!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& 9:;4-)# <&::#.5.-8)#$=)8.0")#2$ $<=,+2(<&6EBF,@2*,/&%(23+*G1(@ & & !2*,H2&,+<&I(-=(&7,*+& Go to: www.advanced-trainings.com/abmp11s/ & • Videos of webinar techniques. !"#$#%&#'()*(&+#(,-.!/(,01(23(2455( & • Request the free Sciatica Webinar “Mini- Manual ” (30-page PDF of slides, more !"#$%&'()&$ techniques, and detailed notes). *+,)-'.+/!0)"-"-123'45$ & • Links to ABMP, quiz, and optional CE Credit 6,+E&*C,?(@& 6 70"5)#$7"'8&0.2$%8+ .&1@(<&)E&J(-C*@@*B+A& And more.. • Webinar Topics: Getting the Most out of Your Webinar 1. Tests for distinguishing the two main • Avoid multitasking types of sciatic pain; • Engage your body 2. Understanding peripheral nerve pain in general; • Engage your mind 3. Considerations and techniques for working with each type of sciatic nerve pain. K&$<=,+2(<>%-,*+*+?@A2BC& K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & & & (& Time for a poll ! • Have you ever experienced sciatic pain? K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & $<=,+2(<>%-,*+*+?@A2BC.&849D;;& ;&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& %EJ(@&BF&!2*,H2,& *>")#$<'");')$ *::.-+"'&#)0$<'");')$ 6*7#(8/( “ 6"0#(9:;<=:< ” ( 6*7#(88/( “ !$#0'>$:;<=:< ” /( *#24$?-4@-$)2333$ !;";?>"@;$(9*%'">@#( A45:0.22"4-$2"8.$ A#"B#(">>&$( C;$&<D(&>(%#"B#(">>&$( %4@$B)'?$:)"-$ EF#%(7"#$#%&( G$0<DD*(<)$#%&( 74283$8("1(C$B&D4'?$:)"-$ G$0<DD*(7"#$#%&( G$0<DD*(7"#$#%&( 7)"-$+"28)#$84$?-..$ G$0<DD*(<)$#%&( 9>@#=@#$(7"#$#%&( E4)#2$ H#%&D*('#:>@7"#$$(D0@)<"$I( L#D#<$#(#%&"<7@#%&$I( J<$#(>B#"<DD(10<"';%1(<%'( J%$0"#(%#"B#(1D;'#( #K#:&$(>?(7<;%( K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & A)&2.2$4F$*>")#$<'");'$G-80):5.-8$ • Lumbar vertebra position (e.g., spondylolisthesis, scoliosis) • Bulging or herniated disc; degenerative disc disease • Spinal stenosis (canal or foramen narrowing) • Spinal tumor or infection; prostate cancer • Direct trauma and injury to nerve roots • Pregnancy • Psoas entrapment (3 rd and 4 th lumbar ventral spinal rami) K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & $<=,+2(<>%-,*+*+?@A2BC.&849D;;& 9&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& $<=,+2(<>%-,*+*+?@A2BC.&849D;;& N&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& *>")#$<'");')$<"1-2$ 1. Pain in back, buttock, and/or thigh, usually not below knee. 2. Positive (painful) SLT 3. “Sciatic scoliosis”: Leaning away from affected side K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & *>")#$<'");')$A4-2"+.0);4-2$ • Goals: 1. Gently decompress lumbars; 2. Ease overall guarding and effects of pain. • Work slowly: do deep work only gradually, noting response between sessions. • If you do direct work with lumbar area, get informed consent: “There’s a chance you could feel worse.” • Avoid longitudinal compression or anterior shearing (listhesis) of vertebra; use caution with prone or seated positions. • Don’t hesitate to refer to an MD, Orthopedist, Chiropractor, PT, DO, Advanced Rolfer, other rehabilitation specialist. K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & $<=,+2(<>%-,*+*+?@A2BC.&849D;;& :&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& E: Epineurium P: Perineurium $<=,+2(<>%-,*+*+?@A2BC.&849D;;& O&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& $<=,+2(<>%-,*+*+?@A2BC.&849D;;& P&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& A-02: Piriformis Test *::.-+"'&#)0$<'");')$<"1-2$ 1. Pain in buttock and/or thigh, sometimes below knee. 2. Positive (painful) Piriformis Test 3. Increased pain with: • Sitting • Stairs • Direct pressure • Active external hip rotation 4. Can be worse at night (from accumulated nervi nervorum stimuli and decreased efferent nerve activity). K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & $<=,+2(<>%-,*+*+?@A2BC.&849D;;& Q&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& (& Time for a poll ! <AH*!HA*$<!*!< & • If you have ever experienced sciatic pain, do you think it 1. Piriformis issues are twice as common as lumbar issues in sciatica. was: 2. Piriformis syndrome is 6 times more frequent in 1. Axial Sciatica women than in men. 2. Appendicular Sciatica 3. Lumbar disk issues are 2 times more common in 3. Both men than women. 1. Filler A, Haynes J, Jordan S, et al. Journal of Neurosurgery: Spine, 2005;2(2):99-115. (If you have never had sciatic pain, skip this poll). 2. Carol L. Otis, M.D., http://www.sportsdoctor.com/articles/sciatica3.html 3. Noordeen, Hilali et al. Interactive Spine v1.66. Primal Pictures Ltd, 2009 K&$<=,+2(<>%-,*+*+?@A2BC& K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & & & A4-80"B&8402$84$*::.-+"'&#)0$<'");')$ • Sitting: pressure from wallets, bucket seats • Driving: sitting; gas pedal (also a risk factor for disk issues) • Sacral position and freedom (piriformis acts on sacrum) • Leg length differences, ankle pronation, hip rotation • Direct trauma and injury to sciatic nerve • Pregnancy • Connective tissue hardening or hypertrophy of rotators / hamstrings (from over-use or postural strain) K&$<=,+2(<>%-,*+*+?@A2BC& B-02: Sciatic Nerve Glide Test LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & *::.-+"'&#)0$<'");'$$ G-80):5.-8$<"8.2 & 1. Under, over, through, or around the piriformis K&$<=,+2(<>%-,*+*+?@A2BC& B-02: Sciatic Nerve Glide Test LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & $<=,+2(<>%-,*+*+?@A2BC.&849D;;& 8&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& *::.-+"'&#)0$<'");'$$ G-80):5.-8$<"8.2 & 1. Under, over, through, or around the piriformis K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & *::.-+"'&#)0$<'");'$$ G-80):5.-8$<"8.2 & 1. Under, over, through, or around the piriformis 2. Between rotators and gluteus maximus K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & $<=,+2(<>%-,*+*+?@A2BC.&849D;;& R&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& XB-08: Piriformis & Rotators Technique XB-08: Piriformis & Rotators Technique *::.-+"'&#)0$<'");'$$ *::.-+"'&#)0$<'");'$$ G-80):5.-8$<"8.2 & G-80):5.-8$<"8.2 & 1. Under, over, through, or around the piriformis 1. Under, over, through, or around the piriformis 2. Between rotators and gluteus maximus 2. Between rotators and gluteus maximus 3. In the intermuscular septum between biceps femoris/adductor magnus in the posterior thigh. K&$<=,+2(<>%-,*+*+?@A2BC& K&$<=,+2(<>%-,*+*+?@A2BC& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& LLLA,<=,+2(<>M-,*+*+?@A2BC4,)CJ;;@4& & & & & $<=,+2(<>%-,*+*+?@A2BC.&849D;;& ;D&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& B-07: Biceps Femoris/Adductor Magnus Technique B-07: Biceps Femoris/Adductor Magnus Technique $<=,+2(<>%-,*+*+?@A2BC.&849D;;& ;;&
!"#$%#"$&'()*+,-.&%*/&0123,1&4&$567& 849:4;;& B-10: Sciatic Nerve Technique: Supine “B” B-10: Sciatic Nerve Technique: Supine “B” $<=,+2(<>%-,*+*+?@A2BC.&849D;;& ;9&
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