May 28, 2025 • 48 mins
This episode is all about helping you discover lasting relief strategies for sciatica pain.
It’s broken down into 4 parts:
- 1. What are the causes of sciatica, in detail
- 2. What are interventions and treatments that don’t work long term?
- 3. What are my top 3 interventions to relief sciatica immediately?
- 4. What are the top long term strategies to relieve sciatica but also keep it from coming back
This is essentially a lifetime’s worth of treating hundreds of clients with sciatica pain, consolidate for you into a 50 minute training.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Welcome guys to another episodeof the Won Body Won Life.
I am your host, Dr.
Jason Won, lifestyle physicalTherapist.
Today I wanna talk about SCIAHacks.
I wanna talk about instant aswell as lasting solutions for
sciatica because I think a lotof healthcare is predicated on a
lot of short-term solutions.
Those short-term solutions areoftentimes putting up.
Bandaid on things.
(00:24):
It manually fixes things ormassages the pain out, but it
doesn't actually give youlasting relief.
So I'm gonna share with you acouple things.
First, I'll talk about mostcommon causes of sciatica, so
you get a very well-roundedbackground of what might be
causing your sciatica issues.
I also wanna talk about what, inmy opinion, doesn't work long
term for sciatica, and I wannatalk about my specific short
(00:47):
term relief strategies that Ihave.
Done for myself, but also a lotof my clients in order to see
quick wins within the first twoweeks.
So definitely stick around tothat part of this episode.
And lastly, looking at somelong-term solutions.
Those long-term solutions areoften a combination of some form
of lifestyle modification andchanges.
(01:08):
So if you are looking for.
Long-term changes to yoursciatica.
Maybe you've had sciatica forlonger than three to six months
or even years.
You have to realize that thereare really no shortcut or
band-aid solutions to gettingrid of it.
It is a very common conditionthat often requires
modifications to your lifestyle,as what I would always say is
(01:29):
that modifica lifestyle changesnegative ones have often led to
sciatica.
All right, so let's talk aboutthe most common.
Causes for sciatica, and I wouldstart this off with a grain of
salt because when I do talkabout these things, I don't want
this to cause more fearmongering or any anxiety
(01:49):
related.
So as I open up the manydifferent ways in which sciatica
can start, I don't want you topigeonhole yourself into
thinking, oh, that's me, becausea sciatica.
Especially chronic is amanifestation of everything that
we are from our culture, ourvalues, our beliefs, some of the
negative experiences that we'vehad, some of the things that
(02:10):
doctors have said, some of thethings that our parents have
often used for their own relief.
So a lot of this is mimicry.
A lot of this is listening toauthority.
So while I am, I could, I wouldconsider a authoritative figure.
When it comes to health andhelping a lot of people with
sciatica, I don't want you totherefore cause more
(02:30):
uncertainty, fear, or anxietywhen I'm talking about this.
Okay?
So that is my disclaimer there.
So the very first and oftentimescauses could be also a herniated
disc.
Now this is more an acutesituations.
Sometimes if you just injuredyourself sometimes if you picked
up something wrong and then youfelt like a small pop in your
back, oftentimes you may.
Irritate a disc, and so whendisc get irritated, there are
(02:54):
nerves that come out of thespine, and so those nerves can
oftentimes either one just getirritated in itself, like you
overstress the sciatic nervethat are accompanying with the
muscles that go down your leg,or sometimes you do actually
injure a disc, and then thatdisc is temporarily, then I will
say temporarily contacting anerve.
(03:14):
So that is a common cause.
However many disc herniationsare self resolving.
As in, if you just have apositive mindset and you just
wait over time, most sciatica aswell as low back pain does go
away.
Or the other things that you cando are, modifying your posture
as well.
And a lot of herniated disc,believe it or not.
Many people over the age of 30actually have a herniated disc,
(03:37):
but have no pain whatsoever.
So they screen, over, a fewthousand people in the study.
And I can quote it somewhereelse, but the study showed they,
they did a bunch of they did abunch of MRIs on a ton of
asymptomatic individuals,meaning that they had no
symptoms whatsoever, and whatthey showed was that, as you are
at the age of 30, you may showsome degenerative changes.
(04:00):
You may show that you even havesome disc bulges or some
herniations and each and everydecade, so like from 40, 50, 60,
the spine only changes, right?
If anything, the MRI starts toquote unquote look worse.
So you start to see a lot moredegenerative changes.
However, if you look at, again,the study was done on
asymptomatic people.
So what I always say to myclients in order to ensure that
(04:22):
they don't, perseverate or worryabout, whether their sciatica is
coming from the specificdegenerative changes is just
perceived that you know thatthese are normal age related
changes and no matter what youdo.
Your spine is gonna change.
It doesn't matter if you'velived a perfect lifestyle or a
bad lifestyle.
It's just for the fact that asyou get older, it's almost a
(04:44):
privilege to get older.
And also when it comes to.
Know, the things that you see onyour MRI is that it doesn't
matter what's shown on the MRMRI as long as you feel good.
So if you feel good, yourfunction's good, you can
overlook your MR mri and reallythat's not much of an issue.
As I go through more of theother common causes, just wanna
let you know that, with a grainof salt, that these issues can
(05:05):
appear on your MRI, but itshouldn't determine your mindset
or cause any fear.
Okay?
So other causes, as you getolder over the age of 60 and
seventies spinal stenosis.
Becomes more common.
That is when the holes that comeout of the spine, which are
called the intervertebralcanals, that is where the nerves
come out of.
And oftentimes those areas can,I guess you could say the tunnel
(05:26):
is getting a little bit smaller.
So there could be certainpositions like excessive
extension or excessive standingfor long period of time, that
can often cause sciatica formore older individuals.
Okay.
Or for example, they often getrelief with sitting.
So if you get relief withsitting, then potentially you
may, have some common causes ofspinal stenosis.
(05:48):
Or a lot of times with herniateddisc, it's a tossup, but
sometimes, if you sit for anextended period of time, you can
start to feel symptoms eitherdown your leg into your glute.
But sometimes, walking alsoeither makes you feel better and
sometimes, or sometimes makesyou feel worse.
So that's why, hiring a goodphysical therapist or coach that
understands.
What to do with sciatica is todetermine what are the next
(06:08):
steps, what are the certainpositions, exercises that will
be con most conducive to yourelieving your sciatica pain,
right?
Other things arespondylolisthesis.
That is when one spineessentially like moves forward,
like one vertebral.
One full vertebral plate or likefor example, like L one will
ride forward over L two.
So the positioning is forward,right?
(06:29):
It's not just one stackedbuilding up top.
You start to see that some ofthe vertebral end plates are
pushing forward, so thatoftentimes can be a cause of
sciatica.
Oftentimes if you do havespondylolisthesis is oftentimes
anterior means it's pushingforward.
Excessive sprinting, like somepeople get pain with sprinting
or running because it's, you'rein a more extended position.
And then sometimes when youcontract your front abdominals
(06:51):
and you go into posterior pelvictil, or you do some core
strengthening, which we'll gointo later, then that oftentimes
can be relieving.
Okay.
Just to speed this up so we cango into some of the good stuff,
like the instant and long-termstrategies.
But trauma injuries clear enoughthat can cause true inflammation
in the body.
That can be temporary Pregnancy.
Pregnancy will secrete oxytocin.
(07:11):
That will make some of yourligaments more laxed in your
spine.
And then oftentimes can rendersciatica like symptoms.
Tumors are infections, so youknow, it does sometimes.
Tumors or infections, theyhappen insidiously, there's no
common cause.
Sometimes it's a product of yourdiet as well, in which, a tumor
can actually push up directly ona nerve.
And also scar tissue formation.
So if you, whether you've gottensurgery in the past and
(07:33):
oftentimes like excessivesitting and also lifestyle
factors are all common causes.
So partly anatomical, meaningthat, like we talked about, what
anatomical things can actuallycause Attica, but also some of
the, the mental factors as well.
So let's talk.
What doesn't work and I will saythis with a grain of salt as
well.
Because everything is somewhatarbitrary sometimes It depends,
(07:54):
right?
They, it is a very common thingin physical therapy that, we
don't always con give like avery just straightforward
answer.
'cause sometimes we don'toftentimes act in absolutes.
We may be absolute in certainthings some of the long-term
strategies I'll talk about,which I think are absolutely the
things that you wanna employ.
It's just that, when it comes tothings that don't work is,
(08:14):
oftentimes what I'll say is thatwhat doesn't work long term.
Okay, so here's the first one,and this is gonna push even some
physical therapists in the wrongdirection or rub them in the
wrong way, is prolongedstretches.
I often think that, for example,lying down on the floor and then
putting your legs straight up inthe air and putting your heel on
the door.
Dors cell is not a long-termsolution.
(08:37):
Stretching the nerve andexpecting it to feel better in
any way, long-term is not gonnabe a long-term solution.
It may feel good in the moment.
You may feel like the calve orthe hamstring, or you may feel a
stretch in your glute or yourlower back, but what is that
really gonna do for you in life,right?
You're gonna go through lifewalking.
Your job demands of sitting fora long period of time.
(08:58):
Maybe you do a lot of chores,maybe you pick up kids, maybe
you do sports.
How do you really feel that along-term stretch like that is
going to do anything?
It's not right.
It's not gonna protect you fromgetting hurt again.
Okay?
It's just gonna give you sometemporary relief in the moment.
Okay prolonged stretches.
I'm usually not a fan of it.
Even the figure four stretch,I'm usually not a fan of just
(09:18):
stretching tissue, right?
Imagine if the sciatic nerve wasvery tense, or also if it was
like, let's say the nerve, ifyou don't know, piriformis
syndrome is that the nerve doesgo underneath or sometimes over
a muscle in our gluteal or abutt cheek, which is called the
the piriformis, and oftentimespiriformis.
Is demonized, right?
(09:39):
It's oh, that's the common,that's the most common muscle
that hurts our body.
I always say that every muscleserves a role, right?
So the piriformis essentially isjust an external or an internal
rotator, depending on thedegrees of hip flexion or hip
extension, right?
So usually when.
You go into hip flexion, whichis like the knee going towards
the belly button, it becomes anin, it becomes an internal
(10:01):
rotator.
It internally rotates our hipand from a straight position.
So when I like to straight mestanding while filming this
episode, it is more of ainternal rotators, right?
So I.
Alright.
I'm sorry.
An external rotator.
So if you're looking at thescience of things is that it is
really just, a common glute tealmuscle.
For example, the glute max isnever demonized, right?
(10:22):
Maybe like we wanna strengthenit, but in the same way, the
piriformis is a muscle thatserves a specific role of
stabilizing the hip.
It also contributes to externalor internal rotator.
So it's a secondary, external,internal rotator.
So in no way should we bedemonizing this muscle or just
stretching this muscle intooblivion, right?
Because if you stretch themuscle, think about you causing
(10:43):
more compression, right?
Which therefore it's contactingthe nerve more when you're being
in those prolonged figure fourstretch positions.
Okay?
Like I said, while it does feelgood in the moment, if your
brain perceives that it's, itdoes it, it feel, it feels good,
it's beneficial.
Go ahead and do it.
Just understand that prolongedstatic stretches anywhere of 30
to 90 seconds.
(11:04):
Those are usually not gonna belong-term solutions, right?
Because we walk and we move.
So if our, a lot of our painsare somewhat more movement based
or we have active goals, wereally don't wanna be relying on
prolonged stretches.
Okay?
Medication.
Medication is clearly somethingthat's.
90% of it is synthetic.
Yeah, maybe there's herbs andmedicines out there, but it is
(11:25):
relatively passive, right?
So passive modalities such astaking oral medication isn't
going to change the state of thetissues, right?
It's really not gonna make thetissue stronger.
It's not gonna make it morepliable or more mobile in any
way.
If you look at a lot of chronicsciatica is that sciatica is
often a manifestation of likemind, sometimes body.
It's oftentimes manifestation ofour sitting position, our mental
(11:48):
stressors as well.
So when you're taking, forexample, ibuprofen for medic as
a medication or flexural,there's really no inflammatory
symptom going on.
There's no inflammation present.
So you taking ananti-inflammatory.
For something that's notinflammatory in nature, it's not
really gonna do much.
Same thing with gabapentin.
Gabapentin, while it does havesome merit and short-term
(12:11):
effects on nerve relatedsymptoms as far as curbing
nerves, is that while curbingsymptoms, the side effects are
oftentimes a lot more prominenceand therefore I'll tell you what
they are.
A lot of times it's stomachindigestion, it's reduction of
energy, it's malice.
Okay.
It's drowsiness, it's fatigue.
So if you think about it, isthat people oftentimes don't
(12:31):
wanna be on GABA in long termbecause it doesn't allow them to
function at work.
It oftentimes can change yourposture, it can make you sleep
at work.
And also while it is making youdrowsy and fatigued, you
essentially, you lose parts ofquality of life.
You're trying to get more, I.
Active, but the gabapentin isworking against that, right?
It's actually making you moredrowsy.
So you might think I know I needto workout more to maybe curb by
(12:52):
a sciatica, the gabapentin isactually working against you.
Okay?
So it makes you less active.
If that makes sense.
So that's why I don't usuallylike to I, I usually don't
promote gabapentin as a means ofcurbing symptoms because I
prefer to just teach people howto fix it themselves rather than
take a medication for it.
Okay.
(13:13):
What else doesn't work longterm?
I would say chiropractic care.
I'm gonna throw that in there.
While I know greatchiropractors, I don't think
that.
A lot of them have a very goodsense of how to screen the body
effectively, and oftentimes whenthey fix things.
Essentially it's the same thing,right?
It's either a lumbar rotation,manipulation, sometimes it's
traction, right?
(13:33):
Sometimes they're pulling on thehead what they call the ring
dinger.
So yeah, while it cantemporarily like decompress
things the effects areoftentimes very novel, meaning
they're new to you, you haven'tdone it before, and if you have
a strong belief that it maywork, yes, it can reduce some
symptoms.
And also a lot of it is more.
Pathophysiological, right?
(13:53):
The sound, the sensations ofyour back, cracking something,
feeling like a decompressed orit's stretched out.
All those different sensationsin the brain can oftentimes have
downregulation to reduce paintemporarily, right?
So your perception of pain isusually much better getting off
a chiropractic table.
But as again, is that it'softentimes the same exact
(14:14):
treatments over and over again.
If, for example, if it's more ofacute situation and the pain is
not going past the glutealcleft, like past your sitting
bone, then there is someresearch to show that in acute
situations it can be veryeffective short term to allow
you to get more active.
But if you have like long-termsciatica, you have pain
bilateral that's going down pastthe knees or even if you have it
(14:35):
more unilateral where pain isonly going down one leg.
I would say chiropractic care inthis situation is usually not
very effective.
And oftentimes, like I saidbefore on many podcast episodes,
is that passive short-termsolutions are a short-term fix
at a long-term cost.
So you have to go to the, youhave to go to the.
Their clinic.
You have to pay the credit card,you have to drive in the car.
(14:56):
When you drive home, sometimesyour pain comes back because
you're driving in the car to goback home.
Okay?
Instead of just strictly relyingon passive modalities is to use,
I.
Passive means like a lot of thestuff that I just showed told
you, medication, chiropracticcare, even other forms of manual
care like acupuncture and manualtherapy and massage, you can use
(15:17):
those.
It's just to understand that youdon't want to use those in
isolation.
You don't want to be reliant oraddicted to those things.
And if you do get any passive.
Treatment is that you need to,essentially, what I always say
is that if you get a passive oftreatment immediately after, use
it as a window of opportunity toget your body moving.
So maybe you can tolerate moreexercise now that your
(15:38):
perception of pain is much less.
So don't just go back home andthen go back again to the same
exact lifestyle, the same exactpostures.
If you don't modify anything inyour life right then the pain is
just going to be returning witha vengeance.
Okay?
So let me talk to you about nowgoing into my next segment,
right?
We're gonna talk aboutshort-term solutions, things
(16:00):
that may actually workeffectively and immediately.
And I think that these arereally good to use within the
first two to six weeks oftreatments.
And I'm gonna talk aboutlong-term strategies that I've
given to hundreds of my clients,and pretty much 90 to a hundred
percent of the time, it workslong term.
Okay?
So short term strategies.
Typically enough, the easiestone is just walking, and I'll go
into details about long-termstrategies for walking, but
(16:23):
walking more is usually a prettygood long-term solution.
If you're somebody that's ofolder age, like 60, 70 60, 70
plus, then maybe you wanna likestill walk because it's still
going to get some good bloodflow and rotation to your spine.
And to your legs.
But you may want to, forexample, reduce your stride
length, when you lengthen yourstride.
That can be.
(16:43):
Causative factor to make yoursciatica symptoms worse, but how
to reduce walking sorry.
How to reduce the symptoms withwalking is just understand the
right amount.
So just understand likemeasuring the amount of distance
or the amount of time thatyou're walking as well as.
Sometimes reducing your stride,sometimes changing your
position, sometimes you know,even bracing for some per pulse,
(17:05):
like bracing your abs whilewalking can be effective.
And these are all just, I'm justthrowing a lot of stuff out
there that I've given toclients, but understand that I'm
just wrapping up, the number ofdifferent common CAU causes for
us sciatica, and it's not gonnabe directly conducive to you you
have to test it out the rightdistance, the right time.
The right stride length as well.
(17:25):
Sometimes even the right shoewear, right?
How to walk appropriately,right?
So the walking for most peopleare still gonna be effective for
Attica awareness of yourpositioning.
So awareness of how long you'restaying in one place.
So whether that's even likeprolonged standing, which I'm
standing right now, but also ifyou do have pain with prolonged
sitting is that you can do allthe best solutions.
(17:48):
You could do either the shortterm.
Stuff or you can strength train,but also if you're not, if
you're continuously flaring upyour body or you're allowing the
pain to come back with thosepositions that trigger your
pain, then you're not reallymodifying your lifestyle in any
way or form I, so you have torealize that being more aware,
(18:12):
the word is awareness.
The awareness of hours ofsitting, right?
So maybe you have to set atimer.
In order to get your butt off ofyour desk and take a small break
to walk around the room, maybeyou go outside, maybe you get to
the floor and you do some foamrolling, right?
How, however it is that you wantto make sure that you are
changing your positions often,okay?
And sometimes temporarily lumbarsupport can help.
(18:34):
So if you sit with a chair thathas like a backrest you may want
to buy something from Amazon,for example.
I can list it off in the commentsection of the description.
And having something toessentially support the natural
curvatures of your back nanamely lumbar lordosis where the
back has a slight amount ofextension.
If you do have or you do getsome lumbar support, that can
(18:57):
help to reduce the amount ofmuscular load associated with
neat of the demands of sitting.
And that can also help reducesymptoms as well.
Short term strategies, reductionof stress.
Okay, and I guess I could putthese, put this in short term
and long term strategies, butreduction of stress.
Why would you wanna reducestress?
Okay.
So you know, a lot of anatomicalthings that you can do now.
(19:18):
There's nerves, there's muscles,there's joints, and a bunch of
stuff that we want to talk aboutin our long-term strategies, but
reduction of stress.
The reason why you wanna reduceyour overall mental stress is
because increased cortisolsecretion, the common, the most
common hormone for stress canincrease muscular tension.
It can also have a change inpain perception, which is
(19:39):
oftentimes not talked about.
Okay?
We talk about posture andexercise, but even just you
being in a stressful situation.
Money, situations, fights withyour wife or kids or partner,
right?
Job deadlines, right?
You having the potential to loseyour job.
Politics, the environ,environmental stressors, global
warming.
(19:59):
Okay?
I can go for days on the manythings that can stress you out,
but.
You can actually develophyperalgesia or even allodynia.
So hyperalgesia is basically aheightened state of pain.
So something that like, let'ssay a pin prick for me is ooh,
there's a little pinch, a pinprick.
For somebody that'shyperalgesic, they can have this
(20:20):
enormous reaction to that pinprick.
Okay?
That is what we callhyperalgesia an increase
hypersensitivity to pain.
Okay.
Or allodynia.
Allodynia is basically I couldbe touching your skin and
there's this enormously, almostabnormal response to somebody
touching your skin, right?
So those are oftentimes lesscommon with sciatica.
(20:41):
But I have seen that beforewhere like the, even just
temperature.
Somebody just touching the leg.
A lot of times that can makethem scream and jump off the
table.
Okay.
Very uncommon, but you stillwanna be aware of it.
Okay?
Especially with increasedstress, low motivation wanting
to sleep more, not the littleinterest in doing anything,
including working out right orgetting more active.
(21:04):
Okay?
Stress can cause that, right?
Stress.
Essentially can you will havecertain coping strategies, like
whether you smoke, drink liedown watch Netflix, scroll,
social media.
These are all stress reduction,interventions that we do go to,
we go to places of comfort, butoftentimes those places of
comfort, those comfortstrategies are oftentimes not
(21:24):
conducive to reduc reducing yoursciatica long term.
Okay.
Stress reduction.
It there, there is some thingsto theorize that it does reduce
overall blood flow to specifictissues and can actually deoxy,
oxygenate certain blood flow tospecific tissues.
So if you need blood flow toyour low back, you need blood
flow to your piriformis and alot of the muscles in your legs.
(21:47):
Sometimes in states ofheightened stress is that our
body prioritizes blood flow toessential organs like our
stomach, as well as our brain,as well as our heart, just to
keep our body alive.
So when de oxygenation oftissue, anything that you
detonate.
So imagine like you, me, likesqueezing your wrist so that I'm
basically temporarily.
(22:09):
Causing less blood flow to thehand is that your hand will
start to turn black and blue.
It'll start to feel tingly, andoftentimes it'll start to feel,
it'll start to hurt, right then.
The same thing goes with stressas well.
Okay, so you want to think aboutreducing your stress as much as
possible, whether that's youmeditating or positive
affirmations, all that.
(22:29):
So those are some short-termstrategies I wanna talk about.
All right.
Last thing, I wanna talk aboutlong-term strategies.
What does that kind of look likefor you?
I.
These are long-term strategiesthat I really feel have made the
biggest difference for a lot ofmy clients as well as many
people that I've spoken to.
So I want to talk to you about,first of all, probably the most
(22:50):
potent pain relief strategy.
And this is one that oftentimesis very overlooked and is
oftentimes harder to implementinto your own life.
If you do this, I promise you,you will see long-term results
and the very first one isstrengthening your legs.
Okay?
I'm gonna tell you why first,and then I'll go into some
(23:11):
actual specific exercises youcan do.
So strengthening your legs, whydo you want to do that?
If you look at the nerve, solet's go into anatomy.
Your sciatic nerve isinnervated, and it's a
combination of.
Nerves that come from the spine.
So I talked to you about,there's different levels like L
one, L two, L three.
(23:32):
In between those levels aredisc, and right around the disc
is where we call ourintervertebral canal.
That is where the nerve exitsout of the spine from the spinal
canal, and those nerves willserve specific.
Things, certain nerves arestrictly sensory.
That means that when you touchthat area of skin that is
associated with that nerve willtell your, that nerve will send
(23:56):
afferent signals back to thespinal cord and therefore it'll
go about up to the brain.
The brain will perceive thatsomething is touching that part
of my leg.
They'll send back signals backdown to that leg.
So that's afferent, right?
That's afferent nerves wherethat nerve is strictly sensory
and there are certain nervesthat are.
Sensory but also motor.
And there are all cer.
(24:16):
There's also certain nerves thatare strictly motor, and what I
mean by motor is that the braintells the spinal, will send
signals down the spinal cord outof that specific intervertebral
canal at that specific level,and that nerve will send signals
down to specific aspects of yourleg and it'll tell that part of
your leg to move.
Okay.
So sciatic nerve is acombination of afferent as well
(24:38):
as ENT nerve endings, right?
It's basically, it's motor andsensory.
So you have nerves that comefrom L four all the way down to
S3, right?
So L four, L five, S one, S two,S3, all those little nerves
converge into the satic nerve.
The satic nerve is the largestnerve in the body.
(24:58):
And so those nerves are mixtureof, like I said.
Motor and sensory.
So if somebody touches thebottom of our foot, that is
mainly your sciatic nerve.
If somebody touches your calve,that is mainly satic nerve.
If somebody touches yourhamstring the vast majority of
the hamstring is innervated bythe satic nerve.
However, there are dominance andthere's levels of nerves, right?
(25:20):
So think about King, queen,Bishop Rook pawn, right?
In the, in terms of, in terms ofchess, think about also like
royalty, like king and queen areup top and then they have all
the other parts of the kingdom,right?
So you have your alpha motorneurons.
Those are essentially yourlargest motor neurons.
Those are your largest neuronsby far.
So what research shows is thatwhen you're actively resisting
(25:46):
or loading that nerve and you'remaking those nerves do work,
meaning that you are activelymoving your leg.
Against resistance is thatessentially those alpha motor
neurons will have downregulationregulating signals to other
sensory neurons, and also see indelta fibers, which are
(26:06):
essentially nerve fibers thatdetect temperature, that detect
pin prick, that detect two pointdiscrimination.
And al also a combination of allthese is what kind of detects
pain essentially.
So what I'm trying to say isthat when you are contracting.
Muscles, especially muscles thatare innervated by the sciatic
nerve, that will essentiallyreduce the sensation, the
(26:29):
tightness of the nerve that isaccompanying, so essentially it
reduces your sciaticasignificantly.
So that's what I'm trying to sayis that when you're reliant on
medication or manual therapy, isthat those aren't even your best
strategies.
Your best strategies areactually loading the sciatic
nerve or loading the musclesaround the sciatic nerve.
That's what I'm trying to tellyou.
(26:50):
So things such as squats.
Squats, actually, I thinkamongst all exercises, squats, I
think when you do squat and whenyour hips bend and when your
knees bend.
So think about the S staticnerve running from your low back
down, your glute pass, your kneeinto past your ankle and
(27:10):
exiting.
Or I guess stopping at your footthere.
Nothing past your toes.
Is that when you squat?
Is the greatest excursion ofsciatic nerve movement, right?
So your sciatic nerve movesaround these joints that are
bending and that movement aroundthe nerve.
So think about getting a tensenerve to essentially stretch it
(27:32):
out.
So think about I.
I don't know.
Think about a Italian restaurantand they're rolling out dough,
right?
And as they roll it out more,they start to swing it around,
right?
Some of them, them making intopizza, but some of them making
into noodles, right?
So think about a, the more thatyou move.
That dough, right?
It starts off as like this fatbundle that's compressed, but
eventually starts to lengthen,right?
And, that Italian or Japaneserestaurants, any restaurants
(27:53):
that serve noodles, sorry, ifI'm making this analogy up, but
think about that nerveessentially getting looser,
right?
And it, it starts to relax more.
That is what squats can do foryou.
Same thing like lunges.
Lunges, just like a harderversion of a squat, just more
unilateral deadlifts as well.
There are many differentvariations of deadlifts.
That I've talked to a lot of myclients that have really like
(28:14):
even immediately reduced theirsymptoms.
It's just that, you can startoff with a one to five pound
deadlift and just get that sstatic and nerve moving.
Or you, if you can't dodeadlifts yet, then you can also
again do squats.
Squats, deadlifts even doingmachines, right?
Doing hamstring curls at thegym, right?
What, hamstring is probably thelargest muscle innervated by the
satic nerve.
(28:35):
So getting, doing hamstringcurls, some of the easiest
things that you can do for asciatica, just know that
certain.
Hamstring curl machines arebuilt differently.
Some of them you're sitting, soyou're sitting in a hip flex
position that does stretch thesciatic nerve more right from
the get go.
Prone hamstring curls, you'relying down on your back, or
(28:56):
sorry, you're lying down on yourbelly.
So if your body.
It doesn't appreciate being in aprone position in an extended
position.
You might want to go with aseated hamstring curl version.
Instead.
That might be somebody with morelike spinal stenosis where they
have an aversion to prolongstanding and walking.
But let's say if you're somebodythat, let's say your symptoms
are triggered by prolongedsitting.
(29:19):
And, but you feel better withstanding and walking.
You may actually appreciate theprone hamstring curl variation
instead because that you're in amore extended position.
And also there's a standinghamstring curl variation as
well, right?
So you could see that there's alot of devising and maneuvering
around which machines or whichexercises are best for that
(29:40):
specific person with sciatica,because like I said, we talked
about anatomical causes, mentaland emotional causes.
So there are different ways onhow to devise.
Perfect or as perfect of astrengthening routine for
sciatica, right?
So if you're interested in,learning more about, how you can
have coaching or have a programdevice for you, then definitely
(30:03):
look into the description.
We always send out like anapplication and a booking page
so you can book in for a freeconsultation with us and see how
we can help you with overcomingyour chronic static issues.
Okay.
Other forms are also like calvestrengthening, right?
Calves are some of sometimes theeasiest bang for buck exercise.
I always say a good amount ofpeople that do calve raises that
have sciatica.
(30:24):
Rare.
It's very rare that they wouldstart to complain of triggering
a pain with calf raises.
Okay, so if you do calf raises,calves are innervated by the
satic nerve as well, a branch ofthe satic nerve, right?
So like I said, the more youstimulate alpha motor neurons
the motor neuron specificbranches of the sciatic nerve,
that may actually eitheroverwhelm.
(30:47):
Damper or sometimes relax thesensory neurons associated with
the satic nerve.
Okay.
I really hope that's makingsense of things.
Okay.
Let's also talk about anotherlong-term strategy, core
strengthening.
Okay.
Till this day, I still feel likethere is some nuance on why core
strengthening would work.
(31:07):
Okay.
But I'll give you an example.
I had actually one client thathad chronic sciatic pain.
They also had pain into theirfoot.
So they had plantar fasciitisand also they had actually had a
little bit of foot drop, right?
They actually had some symptomswhere they were actually feeling
motor weakness.
Their leg, but they're alsohaving a significant amount of
sciatica.
(31:27):
So I had this person strictlyjust do some core strengthening.
So I had them resist load.
I actually had them do a plankand I actually put some weight
onto their back.
So it increased the resistanceand the demands on the
abdominals itself.
And then what I did was I, theywere, their abs were super
fatigued, and then what I hadthem do was I had them stand up.
(31:47):
I had them bend forward becausebending forward.
Was causing symptoms in theirsatic nerve.
It was triggering symptoms.
And then after the corestrengthening, they actually
touched their toes, right?
So they actually increased theirmobility and also their symptoms
of sciatica were drasticallyreduced.
By doing core strengthening,right?
(32:09):
And so my theory around this isthat what you're doing is you're
stimulating the central commandcenter, right?
So when you contract your coreand you brace, that does give
some spinal stability, right?
So think about contracting themuscles around the spine so it
stabilizes the spine.
The other thing that I thinkthat it does is that when you
are doing a lot of corestrengthening, you are
(32:30):
stimulating a lot of hipmuscles, ab muscles.
Like I said.
The theory around alpha motorneurons dominating the sensory
neurons that also had someregulation of reduction of
symptoms of sciatica.
The other thing that I thinkabout too was.
You're teaching the person andyou're telling the person that
it's okay to load the body,right?
(32:52):
So when sometimes people come inwith a lot of fear and aversions
and anxiety and they're like,oh, I don't wanna move because
I've flared up my sciaticabefore you get them to do
something an exercise that's notthreatening to them, right?
They're like, trust me.
Just do a plank or do an inclineplank.
And I can assure you that thiswill, that, that this will help.
So you're giving the personassurance that it will work.
(33:14):
You're also trying to devise theexercises that are not
threatening to the body.
So for example, if theycontinuously flare their
sciatica nerve with eitherrunning or lifting something off
the floor, I may not have themrun or lift something off the
floor.
During my session, right?
Because their brain is also, isalready detecting that is
(33:35):
threatening to my body.
But if you give them a plank,they're like, oh I didn't try
plank for mystica.
I'm not sure.
So they're like let me just tryit.
And when you can.
Tell the body when you can tellyour spine and everything and
you can tell your brain thatit's okay to load up the body,
is that what will happen isyou're sending good signals up
the spinal cord up to the brain,and then the brain is sending
(33:58):
signals and saying, whoa.
This is not flaring up mysciatica.
So therefore your brain issending signals back down the
spinal cord, out to theperipheral nerves stimulating
your satic nerve and saying wow,I can actually load up, my core.
I can load up my s sciatic nervewith this exercise and it's not
flaring me up.
So therefore, when you'resending, comfort signals and
(34:21):
sending signals to the body thatit's okay to strengthen, it's
okay to load.
That is what also has a factorwith sciatica.
Okay, so somewhat long-winded,but just to tell you that when
you're telling the commandcenter that it's okay to load
the body.
That is then therefore tellingthe command center that it's
okay, it was okay to do moreexercise.
Okay.
Hopefully that makes sense.
(34:41):
Okay.
Like I said, coordinate spinalcoordination stimulating of the
sciatic nerve.
Okay.
Contracting the core muscles.
Sometimes again, contractingcore muscles with something with
spinal stenosis, it can help tolike.
Change the positioning of thepelvis temporarily.
It can it can change thepositioning of the spine.
Like I said, there's a lot oftheory on why core strengthening
works, but it does.
(35:03):
Okay.
And there's different versions.
There's not just.
Just planks.
There's side planks, there'sSupermans, there's ex, there,
there's lumbar extensionloading, there's Roman
Hyperextensions.
There's prone glute squeezesthere, there's reverse hypers,
there's pelvic corestrengthening.
There's many different avenuesof core strengthening that you
can do.
Like I said, if you're confusedon which ones.
(35:25):
Are gonna be the right ones foryou.
Like I said, feel free to fillan application, book a call with
us, book a free consultation andsee how we may be help able to
help you.
Okay?
Other long-term strategies, Iwanna go into walking, but
specifically I.
Walking in more barefoot shoes.
Walking in more barefoot shoes.
Why is that?
You know when you look at someof the acupuncture theories
(35:46):
around there, where, you knowthey're putting their foot onto
like sharp kind of pricklyobjects, right?
I'm not sure you've heard ofthat, is that it's sim it is
stimulating different aspects ofthe foot and it's sending good
signals back up to the spinalcord.
And a lot of times when youmassage the foot, there's
reduction of symptoms.
There's reduction of symptoms,not just in the foot, but also
in the calve and anywhere thatsciatic nerve is contacting,
(36:09):
right?
Walking in barefoot shoes, whenyou do, or you walk more
barefoot, you are feeling morerocks on the ground.
You're feeling more twigs on theground, so you're giving more
proprioceptive stimuli to thefoot.
Therefore, when you'restimulating the foot more, you
are not just stimulating thesensations of the sciatic nerve.
(36:31):
So that in itself can reducepain, but also you are
strengthening the muscles of thefoot as well.
There are four layers of musclein the foot.
I always say that, the footmuscles have core strength as
well in itself.
So while you are training yourfoot.
To get stronger, to build moremuscle in the foot, just
strictly through walking in moreminimalistic shoes.
(36:55):
That actually has been shown toreduce symptoms at the knee, the
hip, as well as the lower back.
But when you're given, andsometimes this is the wrong
thing to do in my opinion, isthat when you're given orthotics
or sometimes shoes to correctfor and for pronation.
(37:15):
And so when you are given thosetypes of shoes, yes, I would
always say that.
Even just.
Your foot contacting the floordifferently with standing and
walking, that will reduce pain.
And it's just for the fact thatyou're not striking the floor in
the same way as barefoot.
So there is, I will always saythat with heel cups and all the
(37:39):
different like foot technologyout there, 90% of the time.
That will always reduce painacutely.
Whether you've had PLA plantarfasciitis, sometimes hamstring
tension or s tension, a lot oftimes it's gonna work.
So I would maybe put orthoticsor these types of like foot
control technologies intoshort-term strategies.
(38:01):
But however, a lot of peoplearen't told that they need to
wean off.
The orthotics or those footcontrol technologies long term.
So what I see is that whenthey're put into more
comfortable shoes, is that one,I do feel like the foot gets
weaker.
I do see that people with reallyhard orthotics, that they
actually have foot atrophy.
(38:22):
The muscles have actually gottenweaker.
You'd start to see like the bonycontours of the foot versus if I
were to take a picture of myfoot has nerves.
It has thick amount of musclearound the plantar fascia
because all I really wearnowadays is mostly minimalistic
shoes or barefoot.
Okay?
And so when you have footmuscles that are weak.
It's going to have, it's thefoot muscles that contact the
(38:45):
floor.
It, you're gonna have, you'regonna eventually feel that your
foot can't absorb the shock ofyou walking.
So therefore it's going to causemore knee pain.
It's gonna cause more hamstringtension or cab tension.
It's gonna cause more hiprelated issues.
And lastly, it can cause yoursciatica to stay in orthotics.
(39:05):
Okay, weaning down to shoes thatare more minimalistic in nature,
and also where you can regainstrength, intrinsic muscle, foot
strength.
You can start to feel the floorbetter with improved
proprioception.
I've always felt that was alwaysa good long-term strategy.
I've seen it so many times whereI've helped people to slowly
(39:27):
reduce the need for orthotics.
And what had happened was thisperson that has had 10, 20 years
of like consistently gettingmore foot control technology,
that what happened was theyended up needing a knee
replacement.
They had chronic sciaticabilaterally, and they also had
one hip replacement, that hiparthritis.
(39:50):
Tons of bad stuff as a result ofwearing.
Thicker shoes.
Shoes that compress your toes,shoes that don't allow you to
feel the floor more.
So when you are put into thoseshoes and you are not told by
your podiatrist or your physicaltherapist or your running
trainer that hey, it mayactually be a good strategy
(40:13):
acutely to wear these shoesshort term, but you may want to
slowly progress to a moreminimalistic shoe to strengthen
your foot more.
That is where I'll notice that alot of people do it wrong.
A lot of trainers and otherhealthcare practitioners do it
wrong, in my opinion.
And I do feel like most people,90% of people should benefit
from minimalistic wear.
(40:34):
The 10%, I'm not gonna go intoit now, there's people with
stress fractures, really chronicfailure of certain tendons at
their foot.
So if you are in that smallcategory where you do need more
supportive shoes.
I would say, therefore, you, youmay not be a candidate for
minimalistic wear, but chronicsciatica, though I would
(40:54):
definitely say.
Definitely benefit from moreminimalistic wear as well.
Okay.
I'll go into this really quick.
I'll, I guess I'll encompas thisinto two more things.
One I would say is nutrition andsleep.
Nutrition, eating adequateamounts of protein, right?
Especially if you're notrecovering properly.
Protein is broken down intoamino acids.
Amino acids are reuptaken.
By the body in the form ofinsulin.
(41:16):
Insulin is the thing that bringsamino acids into the damaged
tissues.
However, when your body is notprioritizing protein and you're
like, let's say increasing,let's say you're eating the
typical American diet, a lot ofcarbs, a lot of sugar,
carbohydrates in itself mostlyhas some sort of insulin spike
insulin.
It can create insulinresistance.
(41:37):
Chronic insulin resistance canlead to.
Interstitial vascularinflammation.
So anything that receives bloodflow, which is essentially
everything in our body, anythingcan be broken down, right?
So for example, if you haveinsulin resistance, some people
develop retinopathy and they cango blind because there's less
blood flow to the optical arteryand nerve, right?
(41:58):
Same thing with sciatica, right?
Are when you have.
Insulin resistance and we havevascular inflammation.
Vascular inflammation willappear differently for certain
people and it eventually canaffect the body systemically.
It is affecting the bodysystemically.
But for you for some people, ifyou have chronic sciatica, you
may look into you your amount ofsugar intake, the amount of
(42:20):
carbohydrate intake, how oftenyou're spiking insulin,
increasing your protein intakewhile also increasing your fat
intake.
So in the form of good, let'ssay monounsaturated fats.
That is oftentimes a way toreduce overall systemic
inflammation.
If you didn't know this, is thatthere are three macronutrients,
protein, carbs, and fats, right?
So protein, amino acids, as wellas carbs.
(42:42):
Carbs broken down into glucose.
Those are actually the twothings that secrete the most
amount of insulin, right?
Carbs, the most amount ofinsulin.
Excessive protein also willsecrete insulin because it has
to reuptake amino acids into theworking tissues.
But if you, but fat is actuallythe one macronutrient that
actually secretes the leastamount of insulin.
(43:04):
So if you eat greater, healthieramounts of fat, you are going to
become more insulin sensitive.
You're going to create lesssystemic inflammation overall.
And that, again, is a more longterm, more internal strategy.
That will help you with yoursciatica long term.
So I would consider likestrength training and core
strengthening that's more,putting external load onto your
(43:25):
body.
I would say that's less internaloverall, the food that you
ingest and absorb, that can go along way as well.
Sleep.
Sleep is very neglected,especially in our American
society.
We're all succumbed to asmartphone.
I'll definitely admit that,sleep amongst the many things
that I do well in my own life.
Sleep is something that I canalways improve, but getting a
legit seven to nine hours ofsleep can help to reduce overall
(43:49):
stress.
The more you sleep, the morecortisol is dampered and
downregulated.
When you wake up, there is anincrease in cortisol in order to
increase your blood pressure, toget you to stand upright.
And then your cortisol slowlytapers down after, six to 120
minutes of being awake.
But for some, with increasedstress in their life, or
sometimes with a lot ofsciatica, a lot of pain cortisol
(44:11):
can stay elevated, right?
So the more you sleep, the moreyou can regulate cortisol.
Okay.
And also you think more clearlyyou have more energy, so you
have more motivation to workout, right?
So obviously I.
There's many books on sleep.
I'm not a sleep expert initself, but sleep has overall an
amazing amount of positivesystemic benefits physiological
(44:34):
benefits as well, right?
So getting enough sleep, reallycritical.
Lastly, just positive outlook,right?
Because many people with chronicsciatica, whether you've injured
yourself a lot.
Whether you've gotten a lot ofMRIs, whether you've been stuck
in a broken medical system andnobody's really helping you, you
feel the medical system's letyou down.
There's just so many differentthings that can cause a negative
outlook.
But creating a more positiveoutlook, maybe listening more to
(44:57):
my podcast gives you a morepositive outlook, whether you
start to employ strengthtraining as a means of a good
long-term intervention, right?
So starting to replace a lot ofyour negative coping strategies
starting to also.
Try not to let current, or evenpast circumstances or past
negative events determine whatyou can do today with your s
(45:19):
static symptoms, right?
So having that positive outlookand focusing and grounding
yourself in today will reallymake meaningful differences
today and then long term, right?
You might not notice, wow, mysatic pain is gone in one day
with this positive outlook,because you're gonna have these
wavering of your brain.
Start to perceive, oh, I'llnever get better, or you start
(45:40):
to feel helpless, but creatingmore of a positive outlook and
employing a lot more of thesegood short-term strategies I
told you about, as well as theselong-term strategies I told you
about.
Again, making meaningfuldifferences long-term.
You can't think about just whatyou can do today.
You have to think about howtoday capitalizes onto the next
(46:00):
day and onto the next week, thenext month, the next year, and
how your body can become moreresilient.
To sciatica overall is that youhave to look at the long-term
outlook.
I have to stay on a strengthtraining plan.
I have to consistently work onmy sleep quality.
I have to consistently work onmy nutrition.
Because sometimes you mightfalter back into, I.
(46:20):
Eating a ton of crap, forexample, or eating a lot of
vegetable oil, eating a lot ofpro-inflammatory substances, and
maybe your sica symptoms comeback because of mixture of diet,
stress, sleep, lack of training,lack of resistance training,
lack of walking.
Okay.
But, putting those four thingstogether, while it does sound
simple, just me talking aboutit.
That it's not built into ourDNA.
(46:42):
It's not built in as a habit.
So you have to think about thelong-term game, that positive
outlook, and starting your daywith gratitude, starting your
day with positive affirmations.
Maybe you need to calm thenervous system down by
meditating, right?
I.
So many different strategies.
I'm not saying that one personhas to lock onto everything that
I say is that you will find yourown kind of sciatica roadmap, if
(47:04):
you will, but taking some of thethings that I say or taking all
of it, I, I know and I canguarantee that, you can say for
yourself that if I employ a moreholistic strategy, so sciatica,
I can overcome this overall, notjust short term, but also long
term.
And that's what I got for youguys today.
If you found this helpful, evenremotely helpful at all, click
(47:25):
that share button.
Share it with a friend.
Share it with a friend that notjust has Attica, but also is
contemplating, like preventionstrategies.
This can be super helpful tothem.
If you're listening to this onFacebook or podcast or wherever,
YouTube I encourage you to one,click the like button click
follow and subscribe.
If you can also leave a commentor leave a five star review,
(47:45):
especially if you found thissuper helpful, I am doing my
best to.
Create more impact in the world.
But you also engaging with thisepisode as well, that pays huge
dividends that allows otherpeople that are searching for
sciatica or searching for painto be able to find this episode
a lot easier.
I.
So you helping yourself,hopefully you can help others as
(48:06):
well and help me in that processtoo.
If you have any feedback fromme, definitely email me,
jason@flexwithdoctorjay.com.
And if you're interested at allin speaking with me or my team,
definitely look at thedescription section.
You'll always see there's asection to.
To fill out an application, feelfree.
And the application will bebackground information so that
we can make the most out of ourfree consultation.
(48:28):
So if you're interested in thatas well we're always looking to
help more people.
So that's what I got for youguys today and I appreciate you
guys.
Have a beautiful rest your day.
Stay active and I'll leave youalways with my quote as well, is
that we only have one body, onelife.
Make every action you take, beone that makes you a better
version of you.
Take care and have a beautifulrest of your day.
Welcome guys to another episodeof the Won Body Won Life.
I am your host, Dr.
Jason Won, lifestyle physicalTherapist.
Today I wanna talk about SCIAHacks.
I wanna talk about instant aswell as lasting solutions for
sciatica because I think a lotof healthcare is predicated on a
lot of short-term solutions.
Those short-term solutions areoftentimes putting up.
Bandaid on things.
(00:24):
It manually fixes things ormassages the pain out, but it
doesn't actually give youlasting relief.
So I'm gonna share with you acouple things.
First, I'll talk about mostcommon causes of sciatica, so
you get a very well-roundedbackground of what might be
causing your sciatica issues.
I also wanna talk about what, inmy opinion, doesn't work long
term for sciatica, and I wannatalk about my specific short
(00:47):
term relief strategies that Ihave.
Done for myself, but also a lotof my clients in order to see
quick wins within the first twoweeks.
So definitely stick around tothat part of this episode.
And lastly, looking at somelong-term solutions.
Those long-term solutions areoften a combination of some form
of lifestyle modification andchanges.
(01:08):
So if you are looking for.
Long-term changes to yoursciatica.
Maybe you've had sciatica forlonger than three to six months
or even years.
You have to realize that thereare really no shortcut or
band-aid solutions to gettingrid of it.
It is a very common conditionthat often requires
modifications to your lifestyle,as what I would always say is
(01:29):
that modifica lifestyle changesnegative ones have often led to
sciatica.
All right, so let's talk aboutthe most common.
Causes for sciatica, and I wouldstart this off with a grain of
salt because when I do talkabout these things, I don't want
this to cause more fearmongering or any anxiety
(01:49):
related.
So as I open up the manydifferent ways in which sciatica
can start, I don't want you topigeonhole yourself into
thinking, oh, that's me, becausea sciatica.
Especially chronic is amanifestation of everything that
we are from our culture, ourvalues, our beliefs, some of the
negative experiences that we'vehad, some of the things that
(02:10):
doctors have said, some of thethings that our parents have
often used for their own relief.
So a lot of this is mimicry.
A lot of this is listening toauthority.
So while I am, I could, I wouldconsider a authoritative figure.
When it comes to health andhelping a lot of people with
sciatica, I don't want you totherefore cause more
(02:30):
uncertainty, fear, or anxietywhen I'm talking about this.
Okay?
So that is my disclaimer there.
So the very first and oftentimescauses could be also a herniated
disc.
Now this is more an acutesituations.
Sometimes if you just injuredyourself sometimes if you picked
up something wrong and then youfelt like a small pop in your
back, oftentimes you may.
Irritate a disc, and so whendisc get irritated, there are
(02:54):
nerves that come out of thespine, and so those nerves can
oftentimes either one just getirritated in itself, like you
overstress the sciatic nervethat are accompanying with the
muscles that go down your leg,or sometimes you do actually
injure a disc, and then thatdisc is temporarily, then I will
say temporarily contacting anerve.
(03:14):
So that is a common cause.
However many disc herniationsare self resolving.
As in, if you just have apositive mindset and you just
wait over time, most sciatica aswell as low back pain does go
away.
Or the other things that you cando are, modifying your posture
as well.
And a lot of herniated disc,believe it or not.
Many people over the age of 30actually have a herniated disc,
(03:37):
but have no pain whatsoever.
So they screen, over, a fewthousand people in the study.
And I can quote it somewhereelse, but the study showed they,
they did a bunch of they did abunch of MRIs on a ton of
asymptomatic individuals,meaning that they had no
symptoms whatsoever, and whatthey showed was that, as you are
at the age of 30, you may showsome degenerative changes.
(04:00):
You may show that you even havesome disc bulges or some
herniations and each and everydecade, so like from 40, 50, 60,
the spine only changes, right?
If anything, the MRI starts toquote unquote look worse.
So you start to see a lot moredegenerative changes.
However, if you look at, again,the study was done on
asymptomatic people.
So what I always say to myclients in order to ensure that
(04:22):
they don't, perseverate or worryabout, whether their sciatica is
coming from the specificdegenerative changes is just
perceived that you know thatthese are normal age related
changes and no matter what youdo.
Your spine is gonna change.
It doesn't matter if you'velived a perfect lifestyle or a
bad lifestyle.
It's just for the fact that asyou get older, it's almost a
(04:44):
privilege to get older.
And also when it comes to.
Know, the things that you see onyour MRI is that it doesn't
matter what's shown on the MRMRI as long as you feel good.
So if you feel good, yourfunction's good, you can
overlook your MR mri and reallythat's not much of an issue.
As I go through more of theother common causes, just wanna
let you know that, with a grainof salt, that these issues can
(05:05):
appear on your MRI, but itshouldn't determine your mindset
or cause any fear.
Okay?
So other causes, as you getolder over the age of 60 and
seventies spinal stenosis.
Becomes more common.
That is when the holes that comeout of the spine, which are
called the intervertebralcanals, that is where the nerves
come out of.
And oftentimes those areas can,I guess you could say the tunnel
(05:26):
is getting a little bit smaller.
So there could be certainpositions like excessive
extension or excessive standingfor long period of time, that
can often cause sciatica formore older individuals.
Okay.
Or for example, they often getrelief with sitting.
So if you get relief withsitting, then potentially you
may, have some common causes ofspinal stenosis.
(05:48):
Or a lot of times with herniateddisc, it's a tossup, but
sometimes, if you sit for anextended period of time, you can
start to feel symptoms eitherdown your leg into your glute.
But sometimes, walking alsoeither makes you feel better and
sometimes, or sometimes makesyou feel worse.
So that's why, hiring a goodphysical therapist or coach that
understands.
What to do with sciatica is todetermine what are the next
(06:08):
steps, what are the certainpositions, exercises that will
be con most conducive to yourelieving your sciatica pain,
right?
Other things arespondylolisthesis.
That is when one spineessentially like moves forward,
like one vertebral.
One full vertebral plate or likefor example, like L one will
ride forward over L two.
So the positioning is forward,right?
(06:29):
It's not just one stackedbuilding up top.
You start to see that some ofthe vertebral end plates are
pushing forward, so thatoftentimes can be a cause of
sciatica.
Oftentimes if you do havespondylolisthesis is oftentimes
anterior means it's pushingforward.
Excessive sprinting, like somepeople get pain with sprinting
or running because it's, you'rein a more extended position.
And then sometimes when youcontract your front abdominals
(06:51):
and you go into posterior pelvictil, or you do some core
strengthening, which we'll gointo later, then that oftentimes
can be relieving.
Okay.
Just to speed this up so we cango into some of the good stuff,
like the instant and long-termstrategies.
But trauma injuries clear enoughthat can cause true inflammation
in the body.
That can be temporary Pregnancy.
Pregnancy will secrete oxytocin.
(07:11):
That will make some of yourligaments more laxed in your
spine.
And then oftentimes can rendersciatica like symptoms.
Tumors are infections, so youknow, it does sometimes.
Tumors or infections, theyhappen insidiously, there's no
common cause.
Sometimes it's a product of yourdiet as well, in which, a tumor
can actually push up directly ona nerve.
And also scar tissue formation.
So if you, whether you've gottensurgery in the past and
(07:33):
oftentimes like excessivesitting and also lifestyle
factors are all common causes.
So partly anatomical, meaningthat, like we talked about, what
anatomical things can actuallycause Attica, but also some of
the, the mental factors as well.
So let's talk.
What doesn't work and I will saythis with a grain of salt as
well.
Because everything is somewhatarbitrary sometimes It depends,
(07:54):
right?
They, it is a very common thingin physical therapy that, we
don't always con give like avery just straightforward
answer.
'cause sometimes we don'toftentimes act in absolutes.
We may be absolute in certainthings some of the long-term
strategies I'll talk about,which I think are absolutely the
things that you wanna employ.
It's just that, when it comes tothings that don't work is,
(08:14):
oftentimes what I'll say is thatwhat doesn't work long term.
Okay, so here's the first one,and this is gonna push even some
physical therapists in the wrongdirection or rub them in the
wrong way, is prolongedstretches.
I often think that, for example,lying down on the floor and then
putting your legs straight up inthe air and putting your heel on
the door.
Dors cell is not a long-termsolution.
(08:37):
Stretching the nerve andexpecting it to feel better in
any way, long-term is not gonnabe a long-term solution.
It may feel good in the moment.
You may feel like the calve orthe hamstring, or you may feel a
stretch in your glute or yourlower back, but what is that
really gonna do for you in life,right?
You're gonna go through lifewalking.
Your job demands of sitting fora long period of time.
(08:58):
Maybe you do a lot of chores,maybe you pick up kids, maybe
you do sports.
How do you really feel that along-term stretch like that is
going to do anything?
It's not right.
It's not gonna protect you fromgetting hurt again.
Okay?
It's just gonna give you sometemporary relief in the moment.
Okay prolonged stretches.
I'm usually not a fan of it.
Even the figure four stretch,I'm usually not a fan of just
(09:18):
stretching tissue, right?
Imagine if the sciatic nerve wasvery tense, or also if it was
like, let's say the nerve, ifyou don't know, piriformis
syndrome is that the nerve doesgo underneath or sometimes over
a muscle in our gluteal or abutt cheek, which is called the
the piriformis, and oftentimespiriformis.
Is demonized, right?
(09:39):
It's oh, that's the common,that's the most common muscle
that hurts our body.
I always say that every muscleserves a role, right?
So the piriformis essentially isjust an external or an internal
rotator, depending on thedegrees of hip flexion or hip
extension, right?
So usually when.
You go into hip flexion, whichis like the knee going towards
the belly button, it becomes anin, it becomes an internal
(10:01):
rotator.
It internally rotates our hipand from a straight position.
So when I like to straight mestanding while filming this
episode, it is more of ainternal rotators, right?
So I.
Alright.
I'm sorry.
An external rotator.
So if you're looking at thescience of things is that it is
really just, a common glute tealmuscle.
For example, the glute max isnever demonized, right?
(10:22):
Maybe like we wanna strengthenit, but in the same way, the
piriformis is a muscle thatserves a specific role of
stabilizing the hip.
It also contributes to externalor internal rotator.
So it's a secondary, external,internal rotator.
So in no way should we bedemonizing this muscle or just
stretching this muscle intooblivion, right?
Because if you stretch themuscle, think about you causing
(10:43):
more compression, right?
Which therefore it's contactingthe nerve more when you're being
in those prolonged figure fourstretch positions.
Okay?
Like I said, while it does feelgood in the moment, if your
brain perceives that it's, itdoes it, it feel, it feels good,
it's beneficial.
Go ahead and do it.
Just understand that prolongedstatic stretches anywhere of 30
to 90 seconds.
(11:04):
Those are usually not gonna belong-term solutions, right?
Because we walk and we move.
So if our, a lot of our painsare somewhat more movement based
or we have active goals, wereally don't wanna be relying on
prolonged stretches.
Okay?
Medication.
Medication is clearly somethingthat's.
90% of it is synthetic.
Yeah, maybe there's herbs andmedicines out there, but it is
(11:25):
relatively passive, right?
So passive modalities such astaking oral medication isn't
going to change the state of thetissues, right?
It's really not gonna make thetissue stronger.
It's not gonna make it morepliable or more mobile in any
way.
If you look at a lot of chronicsciatica is that sciatica is
often a manifestation of likemind, sometimes body.
It's oftentimes manifestation ofour sitting position, our mental
(11:48):
stressors as well.
So when you're taking, forexample, ibuprofen for medic as
a medication or flexural,there's really no inflammatory
symptom going on.
There's no inflammation present.
So you taking ananti-inflammatory.
For something that's notinflammatory in nature, it's not
really gonna do much.
Same thing with gabapentin.
Gabapentin, while it does havesome merit and short-term
(12:11):
effects on nerve relatedsymptoms as far as curbing
nerves, is that while curbingsymptoms, the side effects are
oftentimes a lot more prominenceand therefore I'll tell you what
they are.
A lot of times it's stomachindigestion, it's reduction of
energy, it's malice.
Okay.
It's drowsiness, it's fatigue.
So if you think about it, isthat people oftentimes don't
(12:31):
wanna be on GABA in long termbecause it doesn't allow them to
function at work.
It oftentimes can change yourposture, it can make you sleep
at work.
And also while it is making youdrowsy and fatigued, you
essentially, you lose parts ofquality of life.
You're trying to get more, I.
Active, but the gabapentin isworking against that, right?
It's actually making you moredrowsy.
So you might think I know I needto workout more to maybe curb by
(12:52):
a sciatica, the gabapentin isactually working against you.
Okay?
So it makes you less active.
If that makes sense.
So that's why I don't usuallylike to I, I usually don't
promote gabapentin as a means ofcurbing symptoms because I
prefer to just teach people howto fix it themselves rather than
take a medication for it.
Okay.
(13:13):
What else doesn't work longterm?
I would say chiropractic care.
I'm gonna throw that in there.
While I know greatchiropractors, I don't think
that.
A lot of them have a very goodsense of how to screen the body
effectively, and oftentimes whenthey fix things.
Essentially it's the same thing,right?
It's either a lumbar rotation,manipulation, sometimes it's
traction, right?
(13:33):
Sometimes they're pulling on thehead what they call the ring
dinger.
So yeah, while it cantemporarily like decompress
things the effects areoftentimes very novel, meaning
they're new to you, you haven'tdone it before, and if you have
a strong belief that it maywork, yes, it can reduce some
symptoms.
And also a lot of it is more.
Pathophysiological, right?
(13:53):
The sound, the sensations ofyour back, cracking something,
feeling like a decompressed orit's stretched out.
All those different sensationsin the brain can oftentimes have
downregulation to reduce paintemporarily, right?
So your perception of pain isusually much better getting off
a chiropractic table.
But as again, is that it'softentimes the same exact
(14:14):
treatments over and over again.
If, for example, if it's more ofacute situation and the pain is
not going past the glutealcleft, like past your sitting
bone, then there is someresearch to show that in acute
situations it can be veryeffective short term to allow
you to get more active.
But if you have like long-termsciatica, you have pain
bilateral that's going down pastthe knees or even if you have it
(14:35):
more unilateral where pain isonly going down one leg.
I would say chiropractic care inthis situation is usually not
very effective.
And oftentimes, like I saidbefore on many podcast episodes,
is that passive short-termsolutions are a short-term fix
at a long-term cost.
So you have to go to the, youhave to go to the.
Their clinic.
You have to pay the credit card,you have to drive in the car.
(14:56):
When you drive home, sometimesyour pain comes back because
you're driving in the car to goback home.
Okay?
Instead of just strictly relyingon passive modalities is to use,
I.
Passive means like a lot of thestuff that I just showed told
you, medication, chiropracticcare, even other forms of manual
care like acupuncture and manualtherapy and massage, you can use
(15:17):
those.
It's just to understand that youdon't want to use those in
isolation.
You don't want to be reliant oraddicted to those things.
And if you do get any passive.
Treatment is that you need to,essentially, what I always say
is that if you get a passive oftreatment immediately after, use
it as a window of opportunity toget your body moving.
So maybe you can tolerate moreexercise now that your
(15:38):
perception of pain is much less.
So don't just go back home andthen go back again to the same
exact lifestyle, the same exactpostures.
If you don't modify anything inyour life right then the pain is
just going to be returning witha vengeance.
Okay?
So let me talk to you about nowgoing into my next segment,
right?
We're gonna talk aboutshort-term solutions, things
(16:00):
that may actually workeffectively and immediately.
And I think that these arereally good to use within the
first two to six weeks oftreatments.
And I'm gonna talk aboutlong-term strategies that I've
given to hundreds of my clients,and pretty much 90 to a hundred
percent of the time, it workslong term.
Okay?
So short term strategies.
Typically enough, the easiestone is just walking, and I'll go
into details about long-termstrategies for walking, but
(16:23):
walking more is usually a prettygood long-term solution.
If you're somebody that's ofolder age, like 60, 70 60, 70
plus, then maybe you wanna likestill walk because it's still
going to get some good bloodflow and rotation to your spine.
And to your legs.
But you may want to, forexample, reduce your stride
length, when you lengthen yourstride.
That can be.
(16:43):
Causative factor to make yoursciatica symptoms worse, but how
to reduce walking sorry.
How to reduce the symptoms withwalking is just understand the
right amount.
So just understand likemeasuring the amount of distance
or the amount of time thatyou're walking as well as.
Sometimes reducing your stride,sometimes changing your
position, sometimes you know,even bracing for some per pulse,
(17:05):
like bracing your abs whilewalking can be effective.
And these are all just, I'm justthrowing a lot of stuff out
there that I've given toclients, but understand that I'm
just wrapping up, the number ofdifferent common CAU causes for
us sciatica, and it's not gonnabe directly conducive to you you
have to test it out the rightdistance, the right time.
The right stride length as well.
(17:25):
Sometimes even the right shoewear, right?
How to walk appropriately,right?
So the walking for most peopleare still gonna be effective for
Attica awareness of yourpositioning.
So awareness of how long you'restaying in one place.
So whether that's even likeprolonged standing, which I'm
standing right now, but also ifyou do have pain with prolonged
sitting is that you can do allthe best solutions.
(17:48):
You could do either the shortterm.
Stuff or you can strength train,but also if you're not, if
you're continuously flaring upyour body or you're allowing the
pain to come back with thosepositions that trigger your
pain, then you're not reallymodifying your lifestyle in any
way or form I, so you have torealize that being more aware,
(18:12):
the word is awareness.
The awareness of hours ofsitting, right?
So maybe you have to set atimer.
In order to get your butt off ofyour desk and take a small break
to walk around the room, maybeyou go outside, maybe you get to
the floor and you do some foamrolling, right?
How, however it is that you wantto make sure that you are
changing your positions often,okay?
And sometimes temporarily lumbarsupport can help.
(18:34):
So if you sit with a chair thathas like a backrest you may want
to buy something from Amazon,for example.
I can list it off in the commentsection of the description.
And having something toessentially support the natural
curvatures of your back nanamely lumbar lordosis where the
back has a slight amount ofextension.
If you do have or you do getsome lumbar support, that can
(18:57):
help to reduce the amount ofmuscular load associated with
neat of the demands of sitting.
And that can also help reducesymptoms as well.
Short term strategies, reductionof stress.
Okay, and I guess I could putthese, put this in short term
and long term strategies, butreduction of stress.
Why would you wanna reducestress?
Okay.
So you know, a lot of anatomicalthings that you can do now.
(19:18):
There's nerves, there's muscles,there's joints, and a bunch of
stuff that we want to talk aboutin our long-term strategies, but
reduction of stress.
The reason why you wanna reduceyour overall mental stress is
because increased cortisolsecretion, the common, the most
common hormone for stress canincrease muscular tension.
It can also have a change inpain perception, which is
(19:39):
oftentimes not talked about.
Okay?
We talk about posture andexercise, but even just you
being in a stressful situation.
Money, situations, fights withyour wife or kids or partner,
right?
Job deadlines, right?
You having the potential to loseyour job.
Politics, the environ,environmental stressors, global
warming.
(19:59):
Okay?
I can go for days on the manythings that can stress you out,
but.
You can actually develophyperalgesia or even allodynia.
So hyperalgesia is basically aheightened state of pain.
So something that like, let'ssay a pin prick for me is ooh,
there's a little pinch, a pinprick.
For somebody that'shyperalgesic, they can have this
(20:20):
enormous reaction to that pinprick.
Okay?
That is what we callhyperalgesia an increase
hypersensitivity to pain.
Okay.
Or allodynia.
Allodynia is basically I couldbe touching your skin and
there's this enormously, almostabnormal response to somebody
touching your skin, right?
So those are oftentimes lesscommon with sciatica.
(20:41):
But I have seen that beforewhere like the, even just
temperature.
Somebody just touching the leg.
A lot of times that can makethem scream and jump off the
table.
Okay.
Very uncommon, but you stillwanna be aware of it.
Okay?
Especially with increasedstress, low motivation wanting
to sleep more, not the littleinterest in doing anything,
including working out right orgetting more active.
(21:04):
Okay?
Stress can cause that, right?
Stress.
Essentially can you will havecertain coping strategies, like
whether you smoke, drink liedown watch Netflix, scroll,
social media.
These are all stress reduction,interventions that we do go to,
we go to places of comfort, butoftentimes those places of
comfort, those comfortstrategies are oftentimes not
(21:24):
conducive to reduc reducing yoursciatica long term.
Okay.
Stress reduction.
It there, there is some thingsto theorize that it does reduce
overall blood flow to specifictissues and can actually deoxy,
oxygenate certain blood flow tospecific tissues.
So if you need blood flow toyour low back, you need blood
flow to your piriformis and alot of the muscles in your legs.
(21:47):
Sometimes in states ofheightened stress is that our
body prioritizes blood flow toessential organs like our
stomach, as well as our brain,as well as our heart, just to
keep our body alive.
So when de oxygenation oftissue, anything that you
detonate.
So imagine like you, me, likesqueezing your wrist so that I'm
basically temporarily.
(22:09):
Causing less blood flow to thehand is that your hand will
start to turn black and blue.
It'll start to feel tingly, andoftentimes it'll start to feel,
it'll start to hurt, right then.
The same thing goes with stressas well.
Okay, so you want to think aboutreducing your stress as much as
possible, whether that's youmeditating or positive
affirmations, all that.
(22:29):
So those are some short-termstrategies I wanna talk about.
All right.
Last thing, I wanna talk aboutlong-term strategies.
What does that kind of look likefor you?
I.
These are long-term strategiesthat I really feel have made the
biggest difference for a lot ofmy clients as well as many
people that I've spoken to.
So I want to talk to you about,first of all, probably the most
(22:50):
potent pain relief strategy.
And this is one that oftentimesis very overlooked and is
oftentimes harder to implementinto your own life.
If you do this, I promise you,you will see long-term results
and the very first one isstrengthening your legs.
Okay?
I'm gonna tell you why first,and then I'll go into some
(23:11):
actual specific exercises youcan do.
So strengthening your legs, whydo you want to do that?
If you look at the nerve, solet's go into anatomy.
Your sciatic nerve isinnervated, and it's a
combination of.
Nerves that come from the spine.
So I talked to you about,there's different levels like L
one, L two, L three.
(23:32):
In between those levels aredisc, and right around the disc
is where we call ourintervertebral canal.
That is where the nerve exitsout of the spine from the spinal
canal, and those nerves willserve specific.
Things, certain nerves arestrictly sensory.
That means that when you touchthat area of skin that is
associated with that nerve willtell your, that nerve will send
(23:56):
afferent signals back to thespinal cord and therefore it'll
go about up to the brain.
The brain will perceive thatsomething is touching that part
of my leg.
They'll send back signals backdown to that leg.
So that's afferent, right?
That's afferent nerves wherethat nerve is strictly sensory
and there are certain nervesthat are.
Sensory but also motor.
And there are all cer.
(24:16):
There's also certain nerves thatare strictly motor, and what I
mean by motor is that the braintells the spinal, will send
signals down the spinal cord outof that specific intervertebral
canal at that specific level,and that nerve will send signals
down to specific aspects of yourleg and it'll tell that part of
your leg to move.
Okay.
So sciatic nerve is acombination of afferent as well
(24:38):
as ENT nerve endings, right?
It's basically, it's motor andsensory.
So you have nerves that comefrom L four all the way down to
S3, right?
So L four, L five, S one, S two,S3, all those little nerves
converge into the satic nerve.
The satic nerve is the largestnerve in the body.
(24:58):
And so those nerves are mixtureof, like I said.
Motor and sensory.
So if somebody touches thebottom of our foot, that is
mainly your sciatic nerve.
If somebody touches your calve,that is mainly satic nerve.
If somebody touches yourhamstring the vast majority of
the hamstring is innervated bythe satic nerve.
However, there are dominance andthere's levels of nerves, right?
(25:20):
So think about King, queen,Bishop Rook pawn, right?
In the, in terms of, in terms ofchess, think about also like
royalty, like king and queen areup top and then they have all
the other parts of the kingdom,right?
So you have your alpha motorneurons.
Those are essentially yourlargest motor neurons.
Those are your largest neuronsby far.
So what research shows is thatwhen you're actively resisting
(25:46):
or loading that nerve and you'remaking those nerves do work,
meaning that you are activelymoving your leg.
Against resistance is thatessentially those alpha motor
neurons will have downregulationregulating signals to other
sensory neurons, and also see indelta fibers, which are
(26:06):
essentially nerve fibers thatdetect temperature, that detect
pin prick, that detect two pointdiscrimination.
And al also a combination of allthese is what kind of detects
pain essentially.
So what I'm trying to say isthat when you are contracting.
Muscles, especially muscles thatare innervated by the sciatic
nerve, that will essentiallyreduce the sensation, the
(26:29):
tightness of the nerve that isaccompanying, so essentially it
reduces your sciaticasignificantly.
So that's what I'm trying to sayis that when you're reliant on
medication or manual therapy, isthat those aren't even your best
strategies.
Your best strategies areactually loading the sciatic
nerve or loading the musclesaround the sciatic nerve.
That's what I'm trying to tellyou.
(26:50):
So things such as squats.
Squats, actually, I thinkamongst all exercises, squats, I
think when you do squat and whenyour hips bend and when your
knees bend.
So think about the S staticnerve running from your low back
down, your glute pass, your kneeinto past your ankle and
(27:10):
exiting.
Or I guess stopping at your footthere.
Nothing past your toes.
Is that when you squat?
Is the greatest excursion ofsciatic nerve movement, right?
So your sciatic nerve movesaround these joints that are
bending and that movement aroundthe nerve.
So think about getting a tensenerve to essentially stretch it
(27:32):
out.
So think about I.
I don't know.
Think about a Italian restaurantand they're rolling out dough,
right?
And as they roll it out more,they start to swing it around,
right?
Some of them, them making intopizza, but some of them making
into noodles, right?
So think about a, the more thatyou move.
That dough, right?
It starts off as like this fatbundle that's compressed, but
eventually starts to lengthen,right?
And, that Italian or Japaneserestaurants, any restaurants
(27:53):
that serve noodles, sorry, ifI'm making this analogy up, but
think about that nerveessentially getting looser,
right?
And it, it starts to relax more.
That is what squats can do foryou.
Same thing like lunges.
Lunges, just like a harderversion of a squat, just more
unilateral deadlifts as well.
There are many differentvariations of deadlifts.
That I've talked to a lot of myclients that have really like
(28:14):
even immediately reduced theirsymptoms.
It's just that, you can startoff with a one to five pound
deadlift and just get that sstatic and nerve moving.
Or you, if you can't dodeadlifts yet, then you can also
again do squats.
Squats, deadlifts even doingmachines, right?
Doing hamstring curls at thegym, right?
What, hamstring is probably thelargest muscle innervated by the
satic nerve.
(28:35):
So getting, doing hamstringcurls, some of the easiest
things that you can do for asciatica, just know that
certain.
Hamstring curl machines arebuilt differently.
Some of them you're sitting, soyou're sitting in a hip flex
position that does stretch thesciatic nerve more right from
the get go.
Prone hamstring curls, you'relying down on your back, or
(28:56):
sorry, you're lying down on yourbelly.
So if your body.
It doesn't appreciate being in aprone position in an extended
position.
You might want to go with aseated hamstring curl version.
Instead.
That might be somebody with morelike spinal stenosis where they
have an aversion to prolongstanding and walking.
But let's say if you're somebodythat, let's say your symptoms
are triggered by prolongedsitting.
(29:19):
And, but you feel better withstanding and walking.
You may actually appreciate theprone hamstring curl variation
instead because that you're in amore extended position.
And also there's a standinghamstring curl variation as
well, right?
So you could see that there's alot of devising and maneuvering
around which machines or whichexercises are best for that
(29:40):
specific person with sciatica,because like I said, we talked
about anatomical causes, mentaland emotional causes.
So there are different ways onhow to devise.
Perfect or as perfect of astrengthening routine for
sciatica, right?
So if you're interested in,learning more about, how you can
have coaching or have a programdevice for you, then definitely
(30:03):
look into the description.
We always send out like anapplication and a booking page
so you can book in for a freeconsultation with us and see how
we can help you with overcomingyour chronic static issues.
Okay.
Other forms are also like calvestrengthening, right?
Calves are some of sometimes theeasiest bang for buck exercise.
I always say a good amount ofpeople that do calve raises that
have sciatica.
(30:24):
Rare.
It's very rare that they wouldstart to complain of triggering
a pain with calf raises.
Okay, so if you do calf raises,calves are innervated by the
satic nerve as well, a branch ofthe satic nerve, right?
So like I said, the more youstimulate alpha motor neurons
the motor neuron specificbranches of the sciatic nerve,
that may actually eitheroverwhelm.
(30:47):
Damper or sometimes relax thesensory neurons associated with
the satic nerve.
Okay.
I really hope that's makingsense of things.
Okay.
Let's also talk about anotherlong-term strategy, core
strengthening.
Okay.
Till this day, I still feel likethere is some nuance on why core
strengthening would work.
(31:07):
Okay.
But I'll give you an example.
I had actually one client thathad chronic sciatic pain.
They also had pain into theirfoot.
So they had plantar fasciitisand also they had actually had a
little bit of foot drop, right?
They actually had some symptomswhere they were actually feeling
motor weakness.
Their leg, but they're alsohaving a significant amount of
sciatica.
(31:27):
So I had this person strictlyjust do some core strengthening.
So I had them resist load.
I actually had them do a plankand I actually put some weight
onto their back.
So it increased the resistanceand the demands on the
abdominals itself.
And then what I did was I, theywere, their abs were super
fatigued, and then what I hadthem do was I had them stand up.
(31:47):
I had them bend forward becausebending forward.
Was causing symptoms in theirsatic nerve.
It was triggering symptoms.
And then after the corestrengthening, they actually
touched their toes, right?
So they actually increased theirmobility and also their symptoms
of sciatica were drasticallyreduced.
By doing core strengthening,right?
(32:09):
And so my theory around this isthat what you're doing is you're
stimulating the central commandcenter, right?
So when you contract your coreand you brace, that does give
some spinal stability, right?
So think about contracting themuscles around the spine so it
stabilizes the spine.
The other thing that I thinkthat it does is that when you
are doing a lot of corestrengthening, you are
(32:30):
stimulating a lot of hipmuscles, ab muscles.
Like I said.
The theory around alpha motorneurons dominating the sensory
neurons that also had someregulation of reduction of
symptoms of sciatica.
The other thing that I thinkabout too was.
You're teaching the person andyou're telling the person that
it's okay to load the body,right?
(32:52):
So when sometimes people come inwith a lot of fear and aversions
and anxiety and they're like,oh, I don't wanna move because
I've flared up my sciaticabefore you get them to do
something an exercise that's notthreatening to them, right?
They're like, trust me.
Just do a plank or do an inclineplank.
And I can assure you that thiswill, that, that this will help.
So you're giving the personassurance that it will work.
(33:14):
You're also trying to devise theexercises that are not
threatening to the body.
So for example, if theycontinuously flare their
sciatica nerve with eitherrunning or lifting something off
the floor, I may not have themrun or lift something off the
floor.
During my session, right?
Because their brain is also, isalready detecting that is
(33:35):
threatening to my body.
But if you give them a plank,they're like, oh I didn't try
plank for mystica.
I'm not sure.
So they're like let me just tryit.
And when you can.
Tell the body when you can tellyour spine and everything and
you can tell your brain thatit's okay to load up the body,
is that what will happen isyou're sending good signals up
the spinal cord up to the brain,and then the brain is sending
(33:58):
signals and saying, whoa.
This is not flaring up mysciatica.
So therefore your brain issending signals back down the
spinal cord, out to theperipheral nerves stimulating
your satic nerve and saying wow,I can actually load up, my core.
I can load up my s sciatic nervewith this exercise and it's not
flaring me up.
So therefore, when you'resending, comfort signals and
(34:21):
sending signals to the body thatit's okay to strengthen, it's
okay to load.
That is what also has a factorwith sciatica.
Okay, so somewhat long-winded,but just to tell you that when
you're telling the commandcenter that it's okay to load
the body.
That is then therefore tellingthe command center that it's
okay, it was okay to do moreexercise.
Okay.
Hopefully that makes sense.
(34:41):
Okay.
Like I said, coordinate spinalcoordination stimulating of the
sciatic nerve.
Okay.
Contracting the core muscles.
Sometimes again, contractingcore muscles with something with
spinal stenosis, it can help tolike.
Change the positioning of thepelvis temporarily.
It can it can change thepositioning of the spine.
Like I said, there's a lot oftheory on why core strengthening
works, but it does.
(35:03):
Okay.
And there's different versions.
There's not just.
Just planks.
There's side planks, there'sSupermans, there's ex, there,
there's lumbar extensionloading, there's Roman
Hyperextensions.
There's prone glute squeezesthere, there's reverse hypers,
there's pelvic corestrengthening.
There's many different avenuesof core strengthening that you
can do.
Like I said, if you're confusedon which ones.
(35:25):
Are gonna be the right ones foryou.
Like I said, feel free to fillan application, book a call with
us, book a free consultation andsee how we may be help able to
help you.
Okay?
Other long-term strategies, Iwanna go into walking, but
specifically I.
Walking in more barefoot shoes.
Walking in more barefoot shoes.
Why is that?
You know when you look at someof the acupuncture theories
(35:46):
around there, where, you knowthey're putting their foot onto
like sharp kind of pricklyobjects, right?
I'm not sure you've heard ofthat, is that it's sim it is
stimulating different aspects ofthe foot and it's sending good
signals back up to the spinalcord.
And a lot of times when youmassage the foot, there's
reduction of symptoms.
There's reduction of symptoms,not just in the foot, but also
in the calve and anywhere thatsciatic nerve is contacting,
(36:09):
right?
Walking in barefoot shoes, whenyou do, or you walk more
barefoot, you are feeling morerocks on the ground.
You're feeling more twigs on theground, so you're giving more
proprioceptive stimuli to thefoot.
Therefore, when you'restimulating the foot more, you
are not just stimulating thesensations of the sciatic nerve.
(36:31):
So that in itself can reducepain, but also you are
strengthening the muscles of thefoot as well.
There are four layers of musclein the foot.
I always say that, the footmuscles have core strength as
well in itself.
So while you are training yourfoot.
To get stronger, to build moremuscle in the foot, just
strictly through walking in moreminimalistic shoes.
(36:55):
That actually has been shown toreduce symptoms at the knee, the
hip, as well as the lower back.
But when you're given, andsometimes this is the wrong
thing to do in my opinion, isthat when you're given orthotics
or sometimes shoes to correctfor and for pronation.
(37:15):
And so when you are given thosetypes of shoes, yes, I would
always say that.
Even just.
Your foot contacting the floordifferently with standing and
walking, that will reduce pain.
And it's just for the fact thatyou're not striking the floor in
the same way as barefoot.
So there is, I will always saythat with heel cups and all the
(37:39):
different like foot technologyout there, 90% of the time.
That will always reduce painacutely.
Whether you've had PLA plantarfasciitis, sometimes hamstring
tension or s tension, a lot oftimes it's gonna work.
So I would maybe put orthoticsor these types of like foot
control technologies intoshort-term strategies.
(38:01):
But however, a lot of peoplearen't told that they need to
wean off.
The orthotics or those footcontrol technologies long term.
So what I see is that whenthey're put into more
comfortable shoes, is that one,I do feel like the foot gets
weaker.
I do see that people with reallyhard orthotics, that they
actually have foot atrophy.
(38:22):
The muscles have actually gottenweaker.
You'd start to see like the bonycontours of the foot versus if I
were to take a picture of myfoot has nerves.
It has thick amount of musclearound the plantar fascia
because all I really wearnowadays is mostly minimalistic
shoes or barefoot.
Okay?
And so when you have footmuscles that are weak.
It's going to have, it's thefoot muscles that contact the
(38:45):
floor.
It, you're gonna have, you'regonna eventually feel that your
foot can't absorb the shock ofyou walking.
So therefore it's going to causemore knee pain.
It's gonna cause more hamstringtension or cab tension.
It's gonna cause more hiprelated issues.
And lastly, it can cause yoursciatica to stay in orthotics.
(39:05):
Okay, weaning down to shoes thatare more minimalistic in nature,
and also where you can regainstrength, intrinsic muscle, foot
strength.
You can start to feel the floorbetter with improved
proprioception.
I've always felt that was alwaysa good long-term strategy.
I've seen it so many times whereI've helped people to slowly
(39:27):
reduce the need for orthotics.
And what had happened was thisperson that has had 10, 20 years
of like consistently gettingmore foot control technology,
that what happened was theyended up needing a knee
replacement.
They had chronic sciaticabilaterally, and they also had
one hip replacement, that hiparthritis.
(39:50):
Tons of bad stuff as a result ofwearing.
Thicker shoes.
Shoes that compress your toes,shoes that don't allow you to
feel the floor more.
So when you are put into thoseshoes and you are not told by
your podiatrist or your physicaltherapist or your running
trainer that hey, it mayactually be a good strategy
(40:13):
acutely to wear these shoesshort term, but you may want to
slowly progress to a moreminimalistic shoe to strengthen
your foot more.
That is where I'll notice that alot of people do it wrong.
A lot of trainers and otherhealthcare practitioners do it
wrong, in my opinion.
And I do feel like most people,90% of people should benefit
from minimalistic wear.
(40:34):
The 10%, I'm not gonna go intoit now, there's people with
stress fractures, really chronicfailure of certain tendons at
their foot.
So if you are in that smallcategory where you do need more
supportive shoes.
I would say, therefore, you, youmay not be a candidate for
minimalistic wear, but chronicsciatica, though I would
(40:54):
definitely say.
Definitely benefit from moreminimalistic wear as well.
Okay.
I'll go into this really quick.
I'll, I guess I'll encompas thisinto two more things.
One I would say is nutrition andsleep.
Nutrition, eating adequateamounts of protein, right?
Especially if you're notrecovering properly.
Protein is broken down intoamino acids.
Amino acids are reuptaken.
By the body in the form ofinsulin.
(41:16):
Insulin is the thing that bringsamino acids into the damaged
tissues.
However, when your body is notprioritizing protein and you're
like, let's say increasing,let's say you're eating the
typical American diet, a lot ofcarbs, a lot of sugar,
carbohydrates in itself mostlyhas some sort of insulin spike
insulin.
It can create insulinresistance.
(41:37):
Chronic insulin resistance canlead to.
Interstitial vascularinflammation.
So anything that receives bloodflow, which is essentially
everything in our body, anythingcan be broken down, right?
So for example, if you haveinsulin resistance, some people
develop retinopathy and they cango blind because there's less
blood flow to the optical arteryand nerve, right?
(41:58):
Same thing with sciatica, right?
Are when you have.
Insulin resistance and we havevascular inflammation.
Vascular inflammation willappear differently for certain
people and it eventually canaffect the body systemically.
It is affecting the bodysystemically.
But for you for some people, ifyou have chronic sciatica, you
may look into you your amount ofsugar intake, the amount of
(42:20):
carbohydrate intake, how oftenyou're spiking insulin,
increasing your protein intakewhile also increasing your fat
intake.
So in the form of good, let'ssay monounsaturated fats.
That is oftentimes a way toreduce overall systemic
inflammation.
If you didn't know this, is thatthere are three macronutrients,
protein, carbs, and fats, right?
So protein, amino acids, as wellas carbs.
(42:42):
Carbs broken down into glucose.
Those are actually the twothings that secrete the most
amount of insulin, right?
Carbs, the most amount ofinsulin.
Excessive protein also willsecrete insulin because it has
to reuptake amino acids into theworking tissues.
But if you, but fat is actuallythe one macronutrient that
actually secretes the leastamount of insulin.
(43:04):
So if you eat greater, healthieramounts of fat, you are going to
become more insulin sensitive.
You're going to create lesssystemic inflammation overall.
And that, again, is a more longterm, more internal strategy.
That will help you with yoursciatica long term.
So I would consider likestrength training and core
strengthening that's more,putting external load onto your
(43:25):
body.
I would say that's less internaloverall, the food that you
ingest and absorb, that can go along way as well.
Sleep.
Sleep is very neglected,especially in our American
society.
We're all succumbed to asmartphone.
I'll definitely admit that,sleep amongst the many things
that I do well in my own life.
Sleep is something that I canalways improve, but getting a
legit seven to nine hours ofsleep can help to reduce overall
(43:49):
stress.
The more you sleep, the morecortisol is dampered and
downregulated.
When you wake up, there is anincrease in cortisol in order to
increase your blood pressure, toget you to stand upright.
And then your cortisol slowlytapers down after, six to 120
minutes of being awake.
But for some, with increasedstress in their life, or
sometimes with a lot ofsciatica, a lot of pain cortisol
(44:11):
can stay elevated, right?
So the more you sleep, the moreyou can regulate cortisol.
Okay.
And also you think more clearlyyou have more energy, so you
have more motivation to workout, right?
So obviously I.
There's many books on sleep.
I'm not a sleep expert initself, but sleep has overall an
amazing amount of positivesystemic benefits physiological
(44:34):
benefits as well, right?
So getting enough sleep, reallycritical.
Lastly, just positive outlook,right?
Because many people with chronicsciatica, whether you've injured
yourself a lot.
Whether you've gotten a lot ofMRIs, whether you've been stuck
in a broken medical system andnobody's really helping you, you
feel the medical system's letyou down.
There's just so many differentthings that can cause a negative
outlook.
But creating a more positiveoutlook, maybe listening more to
(44:57):
my podcast gives you a morepositive outlook, whether you
start to employ strengthtraining as a means of a good
long-term intervention, right?
So starting to replace a lot ofyour negative coping strategies
starting to also.
Try not to let current, or evenpast circumstances or past
negative events determine whatyou can do today with your s
(45:19):
static symptoms, right?
So having that positive outlookand focusing and grounding
yourself in today will reallymake meaningful differences
today and then long term, right?
You might not notice, wow, mysatic pain is gone in one day
with this positive outlook,because you're gonna have these
wavering of your brain.
Start to perceive, oh, I'llnever get better, or you start
(45:40):
to feel helpless, but creatingmore of a positive outlook and
employing a lot more of thesegood short-term strategies I
told you about, as well as theselong-term strategies I told you
about.
Again, making meaningfuldifferences long-term.
You can't think about just whatyou can do today.
You have to think about howtoday capitalizes onto the next
(46:00):
day and onto the next week, thenext month, the next year, and
how your body can become moreresilient.
To sciatica overall is that youhave to look at the long-term
outlook.
I have to stay on a strengthtraining plan.
I have to consistently work onmy sleep quality.
I have to consistently work onmy nutrition.
Because sometimes you mightfalter back into, I.
(46:20):
Eating a ton of crap, forexample, or eating a lot of
vegetable oil, eating a lot ofpro-inflammatory substances, and
maybe your sica symptoms comeback because of mixture of diet,
stress, sleep, lack of training,lack of resistance training,
lack of walking.
Okay.
But, putting those four thingstogether, while it does sound
simple, just me talking aboutit.
That it's not built into ourDNA.
(46:42):
It's not built in as a habit.
So you have to think about thelong-term game, that positive
outlook, and starting your daywith gratitude, starting your
day with positive affirmations.
Maybe you need to calm thenervous system down by
meditating, right?
I.
So many different strategies.
I'm not saying that one personhas to lock onto everything that
I say is that you will find yourown kind of sciatica roadmap, if
(47:04):
you will, but taking some of thethings that I say or taking all
of it, I, I know and I canguarantee that, you can say for
yourself that if I employ a moreholistic strategy, so sciatica,
I can overcome this overall, notjust short term, but also long
term.
And that's what I got for youguys today.
If you found this helpful, evenremotely helpful at all, click
(47:25):
that share button.
Share it with a friend.
Share it with a friend that notjust has Attica, but also is
contemplating, like preventionstrategies.
This can be super helpful tothem.
If you're listening to this onFacebook or podcast or wherever,
YouTube I encourage you to one,click the like button click
follow and subscribe.
If you can also leave a commentor leave a five star review,
(47:45):
especially if you found thissuper helpful, I am doing my
best to.
Create more impact in the world.
But you also engaging with thisepisode as well, that pays huge
dividends that allows otherpeople that are searching for
sciatica or searching for painto be able to find this episode
a lot easier.
I.
So you helping yourself,hopefully you can help others as
(48:06):
well and help me in that processtoo.
If you have any feedback fromme, definitely email me,
jason@flexwithdoctorjay.com.
And if you're interested at allin speaking with me or my team,
definitely look at thedescription section.
You'll always see there's asection to.
To fill out an application, feelfree.
And the application will bebackground information so that
we can make the most out of ourfree consultation.
(48:28):
So if you're interested in thatas well we're always looking to
help more people.
So that's what I got for youguys today and I appreciate you
guys.
Have a beautiful rest your day.
Stay active and I'll leave youalways with my quote as well, is
that we only have one body, onelife.
Make every action you take, beone that makes you a better
version of you.
Take care and have a beautifulrest of your day.
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