One of the most common issues I get regarding nerve entrapment is sciatica. True sciatica is caused by a nerve impingement around the Lumbar plexus due to the vertebrates compressing the nerve or bone spurs. However, more often the case it is also possible to have muscular entrapment of the sciatic nerve by the piriformis muscle. This sciatic issue caused by the piriformis is known as Piriformis Syndrome.
The sciatic nerve is responsible most of the innervation of the posterior thigh and front and lateral lower leg. There is also cutaneous innervation of the posterior leg which is referring to the feeling on the dermis such as touch, temperature, ect.
Signs you may have sciatica/piriformis syndrome:
Low back pain
Pinching sensation in hips
Weakness down leg like hamstrings
Numbness in foot
Lack of sensation around skin in posterior thigh
How to assess with P-DTR:
One of the most important things to check for is the piriformis muscle. This deep hip external rotator is often one of the most common sites of entrapment for the sciatic nerve.
How we do our initial assessment of the sciatic nerve
The most improtant thing is to see if there are signs of nerve entrapment down the leg. The best way to do this is test muscles that are innervated by the sciatic nerve at different points such as: hamstrings, tibialis posterior, and extensor digitorum longus (extension of big toe). If these area all extremely weak then it is likely there could be nerve entrapment down the sciatic nerve. We can also test piriformis and see if it is overworking or locked up. This means it'll be putting extra pressure on the sciatic nerve.
Treatment with P-DTR
Once we identify weakness down the sciatic nerve and a locked piriformis then we can use the P-DTR technique to allow piriformis to relax.
The important part of this method is to make sure we do a lot of positional testing including:
Supine, prone and seated.
Anterior, neutral, and posterior pelvic tilt.
Rotation, tilt, flexion and extension on the neck/head.
Utilizing massage therapy and photobiomodulation to further results
If piriformis was locked then massage therapy and cupping therapy can be a great way to help further relax piriformis after it has been reconditioned. This will help increase blood flow, stimulate lymph, and help break apart any scar tissue.
Helping recharge the nerve with red and infrared light can help kick-start the sciatic nerves muscle innervation.
Schedule Your Bodywork Session Today:
Learn more about P-DTR here:
コメント