Winnipeg Chiropractor

Exercise of the Month: Dead Bug

~ Dr. Robert Speirs DC ~ Leave a comment

Dead Bug

Begin lying on your back with your right arm reaching overhead and your left leg flat on the table. Your right knee should be bent 90 degrees and your hip 45 degrees. Place your left wrist beneath your back to prevent your back from flattening against the ground. Slowly begin by raising your left knee and right arm at the same time until your hand touches your knee. Be sure not to lift your head or allow your spine to flatten against the floor. Return to the start position and repeat for three sets of 10 repetitions on each side, twice per day or as directed.

Trigger points in the piriformis muscle

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The piriformis muscle is a small muscle deep to glute max and lies over top of the sciatic nerve. It originates on the anterior sacrum, and inserts on the greater trochanter of the femur. It’s main action is to laterally rotate the femur. When trigger points developed in this muscle they will refer pain into the sacro-iliac region, across the posterior hip and down the leg. This muscle can also be a cause of sciatic nerve irritation if it gets tight, causing “sciatica” symptoms.

Piriformis Syndrome; a real bummer.

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Piriformis syndrome results from compression of the sciatic nerve as it passes underneath a muscle in your buttock called the piriformis. Your piriformis muscle attaches from the lowest part of your spine (sacrum) and travels across to your hip. The muscle helps to rotate your leg outward when it contracts. In most people, the sciatic nerve travels deep to the piriformis muscle.

When your piriformis muscle is irritated or goes into spasm, it may cause a painful compression of your sciatic nerve. Approximately ¼ of the population is more likely to suffer from piriformis syndrome because their sciatic nerve passes through the muscle.

Piriformis syndrome may begin suddenly as a result of an injury or may develop slowly from repeated irritation. Common causes include: a fall onto the buttocks, catching oneself from a “near fall,” strains, long distance walking, stair climbing or sitting on the edge of a hard surface or wallet. In many cases, a specific triggering event cannot be pinpointed. The condition is most common in 40-60 year olds and affects women more often than men.

Symptoms of piriformis syndrome include pain, numbness or tingling that begins in your buttock and radiates along the course of your sciatic nerve toward your foot. Symptoms often increase when you are sitting or standing in one position for longer than 15-20 minutes. Changing positions may help. You may notice that your symptoms increase when you walk, run, climb stairs, ride in a car, sit cross-legged or get up from a chair.

Sciatic arising from piriformis syndrome is one of the most treatable varieties and generally is relieved by the type of treatment provided in this office. You may need to temporarily limit activities that aggravate the piriformis muscle, including hill and stair climbing, walking on uneven surfaces, intense downhill running or twisting and throwing objects backwards, i.e., firewood. Be sure to avoid sitting on one foot and take frequent breaks from prolonged standing, sitting and car rides. You may find relief by applying an ice pack to your buttock for 15-20 minutes at a time, several times throughout the day.

Trigger points in the gluteus minimus

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The gluteus minimus is a small but important muscle that lies deep to the gluteus medius. It originates on the gluteal surface of the ilium, and attaches on the greater trochanter of the femur. It’s main actions are to abduct and medically rotate the hip. Trigger points in this muscle refer pain into the buttock and down the lateral and posterior leg, mimicking sciatica. This muscle should be the first to be examined if a straight leg test turns out negative.

Osgood Schlatter’s Disease

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Children and adolescents have soft “growth plates,” which are areas where their bone is still growing. In children, this growth plate is much weaker than in adults. This means that children are more likely to suffer growth plate injuries than adults, especially during periods of rapid growth.

Osgood Schlatter’s disease, also called tibial epiphysitis, is a painful irritation of the growth plate near the insertion of your quadriceps muscle on your knee. The powerful thigh muscles attach onto your knee through the patellar tendon. When your thigh muscle contracts- like during running or jumping, they place a sheer force on the growth plate of your knee.
Osgood Schlatter’s disease is more common in athletes, particularly those who participate in soccer, gymnastics, basketball, running or track. It is most common between the ages of 10 and 15 and is relatively equally common between boys and girls. Excessively tight thigh or calf muscles may contribute to this problem.

You may experience pain with activity that requires running or jumping. You will often feel tenderness or even bony enlargement of your “tibial tuberosity”, just below your knee. Kneeling or prolonged squatting may be painful.

Some athletes with mild cases may continue activity as long as it does not increase your symptoms. Most cases may require a period of rest to allow the condition to heal. Depending on the severity of your condition, you may need to limit activities that require running and jumping for a while, usually two to eight weeks. You can often cross train in the pool or on a stationary bike.

You should avoid running with a narrow stride “on a line,” as this may increase your symptoms. Our office may recommend use of a patellar tendon strap to assist with your healing. Osgood Schlatter’s disease can temporarily limit your activity, but most of the time, it can be successfully managed, allowing your return to pain-free activity in a relatively short period of time.

Trigger points in the gluteus medius muscle

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The gluteus medius muscle plays an important role in hip and pelvic stability. It originates on the gluteal surface of the ilium, deep to the gluteus Maximus. It inserts on the greater trochanter of the femur. It’s main actions are to abduct the hip and to assist in internal rotation of the hip. It also maintains pelvic stability during walking and running. Trigger points in this muscle will refer pain into the sacrum, the iliac crest, and down the lateral hip and into the thigh. This muscle is often a cause of lower pack pain.

Knee Arthritis; Who, Where, Why and How?

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The bones in your knee have a slick protective covering called “cartilage” on the joint surfaces that touch each other. This cartilage serves as a friction reducer and shock absorber, thereby helping to extend the life of your joints. “Arthritis” means that your cartilage has begun to thin or crack and may eventually wear away, leading to a painful “bone on bone” situation.

Knee arthritis is very common, affecting more than 1/3 of adults over age 65. People who are overweight or have a history of knee injury or surgery are more likely to develop arthritis. Jobs and activities that require repetitive squatting, kneeling, pivoting or stair climbing may cause increased wear. Contrary to popular opinion, runners have no increased risk of developing knee arthritis. Women are two to three times more likely to develop knee arthritis as compared to men.

The pain of knee arthritis is often described as a “deep ache” that is aggravated by activity and relieved by rest. You probably notice morning stiffness that goes away after a short period of activity, but returns after sitting for long periods of time. Some patients have difficulty squatting, bending and walking stairs. You may notice that your knees pop and crack. Eventually, knee arthritis can cause you to walk slower, lose your balance and even fall more often. Many patients notice that their symptoms increase with weather changes.

Although there is no cure for the irreversible wearing associated with arthritis, there is help for your symptoms. Performing your home exercises is very important. The way that your knee is aligned (and wears) is largely based upon how your hip and foot function, so many of your home exercises will target those regions. Our office may prescribe arch supports or orthotics, since people with flat feet are almost twice as likely to suffer from knee arthritis.

Overweight patients should begin or increase low-impact aerobic exercises like walking, stationary cycling, elliptical exercising, water walking or swimming. Be sure to take frequent breaks from prolonged sitting and avoid overly painful activities.

Trigger points in the gluteus Maximus

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The gluteus Maximus is the buttock muscle. It originates on the gluteal surface of the ilium, lumbar fascia, sacrum and sacrotuberous ligament. It inserts on the gluteal tuberosity of the femur and the iliotibial tract. Extension and lateral rotation of the hip are it’s main actions. This muscle is heavily involved in activities like ice skating and is a common area to develops trigger points. When trigger points do develop they can refer pain in a crescent pattern from the gluteal fold to the sacrum. Trigger points can also refer pain deep into the buttock itself making it feel like other deeper muscles are involved. These symptoms can sometimes be mistaken for s.i. Joint problems.

SI Joint Dysfunction. Nothing FUN about it.

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Your sacroiliac joint is the mechanical link on each side of your hip that connects your legs to the rest of your body. The joint has a limited but very important degree of mobility. Symptoms develop when one or both of the joints loses normal motion. When a joint becomes “restricted”, a self-perpetuating cycle of discomfort follows. Restriction causes the muscles to become overworked, leading to tightness, compression, inflammation, pain and more restriction.
Sacroiliac problems can happen as a result of repetitive strenuous activity or trauma- like a fall onto the buttocks. Other causes of sacroiliac joint problems include, poor posture, having one leg slightly longer than another, having an altered gait, having flat feet or scoliosis, or having pain somewhere else in your legs. Pregnancy is a common trigger for sacroiliac joint problems due to weight gain, gait changes and postural stress.

Sacroiliac joint problems often begin as a focal discomfort in your back just below the belt line, slightly to one side of center. Your pain can travel into your buttock or thigh. Symptoms are often worse by standing on the affected side. The pain may become more apparent when you change positions- like exiting a chair, car or bed, or during long car rides. The pain is often relieved by lying down.

To assist with your recovery, you should avoid any activity that provokes pain, like standing on the affected leg or prolonged sitting.

Trigger points in the supraspinatus

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The supraspinatus is a muscle of the rotator cuff. Is sits above the infraspinatus and originates on the supraspinous fossa of the scapula. It’s insertion point is the superior facet of the greater tubercle of the humerus. It’s main function is to abduct the arm at the glenohumeral joint working with the deltoid. All rotator cuff muscles act to secure and support the head of the humerus in the glenoid fossa during arm movements acting as a sling. This muscle often gets impinged during overhead movements such as painting a ceiling. When trigger points form in this muscle they primarily refer a deep achy pain into the mid deltoid area with spillover pain radiating down the arm into the elbow.