Do you know the difference between soreness and pain?

The attached article describes the difference between soreness and pain. People often don’t seek help until they are experiencing pain that limits them from participating in their fitness regimen of choice. We can help you stay injury free on your path to becoming the best version of yourself.

Our bodies move in the path of least resistance, meaning if you have limited range of motion in one area of your body, another area will pick up the slack. This is often referred to as a compensatory movement pattern. Over time with increased training loads and volume this can lead to injury. By having a movement assessment performed prior to starting a fitness program we can help you restore movement patterns and decrease your injury risk while improving your performance.

Call us today to schedule your movement assessment and let us guide you to optimal performance. 504.324.8345

Sciatic Pain, Are You Suffering? Louisiana Residents Now Have Direct Access to Physical Therapy!


Top 10 Most Burning Questions for Sciatica

Therapydia NOLA

1. Q. How long is this going to take to go away?
A. It depends…it depends on YOU.

In general, it takes 4 to 8 weeks to go through the first 2 phases of healing (no pain, all movement and strength back to normal.

It may take another 1 to 4 months to get back to all activities you want to do…depending on how active you are. This is the third phase of healing.

Here are some variables that determine how fast someone can heal;
√ Overall health. Healthy people heal faster. Young people heal faster.
√ Other health issues such as diabetes, heart disease, high blood pressure, tobacco use, alcohol abuse and body weight all influence healing rates and make the time to heal longer.
√ Diet. People who consume more nutrients in their calories (Dr. Joel Fuhrman calls this “Nutrarian”) heal faster than those who primarily eat processed foods.
√ Rest levels. Our bodies need sleep and rest to rebuild. A lack of sleep slows healing time.
√ Stress levels. People who have high levels of stress heal more slowly.
√ Sedentary lifestyle. People who sit all day for work or to watch TV heal more slowly.
√ People who follow advice and instruction from top level healthcare professionals heal more quickly than those who do not follow through with care.
√ People who are highly aware of their daily postures and habits heal more quickly, because they can adjust habits such as sleep or sitting positions more quickly.

2. Q: How long before I see improvements?
A: Most people we see in the clinic feel better in 2 to 3 visits or within 1 to 2 weeks. If you go longer than 2 weeks without feeling better or moving better, you may be wrong about the cause of your sciatica.
Because we offer one on one care with our patients, your therapist can and will reassess you progress before and during you visit to assure you are getting the care you need to meet your goals.

3. Q: Can I be completely healed or will this come back again:
A: Most people we see who complete the 3 Phases of Healing (meaning they no longer have pain, motion and strength are back to normal and they’re back to doing all the activites they want to do without pain) have a minimal chance the pain will return. The stronger the person is, the less likely the sciatica symptoms will come back.

Your body is a bit like a car. If you take care of it, regularly change the oil and keep it running and fine tuned, there is little chance it will break down. If you ignore it, it is very likely to break down and be in need of repair.

4. Q: Do I need any special equipment?
A: At Therapydia NOLA we use a minimalist approach. We do no use big fancy equipment. [Our model focuses on one on one hands on physical therapy.] We use a variety of techniques including, manual therapy, instrument assisted manual therapy, dry needing, SFMA, and if needed, we have a traction unit in our private treatment room. All patient treatment plans for both in clinic and at home exercises are tailored to each individual and monitored closely by their Doctor of Physical Therapy. Our patients are never handed off to an assistant or tech.

5. Q: Should I use heat or ice on my leg?
A: The cause of most sciatica (pain, numbness or tingling in the leg) is in the lower back. Ice or heat on the leg will not change this.

Consider that sciatica is “inflammation”. So if you’re inflamed, do you want to put heat on it and make it more inflamed? Or ice to calm the inflammation down? We have seen some people use ice on the lower back to calm down the inflammation temporarily.

6. Q: Which exercises should I do:
A: The best exercises for you depend on what the cause of your sciatica is.

We cover the 3 most common causes;
Herniated discs
Stenosis, arthritis
Pelvic or SI joint problem

Each has a series of gradually more advanced exercises. Your therapist will address this and design your exercise program.

7. Q: How often should I do the exercises: And do I need to do them forever?
A: Most people we work with in the clinic for sciatica do the exercises at least once per day, every day. Some will do them up to 3 times per day.

Doing the same exact exercises for years without changing could be a mistake. In general, to get stronger, your exercise should progress and get more difficult. With training your body adapts.

Keep in mind, there are 2 rules for training;
1. Everything works.
2. Nothing works forever.

One of the best programs you can move on to once you complete the 3 Phases of Healing for your sciatica is a consistent walking program. People who walk every day have less risk of reinjuring their back and sciatica.

8. Q: What do I need to do for complete care? Am I going to relapse?
A: The best thing to do for sciatica, if you are worried about it coming back again in the future, is to complete all 3 Phases of Healing.

Phase One is where you focus on getting rid of the pain, numbness and tingling.
Phase Two is where you focus on getting normal movement back and full strength.
Phase Three is where you go back to previous activities you want to do.

We will want to know what your previous activities were before your sciatica, once you are at phase 3 we will guide you back into those activities slowly, after a couple of months we will want to re-check your progress. However, it is very important that you also continue your home program of exercises to insure your body continues to get stronger.

Some people will have a relapse. We will then take a look at the activity and at the program to help them get back on the right track. As mentioned before, people who are stronger recover more quickly. It is usually only one to two visits before that person is on the right track again.

9. Q: How do I know the cause of my pain?
A: There are 3 common cause of pain and here are some general guidelines for each;
-People with sciatica from herniated disc usually have pain bending forward, twisting, coughing or sneezing. The sciatic pain they experience is usually sharp and runs specifically down the back of the leg, possibly into the foot. Herniated disc sufferers are usually 35 years of age or younger.
-People suffering from sciatica because of stenosis or arthritis usually answer yes to these 3 questions;
50 years of age or older?
Pain with standing or walking?
Relief with sitting?
-People suffering with sciatica from SI Joint or Pelvic problems usually have pain with sitting for long periods of time. The sciatica they experience is usually on the outside of the thigh. Symptoms may include heaviness of one leg or feeling twisted.

10. Q: Which position should I sleep in?
A: On your back is best. Next would be on your side. Last would be your stomach.
Regardless, it is best to keep your spine in a neutral position and not twisted to the left or the right, keeping it’s natural curve. Pillows or folded towels can be placed under your knees, side, or feet to help you sleep in the least painful position for you.

Movement Monday: Start Your Mornings Right

Running from the bedroom to the kitchen to pour a hot cup of coffee is not the ideal way to start your day. We think it is, and I can’t go more than five minutes of being awake before pouring the first cup. But after being sedentary for our hours of sleep, we should start our day with a few stretches, deep breathing, and hydration to get our bodies and our minds ready for whatever our day will entail. So instead of reaching for the coffee first, have some water and do these simple stretches to start your day off right and healthy. You can have your coffee afterwards!


A Better Understanding of Your Pain

September is Pain Awareness Month.  Pain is a normal human experience, however living with it is not. In June of 2011, it was estimated that more than 100 million Americans suffer from chronic pain at a cost of around $600 billion a year in medical treatments and lost productivity, according to a report from the Institute of Medicine.  I wanted to share some information I gathered from Adriaan Louw’s book, Why Do I Hurt.  Adriaan Louw is a Physical Therapist that has been teaching post-graduate spinal manual therapy and pain science throughout the US and internationally since 1996.  He has authored and co-authored numerous articles and book chapters related to spinal disorders and pain science.  Recent research shows the more you know about pain and how it works the better off you’ll be.  This includes moving and functioning better. Our body contains more than 400 nerves from head to toe.  Added together the nerves would be the equivalent of 45 miles.  The nerves connect all tissues to the spinal cord.  The spinal cord is the pathway in which the tissues send messages to the brain for analysis.  During the pain experience nerves increase their sensitivity to protect you.  These sensors are constantly updated based on the environment.  Nerves contain various sensors to protect and inform you of any changes in your life.  These sensors include temperature, stress, blood flow, movement, pressure, and immunity. Think of your body as a company, perhaps a fortune 500 company.  Your brain is the CEO.  Your body parts, such as your shoulder, hips, back, and hands are all divisions of the company.  Your body parts (divisions of the company) are constantly sending information to your brain, the CEO, to inform it of how they are doing.  The information is sent via the nervous system and various check points along the way, similar to how CEOs receive messages from managers, directors, and vice presidents.  When you have persistent pain in an area, extra sensitive nerves send increased messages to the spinal cord, and ultimately to the brain to analyze.  In this process the messages will become less altered, and the brain will become more aware of the painful body part.  Once the CEO becomes aware of this underperforming division, he begins to investigate other branches of the company.  This is why you may experience a sense of spreading pain.  It was once thought that there was a single pain area in the brain.  Scientists have established that there are various areas of the brain involved in processing the pain experience.  These areas connect and form a pain map.  These areas are documented as follows; sensation area, movement area, focus and concentration area, fear area, memory area, motivation area, and stress response area. You may have been told that the pain is all in your head.  This is a very true statement.  All tissues contain danger receptors.  These danger receptors alert the brain about danger.  Pain is a decision by the brain, based on everything it knows about the threatening situations.  A few key points to understand are:

  • tissue injury is not needed for pain
  • emotional stress can cause pain
  • many people suffering from pain have experienced a time in their lives filled with many stressors, perhaps involving family, work or financial issues, and even unfortunately, abuse
  • with all these stressors, the brain perceives threat and thus produces pain.

So how do I eliminate pain and take my life back?  Knowledge is power.  Gaining an understanding of the neuroscience of pain will help to ease some fear and anxiety about your persistent pain.  Research has shown that aerobic exercise, which gets your heart pumping a little faster and pumps blood and oxygen through your body, helps calm nerves down.  Getting adequate amounts of sleep has a huge effect on our overall health.  Sleep deprivation has been linked to increased rates of pain, obesity, depression, and other health related disorders.  Setting goals for yourself and pacing are important.  Any task can be broken down into smaller parts.  Two things to consider when setting a goal are the things you need to do and the things you would love to do. I hope I have given a great overview of, Why Do I Hurt and a better understanding of pain.  If you are interested, the book is an easy read and I highly recommend anyone who is hurting to get a copy. Remember pain is a normal part of life.  However, living in pain is not.  The choice is yours.