Piriformis Syndrome

The symptoms of this condition are pain in the buttock area, numbness /tingling down the leg and the foot.

It has been commonly said that about 6% of sciatica problems are caused by the piriformis.

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Scheuremann’s Disease and Hunter Pence

Image result for Hunter Pence baseball picture

Hunter Pence has Scheuremann’s disease. If you look at the picture that is his first picture as an Astro’s player above, he is almost side arming his throw.  (That picture is from the hardball times).  His condition causes stiffness of the mid and upper back and kyphosis. The condition cannot be corrected if the patient tries to use their own muscles.  The back of the spine grows faster than the front and thus the bones grow like a wedge.  This is why he throws so strangely.

Image result for image Scheuermann's disease

He short arms his throws. It is amazing that he is able to throw with such strength, velocity, and accuracy with a short arm throw.  If the spine does not bend as it should it makes throwing significantly more difficult.

In order to throw well from the outfield one must have good throwing mechanics most of the time.  That includes full thoracic extension and he does not have that. His thoracic extension is likely limited by about 20 degrees of normal.  Also his scapula (shoulder blade) and humerus must move in unison well.  His shoulder blade on his ribs is likely stiff as well. The muscles called the middle trapezius , lower trapezius, serratus anterior must help the shoulder blade to rotate upwardly to have excellent throwing motion.  His therapist/trainers in the past asked him to do physical therapy and strengthening exercises on his shoulder and it just hurt too much so they said back off and he has managed just fine.


Image result for image of scapula upward rotators

The muscles above help the scapula rotate well to help in the throwing mechanics of an outfielder.

The lattisumus dorsi helps you pull your shoulder back , the deltoids help you reach your arm up in part, and the triceps help to fling the ball, the biceps help to decelerate the arm.  These are just very basic observations.

Watch next time when he throws. It is amazing that somehow he has overcome a major physical impairment to throw at a professional level.



Chronic Neck pain exercises


Chronic Neck pain exercises

The above picture is from the website : dev.biologists.org

When one does strengthening exercises, satellite cells that are dormant become activated.  They divide and fuse to muscle fibers. Then the muscle grows.  It usually takes 6 weeks-8 weeks of fairly aggressive strengthening 3 to 5 x a week for growth of the muscle to occur. See the picture above to see satellite cells that are dormant (left side of picture above) and activated (right side above).   Don’t pay attention to all of the difficult terms below the pictures. The composition of the muscles changes and cells fill in and around the injured area. It is like an extra support and shield for the muscles.

From my experience I believe the 2 exercises that seem to help chronic neck pain the most are below:

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Chronic pain mid back/upper back exercise

Chronic Mid back/upper back pain treatment

The above picture is from the website: www.sydneyessentialhealth.com.au

It is important to understand what is going on with the muscles when strengthening takes place. That way you can know in your mind – “my muscles are changing – I am creating a shield of protection and support for my injured area.” I want you to see what is literally happening with some pictures. This way the connection from the brain to the nerves to the muscles can be re-wired more effectively.  This can help in essence scrub out the memory of pain etched into the nerves.  This may take 8 weeks of 3 x-5x a week of resistance training.



Image result for Myofibril before and after strength training microscopic image

The above picture is from slideshare.net. It shows muscle fibers before and after strength training. The fibers on the right show an increase in size of the muscle fibers.  With strength training the size of the muscle cells increase as satellite cells are activated and fused with the muscle fibers.


Image result for image of microscopic before and after muscles hypertrophy


Chronic Pain Rehab concepts/back pain

When I was about 26 years old I worked 2 summers as a roofer. I was lifting way too much weight up and down a ladder. I then went to Physical therapy graduate school for 2 and 1/2 years.  I was sitting about 12 hours a day in class or studying on my own. My back started to hurt significantly with sitting and bending forward.  I considered surgery, injections, physical therapy, and a whole array of treatments.  I ended up doing physical therapy 2 x a week, taking anti-inflammatories, ultrasound, massage, joint mobilization, lumbar traction, electrical stimulation, heat,  and ice.  The Doctor I saw performed an X-ray of my back and said it was a muscle strain. Nothing was helping the pain. My back hurt profoundly with trying to surf while I was sitting trying to catch waves, with sitting in Church, bending over to pick something up, and standing for a prolonged period.

The picture above is from the website: www.sportandspinalphysio.com.au

The pain was becoming unbearable.  One time I lifted a patient from their bed during a clinical and my back just gave out.There was a sharp pain in my left low back area.  My back was killing me. I consulted with Doctors, physical therapists, and nurse practicioners.  I could not get a clear diagnosis and I could not get any relief from my back pain. Also I was starting to get symptoms of numbness down my left lateral leg. In hindsight, it is pretty easy to see the diagnosis was a herniated disc at L4/5 in the lumbar /low back region.

My condition became chronic and it lasted for about 3 years.  Over the years I have had some similar patients where they saw a lot of different health care professionals and their pain just was not getting better. With some (not all) of these patients and with myself I found some secrets of sorts to overcome or reduce the pain. Here they are:

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