Question for TGY "Yee Duk, Gung Duk"

So, I have sciatica. A few years ago it flared up really bad. I couldn’t even get six inches from touching my fingertips to the floor.
So, Doctor said to lay off of it, don’t do any stretching to aggravate it, and absolutley no weight training..
So I listened…and it remained the same-which is worse in my book.
Ok, so my student wanted me to show her weight training, and I am showing her the leg curl machine, so I do a few reps to demonstrate, using very light weights, because I don’t want to make things worse.
I get off, and oddly enough, I actually felt better.
So I do another set, with a little more weight.
I get off and feel much better!
hmmm…?
I also notice, that sometimes doing deadlifts relieves my lower back pain. Weird-the lower back-erector spinea is in spasm, and deadlifts would directly affect this muscle group, and you would think that the contractions and subsequent soreness, stiffness from weight training would put me on my back, and yet…?

so…how come?

Hair of the dog…? Personally, I’ve had quite a few injuries that would feel much better after hitting them with some kind of exercise. One constant is my knee…it’s messed up after a botched surgery about a decade ago. Generally speaking, as long as I’m training consistently it feels fine (though it will still have “off” days). After 3 or 4 days off, it starts feeling weaker. After a week, it hurts. Basically, I HAVE to train or my knee goes to ****.

I don’t know the science behind it. Don’t trust doctors much anymore. :stuck_out_tongue:

good question;

in a general sense, there is a principle known as reciprocal inhibition, based on agonist / antagonist relationships of muscles; in other words, if you fire the biceps by bending the elbow, the triceps, elbow extenders, have to shut off in order to allow the elbow to bend w/out resistance; the harder the biceps contraction (e.g., the heavier the load they have to move), the more “off” the triceps get;

this principle is used in manual therapy all the time, be it in active approaches like Proprioceptive Neuromuscular Facilitation (PNF) or Muscle Energy or passive ones like Strain Counterstrain (go look 'em all up for detailed explanations if you are curious);

in your specific case, whatever it was in spasm probably got turned off by the contraction of the muscles doing the loading - in the second case, dead lifts, that is pretty easy to explain: usually “back pain” has a lot to do with some combo of hamstrings, piriformis, iliopsoas quadratus lumborum and / or lumbar spine paraspinals (erector spinae) being in spasm: a strong recruitment of glutes, quads and transversus abdominus, among other anti-gravity extensor muscles, will create inhibition of the former, w a concomitant decrease in pain, etc.; of course, this is a generalization, I’d have to look at you specifically to figure out what was what - there might be other considerations in terms of how your sacrum, iliac, pubes, coccyx and lumbar spine joints were restricted at the joint level; also, pelvic floor and respiratory diaphragm are often drivers of low back pain; however, the aforementioned heavy recruitment of postural extensors can resolve stuff in all those areas (it’s sort of a “shot gun” technique approach - hits 80-85% of what’s going on)

as regards the leg curls, that’s a little trickier to explain bec usually that is pure hamstrings, and recruiting hamstrings is pretty much the opposite of what one typically wants in cases of radiation; one possibility was that your radiation was due primarily to unilateral piriformis spasm / irritation of sciatic nerve passing through it, and that when you did a unilateral leg curl, it somehow caused release of that via recruitment of some combo of pelvic stabilizers that shut piriformis off; another possibility, since you liked extension but didn’t like flexion, since you were in prone extension doing the exercise, you were positionally taking the back extensors off stretch / shoirtening / defacilitating them, and then on top of that, loading them during the exercise, resulting in a post-contractile inhibition that turned them off even more…I don’t know, it’s hard to say, I’m just throwing out ideas - but the take home message is that it’s not implausible; and also, it underscores how (correct) movement goes a long way to relieve back pain more than just laying around doing nothing does, especially if it’s primarily joint / muscle generated pain (w disc / nerve root, it’s a little trickier, sometimes movement helps, sometimes it doesn’t)

BTW, I am very concertedly working to open up a manual therapy practice down by me starting part-time this summer or at latest early fall (just took my first “refresher” manual therapy course last weekend, yay), and hopefully will go full-time within a year or so, so I’ll be stopping by w business cards at some point (and I am strongly believe in a “gung fu” sliding scale for those in the arts who for a legitimate reason are unable to pay regular rates)

anyway, food for thought…

btw, docs often have no idea about the above mentioned stuff, which, on one level, is understandable; however, a lot of PT’s appear to be equally as clueless about how to treat effectively and efficiently according to these principles, and instead do the standard “shake & bake” crap, which, frankly, is inexcusable in my book…

Duhh..that makes good sense!(Nobody remembers the cartoon with the cat and the crow..?)
Anyway, thanx for the reply, TGY. Just what I was hoping for.

I read your reply to a friend, and she says,“Geez, he didn’t have to recite the whole textbook!”
“Nope,” I said,“That’s probably just off the top of his head!”:smiley:

What useful thread… unlike everything else.

Would it be helpful for me to suggest to a friend who has back issues to at least talk to a PT about trying some light deadlifts? I know he has battled with this for quite some time and nothing seems to be helping. I also don’t know what is causing his back pain so i don’t want to give him advice that might end up hurting.

[QUOTE=TenTigers;1082150]Duhh..that makes good sense!(Nobody remembers the cartoon with the cat and the crow..?)
Anyway, thanx for the reply, TGY. Just what I was hoping for.

:D[/QUOTE]

Have you checked your prostate? I thought I had a spam in my lower back and even doctors told me it was muscular. Then I started to suspect my **** prostate and started taking supplements and then my lower back doesn’t bother me as much. Just FYI

Chris, kicking ass in the name of the sciatica !!

I can understand the docs view in regards to stretching but weight training?
That sounds off.
Strength training can be the “cure/remedy” for MANY things that ail us and it seems that many doctors just have no clue about ST at all.

Often times when performing Prone Leg Curls for the HS the Low back is unstable and performs a reverse extension motion thus incorporating the erector spinae and relieving stress or pressure in the area of the LB typically L5 S1 area. This cold have an effect on the Sciatic pain as well. KC:)

[QUOTE=kwaichang;1082318]Often times when performing Prone Leg Curls for the HS the Low back is unstable and performs a reverse extension motion thus incorporating the erector spinae and relieving stress or pressure in the area of the LB typically L5 S1 area. This cold have an effect on the Sciatic pain as well. KC:)[/QUOTE]

I know it’s been a while since I was in school, but wouldn’t a “reverse extension motion” be, um, well, like flexion? Or did u mean something else?

[QUOTE=Brule;1082219]Would it be helpful for me to suggest to a friend who has back issues to at least talk to a PT about trying some light deadlifts? I know he has battled with this for quite some time and nothing seems to be helping. I also don’t know what is causing his back pain so i don’t want to give him advice that might end up hurting.[/QUOTE]
Beats me. I mean, it depends on the PT - personally, there would be any number of more specific things based on my assessment / treatment that I would have someone do, but maybe his PT sucks and / is out of ideas, so why not, if he’s not getting anywhere (personally I’d go look for a better PT…)

As far as giving advice, speak up - let him here everything you have to say, you are under no ethical constraints. Of course, he may be an idiot to take ur advice, but that’s his choice (of course who knows, u may by chance give him the right thing to do!!)

[QUOTE=mig;1082310]Have you checked your prostate? I thought I had a spam in my lower back and even doctors told me it was muscular. Then I started to suspect my **** prostate and started taking supplements and then my lower back doesn’t bother me as much. Just FYI[/QUOTE]

This qualifies as the most logically impoverished line or reasoning I’ve heard for quite sometime…

I’ve got problems with my lower back as well. I can exercise the muscles while in the gym and it feels great, but kneeling down to tie my shoes can cause spasms that almost incapacitate me. Add in tearing the LCL in both of my knees twice each and it’s a miracle I’m still vertical.

With my knees, I have absolutely no endurance. It doesn’t matter if I’m lifting 10 pounds or 200 pounds, after a few sets my legs are jell-o. 5 minutes on a stairmaster I’m done too. Yet, my strength continues to increase and everything I’ve tried doing to increase endurance, like holding low stances, is fruitless.

[QUOTE=crashhelmet;1082381]I’ve got problems with my lower back as well. [/QUOTE]
My wife has back problem too. IMO, the “body bridge” is the best solution for it. It costs about $450. Not cheap.

http://www.google.com/imgres?imgurl=http://www.promolife.com/images/uploads/body_bridge.jpg&imgrefurl=http://www.promolife.com/pain-relief/back-and-neck-relief-tools/the-original-body-bridge/prod_828.html&h=260&w=381&sz=14&tbnid=xi7Y1L-p3qF-8M:&tbnh=84&tbnw=123&prev=/images%3Fq%3Dbody%2Bbridge&zoom=1&q=body+bridge&usg=__jy9P5KZ2xTYdWNm4am0QQWXLeWo=&sa=X&ei=Sg54TeOuLYSW0QHh2vnuBg&ved=0CEwQ9QEwBw

[QUOTE=TenTigers;1082123]So, I have sciatica. [/QUOTE]
Many months ago, I did some sit up wrong and my back and leg hurt like hell. I knew I must pinched some nerve in my spin. It was very hard for me even to walk. Since I already committed myself to go to the Channel Islands with my friends, I brougt a hiking stick with me. On the flat land, I had to take a break for every 60 steps by sitting in my horse stance to release the leg pain while holding the hiking stick as my 3rd leg. When I started to hike uphill, suddently my pain was gone and I could hike up hill 3 miles non-stop. When I walked downhill, there was no leg pain either. I suddently realized that as long as I could keep my leg bending, I was OK. After I came back from that trip, I started my running again (since my legs is always bending when I run). Oneday after 5 miles running, my leg pain was reduced down to 2 or 3 (from 1 to 10). 2 weeks later my pain was complete gone and I even cancelled my doctor appointment.

If I just took easy by sitting around and did nothing, I don’t know I could recover that fast.

[QUOTE=YouKnowWho;1082386]Many months ago, I did some sit up wrong and my back and leg hurt like hell. I knew I must pinched some nerve in my spin. It was very hard for me even to walk. Since I already committed myself to go to the Channel Islands with my friends, I brougt a hiking stick with me. On the flat land, I had to take a break for every 60 steps by sitting in my horse stance to release the leg pain while holding the hiking stick as my 3rd leg. When I started to hike uphill, suddently my pain was gone and I could hike up hill 3 miles non-stop. When I walked downhill, there was no leg pain either. I suddently realized that as long as I could keep my leg bending, I was OK. After I came back from that trip, I started my running again (since my legs is always bending when I run). Oneday after 5 miles running, my leg pain was reduced down to 2 or 3 (from 1 to 10). 2 weeks later my pain was complete gone and I even cancelled my doctor appointment.[/QUOTE]
if your symptoms resolved based on what you described, it was almost certainly a muscle spasm / local inflammation (which makes sense if you were doing sit-ups - you could have, for example, irritated iliopsoas which went into spasm); doing horse stance activates all the antigravity extensors which turn off the hypertonic flexors (psoas, quadratus lumborum, TFL, etc.) that typically cause you distress

[QUOTE=YouKnowWho;1082386]If I just took easy by sitting around and did nothing, I don’t know I could recover that fast.[/QUOTE]
depends on how well your organism was able to compensate on its own; but in general movement is better than stasis for just about anything related to muscular dysfunction

BTW, pay attention everyone: radiation of pain down the leg (so-called “sciatica”; but I hate that term; don’t use it; you’ve been warned) does NOT necessarily mean a compressed spinal nerve root (“pinched nerve”), it can be due to soft tissue / muscle and / or joint dysfunction without the nerve root being involved at all (there are ways to differentiate between the two, but that’s a super duper PT secret that if I share with you, the PT ninja assassins will come to my house and torture me by treating me w hot packs, cold packs, ultra sound, electrical stim, “massage” and use of a weight machine 3x / week for 6 months without resolution of my primary complaint…); so don’t freak out or jump to conclusions if you get radiating leg pain: unless you have dermatomal sensory changes in the same myotome that you have loss of muscle function as well as altered deep tendon reflexes, it’s probably not a nerve root impingement (of course, never try to self-diagnosis - I myself made that mistake about a year ago when I thought I was self-treating a nagging piriformis syndrome that was in fact masking a true L5/S1 disc herniation-in-progress, which ultimately required surgery - oh, the IRONY!!!)

[QUOTE=mig;1082310]Have you checked your prostate? I thought I had a spam in my lower back and even doctors told me it was muscular. Then I started to suspect my **** prostate and started taking supplements and then my lower back doesn’t bother me as much. Just FYI[/QUOTE]

[QUOTE=taai gihk yahn;1082376]This qualifies as the most logically impoverished line or reasoning I’ve heard for quite sometime…[/QUOTE]

Ummmm…I think he is suggesting a specialized form of therapy where the prostate is checked for abnormalities. Perhaps he is hoping you can recommend a nice New York club where this sort of “therapy” is provided free for the asking!:eek:

Reverse Extension

Meaning Caudal to Cranial, sorry I was busy at work when I typed it earlier, sometimes known as the dirty dog for L5 S1 Disc pathology. KC

how bout patella femoral? thats the right name right? when the kneecap scrapes? is it true that the only thing you can really do about it is develop your quads more to pull it up and off??? or am i grossly misinformed here???

dont worry, i wont hold you accountable for any advice… :smiley: no lawsuits…

[QUOTE=Syn7;1082437]how bout patella femoral? thats the right name right? when the kneecap scrapes? is it true that the only thing you can really do about it is develop your quads more to pull it up and off??? or am i grossly misinformed here???

dont worry, i wont hold you accountable for any advice… :smiley: no lawsuits…[/QUOTE]

patello-femoral syndrome refers to improper tracking of the knee cap as it slides over the distal femur during knee flexion / extension; typically, there is excessive lateral tracking of the patella as the knee extends, ostensibly due to imbalance of the medial and lateral quads - hence, the espoused goal is to strengthen the medial quad (vastus medialus oblique, or VMO to be precise); and yes, dysfunction in the legs can contribute to low back pain;

that was a very general answer, approved by my malpractice insurance and their attorneys