Hi Connie, I have a question regarding a client I am working with right now. It is sciatica and I have been doing gentle piriformis stretch, side stepping, glute squeeze, squats, standing back press, pelvic curl, thigh side bends. Also I am doing this in a hot tub, I mentioned there should be permission given for him in the hot tub as he has had a heart bypass. The doctor did give permission for approximately 30 min., and also a Massage Therapist gave a 30 min. time permission. I have kept a record of what I am doing. He has said he is feeling better, I have been working with him since July 22. I think between myself and the massage therapist he is feeling better. He is a short man and I have researched the sciatica and shortness and according to the research a person who is short they are susceptiple to sciatica problems. Can you verify this and if so should his doctor be informing him? I feel that there is very little more I can do. On Thursday he cancelled as he has a rash. When he is ready give me a call to resume or stop treatment. Have I been going in the right direction. Any suggestions would be greatly accepted. Hope your summer is going well. Cheers, Dawn
Hi Dawn,
Since I have spoken to you by phone and checked a few more things about this patient, here are some key points from our discussion:
- Find out his pain relief positions / strategies - either those he has learned from his physio, MD, or other health care professional
- Help him find his best pain relief position in the pool: seated? knees to chest? back in extension?
- My guess, if he has a stenosis and sciatica, he may find relief with posterior pelvic tilt, seated, and knees-to-chest positions. You were doing some of these with him, and he was responding positively.
- He now has a skin rash. You have explained that he loved the pool jets and wanted to spend lots of time in front of one. This can lead to skin irritation & rashes, since the force of the jet drives the pool chemicals into the skin. Once the rash has cleared, and he is back in the pool, please advise him to limit his time in front of the jets.
- Instead of jets, get him to do 'play-freeze-pressure-move' with pressure on the spot that is irritating (rather than putting it in front of a jet). You can show him how to apply the pressure. He may be able to reach the spot and perform this on himself.
- If posterior pelvic tilt decreases pain, assist him with kinesthetic learning re: how to do a posterior pelvic tilt -
- Use the analogy of a dog hiding its tail between its legs
- Show him with your body - including holding his hands on your abdomen and sacrum so he can feel your pelvis tilt
- If appropriate - place your hands on his abdomen & sacrum to feel / assist him to perform the movement
- Have him stand with his back against a wall, knees bent, and either his hand or yours in the lumbar spine - he tilts and puts pressure on the hand by flattening the lumbar curve.
Finally, my BackSplash DVD has many more ideas regarding strengthening the core for people with back pain. You can order it by contacting me, or looking for products to purchase at: www.FortheLoveofFit.com
Good luck, and let me know how i
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