The electrifying truths about sciatica

It’s electrifying, it’s like lightening, it’s not Lightning McQueen though…It’s sciatica. Electric bolts of pain that is really no fun at all.


Sciatica is not a diagnosis but a description of symptoms. It is the umbrella term that describes pain, tingling, numbness or weakness felt in the leg with the cause of these symptoms originating in the lower back.

Different issues in the lower back, such as a herniated disc (aka slipped disc) or degenerative disc disease (ie general wear and tear of the discs), can cause sciatica.

An estimated 70-90% of people (pretty much all of us!!) will suffer from lower back pain at some point in our lives, according to the Australian governments’ Australian Institute of Health and Welfare. Back pain plagues our society, so let’s get into learning some more about it!

4 wheely fun facts about Sciatic nerve anatomy

The sciatic nerve:

  • is the largest single nerve in the human body
  • is as thick as a garden hose in the buttock area
  • runs from each side of the lower spine, through the buttock and down the back of the leg all the way down to the foot. It therefore connects the spinal cord with the leg and foot muscles.
  • can be kinked, compressed or irritated at any point along it’s path. This explains why people describe sciatica differently, as it depends on where the pressure on the sciatic nerve occurs.

The sciatic nerve is pictured below:

What’s that about the bolts of lightening again?

Specific sciatica symptoms can be different in location and severity, depending upon the condition causing the sciatica. Typically what patients feel is:

  • A sharp, shooting pain that may make it difficult to stand up or to walk
  • Constant pain in only one side of the buttock or leg (it very rarely occurs in both legs)
  • Pain that is worse when sitting
  • Leg pain that is often described as burning, tingling or searing (versus a dull ache)
  • Weakness, numbness or difficulty moving the leg or foot
  • Sciatic pain can vary from infrequent and irritating to constant and incapacitating.

Getting to the mechanic – how to treat sciatica

For most people suffering from sciatica, conservative treatment and regular exercise will go a long way to relieving pain and any neurological symptoms.

For a specific group of sciatica sufferers, surgery may be required to provide pain relief and minimize neurological damage.  (If you have the following symptoms – numbness in the groin or pelvic floor area, loss of bladder/bowell function, sudden loss of motor function in both legs, then you need to present to your nearest Emergency Department as this is not sciatica). 

As most cases don’t need to go down the surgical path though, lets look into the broad range of conservative options available for sciatica treatment, with some of the most common and effective options discussed below.

1. Turn the ignition off

In the first couple of days of having acute and severe sciatic symptoms, treatment is focussed on calming the sciatic nerve irritation down. You can:

  • Take medication – talk to your GP or Sports Physician for the most appropriate medication to take.
  • Rest – don’t go to work, forget cleaning the house, just concentrate on looking after yourself. Rest in bed just while the pain is disabling and severe. This should go on for no more than 2 days, until the medication kicks in and your symptoms ease. Then, as you’ll see below you must get up and about.
  • Heat packs – can be a great natural way to give relief and relax the muscles.
  • When the pain is crippling, it can be more effort than it is worth to get into physio, so just stay at home in this really acute period.

2. Ok, time to slowly turn the ignition on now

After the pain relief has kicked in (after 2-3 days), the focus on treatment will change to help get you up and about slowly. Treatment aspects include:

  • Relative rest – the term relative rest is hugely different to just resting! This means you can start to get up and about a little bit, but just be guided by pain. It is hugely important to try and prevent too much deconditioning by completely resting.
  • Heat packs – continue as needed.
  • Medication – continue, as prescribed by your doctor. For worsening cases, imaging and the possibility of injections may be considered.
  • Physio – now we can start! After making a diagnosis, your physiotherapist will most likely do some hands on treatment. You will always be sent home with exercises.. just make sure you do them!

Your physio will work with you to:

  • Reduce the sciatic pain in the short term and help to give you relief
  • Guide you on conditioning exercises (cardio, strengthening and flexibility exercises appropriate to you) to help prevent future episodes.. Let’s explore the exercises in more detail below!

3. Rev up the engine

When the acute pain subsides, now you must start to gradually and progressively build in some exercises.
(NB these exercises are a guide only. You must consult with a physiotherapist to ensure the exercises are appropriate to your body type and your injury at the time).

A. Stretches
Stretching can help to get things moving again, and may provide relief to spasmed and tight muscle groups. 2  helpful stretches to providing relief from sciatic pain are shown below.

B. Strengthening

What lots of people find quite interesting is that after a bout of back pain, your core muscles turn off. Like a switch. Off. The core completely shuts down.

That is why you need to go back to some basic inner core exercises to reassure to the brain, that it is ok to send a message to the right muscle groups to switch on again. Spend 10 minutes, 2-3 times per day for 2 weeks just activating the deep core and focusing on your breathing. Then you can gradually start to increase the difficulty of the inner core activation exercises.

Have you heard of the 10 000 hour rule? In his book, “Outliers: The Story of Success”, Malcolm Gladwell discusses the need to practice a task for 10 000 hours to train your brain. So, get those inner core activation exercises going!!

Just as you start to wake up your deep core, you will also need to start some buttock muscle activation exercises as well. Similar to the deep core, the buttock muscles also switch off when you have back pain.

How to feel as smooth as a Porsche (injury prevention)

To prevent and manage sciatica and other forms of back pain, our physiotherapists at Physiotonic will help you keep:

  • strong in the right places – that is from the inside out in areas such as your core, pelvic floor and buttock muscles. The correct tone and strength of these muscle groups are imperative to support the spine and provide stability.
  • flexible in areas you are tight
  • good posture

Our classes at Physiotonic, will help you to continually work on these factors to keep your spine healthy and prevent Sciatica…. and of course feel as good as a Porsche!

6 things you should know about rotator cuff tears

At some time in your life, either you, a family member or a friend will complain about the crippling effects of shoulder pain.

Although there are many ‘things’ in the shoulder that can cause pain, the most common injury in the shoulder is a rotator cuff tear. The pain can be disruptive to your life, can last a long time and treatment can get very expensive. Let alone if you need surgery to help fix the problem.

In this article, we are going to discuss the 6 things you must know about rotator cuff tears and how to keep your shoulders healthy.

1. The rotator cuff is important!

The rotator cuff is a group of 4 muscles and their tendons that run from your shoulder blade and connect to your arm bone. The connection of your shoulder blade and arm bone is a ball and socket joint. The shapes of these bones when together resemble a golf ball balancing on a golf tee, as shown below.


One of the main functions of the rotator cuff is to help balance the golf ball (the head of the humerus) on the tee (the socket part of the shoulder blade), in order for your shoulder to be able to move.Therefore, if the rotator cuff is torn or partly torn, this can significantly affect your ability to move your arm. That is why it is so important!

 Above: image of the rotator cuff muscles and tendons around the shoulder

2. The referred pain phenomenon

Have you ever had pain down the upper side of your arm?  And as much as you poke and prod it, you just can’t seem to pin point where the pain is coming from? Welcome to the phenomenon of referred pain.

Torn rotator cuff tendons can cause pain deep in the shoulder, around the shoulder or refer down the upper side of the arm. Unfortunately no amount of poking through the side of your arm will lead you to the source of the pain. Just be aware of this, in case it ever happens to you!

Above: the red markings show the ‘referred’ pain you may feel

3. A direct cause and effect

If you have a torn rotator cuff, you can pinpoint exactly what movements cause pain and feel weak. Common painful and weak movements include:

  • lifting
  • overhead activities such as hanging out the clothes
  • tucking your shirt in as you reach behind your back, and for ladies doing your bra up behind your back
  • combing your hair
  • playing tennis
  • swimming

4. Chances are your shoulders are going to wear out through life!

Rotator cuff tendons are so commonly torn and this is in part due to the limited blood supply of the tendon. It is estimated by the age of 50, 60-70% of people will have a tear shown on ultrasound.

The tear can either happen:

  1. in a single traumatic episode, such as falling onto an outstretched arm.
  2. over time due to repetitive microtrauma.

Let’s look at (b) more closely as it is the most common way people end up with a cuff tear, as it is a normal part of ageing.

Your rotator cuff tendons pass through a small space, called the subacromial space. In a normal shoulder, as you reach your arm overhead there is enough room for your tendons and bursa to pass through this space.

However, with various muscle imbalances, what happens when you reach your arm overhead, is that the tendons and bursa get squashed in this space. As they keep getting squashed, initially micro damage to the tendons occur (which typically happens through your 20’s and 30’s) until eventually the tendons get so worn out that they start to tear (which starts to happen in your 50’s), initially with smaller tears and overtime ultimately with larger tears.


5.  Get the right advice

If you start to experience shoulder pain, make sure you see either a:

  • physiotherapist with experience in sports injuries
  • GP with an interest in musculoskeletal medicine
  • Sports Physician
  • Orthopaedic surgeon

Either of these professionals will perform a physical examination to diagnose the problems with your shoulder. They may suggest you get some imaging done to provide further information. Options include:

  • an X-ray – you will most likely need this to asses the integrity and shape of your bones
  • MRI – this is the gold standard and can give you a lot of useful information, but can be expensive
  •  an ultrasound – beware!! not all ultrasound tests are created equally!

A little more information on ultrasounds
Ultrasounds are cheap, non-invasive, quick and free of radiation. However, test results are highly dependant on the person performing them and are notoriously difficult to interpret. Your results may significantly over or under report the damage that is there.

The chances are if we were to repeat the ultrasound on your good, pain-free shoulder, you may have just as many problems on the report for that shoulder. This is because tests can report degeneration and damage but they can’t report where your pain is coming from. Wear and tear is normal. You need a good team of health professionals to interpret any tests you have.

To make the most out of your ultrasound, make sure you are referred to a radiologist who specializes in reporting on the shoulder (there are only a handful in Sydney, so ask us if you ever need a recommendation).

6. You need to keep your shoulder muscles healthy… starting from today!

By coming to Physiotonic classes, we are helping you create a habit of good posture. Research has shown poor posture where the spine is hunched forwards, the shoulders are rounded and the neck pokes out, is linked to shoulder problems. In this poor posture, the muscles at the front of the shoulder such as your pec muscles become very tight and overactive. Meanwhile the muscles at the back of the shoulder become weak.

This simple muscle imbalance exacerbates shoulder problems. So to manage and prevent shoulder and rotator cuff problems, through Physiotonic we  get you to:

  • activate the muscles at the back of your shoulder to help you improve your shoulder posture (which is the shoulder blade setting we talk about during class)
  • continue to work on your deep core activation to help with your overall posture.

Some tips to incorporate in your exercise routine include:

  • do less pushing exercises involving your shoulders such as bench press and chest press
  • do more pulling exercises such as pull downs with the cables,  horizontal pulls and bent over reverse flies.

However, if you are experiencing shoulder pain, you really do need to get yourself to a good sports physio to ensure you are engaging the right muscles, as it is very easy to get it wrong.

In summary, your rotator cuff tendons are important to your shoulder. They are commonly injured, so you need to look after them. Don’t carry a world of pain on your shoulders. It is better to be proactive and do the right exercises for your shoulders, from today.


When an ostrich is scared, the bird apparently buries its head in the sand to avoid danger with the logic, ‘if I can’t see it, it doesn’t exist’. This is the Ostrich effect. Maybe it isn’t as ridiculous as it sounds because humans do it too as we often look away from our problems.We really need to pull our heads out of the sand, face our problems and take life head on to overcome life’s obstacles as we work towards happiness and living a better life.

When I read books to my daughter I notice that it is engrained into us as children that we are all going to live happily ever after. But are we?

Did you know that in Australia, it is estimated that 45 per cent of people will experience a mental health condition in their lifetime? (statistic from Beyond Blue. For more info go to And as reported in The Lancet, December 2014 , mental ill health is now, staggeringly, the most important health issue facing young people worldwide. It is the leading cause of disability in people aged 10–24 years. Wow.

There is only one children’s book I have come across so far that paints a fair and realistic picture of life, encouraging you as the reader to take responsibility and find your own opportunities. That is Dr Seuss’s children’s book ‘Oh, the places you’ll go’.  Don’t get me wrong, fairytales and fantasies certainly do have a role in children’s lives as they plant the seed for us all to dream.

However, it is paramount to be in the right frame of mind, to be truly healthy and happy. Mindfulness is probably a term you have heard thrown around in the media lately, and the talk about it has become as popular as the fashionable vegetable, kale. Mindfulness is the focus of one’s attention on emotions, thoughts and sensations occurring in the present moment. It is used to treat a variety of mental and physical conditions including depression and anxiety.

Physiotonic started the year with the newsletter feature of New Year’s Resolutions. This month our focus is on reflection (by the way how are those NYR’s going?) and to remind you to give some attention to your emotions, thoughts and sensations.

So just how introspective are you? Some questions you could ask yourself are:

  • how healthy are you right now? Where are your aches and pains and what are you doing about it?
  • if you are in a relationship,  what are the relationships’ strengths and weaknesses and what can you do to improve it?
  • how close are you to the rest of your family like your kids, your parents and your siblings? Can you be more active in your relationships with them to feel closer to them?
  • what are your friendships like? Do you surround yourself with energetic, positive, motivated and like-minded people?
  • how much satisfaction and enjoyment does your job bring? Lets face it, you are there probably 50 hours per week, so best to enjoy your time there.
  • are you keeping your mind active by reading and learning about new things?
  • where are your finances up to and what could you be doing better?
  • how well do you sleep? This is an important point as good quality sleep is imperative for your well-being. If you aren’t sleeping well what needs to change? Perhaps you need to avoid screen time 1-2 hours before bed time to improve your sleep, or reduce the amount of caffeine you consume or do a good exercise session during the day to tire you out. We receive great feedback from Physiotonic participants who say they sleep really well after our classes, so perhaps you need to factor in more time to do Physiotonic classes.
Above all, simply ask yourself how am I? Where am I at and what do I need to change to make life happier. Physiotonic is there to help you focus on your:
  • breathing to help you relax, reduce stress and improve your sleep quality
  • strength, tone and flexibility to help you recover and/or manage injuries and reduce your pain (plus the toning exercises will help you look good!)
  • posture to help you feel good and to hold yourself well and with confidence
  • and to remind you about mindfulness… are you feeling introspective yet?!
Take the time to read some of the lines from Dr Seuss’s book ‘Oh the places you’ll go’ written below as we can all learn something from it. And remember… Don’t be an ostrich!“Congratulations! Today is your day. You’re off to Great Places! You’re off and away!

You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose. You’re on your own. And you know what you know. And YOU are the guy who’ll decide where to go….

You won’t lag behind, because you’ll have the speed. You’ll pass the whole gang and you’ll soon take the lead. Wherever you fly, you’ll be best of the best. Wherever you go, you will top all the rest.

Except when you don’t. Because, sometimes youwont. I’m sorry to say so but, sadly, it’s true that Bang-ups and Hang-ups can happen to you. You can get all hung up in a prickle-ly perch. And your gang will fly on. You’ll be left in a Lurch.

You’ll come down from the lurch with an unpleasant bump, and the chances are, then, that you’ll be in a Slump. And when you’re in a slump, you’re not in for much fun. Un-slumping yourself is not easily done….

You can get so confused that you’ll start in to race down long wiggled roads at break-necking pace and grind on for miles across weirdish wild space, headed, I fear, toward a most useless place… The Waiting Place…

for people just waiting. Waiting for a train to go or a bus to come, or a plane to go or the mail to come, or the rain to go or the phone to ring, or the snow to snow or waiting around for a Yes or No or waiting for their hair to grow. Everyone is just waiting.

Waiting for the fish to bite or waiting for wind to fly a kite or waiting around for Friday night or waiting, perhaps, for their Uncle Jake or a pot to boil, or a better break or a string of pearls, or a pair of pants or a wig with curls, or another chance. Everyone is just waiting.

NO! That’s not for you! Somehow you’ll escape all that waiting and staying. You’ll find the bright places where boom bands are playing.

You’ll get mixed up, of course, as you already know. You’ll get mixed up with many strange birds as you go. So be sure when you step. Step with care and great tact and remember that Life’s a Great Balancing Act. Just never forget to be dexterous and deft. And never mix up your right for with your left.

And will you succeed? Yes! You will, indeed! (98 and ¾ cent guaranteed). KID, YOU’LL MOVE MOUNTAINS!…

Today is your day! Your mountain is waiting. So… get on your way!”