Piriformis Syndrome

Are you experiencing pain that feels like it is coming from deep in your gluteal region? Does it go down to your legs? Does it feel like an electric shock, pulling or nerve pain? Has it been so bad that even changing your position does not help relieve it?  Do you sit behind your desk or stand all day? If yes, then you might be having piriformis syndrome.

The piriformis is a muscle that originates from the front of the sacrum and inserts on the side of the femur. It helps to rotate the hip externally and hip abduction. The sciatic nerve runs under the piriformis muscle on its was out of the pelvis.

What causes piriformis syndrome?

  • Poor posture – after sitting or standing for a long period of time(e.g. Office workers, students, and drivers)
  • Muscle overuse – running or jumping for long periods, the muscle is forced to contract beyond its limit
  • Direct trauma – accidental falls, car accidents or sports injuries leading to muscle damage. Lifting heavy objects or sudden twist of the hip

The factors that have mentioned above, will lead to inflammation of the piriformis muscle, resulting in the irritation of sciatica nerve that runs under it. Some common signs of piriformis syndrome include :

  1. Pain starts from buttocks and runs down the leg, like an electric shock
  2. Tenderness when pressure applied directly to the piriformis muscle
  3. Pain in buttocks when changing positions (e.g. From squatting to standing, sitting to standing or turning over the body)
  4. Pain in buttocks after long sitting or standing or even running

How can physiotherapy help you?

  • Deep tissue massage or electrotherapy
    • To relieve pain and muscle spasm, increase blood circulation of the affected side
  • Stretching
    • In sitting position, cross your affected leg over your opposite thigh, slowly lean your body forward until you feel a stretch in the hip, hold for 30s, 35 reps, 3 sets/day.
    • Lying on your back, cross your affected leg over your opposite thigh, pull your opposite thigh to your chest until a stretch is felt deep in your hip, hold for 30s, 35 reps, 3 sets/day.
  • Strengthening (gluteal muscles)
    • Lying on your back, knee bent, hold for 30s, repeat 5-10 times, 3 sets/ day.

To prevent piriformis syndrome, you should do the following:

  • Avoid long sitting, move every 30 mins at least for 3 mins.
  • Maintain good posture while sitting, standing or running
  • Stretch regularly, to maintain or increase the flexibility

References: https://journals.lww.com/acsm-Healthfitness/fulltext/2014/07000/Piriformis_Syndrome.3.aspx

It is becoming more common for us to see patients with this condition. Our physiotherapists team often treat and help patients recover from piriformis syndrome. If you think you may have this condition, we encourage you to seek for proper assessment to be diagnosed and treated by a professional. To make an appointment, call 03-6211 7533.

 

日常生活中您有沒有经历过臀部深处感到疼痛,甚至一站起来就就好像有麻或是电到的感觉,由臀部延伸到大腿或者小腿,让您感到坐立不安,找不到任何姿势去缓解的这种不适?那您又是不是需要又或者是习惯经常久坐的一群呢?如果是的话,那您有可能是梨狀肌症候群哦!

首先,先来了解一下梨狀肌的解剖位置。梨状肌是一条位于臀部深处的小肌肉,起自於荐椎前方,经坐骨大孔,附着在股骨大转子上粗隆的上方,主要负责髋关节的外转,以及协助屈曲的髋关节做外展的动作。从梨状肌下方穿过的神经,正是我们熟知的坐骨神经。

那么造成梨状肌症候群的原因是什么呢?

  1. 姿势不良 – 长时间的久坐不动 (例如上班族、司机、学生)
  2. 过度運動 – 长时间的跑跳(例如跑步),导致梨状肌超出它所能负荷的运动量。需要快速转变方向的运动,例如足球,篮球等
  3. 外傷 – 跌倒、车祸或运动时导致梨状肌受到外力的撞击
  4. 搬重物,扭转身体的动作

上述所提到的这些因素,会造成梨状肌受损发炎(红、肿、热、痛),而发炎反应的肿胀会进而压迫或刺激到底下的坐骨神经,导致这些不适的症状出现:

  1. 臀部深处感到疼痛,从臀部延伸到大腿或小腿的电击感
  2. 患处会有压痛感
  3. 转换姿势像是蹲到站、坐到站、翻身的时候
  4. 长时间走路或跑步

物理治療如何帮助您?

  • 徒手深层按摩或电疗
    • 降低肌肉的疼痛和痉挛,同时促进患侧血液循环
  • 伸展运动
    • 在坐姿下,把患侧脚放在另一只脚膝盖上,做跷二郎腿的动作,收腹,身体向前倾,维持30秒,做3-5次,每天3组。
    • 在躺姿,患侧脚做跷二郎腿的动作,双手抱着另一只脚的大腿拉近胸口至感觉臀部后侧,维持30秒,做3-5次,每天3组。
  • 肌力训练(強化臀部肌力)
    • 在平躺姿势下,膝盖弯曲抬臀,维持10秒,重复5-10次,每天3组

如何预防梨状肌症候群?

  • 避免久坐,每半个小时站起来活动一下
  • 保持良好的坐姿(避免跷二郎腿、站姿、以及跑步、运动时的姿势
  • 适当的做伸展运动,维持良好的柔软度

由于工作需求、不良的姿势,梨状肌症候群已经越来越常见。如果您有上述的症状困扰着您,建议您可以来我们的中心接受评估,我們的物理治疗团队会提供您建议和相对的治疗方案。

预约评估电话, 请拨03-6211 7533。

Piriformis Syndrome2018-12-16T11:49:46+08:00

Hip Hip Hooray, Hip Pain Away!

One of the most common complaints of adverse golfers is hip pain especially of the lead leg, commonly the left leg. The hip joint does a good job of transferring the weight of our body to our pelvic and allowing us to do many activities.

However, the swing and follow through motions of golfing can add a lot of stress to the joint. Specifically, at the follow through phase of a golf swing, almost 90% of an individuals weight is placed onto one hip. Creating a large force and pressure onto a specific joint.

 Why is there pain?

Most golfer will complain of pain on the inner and outer hip.  Many of these symptoms come about because the lead hip is taking a lot more stress and force than it is supposed to.

This causes other parts of the body such as the muscles surrounding the hip, opposite leg, pelvic and low back to have to compensate, which results in pain in those regions.

Focusing on the lead hip pain. Some describe the discomfort as being a pulling sensation on the outer side of their leg. Which is usually cause by the increased tightness of Iliotibial band, muscles and ligaments which has helps to stabilise the leg and hip during swing off.

This muscles and ligaments stretches across the side of the leg and during golfing have to work extra hard to keep your leg in position when you tee off!

The uneven distribution of weight causes the hip joint to be more susceptible to injury. Therefore, it is important to tackle the pain in the early stages than later, as it can lead to degeneration of the joint.

How to avoid injury? 

In order to protect your hip, it is key to strengthen your pelvic and core muscles.

Exercises which focuses on increasing the strength of core muscles, allows the hip to take less of the affects from constant rotation. Instead the weight is more efficiently carried from the pelvic down to the ground.

Specific stretches on the muscles that are constantly contracted during playing golf will also help decrease pain. Doing stretches of the pelvic stabilising muscles (i.e. gluteus medius, piriformis muscles, core muscles and iliotibial band) will allow your hip to maintain a good range of motion and recover better!

Stretches are done to help relax some of the muscles that have to contract and do more work during certain activities.

Here at Healthworks we have a team of Chiropractors, Physiotherapists and Fitness trainers who are well versed with this sort of conditions. We work with our patients to help them Move better, Get fit and Be well. If you are experiencing the symptoms mentioned above, we encourage you to be assessed by a professional. You can make an appointment with us today at https://myhealthworks.com.my/ or contact us at 018 – 982 8539 or 03-6211 7533.

Hip Hip Hooray, Hip Pain Away!2018-11-30T00:03:52+08:00

Headaches & Migraines, Part 2

In a blog I wrote a while ago, I explained that a commonly misdiagnosed headache is a migraine. Many patients mistaken their unilateral (one-sided) headaches as migraines when they actually could be from a variety of secondary headaches.

You can read the blog here: https://myhealthworks.com.my/is-it-a-migraine-or-a-headache/

So, what are secondary headaches? Secondary Headaches are headaches that are present due to another condition. These include:

  1. Neck pain/Cervicogenic headaches: From degenerative arthritis, disc injuries
  2. Sinus congestions or flu/cold
  3. Bleeding in the brain or stroke
  4. Head injuries or whiplash
  5. Tooth pain or Temporo-Mandibular Joint (TMJ) or Jaw pain
  6. Others

These headaches have different presentations and can radiate to different parts of the face.

Most secondary headaches are due to cervicogenic headaches or headaches that are related to the spine and our posture. Bad posture can lead to anterior head carriage which increases the weight of our heads and this in turn creates a burden on our neck muscles and cervical (neck) spine. A lot of this is presented as trigger points. These muscle knots radiate pain across our heads, necks and upper backs recreating and reminiscent of primary headaches such as migraines or tension-type headaches.

Cervicogenic headaches could also be due to something more serious such as degenerative arthritis or a herniated disc in your neck. Degeneration causes bony spurs to form in your cervical spine which can lead to impingement of nerves and muscles which can then radiate pain that mimics a primary headache, especially migraines.

Disc injuries in your neck can also lead to headaches mimicking migraines but more likely if you have a disc herniation or disc degeneration in your cervical spine (neck), you would have associating symptoms such as numbness, tingling or pins and needles down your arm and/or in your finger tips on one or both sides.

Research has shown that a combination of pharmacologic and manipulative interventions are proven to be the most effective way of treating a cervicogenic headache or any headaches that started in your neck and upper back.

Again, always remember: the first step is to correctly diagnose your headache, the second step is to proceed with treatment. So if you have headaches or suffer from migraines, neck pain or upper back pain, come in to Healthworks and let me help diagnose you and help you improve your quality of life.

You can always read more on the different types of headaches on the International Classification of Headaches Disorder website: https://www.ichd-3.org/

Headaches & Migraines, Part 22018-11-29T13:22:46+08:00

Taylors University Lakeside Campus – Mobile clinic

To all Taylors University Faculty, Staff & Students

Let our team of chiropractors reset your posture; restore your spinal health and reactivate your body – allowing you to move better, get fit and be well.

When:

Every Monday & Friday, 2pm – 5pm

Every Wednesday, 9am – 12pm

* Except public holidays

Where:

TEG Assets Office – next to the gym (go up using stairs next to 7-Eleven and turn right!)

To book please give us a call on  (03 6211 7533 | 018 982 8539) or email us at contact@myhealthworks.com.my

 

Taylors University Lakeside Campus – Mobile clinic2019-02-12T07:14:30+08:00

What is Sciatica?

“Doc, I think I have Sciatica” was one of those common statements my clients would provide even before the consultation. How did they know? It is through this network of vast knowledge which we now know it as the internet. Just a few simple keywords on the search engine, and voila! The internet would have given a possible 1000 or more diagnoses known to mankind to your browser. So, what is Sciatica? Is sciatica even a diagnosis?

Sciatic nerve
The sciatic nerve is made up of a few nerve roots that exits the lower back. It is comprised of nerve roots L4-S2. It governs the sensation and the motor function of the lower leg. So, when this large nerve gets irritated or compressed, one the main symptoms would be sciatica.

Sciatica
No, Sciatica is not a diagnosis. Sciatica is a debilitating sensation or a symptom in which the individual experiences pain and/or paresthesia (an abnormal sensation, pins and needles), in the distribution of the sciatic nerve or an associated lumbosacral nerve root. Sciatica pain often is worsened with forward bending of the spine, twisting, bending, or coughing. The most common cause of sciatica is a herniated or bulging lumbar intervertebral disc. For the elderly, lumbar spinal stenosis may cause these symptoms as well. If the sciatic nerve is heavily compressed, severe symptoms like reduction in muscle strength or a loss of control over bowel and bladder will likely to happen.

Risk Factors

1) Age

2) Prolonged sitting

3) Occupation

4) Obesity

How to prevent Sciatica?

1) Reduce the hours of sitting and improve sitting posture

When the body is made to sit for long hours, our spinal discs which is kept healthy through body movements, are made to absorb extra stress due to being stationary.
One of the ways you can prevent prolonged sitting is to make the effort of a minute walk every 30 minutes of sitting. If and when you realize that moving about is not an option, have yourself to practice good posture while sitting. Having a good posture minimizes the stress and strain the body puts on the spine.

2) Regular Exercises

Any form of exercises within limits are naturally good to the body. It enhances nutrient absorption to the spinal disc making sure that your spinal discs stay healthy. Also, having an active lifestyle does not only keep you in shape ensuring that stress and strain in the spine is kept at a minimum, but also keeps diseases away. So, let’s get started with that 150 minutes of exercises every week!

3) Eat Healthy

Humans require energy to carry out activities of daily living. We obtain energy through various foods. However, with high consumption of certain foods will lead to a weight gain. Researchers have found that one of the risk factors affecting Sciatica is obesity. So, to make sure we keep that extra pounds away from our body, let’s eat in moderation.

If you have any questions about Sciatica, feel free to visit us at HealthWorks or give us a call or WhatsApp us at 0189828539.

What is Sciatica?2018-11-19T07:09:53+08:00

Why is Physiotherapy recommended?

Physiotherapy can help you avoid surgery, reduce your medication, manage your pain and reduce the risk of injury. Physiotherapists are highly qualified and can help you with a range of conditions and symptoms, including chronic conditions such as arthritis. Compared with many other treatments, physiotherapy is also highly cost-effective and does not require a referral.

It is commonly recommended to those that has pain, soft tissue injury, joint replacement, mobility issues, difficulties with daily activities or as preventive rehabilitation.

Where can you have Physiotherapy?

Physiotherapy is provided in a range of settings including private and public hospitals, community health services, in private clinics, or in residential aged care facilities.

About a typical physiotherapy session

A session with a physiotherapist is unique to the patient’s needs and health condition.

However, a ‘typical’ session may involve:
• Consultation, history taking and movement assessment
• Assessing and diagnosing the patient’s condition and needs
• Collaborating with patient to work on an agreed goal. Patient’s expectations and needs will be discussed
• Developing a treatment plan with the patient that will consider their lifestyle, health and capability
• Prescribing exercise and physical aides when required
• Scans and various medical investigations might be requested

Thank you for reading! Make sure to catch my blog next month and I will explain why Physiotherapy at Healthworks is different.

Why is Physiotherapy recommended?2018-12-10T06:38:24+08:00

Should my child work out?

If I get a dollar every time a parent asks if their child should work out, I’d retire by 25.

Okay, harsh, sorry. Parents want the best for their kids, and with opinions such as “lifting weights stunts growth” running rampant, it does warrant a second thought.

So, should a child work out?

For many Malaysian kids, sports and exercise take back seat relative to academic work. On top of school hours, extra classes and tuition means the only exercise they have time for is the walk up and down the stairs, into and out of tuition centers.

For these kids, I would wager that that being idle, stagnant, studying machines do more harm than having them working out.

Instead of asking “Should children work out?” a better question would be “How should a child work out?”

Here are 2 considerations when training children (age 7 to 15).

Train Weaknesses

7 to 15 is when kids absorb skills like a dry sponge to water. They have seemingly unlimited raw potential.

With this, I personally recommend less time in the gym, more time on court. They should be practicing running, jumping, kicking, tossing, rolling and all things overprotective Gen-Y parents would gasp at.

And maybe they should gasp, because unstructured play, while necessary, can be chaotic and dangerous.

This is where we return to the gym for planned weak point training.

If a child can’t seem to land without a loud “THUD”, we zone in on force absorption, teaching them how to redirect force in a more joint sparing manner.

If they cross their legs when they run sideways, we zone in on coaching lateral movement. Proper side shuffling is perhaps the most important movement in safely navigating across playing fields.

Mastering the quality of moving well in a controlled gym setting help kids meet the complex nature of movement in sports.

Now, before you register your kids for 5x a weeks of sports training…

Know When is “enough”

Having more of certain things are hands down, better.

More sleep, more money, more time, more food sans the weight gain. But more training isn’t on this esteemed list, especially for children.

Let’s talk periodization, a fancy term to imply how much activity one can do at certain time (of the week/ month/ year) relative to all other variables to ensure the best possible performance.

There is a time and place hard training, and there is a time and place for not so hard training.

During hectic seasons, when assignments pile up and having 6 hours of sleep is considered a luxury, our kids come to training looking like they’ve gone 10 rounds with Mike Tyson.

As coaches, we modify training intensity to coax the best performance for that day. Modification is necessary, because sometimes, they’re exhausted to the point whereby performing at 50% of their regular performance would be a challenge. Other times, with longer warm ups and rest between sets, they get up and going and perform just fine.

But on field, it’s an entirely different ball game (pun intended). The chaotic nature of sports plus even the slightest lapse of concentration is a fertile ground for injury. It’s a risk we’d highly advice against.

To bring this article full circle: If there’s anything that would stunt your child’s growth, it’d be the effects from an irreversible injury.

So, wise cut back on the 7am, 3 hour soccer practices on Monday, Wednesday and Friday during hectic academic seasons, and maintain a weekly session on weekends (or a time where they’re better rested) to maintain their skills. More intensive trainings and games can come during term breaks.

 

Coaching is a 2-way street, we communicate with clients, even if they’re children, to understand how they feel, because that is, in extension, how they will perform. But there seems to be a disconnect in parents’ appreciation of a child’s physical capacity.

While we think the general activity level among kids can be increased, it is equally important to scale back when necessary. And such are communications we often have with parents to design the best approach to bringing out the best athlete in their children.

Here’s a clichéd analogy to end this article: like fertilizers, there is a right time, place and amount necessary to grow a strong tree.

Should my child work out?2018-11-13T07:43:17+08:00

What type of pain do I have and what does it mean?

The main reason patients walk into our clinic is because of pain. They have experienced or is experiencing some form of pain which causes them discomfort. Pain can present itself very differently depending on the cause of it.

Why is knowing the type of pain you have important? Being able to determine what type of pain you are experiencing will be able to give you a good indicator of what conditions you may have. Each and every one of our body tissues are created distinctively for their specific purpose, and so they also respond to injury differently.

So, what are the main TYPES OF PAIN?

MUSCULAR PAIN

Usually described as: Achy, sore, tight, pulling sensation

Indication : Strain, sprain, muscle tear, trigger point, muscle overuse, muscle weakness

NERVE / RADIATING PAIN

Usually described as: Numbness, tingling, pins and needles, electric, weakness radiating sensation

Indication : Nerve irritation, nerve impingement (central or peripheral), nerve damage

ORGAN/ SOFT TISSUE PAIN

Usually described as: Sharp, stabbing, throbbing pain

Indication: Inflamed or infected organs (i.e. kidney, liver), fracture, muscle spasm, disc injury

Of course, it is important for you to not try to self-diagnose what conditions you might have based on this. However, it is a good indication that there may be damage to certain tissues in your body and that you should seek a professional physician to identify the cause of your pain.

Here at Healthworks we do a thorough history taking, physical assessments and diagnostic tests to determine the cause of pain for our patients. If you would like to know more about your pain and or what may be causing it, you can visit us by making an appointment at www.myhealthwork.com.my

What type of pain do I have and what does it mean?2018-11-06T09:33:08+08:00

Acute and chronic pain, what is the difference?

Acute pain is simply described as pain that is sudden and usually is caused by a specific pain. Depending on who you ask, there are different time frames and descriptions. As for me, as a chiropractor, it is important to be able to distinguish between acute and chronic pain. Different types of pain requirement different management and plans.

Acute pain is generally caused by a specific and identifiable cause. This can resolve itself between 4-6 weeks. With chiropractic care, this can usually be reduced to 2-3 weeks. Chronic pain usually does not have an identifiable cause and has persisted constantly for longer than 4-6 weeks or has been going on and off for about 3 months. These cases take slightly longer to diagnose and treatment plans generally need a longer time frame to recovery.

Let us take back pain as an example. I am a chiropractor after all! The rule of thumb when it comes to acute and chronic pain is:

1 week or less : Acute

1 week – 1 month: Sub-acute

1 month – 3 months: Sub-chronic

3 months or more: Chronic

When a patient presents with acute back pain, my main focus is to help reduce the pain as previously mentioned, the cause of the pain is usually specific and memorable (i.e. a fall, waking up with a stiff neck, hitting one’s elbow on a door, etc). We can then help clients realign their joints and create mobility if there is stiffness due to the pain. It is also advisable to apply pressure and ice to fresh, new injuries. This can reduce swelling as mentioned in previous blogpost. Look for the blogpost titled “Ice or Heat” or click on this link: https://myhealthworks.com.my/ice-or-heat/

If a patient presents with chronic back pain instead, the main focus is actually to diagnose the pain as it can be usually caused by multiple injuries, by an old injury that has persisted or by referred pain (most common with headaches). After diagnosis, it is important to create a mobility in the patient’s joints. Usually the muscles surrounding the joint will present with some hypertonicity, tenderness and trigger points as well. This makes treatment plans slightly more complicated and this explains why it takes longer for a complete healing.

So I would suggest that whether you have an acute pain that you recently felt since waking up this morning or a chronic condition that has been crippling you for months or even years, come in to Healthworks and let us help diagnose you as diagnosis is always the first and most important step. What you choose to do about the pain is secondary.

Acute and chronic pain, what is the difference?2018-11-06T09:28:12+08:00
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