Piriformis Syndrome (Sciatic Pain) II

Sciatic PainSciatic pain comes about either due to a traumatic event, muscle imbalances, or a combination of both.

When you have an injury to a muscle, both strength and flexibility are compromised, and if your recovery ends before strength and flexibility return, you will never be 100% and will likely struggle with the problem forever.

The other way sciatic pain creeps into your life is due to your lifestyle and habits, and that is what we like to call the process. The process can be described as a prolonged onset of symptoms based on your everyday activities.

However, from a technical stand point the process really describes the development of the muscle imbalance in your hip. The Piriformis muscle is responsible for external rotation (moving your leg so your feet point outward). So over time that muscle gets tight from the positions you put yourself in and weaken from lack of use.

Here are some examples: If you sit on the edge of your chair with you legs separated and your feet pointing outward you are keeping your Piriformis muscle in a shortened position and that’s how it gets tight and with extended sitting in that position, it gets weak form lack of use. Hence the imbalance.

Another example is runners and bikers who actually work very hard tend to get sciatica because they fail to keep a strength vs. stretch balance in their workouts. Hence the imbalance creates a greater pull toward external rotation and the result is a tight Piriformis and an irritated sciatic nerve creating pain.

These are just two examples of how muscle imbalances can affect the Piriformis muscle and cause sciatic pain. You may not be a runner or cyclist but I’ll bet you have muscle imbalances that are causing your sciatic pain!

In severe cases, the sciatic pain can run from the top of the hip to the bottom of the foot. It is very important to recognize that changes and shifting of pain is often times a sign of improvement. Furthermore as a way of gauging recovery, take note of how far down the leg the pain goes.

If the pain goes to the foot one day and then only makes it to the calf and then to the knee and then it can only make it to the hamstring that is a sign of improvement. You should feel good about those noticeable improvements and this should give you encouragement to keep working toward a full remission of pain.

So how do you get rid of your pain? Will learning one new stretch be enough? It very well may be. However depending on the severity of your condition you may need to change your activities of daily living to include new stretches, new exercises that include the use of the hip rotators like roller-blading, basketball, tennis, etc, and even better, specific corrective exercise specific to your situation like those covered in our video. As always, learn as much as you can about your condition, so that you can ask the tough questions to your healthcare providers and get the best care possible.

One last point, sciaitic pain is not caused by a lack of prescription medications so don’t think that taking some anti-inflammatories or muscle relaxants will fix it, it won’t! Also, many people are able to eliminate sciatic pain within days just by performing a few exercises and stretches, but not general exercise, the exact corrective exercises and stretches they need to do.

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Piriformis Syndrome (Sciatic Pain)

Piriformis SyndromeSciatica and Piriformis Syndrome are the same condition, it is just that the medical community is starting to call the condition by the muscle (Piriformis) that is involved and getting away from calling it by the name of the nerve that is involved (sciatic) nothing more than semantics.

Did you go see your primary care physician and get diagnosis of Sciatica only to have them refer you to an orthopedic specialist and then get a diagnosis of Piriformis Syndrome and then be told to see a Physical Therapist and the PT tells you a little heat, ultra sound, electrical stimulation and some therapeutic exercises and we will have you good as new???

If this is the path you have been down and you’re tired of all the worthless treatments that just don’t work, you must read this article! I guarantee you, it will likely be far different than what you have read or heard anywhere else!

Sciatic pain is simply caused by pressure being placed on the sciatic nerve and there are primarily four things that can create this you may have one or more of the following:

Pressure caused by shortening and tightening of the piriformis muscle. This is almost always due to months or years of muscle imbalances in the hip rotator muscles.

Pressure caused by spinal stenosis, which is a decrease in the space between the vertebrae. This is primarily caused by uneven pressure and compression due to muscle imbalances.

Pressure caused by Isthmic spondylolisthesis which is simply when a vertebrae slips or moves… this can sometimes pinch the sciatic nerve but often times people who have this condition don’t have any pain, symptoms, or even know they have it!

Pressure caused by a herniated or bulging disc. A herniation is when a disc protrudes out from between the vertebrae and this can either be caused by an event like a car accident, or, by months or years of uneven pressure due to muscle imbalances. It is also important to note that many people with herniated discs don’t even experience pain or symptoms, and many don’t know they have the condition.

As you can see, there is a trend here… in nearly every case, muscle imbalances are the primary cause of the pressure being placed on the sciatic nerve.

If you are not sure which one of the four is causing your sciatic pain, I recommend you start with the basics. Most cases of sciatic pain are caused by muscle imbalances so if you begin to work on correcting any muscle imbalances you have, you should start to see improvement right away.

The event scenario is most likely the catalyst for sudden onset of sciatic pain. So what happens when there is undue stress on the Piriformis muscle that stress causes it to go into spasm and then you have pain due to the Piriformis muscle putting pressure on the sciatic nerve.

In most cases, people go to physical therapy or minimize their physical activity to break the pain – spasm cycle and in most cases your symptoms subside. However the event will also set you up for a life time of sciatic pain if the Piriformis muscle does not recover 100% in both strength and flexibility.

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Herniated Disc

Herniated DiscA herniated disc is simply a protrusion, or sticking out of the disc. Think of a disc as a balloon being held in place between your hands, if you push your hands together unevenly the balloon will bulge out on the opposite side. This is what happens to the disc between the vertebrae.

Herniated discs are probably one of the most common diagnoses for back pain out there, and it is often used when a doctor can’t find an explanation for the person’s pain, similar to a doctor explaining away various aches and pains as arthritis.

The problem is, many people who are diagnosed with a herniated disc don’t have pain because of it and, for years, research has shown that in many cases, people live with herniated discs yet never have any back pain or symptoms. The point is, if you’ve been diagnosed with a herniated or bulging disc, it may not be what’s really causing your back pain!

Even if you’ve had x-rays and MRI’s done that show a herniated disc, chances are still very good that it’s not the problem, so read on to learn more and find out what’s causing your back pain.

So when does a Herniated Disc actually cause pain?

Typically, a herniated disc will cause pain when it is putting pressure on a nerve or nerves and this pain is usually felt down the backside of the leg. However, occasionally individuals experience pain in the disc itself or the area around it.

So what causes a disc to herniate?

Well, many people want you to believe it’s caused by the old age, excess weight, stress, poor genetics, or how you lift a heavy object, while these are all potential factors, the biggest factor or cause is uneven pressure placed on the disc. Months and years of this uneven pressure causes discs to breakdown.

It’s something so simple that is called muscle imbalances. Muscle imbalances will pull your bones and joints, especially the pelvis and spine, out of place and this places excess and uneven wear and tear on the body.

The ONLY way to address muscle imbalances is to first identify them, then work on correcting them with the right combination of corrective exercises and stretches. Any treatment that fails to include this formula is doomed to fail!

The real key is to not only treat the symptoms, but address the cause of the problem also.

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The Misconception of Bodybuilding That Causing Pain

The goal of bodybuilding isn’t to get as big as you can, or at least to us it isn’t and shouldn’t be, but to build a balanced body that is as strong as possible in every way. For example, while being freakishly big may get people’s attention, it serves you no purpose at all.

So many bodybuilders build massive amounts of muscle yet are so unbelievably weak and inflexible. For example, we know a guy who can bench press over 350lbs but can’t do a measly 50 push-ups! On the other hand, what if you were not only big, but also extremely strong and powerful, lightning fast, flexible, and agile enough to kick ass?

The point is, the exercises you choose and how you perform them not only determine how big, strong, and flexible you are, but also affect how your body functions and whether or not you suffer from aches, pains, and injuries like back pain and sciatic pain.

Here are the exercises that create the most problems and are most likely to lead to back pain:

Bench Press

Leg Extension

Of course there are others, these are the two that cause the most damage.

There are several reasons why these exercises made our list of the “worst bodybuilding exercises”. First, all of them target areas that already tend to get worked a lot in everyday life and often times are overdeveloped.

By focusing so much on these exercises you end up creating muscle imbalances, or worsening existing muscle imbalances, which pull your bones and joints out of their normal position. This will leads to uneven pressure and wear and tear on your muscle, ligaments, tendons, bones, and joints and will sooner or later lead a break down or injury.

For example, chronic overuse of the bench press, coupled with little or no exercises targeting the upper back, leads to an overdevelopment of the chest and a lack of strength and development in the upper back.

This all too common combination leads to what we call “Turtle Back”. The shoulders are pulled so far forward, lats are as wide as barn, and from behind, their back looks like a giant sea turtle shell. This “Turtle Back” posture can create neck, upper back, and shoulder pain and injuries fast.

There are many better exercises for chest development that not only stimulate more muscle, but also build more usable strength.

Meanwhile at the leg extension, not only does it place an unbelievable amount of strain on the knee joint, but it also will quickly overdevelop the quads, which are already getting far more work than their counterpart, the hamstrings.

An imbalance between the quadriceps and hamstrings, which is also extremely common in bodybuilders, is a key contributor to back pain.

So hopefully you can see how important it is to choose your exercises wisely. It is strongly recommend that you cut out these exercises, or at least cut back on using them and add in targeted exercises for the opposing muscle groups and targeted stretches for those tight, overdeveloped muscles.

The key to eliminating back pain, or any other ache, pain or injury for that matter, is to bring your body closer to balance.

What good is muscle if you can’t use it? How many more workouts are you going to miss because of back, neck, or shoulder pain? How much bigger and stronger could you be if back pain and other injuries weren’t ruining your training?

Just imagine how bad things will be 10, 20, or 30 years from now if you don’t make changes to your training now.

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