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.

Understand Your MRI Results

shutterstock203524102Getting MRI results can sometimes be intimidating. Big words and diagnosis’ that can be scary. Here is a GREAT article that is certain to ease the anxiety of MRI results.

What is Dry Needling?

dn2“Dry Needling is a skilled intervention performed by a physical therapist that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular and connective tissues for the management of neuromusculoskeletal pain and  movement impairments.” (American Physical Therapy Association Dry Needling Task Force, May 2012)  Physical Therapists use dry needling to decrease pain, increase range of motion, and to restore function. Karl Lewit, MD, DSC. published “The Needle Effect”, in 1979 stating that a needle could be used as an extension of treatment of orthopedic dysfunctions.  The original treatment used a hypodermic needle and an injectable substance for pain relief, until it was discovered that a dry needle could achieve the same result.  Since then, the hypodermic needle has been replaced with a solid filament needle and is what we refer to today as dry needling.

So how does dry needling work?  Research has shown that trigger points contain increased inflammatory chemicals, increased contraction of muscle fibers, and decreased blood flow.  These trigger points can cause a number of symptoms such as; pain upon palpation or referred pain (pain in another area of the body).  A small filiform needle is used to deactivate hyper irritable spots (trigger points) within the muscle.  Insertion of the needle into these points causes a local twitch response, which increases blood flow and decreases binding.  Dry needling is always followed with a manual therapy technique or corrective exercise.  It is a great tool that has helped many of my patients return to pain free activity.

My experience with dry needling at our clinic is that is has helped my patients suffering with many different types of pain.  A great example of a dry needling success story is a patient that came to me after suffering with a severe headache for three months following a car accident.  After assessing the patient, I was able to determine that his upper trap was the significant pain generator causing his headache.  After one session of dry needling, the patient reported that his headache was gone.

Dry needling is one tool I use to make changes within a treatment session.  Positive changes include decreased pain, increased range of motion, or improved movement patterns.  Call us today to see how dry needling can help you.