Piriformis Syndrome

  • Piriformis syndrome is a common diagnosis for pain in the buttock. It is often attributed to issues related to the sciatic nerve but that’s not really the cause. In more than 80% of cases it has to do with some kind of trauma or repetitive motion not an anatomical difference of the piriformis muscle and sciatic nerve.
  • Chip Review @ (17:35): Yaokin – Mr. Cabbage Taro – “Sauce Flavor” (Hugh Thank you to Steve-O)
  • Trivia question of the week @ (15:12): How much poop does a rhino make in a single defecation?
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Brief overview of the episode:

Piriformis syndrome is the literal pain in your butt. Other symptoms include low back pain, numbness, difficulty walking, pain with sitting/squatting/standing/bowel movements and tenderness. Sometimes this is called deep gluteal syndrome, extra-spinal sciatica or wallet neuritis.

The reason that the piriformis muscle is so famous is because it can have a unique arrangement with the sciatic nerve. There are 6 other muscles in this area that can also play a role and that is why primary piriformis syndrome makes up less than 15% of cases.

Secondary pirifomris syndrome is by far more common. This is usually due to some kind of trauma, muscle holding, gait patterns or other issue further down or up the kinetic chain. That will then present as pain in the buttocks.

Women are affected 6x more than men. This seems to be due to an increased q angle as this impacts the relationship between the quadratus femoris and the OS Coxae.

Most people you experience piriformis syndrome will get better with short-term activity modification and exercises. Surgery is not often recommended even in cases of primary piriformis syndrome.

Other episodes you might enjoy:  

Lumbar Strain: Episode 123

Lateral Shift: Episode 106

Sciatica: Episode 34

Lumbar Strain

(Weight Lifters Back)

  • Lumbar strain also known as weight lifters back, low back pain, pulled back, my back went out, strained back and lumbago is a really common issues. It is likely that everyone will deal with this at some point in their lives.
  • Chip Review @ (19:49): Trader Joe’s – Cornbread Crisps
  • Trivia question of the week @ (18:23): In geology, how long is an eon?
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Lumbar strain is one of the most common reasons someone will go to their primary care physician or the emergency room. It occurs as a result of trauma, overuse, sports, slips and falls. Sometimes called weight lifters back, lumbago, back strain, pulled back and is a result of a muscle, tendon or ligament injury of the low back.

The most common muscles injured are the quadratus lumborum, multifidus, gluteus medius, gluteus max and piriformis. These are muscles of the low back and the buttocks/hip. Symptoms will included low back pain, spasming and being sore to the touch.

Most people will have some reduction in symptoms with walking, short duration stretching and ice/heat/NSAIDS. In most cases it is not necessary to see a physician or have imaging done. Symptoms will improve in 1-4 weeks and should fully resolve in less than 8 weeks.

Low back pain is most often a result of some activity and usually you know what caused your pain. There is high likely hood that you pain will improve with gentle movement and activity and there is not a serious underlying pathology.

Other episodes you might enjoy:  

Lateral Shift: Episode 106

Core/Abdominal Wall: Episode 35

Low Back Pain: Episode14

 

Ankylosing Spondylitis

  • In this episode: Ankylosing Spondylitis is an autoimmune disorder that affects the spine, eyes and heart. With physical therapy the biggest concern is fusion of spinal segments. Usually beginning in near the sacrum and lumbar spines. Its biggest concern is loss of rib cage expansion limiting respiration.

  • Chip Review @ (13:07): Frozen – Utz Crab Chips (Thank you Linda Payne)

  • Trivia question of the week @ (11:56): Which dinosaur’s name translates to “fused-lizard”?

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Brief overview of the episode:

            Ankylosing Spondylitis is a rare auto-immune disease that predominantly affects the spine. It causes the spine to fuse along its length. Fusion typically begin near the SI joint though the biggest concern is when it causes the costoverterbal (ribcage) joints to fuse. This prevents typical respiration. There are additional affects on the eyes as well as the heart.

            When treating someone who has Ankylosing Spondylitis the main goal is to prevent the spine from fusing in a hunched posture. This limits loss of function, improves respiration and limits the impact on daily life that can occur when left untreated.

            Physical therapy is provided in conjunction with medication. As Ankylosing Spondylitis falls under the rheumatic diseases it has been found to have a common genetic component. Individuals who have Ankylosing Spondylitis presents with the HLA – B28 gene 95% of the time. Having the HLA-B28 gene is not however, a diagnosis as most individuals with it will not present with symptoms of Ankylosing Spondylitis.

            The prevalence is about 0.1-0.2% of the population. It affects men 3x as often as women and is most likely to affect white individuals.

 

Other episodes you might enjoy:

Discectomy: Episode 81

Stretching: Episode 25

Stress Fractures: Episode 43

 

 

Lateral Shift

  • In this episode: A lateral shift, sometimes called a lumbar list, is the presents of the torso shifted to the left or right relative to the hips. It can also be called an acute scoliosis and is most often due to a disk protrusion or herniation.

  • Chip Review @ (10:11): Old Dutch – Bar –B-Q

  • Trivia question of the week @ (08:00): From Scooby-Doo, what is Shaggy’s real name?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

To Subscribe, Review and Download select your preferred hyperlink below 

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Brief overview of the episode:

            A lateral shift is a visual shift in the spine to the left or right relative to the spine below. It is most common in the lumbar spine and is usually due to low back pain, a disk herniation or disk protrusion. Sometimes it can occur as a result of spondylolisthesis or scoliosis. A lateral shift can also be referred to as a lumbar list or an acute scoliosis.            

            In many cases a lateral shift is not painful. Or when a person has shifted their pain reduces. A lateral shift is not a diagnosis but it is a useful symptom when attempting to diagnosis.

            Most people will be able to reduce a lateral shift in a few days or weeks. However, the underlying cause (usually disk related) can continue to cause problems. More than 80% of people who experience a lateral shift will not need any significant medical follow up.

Other episodes you might enjoy:  

Spine Surgery Overview: Episode 80

Scoliosis: Episode 37

Low Back Pain: Episode14

 

Laminectomy/Laminotomy: Episode 82 

  • In this episode: What is the difference between a Laminectomy and Laminotomy and when are they used.

  • Chip Review @ (07:29): Deep River – Mango Habanero

  • Trivia question of the week @ (05:16): What is a group of hippos called?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

To Subscribe, Review and Download select your preferred hyperlink below 

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Google Play:

Youtube: 

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Podbean: 

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Brief overview of the episode: 

            Laminectomy and laminotomy are both used to increase space around a spinal nerve. They are both forms of spinal decompression.
            Laminectomy is a complete removal of the lamina which is a part of the spinal vertebra. This procedure can often be on it’s own but it is often done in conjunction with a fusion. A fusion is done because the full removal of the lamina can lead to instability, specifically anterior instability known as a spondylolisthesis.
            Laminotomy is a partial removal of the lamina. This opens up space but maintains stability. This procedure is usually done without any additional surgical intervention.
            Both are typically done when stenosis is present and non-surgical treatment has not provided adequate pain relief. It is always a good idea to purse all non-surgical options prior to committing to a spinal surgery because at the end of the day you can’t put the lamina back.

 


Other Episodes you might enjoy:

Pain: Episode 29

Discectomy: Episode 81

Stenosis: Episode 36

 

Scoliosis: Episode 37

  • In this episode: We cover Scoliosis. Which has several varieties affecting people across the lifespan.

  • Chip Review: Albert Heijn Kronkels – Big ups to McKenna Homner for the hand delivery

  • Trivia question of the week: We forgot to ask it but it should have been – What is the highest grossing movie of the 80’s?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

Scoliosis is our topic today and we will be reviewing Albert Heijn Kronkels, compliments of McKenna Homner. Kronkels also known as Vockles. Yes, this is the store brand version. They are a little wider then the Vockle which is a tight spiral. Like a corkscrew. Yes, the Vockle is more like a Fritos Twist.
Scoliosis, there are a couple main types. We won’t be able to fully discuss all the kinds. The big diagnosis value is the Cobb Angle. The Cobb Angle measures the amount of curvature in the spine. Anything-greater than 10degrees is considered officially scoliosis. That could be functional which you could actively correct. Or postural which you could not actively correct.
When with physical therapy we see a secondary diagnosis of scoliosis that is typically a functional instead of structural. Commonly the functional type is 10ish degrees or at least milder.
One of the more commons ones is adolescent idiopathic. This is going to affect a small percentage. Less then 5% of kids going through their teenage years, the growth spurt years. These are individuals without any other cause for the curvature. So idiopathic means; without a cause.
The more significant forms are congenital, which is due typically to a birth defect and neuromuscular which is secondary to another issue; Muscular dystrophy, cerebral palsy or some other kind of neurological disorder.
Scoliosis is either a “C” or “S” shape. This is named for the curve the spine assumes. If you look at someone’s back and the spine is not straight like and “I” but curves like a “C”. That would be a “C” scoliosis. If it has a double curve then it would be an “S” scoliosis.

Check out some of these related podcast topics:

 

Core/Abdominal Wall: Episode 35

Sacroiliac Joint Dysfunction: Episode 27

Low Back Pain: Episode14

Stenosis: Episode 36

  • In this episode: Stenosis – basically it is narrowing of the spinal canal and it is quite common.

  • Chip Review: Funny-Frisch Kessel Chips Sweet Chili & Red Pepper Big Thank you to Liz Schneider for bringing these back from Germany

  • Trivia question of the week: Who was the shortest US president?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

Today we are going to be discussing stenosis and we will be reviewing the Funny-Frisch Kessel Chips Sweet Chili & Red Pepper. These chips have been delivered to us by Liz Schneider following her recent trip to Germany.
Stenosis, simply is narrowing of the spinal canal. Usually bone related but can be from other structures. Thickening of the ligamentum flavum is one. I just saw a great ligamentum flavum at the Museum of Technology in San Jose. They had a Body Works exhibit with Flamenco dancers. One of the dancers had her back opened and you could see the ligamentum flavum nicely.
The ligamentum flavum means yellow ligament. It runs along the inside of the spinal canal. If that thickens it will narrow the space and play a role in stenosis.
Stenosis is not a disk bulge, it is not disk degeneration, it has nothing to do with disks. Most people report Low back pain or Sciatica. The most common additional change you will see with it is a spondylolisthesis. This is when one vertebra is shifted forward of backward relative to the ones above or below it.
Sometime stenosis is referred to as shoppers’ disease. One of the classic symptoms is that you can walk for about 200 feet up to a half-mile the pain become to much and then you need a break. You will also see this as someone who has to bend or hunch over his or her shopping cart to prevent symptoms.
In almost all cases symptoms are reduced with sitting or other forms of spine flexion. This immediate reduction in symptoms is one of the tale-tale signs that someone is dealing with stenosis. This symptom pattern is known as neurogenic claudication.

Sciatica: Episode 34

  • In this episode: We cover Sciatica as it relates to the general population as well as during pregnancy. We also touch on piriformis syndrome and what “double crush” is.

  • Chip Review: Calbee Seaweed & Salt Potato Chips, Huge thank you again to Steve Kovisto

  • Trivia question of the week: What 2 US states have their own time zones?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

In this episode we are going to go over sciatica and will be reviewing the Calbee Seaweed & Salt Potato Chip.
Sciatica, typically people have low back pain and pain in the buttocks. Pain can then extend into the knee or as far as the foot. Following the path of the sciatic nerve distribution. Sciatica affects men and women pretty much equally. It does not have an age range that is really prevalent. You kind of see it across the age ranges. Something that crops up during pregnancy, we will get into sciatica and pregnancy a little later in the episode.
The biggest cause for sciatica is a herniated disk, also nerve root irritation or compression on the nerve. Imaging can be helpful but it does not tell you the whole story. If you have sciatica symptoms and they take an x-ray or MRI and they see something. Don’t panic, don’t freak out. The chances that what is there having just shown up are pretty darn low. Occasionally there can be trauma and sciatic can follow that. But most of the time or a lot of the time this is something that is non-irritable for a period of time. Then something happens and you have symptoms.
There is this thing called “double crush” syndrome. Which means that if you have irritation of the nerve anywhere in your body. But it is not enough to have symptoms. Then you get a second irritation somewhere else along that nerve. Now you get symptoms. With sciatica this is often at the piriformis muscle. Which is right in the center of your buttocks.

Other episodes you might find useful:

 

Upper and Lower Extremity Posture: Episode 8

 

Low Back Pain: Episode14

Hip Pain: Episode 15

Radicular Pain: Episode 22

Greater Trochanteric Bursitis: Episode 28

Pain: Episode 29

 

Sacroiliac Joint Dysfunction: Episode 27

  • Sacroiliac joint dysfunction is controversial. The joint itself is not really mobile and therefore does not act like other joints.

  • Today’s Chips: Tim’s Cascade Snacks – Hawaiian Ginger Wasabi. Thank you Steve Kovisto!

  • Trivia question of the week: What American city is considered the birthplace of the potato chip?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

 

 

Rebound Therapy & Wellness Clinic has joined Team Grover for the Fight for Air Climb on March 3rd at Republic Plaza. This even raises money for the American Lung Association.

To learn more check out: https://action.lung.org/site/TR?fr_id=17508&pg=entry&_ga=2.8921013.1498938364.1547918000-523393982.1547225137

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To donate: https://action.lung.org/ffaClimbFY19/dashboard.html?pc2_page=center&fr_id=17508

 

 

Today we are going to be covering SI Joint dysfunction. Oh that is a controversial topic. And we are going to be reviewing Tim’s Hawaiian Ginger Wasabi compliments of Steve Kovisto. Why did you say Steve’s. Not Tim’s. It’s the brand name, the brand name is Tim’s. No it’s Hawaiian. No it’s Tim’s. Ok, That does not make any sense. You are right that does not make any sense. They are special. Ok. Looking forward to it. SI joint dysfunction.

 

What is your take on it Christiaan? The SI joint is a pseudo-joint. It’s kind of misnamed isn’t it? It’s very misnamed, it’s where several bones come together. Yeah but It’s not like any other joint in the body that is a nice smooth congruent surface that is designed for movement. That’s true. The SI joint was designed for a lot of things but movement was not one of them.

 

The articular surfaces, if you even want to call them that, are basically course and have ridges and depressions. They are almost like 2 interlocking ridges. If you were designing that for movement you would do a bad job. I almost said a bad word. The best way to think of it is to take your knuckles and stick them together. That is kind of what they look like. Yup, which would provide a ton of stability. Yes, That is what we are looking for. Mobility not Stability.

 

The joint itself has about total of 3 degrees or less of translation which accounts to about 2mm or less of movement. That is not a lot. If you know millimeters that is less then a 1/32 of an inch.

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