Is my sciatica actually piriformis syndrome?

Posted on November 10, 2020 by admin

Both sciatica and piriformis syndrome produce similar symptoms. In our post on sciatica we talk about how sciatica is caused by an irritation of the nerve typically due to a spinal pathology. However, piriformis syndrome will cause a compression of and irritate the sciatic nerve. Piriformis syndrome can have symptoms that follow a similar trend of sciatica; there are complaints of a persistent and radiating lower back pain, whilst a numbness and difficulty walking is also felt.

What could my glute pain be?

Piriformis syndrome is one of the most common causes of glute pain in the current population. However, this could be a whole multitude of things and needs to be accurately diagnosed by a professional. The pain could be anything from a spinal pathology, an inflamed bursa or tendinopathy, to a name a few. By performing specific tests the healthcare professional can determine the cause of the pain and put together an action plan to fix this.

What is the piriformis muscle?

The piriformis muscle is a deep lying flat muscle located in the gluteal region. It originates from the sacrum, bottom end of the spine, and attaches into the greater trochanter (the bump on the outside of the upper leg). This muscles aids with a few movements. When in standing the muscle will laterally rotate the hip, abduct the leg when the hip is in a flexed position; whilst it also aids the pelvis tilt.

What can I do to alleviate this pain in my piriformis?

Ultimately, the main aim should be to release the muscle. The easiest and best way for this to take place is by booking in for a treatment. Going through the process of seeing a healthcare professional will make sure the true reason of your pain can be determined. In the mean time, you can use hot/cold packs for pain relief and to reduce the inflammation on the sciatic nerve. Then following this initial bout of pain relief, there should be stretching and strengthening exercises implemented. However, this should only be done following consultation with a professional, so that it is specific to your problem.

How can I release the piriformis without having a treatment?

Following your consultation, you will have several exercises to complete. These exercises will target the direct cause and prevent it from occurring again. Below we have chosen three products that can help you. By placing the trigger point balls into the piriformis and applying some pressure you can release the tight tissue beneath, in this case the piriformis. The 3rd product on the list is a bargain, getting 4 products that can assist not only in the release of the piriformis but help complete the stretching and strengthening exercises.

Is working from home linked to your lower back pain?

Posted on November 2, 2020 by admin

A trend that we have seen since we were allowed to re-open is a surge in lower back and neck pain. This has typically been linked to the shift to a greater number of people working from home, instead of in their offices. For a lot of people this can be seen as very stressful. There is no longer the divide in home and work life, now there is a combination of both, this leads to more stress being kept in the house rather than being left at work. A change in chair, posture when working, or if you aren’t working a change in your lifestyle can affect the risk of suffering from lower back pain.

What causes lower back pain?

Now there are many reasons why you can be suffering from lower back pain, we will just outline a couple that can cause pain. Ultimately, you should book in and seek professional advice on what is definitively causing your pain. We have outlined 5 possible causes for your lower back pain below.

Poor lifting techniques
Repetitive bending
Poor posture
Weakness in your core muscle group
Sedentary/inactive lifestyle

How does the lockdown affect us?

When the country had previously been placed into lockdown there was a great deal of unknowns in the country. Many people being furloughed, universities closing, no physical interactions and the stress of job security became common place. With the majority of workplaces shut down, many people ended up working from home. This meant use of the office chair at a desk that is a specific height to help with your working posture are no more. Dining rooms have become make shift offices, the sofa has become the workplace and the bed has been the office for the morning.

The change in environment has lead to an increase in lower back pain and tight shoulders; with many comments regarding the seat they are using, position they sit in and how the table they use is much lower. So what does this mean? Well the change in seat is something you are not used to, you change your position to get comfy and end up rolling your shoulders forward and slouching over. This then leads to tightness in your shoulders and lower back. You are inactive throughout the day because you have to work, a risk factor for lower back pain, whilst getting the perfect desk height will help you with sitting in a correct and comfy position.

To try help this spend 5 minutes in every hour on stretching, or, on your lunch break go for a walk. This will have a positive impact on your mental wellbeing as well as your physical wellbeing. Having a break from your work and getting into the outdoors will help you to destress and get those muscles working.

How do we find a balance in our daily activities?

One thing we noticed during the first lockdown was there seemed to be two extremes when it came to exercise. With the gyms shut, people either stopped altogether or went hell for leather and did an excessive amount of exercise. You should aim to do a minimum of 30 minutes of moderate intensity exercise a day. However, if you have set yourself goals, such as to lose weight, then increasing the length of exercise you complete is going to be a necessity.

With the gyms shut, there has been less structure with the exercise completed. A lot of people go to the gym to complete specific exercise classes, such as pilates, but what do you do when this isn’t available. We have joined an online exercise community, that gives us even more support than a gym, whilst also allowing us to meet targets that we want to hit. Whether it is a 21-day transformation or just to feel part of something again it has been fantastic and would recommend it to everyone!

How can you get rid of your lower back pain quickly?

Remedies to get your lower back fixed as quickly and safely as possible will vary person to person. The main piece of advice that may seem counterintuitive but trust me here, get yourself up and moving. Do some stretches that target your legs, glutes and lower back. When it comes to strengthening exercises, these should target the glutes and the core muscle groups.

The top 5 stretches to get rid of your lower back pain fast.

To go along with this, try change how you sit at your desk, change the height of the desk, get a chair that offers as much support as possible. We are open throughout lockdown, unless told otherwise, so get yourself booked in so we can put together an action plan that can get you back working pain free.

To Inject Or Not To Inject That Is The Question?

Posted on October 26, 2020 by admin

When having a steroid injection to combat pain, this is usually given by the healthcare professional alongside anaesthetic. This gives immediate pain relief, but dependent on the site of injection the length of relief will vary. Injections have been commonly prescribed in the treatment of tendinopathies, however, despite the widespread use, there is a controversy surrounding the usefulness and safety of the injections.

On the whole steroid injections have very mixed results depending on the site of injury. Short-term pain control, up to 6 weeks, has been reported as good in patients suffering from tennis elbow and shoulder impingement. However, the efficacy of the steroid injections for the long term has not been demonstrated. In comparison to rehabilitation with a qualified professional, the steroid injection provided no true long-term benefit (6-12months after).

In addition to the question of the efficacy of corticosteroid injections in the medium-term treatment of tendinopathy, there is a question of safety with using these medications in this setting. Several cases of Achilles tendon rupture have been reported after corticosteroid injections to this region. More recently, a study completed in 2004 described a series of 83 injections to the Achilles region without serious complication. These injections were performed under fluoroscopic guidance, simply put this is multiple x-rays taken in one go. Of note, only 40% of the patients in this series reported improvement after the procedure at the 2-year follow-up appointment. As previously mentioned, the effects of the steroid injection have shown to be beneficial in relieving pain in thew short term, but how does the combination of steroid and anaesthetic affect the body?

The healthcare professional will combine the steroid with an anaesthetic to provide an immediate pain relief. It has been reported that there are significant negative effects on tendons when a steroid injection is administered. There is an increase in collagen disorganisation, reduced collagen production and a decrease in cell proliferation. Further to this, the mechanical properties of the tendon are significantly reduced. So what does this mean?

It has been reported that the use of a corticosteroid injection has caused a decrease in the tensile strength of isolated fascicles but it is unknown how the injection affects the whole tendon. This weakening, can make the tendon more susceptible to rupture. It does boil down to what you want. IF you have been suffering with this pain for a long period of time and rehabilitative exercises are showing no signs of improvement, then yes maybe think having an injection to allow you to perform pain free. Remember, this lasts up to 6-weeks maximum, you may only have relief for a few days. This is then tied in with the cost of the injection, unless you are willing to wait long periods of time to get referred on the NHS then you will go privately. This can cost more than £200 a time, and the fact there are no true long term benefits it is up to you whether you see if it is worth it.

All I can recommend is that you speak to a physiotherapist or a sports therapist so they can guide you on whats best for you. We are happy to answer any questions you may have contact jason@cardysportsclinic.co.uk or book in to work out whats best for you in the long term.

What is your tendon pain and how to best manage this?

Posted on October 26, 2020 by admin

Tendon pain is often referred to as a tendinopathy, this can be defined as the failed healing response of the tendon. This is typically associated with many conditions that are brought about through overuse in and around the tendons. This is a common pathology observed in runners.

In comparison to muscles, tendons have an oxygen consumption rate 7.5 times lower, this is essential to carry loads and maintain tension. Subsequently, the low metabolic rate leads to a slow healing rate in the tendon.

A term that has previously been used to define tendon pain has been tendonitis. Simply defined, this refers to the inflammation of a tendon. A tendinopathy has been previously classified as the degenerative change of a tendon with an absence of inflammation. Research has reported that this is not true, instead, chronic inflammation is present in the majority of these cases but the exact role this plays on pain and function is an unknown. Alleviating this inflammation isn’t necessarily the ideal answer, the use of NSAID’s* can be detrimental to the healing process.

The classic presentation of a tendinopathy is after a period of increased activity, whilst the increase in subsequent load relates to the pain that is felt. During the early stages of its presentation, pain can be felt at the start of an activity, disappear during the activity and then re-appear during a cool-down. This pain is typically localised and can be described as a severe or sharp type of pain. When this has been present for some time then this pain can be described as a dull ache in nature.

Example rehabilitation for Achilles Tendinopathy

Level 1 - Early	Daily Isometric exercises - Seated heel raise: 3 set of 5 reps (each rep lasts 45 seconds)				Marker for Progression - Decrease of pain to 3/10 or less - Isometric exercise causes no pain or discomfort
Level 2 - Intermediate	Daily Isometric exercises - Seated heel raise: 3 set of 5 reps (each rep lasts 45 seconds)	Isotonic Exercises (3 x a week) - Standing Heel Raise 2-legged, (2 sets 25 reps) - Individually tailored hip abduction/extension exercises			Marker for Progression - Pain less than 3/10 - Able to perform 20 DL jumps with no pain
Level 3 - Late	Daily Isometric exercises - Seated heel raise: 3 set of 5 reps (each rep lasts 45 seconds)	Isotonic Exercises (3 x a week) - Standing Heel Raise 2-legged, (2 sets 25 reps) - Individually tailored hip abduction/extension exercises	DL Jumps (3 x a week) - 3 sets 60 reps DL with knee bend - 3 sets 30 reps DL with stiff legs - 3 sets 5 reps DL forward/back - 3 sets 5 reps DL onto a step		Marker for Progression - Pain less than 3/10 - Able to perform 10 SL hops with no pain
Level 4 - Return to Performance	Daily Isometric exercises - Seated heel raise: 3 set of 5 reps (each rep lasts 45 seconds)	Isotonic Exercises (3 x a week) - Standing Heel Raise 2-legged, (2 sets 25 reps) - Individually tailored hip abduction/extension exercises	DL Jumps (3 x a week) - 3 sets 50 reps DL with knee bend (warm-up) - 3 sets 30 reps SL with knee bend - 3 sets 15 reps SL with stiff legs - 3 sets 5 reps SL forward/back - 3 sets 10 reps SL onto a step	Sport Specific Movements - Steadily build load - If symptoms increase regress the exercise	SL - Single Leg DL - Double Leg

Tendinopathies can often hang about for a long time, depending on the type of care you have been given it can either get better or still be painful. This gets you wondering, how else can I alleviate my symptoms without having to do those monotonous exercises. A well known treatment technique for tendinopathies has been steroid injections. This is purely up to what you feel is best for you, here we talk about steroid injections. If your rehabilitation is completed to a high level and the exercises are targeted correctly the pathology should disappear over time. Ultimately, it boils down to the effectiveness of the exercises and your own buy-in to the exercise prescription.

We are able to treat and manage all tendinopathies that present themselves. Book in for you treatment so we can help and assist you.

*NSAID’s – Non-steroidal anti-inflammatory drugs

Equipment that can help progress your Rehabilitation at Home

Posted on October 15, 2020 by admin

After the conclusion of your treatment with your therapist you should always be given exercises that can help you to further progress away from your injured state. You may think that the kit required to perform some of the prescribed exercises will cost a fortune and not benefit you in the long run. In no way are these products endorsed by ourselves, instead, they are options for kit that can be used to get you back to performing your activity at your pre-injury state.

Type of Equipment	Why this kit?	Product Link
Resistance Bands	There are a variety of ways in which resistance bands can be used. This can be used when stretching your muscles, for resistance strengthening exercises and are a great tool to isolate specific muscle groups.
Trigger Point Massage Ball	Nothing beats having a sports massage and truly feeling the trigger points or knots releasing under the pressure of the therapist. When you don’t have as much time available you need a tool that can help keep the knots at bay, this piece of kit is cheap and very durable.
Foam Roller	This is a great piece of equipment to help relieve tightness in a muscle. Whilst you can use this during a warm-up or cool-down to help with your preparation for exercise or to help with recovery.
Exercise Ball	A variety of exercises can be performed with this bit of kit. Ultimately, a good level of core stability can help to reduce the risk of injury in the future. An exercise ball helps to work stabilising muscles in the core and lower back. Whilst the ball can be incorporated into a strengthening programme.
Balance Board	This is perfect to help build proprioception following injury or a period of immobilisation. Proprioception can be defined as the awareness of joint position in space. This is usually used for lower limb injuries but having a high level of proprioception can lead to a reduced risk of injury. A balance board can be used for the upper limb too, for example, performing a press-up whilst on a balance board.

To see how we can help you book in or email us for advice on what would be the best course of action.

The Causes and Meanings Behind Different Varieties of Pain

Posted on October 9, 2020 by admin

Pain comes in all shapes and sizes, and affects all of us in different ways. Most people assume that you only have pain when you have suffered an injury, however, pain can be due to infection, disease or an emotional disorder. Here we talk about the two types of pain with the particular symptoms related to the type of pain.

Acute Pain

This type of pain occurs as a result of an injury and tends to disappear when the injury has healed. In particular, acute pain is linked with injuries to the tissues of the body, whilst anxiety is commonly seen alongside acute pain. We talk about acute muscle injuries and their treatments here. You may suffer from acute pain following invasive surgeries, a strain of a muscle or a collision to name a few examples.

Symptoms of Acute Pain:

There is a known site of pain that is easily located
Sharp pain
A sense of burning around the area of pain
Cramping
Aching
A feeling of pressure

Chronic Pain

We talk briefly about chronic pain here, but we will go into more depth regarding chronic pain. So this type of pain will last beyond the healing period of the injury, whilst the pain can be vague in nature with no indication on the source of the pain. Depression is commonly seen in patients suffering from chronic pain. This can then be subdivided into three types; neuropathic, non-neuropathic or unknown.

Neuropathic Chronic Pain – This is usually caused by an injury to a nerve. You will often had tingling, numbness or a burning sensation whilst it is difficult to treat. Examples of the common reasons for neuropathic chronic pain are; diabetic neuropathy whereby the high blood sugar has caused nerve damage, pain from a viral illness, shingles or a peripheral vascular disease. Symptoms are:

Painful itching
Strange sensations
Extreme sensitivity to touch and temperature
Burning sensation
A painful numbness
Pins and needles

Non-neuropathic Chronic Pain – This is a pain that is not caused by an injury to a nerve. The most common reasons for this kind of pain is lower back pain, osteoarthritis or rheumatoid arthritis. Symptoms for this are:

Lack of location with the pain, may be unable to pinpoint the exact location of pain
Gnawing feeling
Pounding
Deep aching pain

Unknown: There are many causes of chronic pain that are neither neuropathic nor non-neuropathic in category. Symptoms can include a mixture of the symptoms outlined previously. Some possible causes of an unknown chronic pain are:

Fibromyalgia syndrome
Tension headache
Migraines
Irritable Bowel Syndrome

Treatment

Treatment for these types of pain will vary from patient to patient. Not one treatment plan should be the same. You can help prevent the onset of these types of pain through regular exercise and maintaining a healthy balanced diet whilst maintaining a healthy weight.

If you have any of these symptoms book in now so that we can get you back pain free doing what you love.