through, I must do as many pull-ups as I can. I have had patients use their living room or certain pieces of furniture as an exercise tax. Someone has also suggested having certain activities taxed, such as lunch or dinner. This not only improves your activity level but also decreases the amount of food you will ingest as well.

3. Technology Can Be Your Friend

There are numerous phone applications, online tutorials, and other tools you can use to promote physical activity. Pokémon Go has been a huge hit with kids and adults alike and can really promote additional physical activity. Sweatcoin is an app that offers you rewards for working out! Dietbet is another app where you can join a pool of other users and set a bet for how much weight you will lose. If you meet your goal, you split the pot with the others who met their goal.

4. Phone a Friend

Finding a friend or family member to exercise with you can significantly increase your exercise frequency, intensity, and overall enjoyment. There’s nothing quite like having someone else suffer enjoy exercising with you. There are also a number of fun workouts and exercises that require two people. Group classes and other similar activities can create a social community that will keep you accountable to exercise more frequently.

5. Set Timers and Markers

This is probably the most “annoying” tip but can be quite helpful. I encourage my patients to use an actual timer or the timer on their phones to set a time limit on whatever activity they’re doing. When the timer goes off, the patient must perform some type of exercise such as 10 squats, take a lap around the house, 10 shoulder squeezes, etc. This can also be substituted by placing stickers around the house where you must frequently look. Each sticker symbolizes an exercise you must do.

If you’re having difficulty finding the motivation to exercise at home, give these life-hacks a try. You’ve got nothing to lose but a few calories! If you’re dealing with pain, schedule an appointment with us. Our physical therapists can guide you through exercises to help you manage pain and get back to the activities you love.

When it comes to pain, the lower back has always been the ailment that got the most attention. Shoulder pain just had to shrug it off, even though it’s responsible for rotator cuff tears, shoulder impingement, thoracic outlet syndrome, neck pain, and chronic migraines in millions of patients across the US.

Symptoms requiring shoulder pain treatment often begin innocently with little clicking or popping as you move your arms. Our patients say that they’ve been clicking and popping for most of their life and now, many years later, they have an incomprehensible pinching pain in their shoulder.

These injuries can range from slight soreness in the shoulder to full-blown rotator cuff tears that will require a surgical intervention up to shoulder replacement. The recovery from these operations tends to be painful, difficult, and protracted. Most patients need 10-14 weeks of intensive shoulder physical therapy afterward, if not more, before being able to return to their previous quality of life.

The good news is that many of the symptoms are preventable, and correctable if spotted early enough. The most common issues we see are related to poor shoulder alignment and even worse shoulder movement. I recommend that anyone who has had a past injury to schedule an appointment for visit at one of our Foothills Sports Medicine Physical Therapy locations throughout the valley for custom shoulder physical therapy. However, it’s never too early to start addressing your symptoms. Here are some of my favorite tips on how to reduce your shoulder pain.

Don’t Hold the World on Your Shoulders

Ladies, most of your purses are too heavy. All too often, I’ll greet a new patient reporting shoulder pain stating that “I have no idea why my shoulder is hurting” or that “it came out of nowhere.” A quick test reveals that their large purse is roughly 15lbs.

Through plenty of experiences carrying my mother and girlfriend’s purses, I frequently advise my female patients to reduce the amount of items in their purse. Many of my patients respond well to this suggestion.

A simple reduction of even a few pounds significantly decreases stress on the shoulder joint. The most common source of shoulder pain is decreased space in the shoulder for your arm to move. This is most often caused by poor alignment due to shoulders that are sitting too low. Reduce the weight. Increase the space. Decrease the pain.

Posture, Posture, Posture

I find that the majority of my shoulder physical therapy patients have extremely poor posture. Here are some general tips to improving your posture to prevent pain.

  • Limit your computer time and elevate your computer screen; the most ergonomic position is for your screen to be is level with your eyes. Spending less time slouched over your keyboard and mouse will further help with your shoulder positioning.
  • Unweight your shoulders by using your armrests or table to rest your forearms. Each arm is approximately 6.5% of your body weight. That’s 13% of your body weight dragging on your upper body for 8 hours a day if you have a sit-down job.
  • Watch your head and shoulder position. Tucking your chin in results in better posture. Roll your shoulders up and back, not down. Most patients immediately pull their shoulders down when I ask them to show me a good posture; this position decreases space within your shoulder joint and increases impingement. By rolling them backward at a 45° angle, you activate the muscles that can better support your arm.

Do you like to move it, move it?

The shoulder is a complex joint that needs tuning, just like a clock. If one part moves too much or too little, the rest of the joint is strained. Treatment for the shoulder is often corrected with strengthening exercises of your middle and lower trapezius muscle, and rotator cuff muscle.

However, strengthening alone isn’t enough; it’s just as important for you to integrate these movements in daily life. My personal favorites are wall slides, prone mid-trap squeezes, scapular retractions, and PNF D2 flexion exercises, however, these are just the basics. These exercises are simple and pain-free. I often joke with my patients that it’s like having a Lamborghini in your garage but not knowing how to drive.

To learn more about shoulder pain online, visit our body map within our services page. I strongly recommend that you schedule an appointment with one of our movement experts at Foothills so that our team can provide you with the best preventative and corrective care. We want to ensure that your shoulders will be in perfect shape to pick up your future grandchildren.