Sciatica Hacks: Instant And Lasting Relief Strategies || WBWL Ep 106

This episode is all about helping you discover lasting relief strategies for sciatica pain.

It’s broken down into 4 parts:

1. 1. What are the causes of sciatica, in detail
2. 2. What are interventions and treatments that don’t work long term?
3. 3. What are my top 3 interventions to relief sciatica immediately?
4. 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.

If you need tailored solutions, head here to apply and book a call: https://go.flexwithdoctorjay.com/apply

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Transcript

0:03

Welcome guys to another episode of the Won Body Won Life. I am your host, Dr. Jason Won, lifestyle physical Therapist. Today I wanna talk about SCIA Hacks. I wanna talk about instant as well as lasting solutions for sciatica because I think a lot of healthcare is predicated on a lot of short-term solutions. Those short-term solutions are oftentimes putting up. Bandaid on things. It manually fixes things or massages the pain out, but it doesn't actually give you lasting relief. So I'm gonna share with you a couple things. First, I'll talk about most common causes of sciatica, so you get a very well-rounded background of what might be causing your sciatica issues. I also wanna talk about what, in my opinion, doesn't work long term for sciatica, and I wanna talk about my specific short term relief strategies that I have. Done for myself, but also a lot of my clients in order to see quick wins within the first two weeks. So definitely stick around to that part of this episode. And lastly, looking at some long-term solutions. Those long-term solutions are often a combination of some form of lifestyle modification and changes. So if you are looking for. Long-term changes to your sciatica. Maybe you've had sciatica for longer than three to six months or even years. You have to realize that there are really no shortcut or band-aid solutions to getting rid of it. It is a very common condition that often requires modifications to your lifestyle, as what I would always say is that modifica lifestyle changes negative ones have often led to sciatica. All right, so let's talk about the most common. Causes for sciatica, and I would start this off with a grain of salt because when I do talk about these things, I don't want this to cause more fear mongering or any anxiety related. So as I open up the many different ways in which sciatica can start, I don't want you to pigeonhole yourself into thinking, oh, that's me, because a sciatica. Especially chronic is a manifestation of everything that we are from our culture, our values, our beliefs, some of the negative experiences that we've had, some of the things that doctors have said, some of the things that our parents have often used for their own relief. So a lot of this is mimicry. A lot of this is listening to authority. So while I am, I could, I would consider a authoritative figure. When it comes to health and helping a lot of people with sciatica, I don't want you to therefore cause more uncertainty, fear, or anxiety when I'm talking about this. Okay? So that is my disclaimer there. So the very first and oftentimes causes could be also a herniated disc. Now this is more an acute situations. Sometimes if you just injured yourself sometimes if you picked up something wrong and then you felt like a small pop in your back, oftentimes you may. Irritate a disc, and so when disc get irritated, there are nerves that come out of the spine, and so those nerves can oftentimes either one just get irritated in itself, like you overstress the sciatic nerve that are accompanying with the muscles that go down your leg, or sometimes you do actually injure a disc, and then that disc is temporarily, then I will say temporarily contacting a nerve. So that is a common cause. However many disc herniations are self resolving. As in, if you just have a positive mindset and you just wait over time, most sciatica as well as low back pain does go away. Or the other things that you can do are, modifying your posture as well. And a lot of herniated disc, believe it or not. Many people over the age of 30 actually have a herniated disc, but have no pain whatsoever. So they screen, over, a few thousand people in the study. And I can quote it somewhere else, but the study showed they, they did a bunch of they did a bunch of MRIs on a ton of asymptomatic individuals, meaning that they had no symptoms whatsoever, and what they showed was that, as you are at the age of 30, you may show some degenerative changes. You may show that you even have some disc bulges or some herniations and each and every decade, so like from 40, 50, 60, the spine only changes, right? If anything, the MRI starts to quote unquote look worse. So you start to see a lot more degenerative changes. However, if you look at, again, the study was done on asymptomatic people. So what I always say to my clients in order to ensure that they don't, perseverate or worry about, whether their sciatica is coming from the specific degenerative changes is just perceived that you know that these are normal age related changes and no matter what you do. Your spine is gonna change. It doesn't matter if you've lived a perfect lifestyle or a bad lifestyle. It's just for the fact that as you get older, it's almost a privilege to get older. And also when it comes to. Know, the things that you see on your MRI is that it doesn't matter what's shown on the MR MRI as long as you feel good. So if you feel good, your function's good, you can overlook your MR mri and really that's not much of an issue. As I go through more of the other common causes, just wanna let you know that, with a grain of salt, that these issues can appear on your MRI, but it shouldn't determine your mindset or cause any fear. Okay? So other causes, as you get older over the age of 60 and seventies spinal stenosis. Becomes more common. That is when the holes that come out of the spine, which are called the intervertebral canals, that is where the nerves come out of. And oftentimes those areas can, I guess you could say the tunnel is getting a little bit smaller. So there could be certain positions like excessive extension or excessive standing for long period of time, that can often cause sciatica for more older individuals. Okay. Or for example, they often get relief with sitting. So if you get relief with sitting, then potentially you may, have some common causes of spinal stenosis. Or a lot of times with herniated disc, it's a tossup, but sometimes, if you sit for an extended period of time, you can start to feel symptoms either down your leg into your glute. But sometimes, walking also either makes you feel better and sometimes, or sometimes makes you feel worse. So that's why, hiring a good physical therapist or coach that understands. What to do with sciatica is to determine what are the next steps, what are the certain positions, exercises that will be con most conducive to you relieving your sciatica pain, right? Other things are spondylolisthesis. That is when one spine essentially like moves forward, like one vertebral. One full vertebral plate or like for example, like L one will ride forward over L two. So the positioning is forward, right? It's not just one stacked building up top. You start to see that some of the vertebral end plates are pushing forward, so that oftentimes can be a cause of sciatica. Oftentimes if you do have spondylolisthesis is oftentimes anterior means it's pushing forward. Excessive sprinting, like some people get pain with sprinting or running because it's, you're in a more extended position. And then sometimes when you contract your front abdominals and you go into posterior pelvic til, or you do some core strengthening, which we'll go into later, then that oftentimes can be relieving. Okay. Just to speed this up so we can go into some of the good stuff, like the instant and long-term strategies. But trauma injuries clear enough that can cause true inflammation in the body. That can be temporary Pregnancy. Pregnancy will secrete oxytocin. That will make some of your ligaments more laxed in your spine. And then oftentimes can render sciatica like symptoms. Tumors are infections, so you know, it does sometimes. Tumors or infections, they happen insidiously, there's no common cause. Sometimes it's a product of your diet as well, in which, a tumor can actually push up directly on a nerve. And also scar tissue formation. So if you, whether you've gotten surgery in the past and oftentimes like excessive sitting and also lifestyle factors are all common causes. So partly anatomical, meaning that, like we talked about, what anatomical things can actually cause Attica, but also some of the, the mental factors as well. So let's talk. What doesn't work and I will say this with a grain of salt as well. Because everything is somewhat arbitrary sometimes It depends, right? They, it is a very common thing in physical therapy that, we don't always con give like a very just straightforward answer.'cause sometimes we don't oftentimes act in absolutes. We may be absolute in certain things 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 to things that don't work is, oftentimes what I'll say is that what doesn't work long term. Okay, so here's the first one, and this is gonna push even some physical therapists in the wrong direction or rub them in the wrong way, is prolonged stretches. I often think that, for example, lying down on the floor and then putting your legs straight up in the air and putting your heel on the door. Dors cell is not a long-term solution. Stretching the nerve and expecting it to feel better in any way, long-term is not gonna be a long-term solution. It may feel good in the moment. You may feel like the calve or the hamstring, or you may feel a stretch in your glute or your lower back, but what is that really gonna do for you in life, right? You're gonna go through life walking. Your job demands of sitting for a long period of time. Maybe you do a lot of chores, maybe you pick up kids, maybe you do sports. How do you really feel that a long-term stretch like that is going to do anything? It's not right. It's not gonna protect you from getting hurt again. Okay? It's just gonna give you some temporary 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 stretching tissue, right? Imagine if the sciatic nerve was very tense, or also if it was like, let's say the nerve, if you don't know, piriformis syndrome is that the nerve does go underneath or sometimes over a muscle in our gluteal or a butt cheek, which is called the the piriformis, and oftentimes piriformis. Is demonized, right? It's oh, that's the common, that's the most common muscle that hurts our body. I always say that every muscle serves a role, right? So the piriformis essentially is just an external or an internal rotator, depending on the degrees of hip flexion or hip extension, right? So usually when. You go into hip flexion, which is like the knee going towards the belly button, it becomes an in, it becomes an internal rotator. It internally rotates our hip and from a straight position. So when I like to straight me standing while filming this episode, it is more of a internal rotators, right? So I. Alright. I'm sorry. An external rotator. So if you're looking at the science of things is that it is really just, a common glute teal muscle. For example, the glute max is never demonized, right? Maybe like we wanna strengthen it, but in the same way, the piriformis is a muscle that serves a specific role of stabilizing the hip. It also contributes to external or internal rotator. So it's a secondary, external, internal rotator. So in no way should we be demonizing this muscle or just stretching this muscle into oblivion, right? Because if you stretch the muscle, think about you causing more compression, right? Which therefore it's contacting the nerve more when you're being in those prolonged figure four stretch positions. Okay? Like I said, while it does feel good in the moment, if your brain perceives that it's, it does it, it feel, it feels good, it's beneficial. Go ahead and do it. Just understand that prolonged static stretches anywhere of 30 to 90 seconds. Those are usually not gonna be long-term solutions, right? Because we walk and we move. So if our, a lot of our pains are somewhat more movement based or we have active goals, we really don't wanna be relying on prolonged stretches. Okay? Medication. Medication is clearly something that's. 90% of it is synthetic. Yeah, maybe there's herbs and medicines out there, but it is relatively passive, right? So passive modalities such as taking oral medication isn't going to change the state of the tissues, right? It's really not gonna make the tissue stronger. It's not gonna make it more pliable or more mobile in any way. If you look at a lot of chronic sciatica is that sciatica is often a manifestation of like mind, sometimes body. It's oftentimes manifestation of our sitting position, our mental stressors as well. So when you're taking, for example, ibuprofen for medic as a medication or flexural, there's really no inflammatory symptom going on. There's no inflammation present. So you taking an anti-inflammatory. For something that's not inflammatory in nature, it's not really gonna do much. Same thing with gabapentin. Gabapentin, while it does have some merit and short-term effects on nerve related symptoms as far as curbing nerves, is that while curbing symptoms, the side effects are oftentimes a lot more prominence and therefore I'll tell you what they are. A lot of times it's stomach indigestion, it's reduction of energy, it's malice. Okay. It's drowsiness, it's fatigue. So if you think about it, is that people oftentimes don't wanna be on GABA in long term because it doesn't allow them to function at work. It oftentimes can change your posture, it can make you sleep at work. And also while it is making you drowsy and fatigued, you essentially, you lose parts of quality of life. You're trying to get more, I. Active, but the gabapentin is working against that, right? It's actually making you more drowsy. So you might think I know I need to workout more to maybe curb by a sciatica, the gabapentin is actually working against you. Okay? So it makes you less active. If that makes sense. So that's why I don't usually like to I, I usually don't promote gabapentin as a means of curbing symptoms because I prefer to just teach people how to fix it themselves rather than take a medication for it. Okay. What else doesn't work long term? I would say chiropractic care. I'm gonna throw that in there. While I know great chiropractors, I don't think that. A lot of them have a very good sense of how to screen the body effectively, and oftentimes when they fix things. Essentially it's the same thing, right? It's either a lumbar rotation, manipulation, sometimes it's traction, right? Sometimes they're pulling on the head what they call the ring dinger. So yeah, while it can temporarily like decompress things the effects are oftentimes very novel, meaning they're new to you, you haven't done it before, and if you have a strong belief that it may work, yes, it can reduce some symptoms. And also a lot of it is more. Pathophysiological, right? The sound, the sensations of your back, cracking something, feeling like a decompressed or it's stretched out. All those different sensations in the brain can oftentimes have downregulation to reduce pain temporarily, right? So your perception of pain is usually much better getting off a chiropractic table. But as again, is that it's oftentimes the same exact treatments over and over again. If, for example, if it's more of acute situation and the pain is not going past the gluteal cleft, like past your sitting bone, then there is some research to show that in acute situations it can be very effective short term to allow you to get more active. But if you have like long-term sciatica, you have pain bilateral that's going down past the knees or even if you have it more unilateral where pain is only going down one leg. I would say chiropractic care in this situation is usually not very effective. And oftentimes, like I said before on many podcast episodes, is that passive short-term solutions are a short-term fix at a long-term cost. So you have to go to the, you have to go to the. Their clinic. You have to pay the credit card, you have to drive in the car. When you drive home, sometimes your pain comes back because you're driving in the car to go back home. Okay? Instead of just strictly relying on passive modalities is to use, I. Passive means like a lot of the stuff that I just showed told you, medication, chiropractic care, even other forms of manual care like acupuncture and manual therapy and massage, you can use those. It's just to understand that you don't want to use those in isolation. You don't want to be reliant or addicted 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 of treatment immediately after, use it as a window of opportunity to get your body moving. So maybe you can tolerate more exercise now that your perception of pain is much less. So don't just go back home and then go back again to the same exact lifestyle, the same exact postures. If you don't modify anything in your life right then the pain is just going to be returning with a vengeance. Okay? So let me talk to you about now going into my next segment, right? We're gonna talk about short-term solutions, things that may actually work effectively and immediately. And I think that these are really good to use within the first two to six weeks of treatments. And I'm gonna talk about long-term strategies that I've given to hundreds of my clients, and pretty much 90 to a hundred percent of the time, it works long term. Okay? So short term strategies. Typically enough, the easiest one is just walking, and I'll go into details about long-term strategies for walking, but walking more is usually a pretty good long-term solution. If you're somebody that's of older age, like 60, 70 60, 70 plus, then maybe you wanna like still walk because it's still going to get some good blood flow and rotation to your spine. And to your legs. But you may want to, for example, reduce your stride length, when you lengthen your stride. That can be. Causative factor to make your sciatica symptoms worse, but how to reduce walking sorry. How to reduce the symptoms with walking is just understand the right amount. So just understand like measuring the amount of distance or the amount of time that you're walking as well as. Sometimes reducing your stride, sometimes changing your position, sometimes you know, even bracing for some per pulse, like bracing your abs while walking can be effective. And these are all just, I'm just throwing a lot of stuff out there that I've given to clients, but understand that I'm just wrapping up, the number of different common CAU causes for us sciatica, and it's not gonna be directly conducive to you you have to test it out the right distance, the right time. The right stride length as well. Sometimes even the right shoe wear, right? How to walk appropriately, right? So the walking for most people are still gonna be effective for Attica awareness of your positioning. So awareness of how long you're staying in one place. So whether that's even like prolonged standing, which I'm standing right now, but also if you do have pain with prolonged sitting is that you can do all the best solutions. You could do either the short term. Stuff or you can strength train, but also if you're not, if you're continuously flaring up your body or you're allowing the pain to come back with those positions that trigger your pain, then you're not really modifying your lifestyle in any way or form I, so you have to realize that being more aware, the word is awareness. The awareness of hours of sitting, right? So maybe you have to set a timer. In order to get your butt off of your desk and take a small break to walk around the room, maybe you go outside, maybe you get to the floor and you do some foam rolling, right? How, however it is that you want to make sure that you are changing your positions often, okay? And sometimes temporarily lumbar support can help. So if you sit with a chair that has like a backrest you may want to buy something from Amazon, for example. I can list it off in the comment section of the description. And having something to essentially support the natural curvatures of your back na namely lumbar lordosis where the back has a slight amount of extension. If you do have or you do get some lumbar support, that can help to reduce the amount of muscular load associated with neat of the demands of sitting. And that can also help reduce symptoms as well. Short term strategies, reduction of stress. Okay, and I guess I could put these, put this in short term and long term strategies, but reduction of stress. Why would you wanna reduce stress? Okay. So you know, a lot of anatomical things that you can do now. There's nerves, there's muscles, there's joints, and a bunch of stuff that we want to talk about in our long-term strategies, but reduction of stress. The reason why you wanna reduce your overall mental stress is because increased cortisol secretion, the common, the most common hormone for stress can increase muscular tension. It can also have a change in pain perception, which is oftentimes not talked about. Okay? We talk about posture and exercise, but even just you being in a stressful situation. Money, situations, fights with your wife or kids or partner, right? Job deadlines, right? You having the potential to lose your job. Politics, the environ, environmental stressors, global warming. Okay? I can go for days on the many things that can stress you out, but. You can actually develop hyperalgesia or even allodynia. So hyperalgesia is basically a heightened state of pain. So something that like, let's say a pin prick for me is ooh, there's a little pinch, a pin prick. For somebody that's hyperalgesic, they can have this enormous reaction to that pin prick. Okay? That is what we call hyperalgesia an increase hypersensitivity to pain. Okay. Or allodynia. Allodynia is basically I could be touching your skin and there's this enormously, almost abnormal response to somebody touching your skin, right? So those are oftentimes less common with sciatica. But I have seen that before where like the, even just temperature. Somebody just touching the leg. A lot of times that can make them scream and jump off the table. Okay. Very uncommon, but you still wanna be aware of it. Okay? Especially with increased stress, low motivation wanting to sleep more, not the little interest in doing anything, including working out right or getting more active. Okay? Stress can cause that, right? Stress. Essentially can you will have certain coping strategies, like whether you smoke, drink lie down watch Netflix, scroll, social media. These are all stress reduction, interventions that we do go to, we go to places of comfort, but oftentimes those places of comfort, those comfort strategies are oftentimes not conducive to reduc reducing your sciatica long term. Okay. Stress reduction. It there, there is some things to theorize that it does reduce overall blood flow to specific tissues and can actually deoxy, oxygenate certain blood flow to specific tissues. So if you need blood flow to your low back, you need blood flow to your piriformis and a lot of the muscles in your legs. Sometimes in states of heightened stress is that our body prioritizes blood flow to essential organs like our stomach, as well as our brain, as well as our heart, just to keep our body alive. So when de oxygenation of tissue, anything that you detonate. So imagine like you, me, like squeezing your wrist so that I'm basically temporarily. Causing less blood flow to the hand is that your hand will start to turn black and blue. It'll start to feel tingly, and oftentimes it'll start to feel, it'll start to hurt, right then. The same thing goes with stress as well. Okay, so you want to think about reducing your stress as much as possible, whether that's you meditating or positive affirmations, all that. So those are some short-term strategies I wanna talk about. All right. Last thing, I wanna talk about long-term strategies. What does that kind of look like for you? I. These are long-term strategies that I really feel have made the biggest difference for a lot of my 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 potent pain relief strategy. And this is one that oftentimes is very overlooked and is oftentimes harder to implement into your own life. If you do this, I promise you, you will see long-term results and the very first one is strengthening your legs. Okay? I'm gonna tell you why first, and then I'll go into some actual specific exercises you can do. So strengthening your legs, why do you want to do that? If you look at the nerve, so let's go into anatomy. Your sciatic nerve is innervated, 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. In between those levels are disc, and right around the disc is where we call our intervertebral canal. That is where the nerve exits out of the spine from the spinal canal, and those nerves will serve specific. Things, certain nerves are strictly sensory. That means that when you touch that area of skin that is associated with that nerve will tell your, that nerve will send afferent signals back to the spinal cord and therefore it'll go about up to the brain. The brain will perceive that something is touching that part of my leg. They'll send back signals back down to that leg. So that's afferent, right? That's afferent nerves where that nerve is strictly sensory and there are certain nerves that are. Sensory but also motor. And there are all cer. There's also certain nerves that are strictly motor, and what I mean by motor is that the brain tells the spinal, will send signals down the spinal cord out of that specific intervertebral canal at that specific level, and that nerve will send signals down to specific aspects of your leg and it'll tell that part of your leg to move. Okay. So sciatic nerve is a combination of afferent as well as ENT nerve endings, right? It's basically, it's motor and sensory. So you have nerves that come from 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 largest nerve in the body. And so those nerves are mixture of, like I said. Motor and sensory. So if somebody touches the bottom of our foot, that is mainly your sciatic nerve. If somebody touches your calve, that is mainly satic nerve. If somebody touches your hamstring the vast majority of the hamstring is innervated by the satic nerve. However, there are dominance and there's levels of nerves, right? So think about King, queen, Bishop Rook pawn, right? In the, in terms of, in terms of chess, think about also like royalty, like king and queen are up top and then they have all the other parts of the kingdom, right? So you have your alpha motor neurons. Those are essentially your largest motor neurons. Those are your largest neurons by far. So what research shows is that when you're actively resisting or loading that nerve and you're making those nerves do work, meaning that you are actively moving your leg. Against resistance is that essentially those alpha motor neurons will have downregulation regulating signals to other sensory neurons, and also see in delta fibers, which are essentially nerve fibers that detect temperature, that detect pin prick, that detect two point discrimination. And al also a combination of all these is what kind of detects pain essentially. So what I'm trying to say is that when you are contracting. Muscles, especially muscles that are innervated by the sciatic nerve, that will essentially reduce the sensation, the tightness of the nerve that is accompanying, so essentially it reduces your sciatica significantly. So that's what I'm trying to say is that when you're reliant on medication or manual therapy, is that those aren't even your best strategies. Your best strategies are actually loading the sciatic nerve or loading the muscles around the sciatic nerve. That's what I'm trying to tell you. So things such as squats. Squats, actually, I think amongst all exercises, squats, I think when you do squat and when your hips bend and when your knees bend. So think about the S static nerve running from your low back down, your glute pass, your knee into past your ankle and exiting. Or I guess stopping at your foot there. Nothing past your toes. Is that when you squat? Is the greatest excursion of sciatic nerve movement, right? So your sciatic nerve moves around these joints that are bending and that movement around the nerve. So think about getting a tense nerve to essentially stretch it out. So think about I. I don't know. Think about a Italian restaurant and 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 into pizza, but some of them making into noodles, right? So think about a, the more that you move. That dough, right? It starts off as like this fat bundle that's compressed, but eventually starts to lengthen, right? And, that Italian or Japanese restaurants, any restaurants that serve noodles, sorry, if I'm making this analogy up, but think about that nerve essentially getting looser, right? And it, it starts to relax more. That is what squats can do for you. Same thing like lunges. Lunges, just like a harder version of a squat, just more unilateral deadlifts as well. There are many different variations of deadlifts. That I've talked to a lot of my clients that have really like even immediately reduced their symptoms. It's just that, you can start off with a one to five pound deadlift and just get that s static and nerve moving. Or you, if you can't do deadlifts yet, then you can also again do squats. Squats, deadlifts even doing machines, right? Doing hamstring curls at the gym, right? What, hamstring is probably the largest muscle innervated by the satic nerve. So getting, doing hamstring curls, some of the easiest things that you can do for a sciatica, just know that certain. Hamstring curl machines are built differently. Some of them you're sitting, so you're sitting in a hip flex position that does stretch the sciatic nerve more right from the get go. Prone hamstring curls, you're lying down on your back, or sorry, you're lying down on your belly. So if your body. It doesn't appreciate being in a prone position in an extended position. You might want to go with a seated hamstring curl version. Instead. That might be somebody with more like spinal stenosis where they have an aversion to prolong standing and walking. But let's say if you're somebody that, let's say your symptoms are triggered by prolonged sitting. And, but you feel better with standing and walking. You may actually appreciate the prone hamstring curl variation instead because that you're in a more extended position. And also there's a standing hamstring curl variation as well, right? So you could see that there's a lot of devising and maneuvering around which machines or which exercises are best for that specific person with sciatica, because like I said, we talked about anatomical causes, mental and emotional causes. So there are different ways on how to devise. Perfect or as perfect of a strengthening routine for sciatica, right? So if you're interested in, learning more about, how you can have coaching or have a program device for you, then definitely look into the description. We always send out like an application and a booking page so you can book in for a free consultation with us and see how we can help you with overcoming your chronic static issues. Okay. Other forms are also like calve strengthening, right? Calves are some of sometimes the easiest bang for buck exercise. I always say a good amount of people that do calve raises that have sciatica. Rare. It's very rare that they would start 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 of the satic nerve, right? So like I said, the more you stimulate alpha motor neurons the motor neuron specific branches of the sciatic nerve, that may actually either overwhelm. Damper or sometimes relax the sensory neurons associated with the satic nerve. Okay. I really hope that's making sense of things. Okay. Let's also talk about another long-term strategy, core strengthening. Okay. Till this day, I still feel like there is some nuance on why core strengthening would work. Okay. But I'll give you an example. I had actually one client that had chronic sciatic pain. They also had pain into their foot. So they had plantar fasciitis and also they had actually had a little bit of foot drop, right? They actually had some symptoms where they were actually feeling motor weakness. Their leg, but they're also having a significant amount of sciatica. So I had this person strictly just do some core strengthening. So I had them resist load. I actually had them do a plank and I actually put some weight onto their back. So it increased the resistance and the demands on the abdominals itself. And then what I did was I, they were, their abs were super fatigued, and then what I had them do was I had them stand up. I had them bend forward because bending forward. Was causing symptoms in their satic nerve. It was triggering symptoms. And then after the core strengthening, they actually touched their toes, right? So they actually increased their mobility and also their symptoms of sciatica were drastically reduced. By doing core strengthening, right? And so my theory around this is that what you're doing is you're stimulating the central command center, right? So when you contract your core and you brace, that does give some spinal stability, right? So think about contracting the muscles around the spine so it stabilizes the spine. The other thing that I think that it does is that when you are doing a lot of core strengthening, you are stimulating a lot of hip muscles, ab muscles. Like I said. The theory around alpha motor neurons dominating the sensory neurons that also had some regulation of reduction of symptoms of sciatica. The other thing that I think about too was. You're teaching the person and you're telling the person that it's okay to load the body, right? So when sometimes people come in with a lot of fear and aversions and anxiety and they're like, oh, I don't wanna move because I've flared up my sciatica before you get them to do something an exercise that's not threatening to them, right? They're like, trust me. Just do a plank or do an incline plank. And I can assure you that this will, that, that this will help. So you're giving the person assurance that it will work. You're also trying to devise the exercises that are not threatening to the body. So for example, if they continuously flare their sciatica nerve with either running or lifting something off the floor, I may not have them run or lift something off the floor. During my session, right? Because their brain is also, is already detecting that is 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 try it. And when you can. Tell the body when you can tell your spine and everything and you can tell your brain that it's okay to load up the body, is that what will happen is you're sending good signals up the spinal cord up to the brain, and then the brain is sending signals and saying, whoa. This is not flaring up my sciatica. So therefore your brain is sending signals back down the spinal cord, out to the peripheral nerves stimulating your satic nerve and saying wow, I can actually load up, my core. I can load up my s sciatic nerve with this exercise and it's not flaring me up. So therefore, when you're sending, comfort signals and sending signals to the body that it's okay to strengthen, it's okay to load. That is what also has a factor with sciatica. Okay, so somewhat long-winded, but just to tell you that when you're telling the command center that it's okay to load the body. That is then therefore telling the command center that it's okay, it was okay to do more exercise. Okay. Hopefully that makes sense. Okay. Like I said, coordinate spinal coordination stimulating of the sciatic nerve. Okay. Contracting the core muscles. Sometimes again, contracting core muscles with something with spinal stenosis, it can help to like. Change the positioning of the pelvis temporarily. It can it can change the positioning of the spine. Like I said, there's a lot of theory on why core strengthening works, but it does. Okay. And there's different versions. There's not just. Just planks. There's side planks, there's Supermans, there's ex, there, there's lumbar extension loading, there's Roman Hyperextensions. There's prone glute squeezes there, there's reverse hypers, there's pelvic core strengthening. There's many different avenues of core strengthening that you can do. Like I said, if you're confused on which ones. Are gonna be the right ones for you. Like I said, feel free to fill an application, book a call with us, book a free consultation and see how we may be help able to help you. Okay? Other long-term strategies, I wanna 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 some of the acupuncture theories around there, where, you know they're putting their foot onto like sharp kind of prickly objects, right? I'm not sure you've heard of that, is that it's sim it is stimulating different aspects of the foot and it's sending good signals back up to the spinal cord. And a lot of times when you massage the foot, there's reduction of symptoms. There's reduction of symptoms, not just in the foot, but also in the calve and anywhere that sciatic nerve is contacting, right? Walking in barefoot shoes, when you do, or you walk more barefoot, you are feeling more rocks on the ground. You're feeling more twigs on the ground, so you're giving more proprioceptive stimuli to the foot. Therefore, when you're stimulating the foot more, you are not just stimulating the sensations of the sciatic nerve. So that in itself can reduce pain, but also you are strengthening the muscles of the foot as well. There are four layers of muscle in the foot. I always say that, the foot muscles have core strength as well in itself. So while you are training your foot. To get stronger, to build more muscle in the foot, just strictly through walking in more minimalistic shoes. That actually has been shown to reduce symptoms at the knee, the hip, as well as the lower back. But when you're given, and sometimes this is the wrong thing to do in my opinion, is that when you're given orthotics or sometimes shoes to correct for and for pronation. And so when you are given those types of shoes, yes, I would always say that. Even just. Your foot contacting the floor differently with standing and walking, that will reduce pain. And it's just for the fact that you're not striking the floor in the same way as barefoot. So there is, I will always say that with heel cups and all the different like foot technology out there, 90% of the time. That will always reduce pain acutely. Whether you've had PLA plantar fasciitis, sometimes hamstring tension or s tension, a lot of times it's gonna work. So I would maybe put orthotics or these types of like foot control technologies into short-term strategies. But however, a lot of people aren't told that they need to wean off. The orthotics or those foot control technologies long term. So what I see is that when they're put into more comfortable shoes, is that one, I do feel like the foot gets weaker. I do see that people with really hard orthotics, that they actually have foot atrophy. The muscles have actually gotten weaker. You'd start to see like the bony contours of the foot versus if I were to take a picture of my foot has nerves. It has thick amount of muscle around the plantar fascia because all I really wear nowadays is mostly minimalistic shoes or barefoot. Okay? And so when you have foot muscles that are weak. It's going to have, it's the foot muscles that contact the floor. It, you're gonna have, you're gonna eventually feel that your foot can't absorb the shock of you walking. So therefore it's going to cause more knee pain. It's gonna cause more hamstring tension or cab tension. It's gonna cause more hip related issues. And lastly, it can cause your sciatica to stay in orthotics. Okay, weaning down to shoes that are more minimalistic in nature, and also where you can regain strength, intrinsic muscle, foot strength. You can start to feel the floor better with improved proprioception. I've always felt that was always a good long-term strategy. I've seen it so many times where I've helped people to slowly reduce the need for orthotics. And what had happened was this person that has had 10, 20 years of like consistently getting more foot control technology, that what happened was they ended up needing a knee replacement. They had chronic sciatica bilaterally, and they also had one hip replacement, that hip arthritis. Tons of bad stuff as a result of wearing. Thicker shoes. Shoes that compress your toes, shoes that don't allow you to feel the floor more. So when you are put into those shoes and you are not told by your podiatrist or your physical therapist or your running trainer that hey, it may actually be a good strategy acutely to wear these shoes short term, but you may want to slowly progress to a more minimalistic shoe to strengthen your foot more. That is where I'll notice that a lot of people do it wrong. A lot of trainers and other healthcare practitioners do it wrong, in my opinion. And I do feel like most people, 90% of people should benefit from minimalistic wear. The 10%, I'm not gonna go into it now, there's people with stress fractures, really chronic failure of certain tendons at their foot. So if you are in that small category where you do need more supportive shoes. I would say, therefore, you, you may not be a candidate for minimalistic wear, but chronic sciatica, though I would definitely say. Definitely benefit from more minimalistic wear as well. Okay. I'll go into this really quick. I'll, I guess I'll encompas this into two more things. One I would say is nutrition and sleep. Nutrition, eating adequate amounts of protein, right? Especially if you're not recovering properly. Protein is broken down into amino acids. Amino acids are reuptaken. By the body in the form of insulin. Insulin is the thing that brings amino acids into the damaged tissues. However, when your body is not prioritizing protein and you're like, let's say increasing, let's say you're eating the typical American diet, a lot of carbs, a lot of sugar, carbohydrates in itself mostly has some sort of insulin spike insulin. It can create insulin resistance. Chronic insulin resistance can lead to. Interstitial vascular inflammation. So anything that receives blood flow, which is essentially everything in our body, anything can be broken down, right? So for example, if you have insulin resistance, some people develop retinopathy and they can go blind because there's less blood flow to the optical artery and nerve, right? Same thing with sciatica, right? Are when you have. Insulin resistance and we have vascular inflammation. Vascular inflammation will appear differently for certain people and it eventually can affect the body systemically. It is affecting the body systemically. But for you for some people, if you have chronic sciatica, you may look into you your amount of sugar intake, the amount of carbohydrate intake, how often you're spiking insulin, increasing your protein intake while also increasing your fat intake. So in the form of good, let's say monounsaturated fats. That is oftentimes a way to reduce overall systemic inflammation. If you didn't know this, is that there are three macronutrients, protein, carbs, and fats, right? So protein, amino acids, as well as carbs. Carbs broken down into glucose. Those are actually the two things that secrete the most amount of insulin, right? Carbs, the most amount of insulin. Excessive protein also will secrete insulin because it has to reuptake amino acids into the working tissues. But if you, but fat is actually the one macronutrient that actually secretes the least amount of insulin. So if you eat greater, healthier amounts of fat, you are going to become more insulin sensitive. You're going to create less systemic inflammation overall. And that, again, is a more long term, more internal strategy. That will help you with your sciatica long term. So I would consider like strength training and core strengthening that's more, putting external load onto your body. I would say that's less internal overall, the food that you ingest and absorb, that can go a long way as well. Sleep. Sleep is very neglected, especially in our American society. We're all succumbed to a smartphone. I'll definitely admit that, sleep amongst the many things that I do well in my own life. Sleep is something that I can always improve, but getting a legit seven to nine hours of sleep can help to reduce overall stress. The more you sleep, the more cortisol is dampered and downregulated. When you wake up, there is an increase in cortisol in order to increase your blood pressure, to get you to stand upright. And then your cortisol slowly tapers down after, six to 120 minutes of being awake. But for some, with increased stress in their life, or sometimes with a lot of sciatica, a lot of pain cortisol can stay elevated, right? So the more you sleep, the more you can regulate cortisol. Okay. And also you think more clearly you have more energy, so you have more motivation to work out, right? So obviously I. There's many books on sleep. I'm not a sleep expert in itself, but sleep has overall an amazing amount of positive systemic benefits physiological benefits as well, right? So getting enough sleep, really critical. Lastly, just positive outlook, right? Because many people with chronic sciatica, whether you've injured yourself a lot. Whether you've gotten a lot of MRIs, whether you've been stuck in a broken medical system and nobody's really helping you, you feel the medical system's let you down. There's just so many different things that can cause a negative outlook. But creating a more positive outlook, maybe listening more to my podcast gives you a more positive outlook, whether you start to employ strength training as a means of a good long-term intervention, right? So starting to replace a lot of your negative coping strategies starting to also. Try not to let current, or even past circumstances or past negative events determine what you can do today with your s static symptoms, right? So having that positive outlook and focusing and grounding yourself in today will really make meaningful differences today and then long term, right? You might not notice, wow, my satic 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'll never get better, or you start to feel helpless, but creating more of a positive outlook and employing a lot more of these good short-term strategies I told you about, as well as these long-term strategies I told you about. Again, making meaningful differences long-term. You can't think about just what you can do today. You have to think about how today capitalizes onto the next day and onto the next week, the next month, the next year, and how your body can become more resilient. To sciatica overall is that you have to look at the long-term outlook. I have to stay on a strength training plan. I have to consistently work on my sleep quality. I have to consistently work on my nutrition. Because sometimes you might falter back into, I. Eating a ton of crap, for example, or eating a lot of vegetable oil, eating a lot of pro-inflammatory substances, and maybe your sica symptoms come back because of mixture of diet, stress, sleep, lack of training, lack of resistance training, lack of walking. Okay. But, putting those four things together, while it does sound simple, just me talking about it. That it's not built into our DNA. It's not built in as a habit. So you have to think about the long-term game, that positive outlook, and starting your day with gratitude, starting your day with positive affirmations. Maybe you need to calm the nervous system down by meditating, right? I. So many different strategies. I'm not saying that one person has to lock onto everything that I say is that you will find your own kind of sciatica roadmap, if you will, but taking some of the things that I say or taking all of it, I, I know and I can guarantee that, you can say for yourself that if I employ a more holistic strategy, so sciatica, I can overcome this overall, not just short term, but also long term. And that's what I got for you guys today. If you found this helpful, even remotely helpful at all, click that share button. Share it with a friend. Share it with a friend that not just has Attica, but also is contemplating, like prevention strategies. This can be super helpful to them. If you're listening to this on Facebook or podcast or wherever, YouTube I encourage you to one, click the like button click follow and subscribe. If you can also leave a comment or leave a five star review, especially if you found this super helpful, I am doing my best to. Create more impact in the world. But you also engaging with this episode as well, that pays huge dividends that allows other people that are searching for sciatica or searching for pain to be able to find this episode a lot easier. I. So you helping yourself, hopefully you can help others as well and help me in that process too. If you have any feedback from me, definitely email me, jason@flexwithdoctorjay.com. And if you're interested at all in speaking with me or my team, definitely look at the description section. You'll always see there's a section to. To fill out an application, feel free. And the application will be background information so that we can make the most out of our free consultation. So if you're interested in that as well we're always looking to help more people. So that's what I got for you guys today and I appreciate you guys. Have a beautiful rest your day. Stay active and I'll leave you always with my quote as well, is that we only have one body, one life. Make every action you take, be one that makes you a better version of you. Take care and have a beautiful rest of your day.