Dose your body hurt? Ask a RMT anything.

[MeanSeanBean]

I've done this once before, many years ago, and decided to open it back up to celebrate our new home.

I have been in healthcare my entire life. I'm going to keep things vague so you crazy internet stalkers don't find my practice. But I've worked in Manual therapy for over 12 years, done well over 10,000 treatments, worked with some pretty high profile athletes, and now teach my profession at an institutional level. 

Maybe I have some advice on ways you can decrease body pain, or ways to better yourself physically. Maybe you just have questions regarding Massage or other Manual therapies, or questions about surrounding modalities. Maybe you want to ask anything else and never had the chance.

 

Shoot.

[gerg]

After 15 months of suffering, surgery not recommended, multiple chiro (only thing that has made life tolerable), physio (which may have made things worse), doctor (put me on gabapentin) and another RMT, I have come to a conclusion that I only wish sciatica on hitler

[MeanSeanBean]

Sciatica can be brutal. I've generally had good results treating it in my career though. But treatment alone isn't normally the answer. My best suggestion would be giving physio another shot, or someone with a more kin based background. Gotta get that core strong and get the glutes activating properly. If they are just hooking you up to a Tens machine, they ain't the answer.

 

Often people with sciatica aren't actually activating their glutes enough, in my experience. Extension based exercises while focusing on glute activation can help. Also glute rolls while walking. Focus on activating that glute all the way through your gate so your low back doesn't take over the movement.

 

Sciatica sucks ass, but don't give up. Keep pushing and trying to find the solution. There is almost always a key in my experience, you just gotta find it. 

8 minutes ago, gerg said:

After 15 months of suffering, surgery not recommended, multiple chiro (only thing that has made life tolerable), physio (which may have made things worse), doctor (put me on gabapentin) and another RMT, I have come to a conclusion that I only wish sciatica on hitler

 

[Bob Long]

I'm seeing a PT working through a sports hernia I gave myself rock climbing earlier this year. Its rehabbing OK but would like some ideas on what to do on non-workout days - are the massage techniques that can help on recovery days?

[MeanSeanBean]

2 minutes ago, Bob Long said:

I'm seeing a PT working through a sports hernia I gave myself rock climbing earlier this year. Its rehabbing OK but would like some ideas on what to do on non-workout days - are the massage techniques that can help on recovery days?

Unlike most injuries, I don't do much direct treatment on hernias. It's really more about treating the surrounding areas. Myofascial release can be very effective with helping from the inside out, more or less. Also relaxation based treatments to help decrease stress in the surrounding tissue like the hipflexors.

 

As for off days, rest and relaxation are the biggest keys in my experience, along side GENTLE core strengthening. Glutes birdges, birddogs and deadbugs are my general homecare to activate the core. But all these should be done with a less is more attitude.

I've also heard people have had very good experience long term with ice baths. I ice bath 3 days a week, but don't have an personal experience with the effects of hernias and ice bathing, so take that one with a grain of salt.

[Bob Long]

1 minute ago, Shayster007 said:

Unlike most injuries, I don't do much direct treatment on hernias. It's really more about treating the surrounding areas. Myofascial release can be very effective with helping from the inside out, more or less. Also relaxation based treatments to help decrease stress in the surrounding tissue like the hipflexors.

 

As for off days, rest and relaxation are the biggest keys in my experience, along side GENTLE core strengthening. Glutes birdges, birddogs and deadbugs are my general homecare to activate the core. But all these should be done with a less is more attitude.

I've also heard people have had very good experience long term with ice baths. I ice bath 3 days a week, but don't have an personal experience with the effects of hernias and ice bathing, so take that one with a grain of salt.

thanks - yea those are the homework exercises my PT gave me. Doesn't feel like much when you're doing them, but next day you sure know you did them.

First time with this kind of injury, it makes me appreciate the players a bit more thats for sure. 

[MeanSeanBean]

Just now, Bob Long said:

thanks - yea those are the homework exercises my PT gave me. Doesn't feel like much when you're doing them, but next day you sure know you did them.

First time with this kind of injury, it makes me appreciate the players a bit more thats for sure. 

They are the golden standard overall. That's why the less is more attitude is so important, very easy to overdo it. Strengthening the pelvic floor can sometimes be of high value as well. If someone has a weaker pelvic floor (I'll raise my hand on that one), it can cause misalignment of the pelvic and put indeed stress on the lower abdomen.

ignore the title of this thread, we aren't necessarily after pooch here. But the exercise this guy recommends here for pelvic floor is money. I have worked with a couple pelvic floor specialists in my times (most definitely not putting my hand up on this one, not my cup of tea) but they have often recommended exercises to my patients that remind me of this one. I personally do this exercise a few days a week and have notice very good results with it.

Not gonna fix your hernia, but pelvic floor strength can help support it in some cases.

 

 

 

[Bob Long]

4 minutes ago, Shayster007 said:

They are the golden standard overall. That's why the less is more attitude is so important, very easy to overdo it. Strengthening the pelvic floor can sometimes be of high value as well. If someone has a weaker pelvic floor (I'll raise my hand on that one), it can cause misalignment of the pelvic and put indeed stress on the lower abdomen.

ignore the title of this thread, we aren't necessarily after pooch here. But the exercise this guy recommends here for pelvic floor is money. I have worked with a couple pelvic floor specialists in my times (most definitely not putting my hand up on this one, not my cup of tea) but they have often recommended exercises to my patients that remind me of this one. I personally do this exercise a few days a week and have notice very good results with it.

Not gonna fix your hernia, but pelvic floor strength can help support it in some cases.

 

 

 

 

I'm OK on the "pooch" front  but these look great, thanks for this I do think this is an area that I need to strengthen.

Its been about 8 weeks and I am seeing a lot of improvement, not near ready for anything heavy but I will try these.

 

[MeanSeanBean]

1 minute ago, Bob Long said:

 

I'm OK on the "pooch" front  but these look great, thanks for this I do think this is an area that I need to strengthen.

Its been about 8 weeks and I am seeing a lot of improvement, not near ready for anything heavy but I will try these.

 

Right on, keep consistent and keep moving forward slowly Bob. Check back in in a few weeks, I'd love to hear your progress over the next few weeks. For a sports hernia I default to a 8-12 week timeline on average. 

[gerg]

6 hours ago, MeanSeanBean said:

Sciatica can be brutal. I've generally had good results treating it in my career though. But treatment alone isn't normally the answer. My best suggestion would be giving physio another shot, or someone with a more kin based background. Gotta get that core strong and get the glutes activating properly. If they are just hooking you up to a Tens machine, they ain't the answer.

 

Often people with sciatica aren't actually activating their glutes enough, in my experience. Extension based exercises while focusing on glute activation can help. Also glute rolls while walking. Focus on activating that glute all the way through your gate so your low back doesn't take over the movement.

 

Sciatica sucks ass, but don't give up. Keep pushing and trying to find the solution. There is almost always a key in my experience, you just gotta find it. 

 

Extension based exercises? 

Glute activation?

Glute rolls? 

I don't know how to do any of this haha. 

 

Also yea, the Tens machine is what I think made it worse. The guy kept treating me for piriformis muscle syndrome. Every time I got hooked up to this, I came out worse and by the third time, I couldn't cross the street without stopping to sit. (Didn't actually sit on the street, I had to hobble in order to not get run over)

[6of1_halfdozenofother]

I have a whole laundry list of items my (very wonderful, I might add) RMT is working through (and has been working through for the last 8-9 years), so I don't want to muddy the waters by seeking advice here. 

 

However, I do want to give a shout out to all of you guys who do great RMT work and help people through not just the immediate pain and discomfort issues, but also the longer term suggested exercises and advice.

 

Thanks to you and the members of your profession!  

[MeanSeanBean]

56 minutes ago, gerg said:

Extension based exercises? 

Glute activation?

Glute rolls? 

I don't know how to do any of this haha. 

 

Also yea, the Tens machine is what I think made it worse. The guy kept treating me for piriformis muscle syndrome. Every time I got hooked up to this, I came out worse and by the third time, I couldn't cross the street without stopping to sit. (Didn't actually sit on the street, I had to hobble in order to not get run over)

Extension based exercises. Anything that extends a limp or body part out behind your midline. In context to this discussion, it would be extending (moving back) your leg.

 

Stand facing a wall, place one hand in the wall, and one hand on your low back and glutes (butt). Slowly extend your leg out behind you. Leg straight at the knee. You should feel your glute muscles fire, not your low back muscles. If your low back fires more then your glutes, start again. Practice that movement until 90% if it comes from just your glutes. It's their job, not the backs.

Activation referred to the muscles firing and doing their job. When you flex your bicep, you are activating the muscle fibers when you step, you activate muscles in your legs, glutes, core and back to take a step.

Glute rolls. When your walking, focus on the glutes with each step. As your heel hits the ground, feel your glute muscles squeeze to brace for impact. Then as you swing through your step and that leg is going from infront to under and then behind you, focus on the movement, the squeeze of your glute muscles. Try to simulate you are "rolling" trough the nuclear fibers. When your heel hits, it should feel like the bottom of your glute fires the most. As you swing through the step, is should feel like that firing 'rolls' to the upper part of the glute muscles. Go for intentional walks where you are focusing on each step and the activation of your glutes.

 

 

There are some very good physios, and some very bad ones. Same as any profession. Didn't sound like that was the right treatment for your case, actually I reckon it wasn't. You likely needed to strengthen the area.

[MeanSeanBean]

10 minutes ago, 6of1_halfdozenofother said:

I have a whole laundry list of items my (very wonderful, I might add) RMT is working through (and has been working through for the last 8-9 years), so I don't want to muddy the waters by seeking advice here. 

 

However, I do want to give a shout out to all of you guys who do great RMT work and help people through not just the immediate pain and discomfort issues, but also the longer term suggested exercises and advice.

 

Thanks to you and the members of your profession!  

It's the best job in the world and I'm incredibly thankful I've had the chance to dedicate my entire professional career to not only doing it, but training the future generations to do it even better.

[Jess]

Been dealing with some back pains as I've gotten older, which is mildly concerning given I'm only 30 years old. Nothing serious, but can get annoying while sleeping on my side or standing/walking slowly for extended periods of time. Went to a chiropractor for several months, but the improvements I saw were very minor at best. Debating not going back (I switched jobs and just got benefits again). Was I just too impatient with the process or might it actually be that it's not working well for me?

Also, a former co-worker of mine recommended that I get massages to help, though I'm not sure if that'll help or not. I don't have constant back pain, only when my back is under duress.

Finally, I'm considering orthotics, though I've never had anyone mention that I might have a foot issue and I had no back pain at all until my mid-late 20s.

[MeanSeanBean]

@-AJ-

Everything starts from the ground up, if you have high or low arches you may need more support to ground better. If the bottom of the chain is out of wack, the entirety of the chain has to compensate. Orthotics can be very valuable for people that need them, but can actually be hinder those who don't. Without assessing your feet and gait, I can not give you any direct advice on the subject. But it could be worth checking into.

Chrio doesn't sound right for you, based off what you just said. Is it an alignment issue? Possibly, that's why you were getting short term relief. But if the problem started coming back shortly after treatment we need to address the why, not the what. Bones anchor muscles, muscles pull bones. If your having some alignment issues you can realign your skeletal structure till the cows come home. But if you don't address why you continue to have the issues you won't see any long term effects. It could be a weakness, it could be a tightness. Physio or massage sounds like the better pathway for you to get long term results based off what you just told me.

Can you tell me a little more about the back pain. Deep ache, sharp bite? Is it a small area near the spine, or a broad band across the low back? What's the severity? 1/10 or a 4/10 on the pain scale. With more information I might be able to take em educated guess and help you with a stretch or strengthening that could help.

Edited September 18, 2023 by MeanSeanBean

[Jess]

17 minutes ago, MeanSeanBean said:

@-AJ-

Everything starts from the ground up, if you have high or low arches you may need more support to ground better. If the bottom of the chain is out of wack, the entirety of the chain has to compensate. Orthotics can be very valuable for people that need them, but can actually be hinder those who don't. Without assessing your feet and gait, I can not give you any direct advice on the subject. But it could be worth checking into.

Chrio doesn't sound right for you, based off what you just said. Is it an alignment issue? Possibly, that's why you were getting short term relief. But if the problem started coming back shortly after treatment we need to address the why, not the what. Bones anchor muscles, muscles pull bones. If your having some alignment issues you can realign your skeletal structure till the cows come home. But if you don't address why you continue to have the issues you won't see any long term effects. It could be a weakness, it could be a tightness. Physio or massage sounds like the better pathway for you to get long term results based off what you just told me.

Can you tell me a little more about the back pain. Deep ache, sharp bite? Is it a small area near the spine, or a broad band across the low back? What's the severity? 1/10 or a 4/10 on the pain scale. With more information I might be able to take em educated guess and help you with a stretch or strengthening that could help.

Thanks for your detailed response.

I went to chiro for about 4 months I think once a week, then once every two weeks for a while. If I were to look into orthotics, which kind of expert should I see for that? Is it a case of needing to get referred by my family doctor?

Back pain is almost exclusively lower back, though sometimes a bit of the middle, always on the spine. Seems to feel worse when hyperextending and I find that arching forwards with a hunch will alleviate the pain when I feel it. The pain from sleeping only really hits after about maybe 5-6 hours of sleep and it's more significant on one side than the other. As for standing/walking, about 10 minutes of standing is enough for me to start to feel the tiredness in my back and by about 15 minutes, I'll feel some pain which will slowly get worse the longer I go without sitting or even just walking/running to change the stress on my back. The severity will totally depend on how long I persist. It can get pretty intrusive if I don't eventually sit down or do something about it.

My chiropractor gave me a stretch to do for my hips (I also get hip joint pains when I go for a steady, flat walk for about 50+ minutes) and also instructed me not to hyperextend when doing it, so as to avoid pain to my back. It was a sort of lunge, sometimes paired with an arm stretch over my head.

[RWMc1]

I would recommend this to anyone suffering chronic pain. 

Any thoughts on this OP. It was "prescribed" to me by a back specialist.

[MeanSeanBean]

On 9/18/2023 at 10:46 AM, RWMc1 said:

I would recommend this to anyone suffering chronic pain. 

Any thoughts on this OP. It was "prescribed" to me by a back specialist.

I'm not familiar with this particular book or method. But after doing a quick search, it seems to be a book of stretches and strengthening. If so, seems legit to me. When in doubt I'll fall back onto a couple phrases that are always true. One of those phrases is, "movement is medicine". Are you in chronic pain, get moving. Go for walks, stretch it out, put some healthy tension on your muscles.

[6of1_halfdozenofother]

3 hours ago, MeanSeanBean said:

stretch it out, put some healthy tension on your muscles.

 

That's not what my wife said.  

 

 

 

 

 

 

 

 

 

 

 

 

 

[RWMc1]

4 hours ago, MeanSeanBean said:

I'm not familiar with this particular book or method. But after doing a quick search, it seems to be a book of stretches and strengthening. If so, seems legit to me. When in doubt I'll fall back onto a couple phrases that are always true. One of those phrases is, "movement is medicine". Are you in chronic pain, get moving. Go for walks, stretch it out, put some healthy tension on your muscles.

The exercises and stretches are fairly simple. The idea is to put everything back in proper alignment and to strengthen weakened muscles. A specific set of these exercises are used depending on the part of the body being strengthened. It also has maintenance exercises to help keep you at a stable level.

[Playoff Beered]

I dose my body sometimes, but usually not when I'm hurt. I'll have to try that next time.

 

Edited September 23, 2023 by Playoff Beered

[6of1_halfdozenofother]

@MeanSeanBean - is a sore knuckle (in isolation - most of my other knuckles don't seem to have issues) a concern for a possibility to result in gout?  I've had a sore knuckle now for about 4 months, with the pain similar to that of if I knocked on a door too hard.  Bending it is when it gives the most (and mostly acute) pain, but even at rest it still gives off waves of low-grade pain.

[MeanSeanBean]

29 minutes ago, 6of1_halfdozenofother said:

@MeanSeanBean - is a sore knuckle (in isolation - most of my other knuckles don't seem to have issues) a concern for a possibility to result in gout?  I've had a sore knuckle now for about 4 months, with the pain similar to that of if I knocked on a door too hard.  Bending it is when it gives the most (and mostly acute) pain, but even at rest it still gives off waves of low-grade pain.

Not commonly no. It is possible, but uncommon. If something's been sore for 4 months it's worth seeing a doctor, physio, RMT, someone about.