Hi, I'm Dr. Molly with Your Goals Physical Therapy. If sciatica is taking the joy out of your weekend cycling, this is the video for you. So I met Aaron about, I don't know, six to eight months ago, something to that effect. He had been suffering from sciatic pain for months. He had pain If he sat for too long, he was getting residual pain, even if he took too long of a walk. It was going from his butt all the way down his leg at some points and so he had been dealing with that for a long time. He was like, it was relatively minor and I could get into positions and it just went away. It was fine and it didn't interrupt me going for bike rides on the weekend. Which was his main thing. That's his main source of entertainment and how he hung out with friends, see Aaron would get on his bike and ride 30 or so miles.
Their goal would be to hit some bar that had a patio so they could hang out, drink, have lunch, and then they would ride back. That was basically their entire Saturday, him and his friends. And so that was something that he habitually did and he really, really enjoyed it. So his back pain bothering him at work, didn't really affect his bike riding. He sort of ignored it and put it on the back burner assumed it would get better eventually and just was ignoring it.
It wasn't until the pain that was going down his legs started affecting lots of things on the bike. He didn't feel like he had enough pull, right? He wasn't able to use the back of his leg effectively. He was having trouble controlling where his foot was and how his knee was moving while he was peddling. And he felt like it was becoming a little bit dangerous and it would progressively get worse to the point where the burning sensation was more than he could ignore anymore about halfway through his runs. That pain just got so unbearable that he eventually just gave up bike riding, but he thought that he just have to rest for a little bit. And so he rested for a week or two, tried to get back on his bike and that ride ended badly.
He calls his primary care, gets in to see his primary care. They order x-rays imaging and send him to the orthopedic doctor. Thankfully, I mean, he wasn't too thrilled, but thankfully there wasn't really anything huge on his MRI that indicated an immediate surgery or really anything. The doctor offered him a cortisone shot, but was not optimistic. Apparently he was like, I can give this to you, but it may or may not make any difference in what you're dealing with. He didn't opt to take the cortisone shot because that wasn't much of a sales pitch.
He did take the exercises and the stretches that the doctor suggested. He went home and he religiously did them and much to his dismay, he was very upset by this, the stretches made it worse. That's right! He did all the stretches, as far as he knew hundred percent correct, he followed exactly what was on the piece of paper, but his pain level wen up. He calls the ortho. The ortho says, "Well, I mean, maybe go try therapy. So he's calling people down the list and we end up chatting." He comes in and we look at how he's moving and really what's going on with the sciatica.
What Is Sciatic?
Sciatica is the pinching of one of the big nerves that comes out of your spine, the nerve deals with all the muscle strength and all the skin sensitivity, like the fact that you can feel your skin, that nerve controls all of that. So all the muscles in your leg, all the sensation. So when it gets pinched, depending on how hard it's being pinched or how it's being annoyed, you lose either sensation or function and you get this really strong burning sensation and that pain can fluctuate. For most people it fluctuates. Sometimes it stays in their butt, then they'd move a certain way and it shoots all the way down to your heel, then it's very shocking. It grabs your attention, for most people it's very hard to ignore, because it's pretty much there all the time. And if you move a certain way and it doesn't like it, that discomfort lasts a long time. When you aggravate a nerve, it's not the same thing. Like if somebody accidentally hits your arm too hard, that discomfort goes away relatively quickly. Your muscles just sort of are very forgiving in that sense. You pinch a nerve, even if it's only for half a second, you'll have discomfort for at least five minutes. It's unbelievable what the difference is. Nerves do not like compression.
So that was what Aaron was dealing with. He was dealing with this nerve and was just constantly irritated. He didn't really see a rhyme or reason as to what was annoying it, but now it was annoying him because he couldn't bike ride. That meant he couldn't hang out with his friends. That meant he didn't get to clear his mind. It meant that he didn't have a reason to go have a beer at a bar, right? There were all these things that made life enjoyable to Aaron, now being taken away all because of this nerve pain.
When we evaluated and kind of saw what, where things were, I went over how to do the stretches so that they didn't annoy him, which actually a lot of times with sciatica, you don't even want to stretch. We went over the things that we would want to do and why, to really explain the anatomy and what was going on specifically with him. Because everybody's sciatica can be caused by different things. It can be caused from a tight hip muscle, but it can also be caused from a spinal compression, something happening in your spine. So it just sort of depends on what's happening with you and your particular situation. Some of that can have something to do with your job, how much you sit, how much you walk, what you lift, all these other variables that can be in play, how long you drive. Just so many things can play into what's gonna help you specifically with your sciatic pain.
We talked about position changes. We talked again about how you'd stretch, what things we strengthen. We came up with a very global plan specifically for Aaron, with his goal of getting back to biking, riding 20 miles to a bar, 20 miles back from a bar. And I am very happy to say, and I'm sure Aaron is also, that he is fully back to that.
I believe I mentioned that I met him many months ago. That does not mean that he had to see me consistently through there. There are milestones that people hit with rehab and getting better. Instead of taking a traditional approach with people where you have to do all these visits right here and right and you're gonna get better in just six visits and life is gonna be amazing. I tend to take a more holistic approach.
I look at specifically what you're trying to do, and we together get you a good program. Then if we need to, we do follow ups and those follow ups can look at an infinite number of ways, right? So once you get rid of your pain and we're really on a good, strong strengthening program, that takes time. We’ll adjust how frequently we see people based on what their specific needs are and how much accountability that they need, because that is a varied amount for everybody. Some people don't need anybody to work out with them and they will religiously do things every day.
But some of us need a little bit more motivation. We need somebody that's gonna be there and say, you know what? You really do have 10 extra in you, you can do this! And so I treat each client as they are an individual person with individual lifestyle choices and individual needs. And everybody's body's slightly different in how they're gonna react to things. So I find that one size fits all programs work for very few people because it's taking a big global look at what it would look like for a lot of people and trying to make sure the masses are happy. And that, especially for what I do and the specialized treatment that I give people, that does not work. So again, I take a very specialized and individualized plan for each person based on what their goals are. So here, Aaron is back to riding his 20 miles enjoying his day with his friends and then riding back. He's very excited.
So if this is the type of care that you're looking for, then I have two options for you today that I will offer you. One is a discovery visit. That is a 20 minute session where you and I, for free, sit down, talk, get to know each other and see if I'm the right fit to help you get to your specific goals. In some instances there's a movement assessment but that's some. We have 20 minutes to figure out if I'm gonna be able to help you. Now that's one option. So the other option is something called a full body diagnostic. And that is again, 20 minutes. I charge $20 for that, but it is an actual movement assessment. I will not call it an evaluation, because evaluations have a lot more hands on and some manual things that can go with that. An evaluation would also have treatment with it.
So this is just, let's see if there is a mechanical thing. If there's something that we can see that would warrant further looking into to help you get back to what it is that your goals are. It also helps you screen out whether or not therapy is appropriate for you, without having to commit to a full evaluation. Because if we're not appropriate, we're not appropriate. So I would help you find the most appropriate person for you with either one of those choices that you pick. Because I don't wanna just send you into the Meyer That happens to be the medical world at this point, to figure it out on your own. I would definitely help you figure out the next best step for you.
So I hope that this information is very helpful and I hope that you are not being impaired by sciatica and you can enjoy your bike ride this weekend, have a good one.
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WE HELP ACTIVE ADULTS OVERCOME THEIR ACHES AND PAINS TO GET THEM BACK TO THEIR FAVORITE ACTIVITIES WITHOUT MEDICATION, INJECTIONS OR SURGERIES.
Dr. Molly McDonald