Leg pain (hamstring, calve) and often lower back pain

[superward]

Hi,

I was looking for some advice.

I am currently experiencing a lot of pain in my left leg. Most days it is in my hamstring but can also be in the side of my calf or the full leg. It is brought on my by walking (even if only for 5 mins) and once sitting down goes away. I also experience at some times pain in my lower back on the left side just above my buttock which may be connected. But, the leg pain is the most prevalent and painful

I play football 1/2 times a week and while playing it seems to subside but if I stop and stand it often comes back.

Last summer I hurt my back while at work, literally by standing up out of a chair, and could hardly straighten up/tie shoe laces/bend to get something without being in extreme pain which may be connected?

I also have extremely tight hamstrings...always have.

Does wanyone have any advice on what I can do or the causes for this?

[alophysio]

Hi,

It sounds like the back is involved. The symptoms are commonly known as Sciatca although this will need to be checked properly.

There are many reasons why you might have pain in the leg. The fact that moving helps your pain may mean you have a sustained position dysfunction and need to learn to control your posture differently to how you currently hold yourself.

Just because your hamstrings are tight, it doesn't mean they are - they might just be overactive in trying to protect you.

If you haven't seen a physio yet, do so. Find a good one. If you have seen a few, then let us know what they have done to see if there are any gaps we can help with... Cheers

[superward]

Hi,

Thanks a lot for your reply.

I was at a physio last week, got an appointment on Monday with a different one for a 2nd opinion.

The physio I seen implied it was from hurting my back last summer and the muscle being over protected and therefore being very tight and impinging the nerve.

She gave me 6 excercises...well describe best I can

A back arch from press up position
A back arch with arms behind back
Sitting striaght, legs out straight, moving feet back an forth to loosen muscle at bottom of spine.
Lying flat on back, knees together and bent, twist to side and arch back
From chair, leaning over touching ankles to stretch back
Hamstring stretch with both legs holding feet and trying to straighten out.

The last one is VERY painful on my left leg - the one affected.

Will update with what happens on Monday...but what do you think of above?

Thanks a lot in advance

[alophysio]

HI,

DIfficult to say withouyt having examined you but i usually dn't prescribe painful exercises or stretches. From the set of exercises given, perhaps the first 2 are McKenzie extension exercises, the 3rd maybe a neural mobilisation exercise, the 4th a general rotation stretch/mobilisation, 5th a back stretch for the muscles at the back of the back (if you know what i mean!) and the last seems like a very intense hamstring stretch.

The above exercises seem ok but i really don't like the sound of the last one. Many better ways to do stretches and mobility exercises than both legs at the same time.

The main questions are...

...do you feel better for your attendance?

...do you have a decent understanding of your problem (a diagnosis)?

...does this diagnosis sound right to you? - in other words, did you sit there and go "yeah, that makes complete sense!"?

Good luck!

[Canuck Physio]

Lot's of work is needed, no one thing normally will get this done...

These are key areas needing work:

- Soft tissue
- Ergonomics (Gravity acts on us 24hrs/day - its your choice whether that is 24 hrs in good alignment or poor alignment -*NASA studies and bed rest studies show that bed rest ain't the solution).
- Muscle recruitment, balance, spasm etc. (based on the onset of injury it says that something was wrong before that point: in that muscles were not recruiting properly, and your muscles had to spasm and become inflamed to protect you).

Indeed referred symptoms will require much of the work around torso etc.

[alophysio]

Hi,

Thanks Canuck Physio, well said.

Superward, you didn't mention what the physio did for treatment...was it the exercise prescription only? Or was there some soft tissue massage? Stretches? Joint mobilisations? machines used?

I think the point perhaps Canuck Physio was trying to make was that exercises alone is not all there is to treatment (?) - indeed, there are many things that you could address in this condition. At least that's what i am thinking...

[superward]

Hi,

Thanks for all your replies...a little update.

Been a couple of times to the 2nd physio.

She prescribed 5 excercises to me...

1. Sittin on chair, straighten knee as far as possible (probably only about 60 degrees at mo) and bring toe towards me and away.
2. Back stretch from chair as above
3. Lying on back with arms in T position, knees bent, roll both legs side to side,
4. Lie on back, left leg at 90 degrees, rotate hip across body by pulling on toe with belt to stretch muscle in me bum (pirifiros?)
5. A back arch stretch from press up position

The 4th excercise gives me a lot of releif and I think by doing this overall I have had some reilief but in general it is still pretty painful.

On my 2nd visit last monday she used some ultrasound on my back and also some massage. She also was doing something down the bottom of my spine which involved a lot of pushing and pain but really seemed to loosen it up.

Her diagnosis is "stiff" lower back joints and possibly anothe impingement in my piriforsi/bum msucle.
What does everyone think?

[alophysio]

HI,

my thoughts are that you have overly compressed joints and that is why you find relief from the stretching and manual therapy and heat.

Peter O'Sullivan calls it "active extension" pattern. Others call it other things.

[sixphysio]

your physio needs to tell you what is causing the problem, rather that what it is. why the "stiff joints" type of thing.

if the physio can tell you why then you need to have those bits pushed and moved around and the other painful bits stabilised.

none of it should hurt or be painful - it'll feel like your being pushed, but that's all.

can't understand machines - or their users!

as alo said if it smells and tastes right to you (ie you understand what's being said and why) then crack on. i'm sure we'd all do different things, but as long as you are getting better (rather than told you are) then all's good.

cheers

sixphysio