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102 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 6 technique MYOSKELETAL ALIGNMENT TECHNIQUES In full disclosure, the original focus of this column was my personal battle with sciatica, but my wife encouraged me to swallow my professional pride and include the accompanying health-club incident as well. No matter how smart we think we are, our trusty brains occasionally allow us to do really stupid things. In my case, it was during a six-week period in 2005 that I systematically demolished the posterior cruciate ligaments and menisci in both my knees doing calf raises on an incline leg-press machine. It seemed so brilliant at the time—perform my usual 220-pound leg presses, then reposition the balls of my feet at the bottom edge of the foot plate (knees slightly hyperextended) and attempt a few sets of calf raises. With every biomechanically destructive repetition, I remember thinking: "Ahh, that stretch on the back of my knees feels fantastic … really lengthening those hammies!" Thankfully, I've experienced very little pain from the knee instability I created, primarily due to a rigorous rehab routine, which includes swimming six days a week. Earlier this year, however, an orthopedic buddy got me going in a different direction when he brought over a new 3D laser-designed custom knee that was guaranteed to get me back hiking the hills of our Costa Rican casa. That was all the encouragement I needed. A successful bilateral knee replacement surgery allowed me to walk unassisted through the neighborhood by week three, but an unexpected and unfortunate event transpired during my initial hospital stay. As I was lying awkwardly propped up in bed one morning, excruciating pain began shooting down both hips into my legs (Image 1). I'd never personally experienced these symptoms before, but the verdict was immediately irrefutable: bilateral sciatica. UNDERSTANDING SCIATICA In the Treatise of Diseases, Hippocrates coined the term "sciatica" from the Greek ischios, meaning hip. For decades, pelvic and leg pain were wrongly attributed to a subluxated hip. Unfortunately, many of us still consider sciatica a disorder when, in fact, it is a set of symptoms resulting from nerve compression and inflammation. Although there are numerous causes of sciatica, the most common include lumbar disc herniations, osteoarthritic facet joints, spinal stenosis, piriformis syndrome, spondylolisthesis, and sacroiliac dysfunction. Sciatica & The Health-Club Incident A Personal Tale of Trauma By Erik Dalton, PhD 1 2 Sequestrated Extruded Protruded Day three, following the author's bilateral knee replacement surgery. Progression of disc degeneration.