physical therapy

Don't Let Sciatica Slow You Down In 2019


'Sciatica' and 'Bulging Discs'...Can It Get Better Without Surgery?

Is this happening to you?

Have you ever felt a ‘twinge’ in your back bending over to pick something up? Or have you ever felt that nagging discomfort in the back of your hip when you’ve been driving for way too long? Have you ever experienced deep, burning pain that shoots down your leg which seems to come out of nowhere sometimes?

If this sounds like you, then you, like many others out there may be dealing with a common back injury we know as 'sciatica'...

What is sciatica?

Sciatica is a very common symptom usually caused by a ‘pinched nerve’ in your back that may come in the form of a ‘bulging’ or ‘herniated’ disc…

It can cause a 'deep pain' or 'tooth ache' in the back of your hip or 'nerve pain' that travels down your leg...

Sometimes it feels like you've pulled your 'hamstring' muscle, even though you don't recall ever doing anything like that.

What makes it tricky to deal with sometimes is you may feel pain in your LEG, but it might actually be coming from your BACK even though you may not have pain in your back!

Why does it happen?

Sciatica symptoms generally occur in people who sit too much, have poor hip and spine mobility, and weak 'core and back muscles' that are not able to support the back properly.

Like most injuries, it generally doesn’t happen ‘all at once’, but builds-up over time in the form of stress, strain, and pressure on the 'discs' in your back...

These ‘discs’ are generally strong and resilient ‘jelly donuts’ that when introduced with loads greater than the tissues are able to tolerate over long periods of time, may ‘push fluid’ onto the nerves, causing pain.

Over time, more pressure builds up, thus, more pain, and less ability to do simple tasks such as bending or sitting...

Is it fixable?


But it does NOT go away on its own with simply ‘resting’ or ‘waiting’…

Instead of trying to get to the ROOT CAUSE of the problem, most doctors choose to treat the symptoms of ‘sciatica’ with some form of painkiller, recommend 'rest' and also suggest more ‘invasive’ procedures such as an injections, or even surgery if it doesn’t get better!

But they make the critical mistake of only seeing a 'back' and do NOT take a look at the WHOLE PICTURE...

But if you look at the body and its movement as a whole, and put your back in the right ‘environment’ to heal, you still have a GREAT chance at healing completely naturally!

- Just like a cut on your skin will not heal properly if left in a dirty place…

- Or someone trying to lose weight living in a house full of bread and cookies…

- Or imagine a coal-miner who is suffering from lung problems…

The environment in which you live in dictates how well your ‘sciatica’ or ‘pinched nerve’ can heal!!!

For example, recently I worked with a very active woman from Venice named Shelly (age 41)…

She initially hurt her back at Barry’s Boot Camp as she tried desperately to get back in shape for a high school reunion.

She was feeling great, was losing weight, but felt a bit of nagging back stiffness in her workouts...

This quickly turned into something more serious when she was trying to do ‘deadlifts’.

Suddenly, she felt a ‘pull’ which shot down her leg and stopped her from exercising.

She went to see the doctor, but all she got were painkillers (didn't take them), was told ‘rest’ and 'stretch her hamstrings'.

Shelly did what she was told and rested on her sofa, and per the doctor’s advice, stretched her hamstrings 3 times/day.

However, at the end of 6 weeks of ‘resting’, she wasn’t improving, if anything she’d gotten worse…


Because she was 'sitting' too long each day, stretching her 'hamstrings', and not moving enough while 'resting'.

This created a POOR environment for healing, placing MORE strain on her disc, and nerve, rather than alleviating it!

When she did make it in to see us, we were able to quickly get to the root of the problem, and were able to reduce her pain by over 60% within DAYS by doing just 3 simple things…

1. She set a timer on her phone which reminded her to stand up every 10 minutes at her desk at work, and instead of sitting in her recliner at home, she laid on her stomach instead.

2. She performed 10 “backward bending” movements every hour to ‘offset’ the amount of ‘forward bending’ her body was doing.

3. She STOPPED stretching her hamstrings, but instead focused on stretching the ‘tighter’ (but often neglected) “hip flexor” muscles in the front of her legs

Using these 3 very simple strategies put her back, and her body in a MUCH HEALTHIER ENVIRONMENT to heal, and took her body OUT of the position which was causing her pain…

And not only was she out of pain, but she also:

- Returned to the gym (and now exercising with MUCH better form, and crushed her goal of losing 20lbs)

- Made a key change to her lifestyle by using a standing-desk to keep pressure OFF her healing disc

- Was able to heal her ‘bulging disc’ completely naturally without taking a single pill!

Our bodies are capable of healing, in AMAZING way, but understand that placing it in the proper environment to heal is of utmost importance...

And for Shelly, taking FURTHER action, and not simply ‘waiting’ for her back to get better made all the difference…

And even though she’d been diagnosed with a ‘bulging disc’ and had severe ‘sciatica’, she was able to completely return to her normal, active lifestyle…


For each and every person, the root cause of sciatica can be quite different, and what may have worked for Shelly, may not be right for you! If you try some of these movements, or strategies, and you feel it is making your symptoms worse, then I URGE you to stop, and instead, send me an email at and I will do my best to help guide you through this process!

If you want even MORE information about how to not only get rid of your back pain, but fix it for GOOD, check out the free guide I’ve created of 10 Little Known Secrets To Ending Low Back Pain by clicking on the link below.

Just go to the linked page above, fill out the form with your info and the report will be emailed to you within seconds!

To your health in 2019!

Santo Riva, Doctor of Physical Therapy

PS. if you ever have ANY questions, or would like me to clarify about a topic, or would like to talk about any specific problems you may be having, please send me an email at and I’ll be happy to respond to your question promptly!

PPS. If you’re ready for a more specialized treatment plan that is guaranteed to get to the root of your problem, give us a call OR hit the button below and fill out the short form.


Shoulder Pain Slowing You Down? This Easy Self-Assessment Might Tell You The Cause!

“Where you think it is - it ain’t” Ida Rolf

We see hundreds of patients with anterior shoulder pain. And while a lot of the time, the biceps tendon is the culprit (but not always), the real source of the problem is a stiff, or stuck, posterior shoulder!

Here’s a quick screen you can easily perform on your own to assess the range of motion of the primary posterior shoulder muscles - teres minor and infraspinatus.

  1. Lean against a wall (this helps keep your scapula down).

  2. Bring your elbow to shoulder height.

  3. Bend your elbow to 90 degrees and rotate your hand down without letting your shoulder pop forward or your scapula to move.

You SHOULD HAVE about 90 degrees of motion or in other words, be able to almost touch the wall with your hand.

Limited internal rotation ROM leads to compensations with functional activities and can ultimately lead to pain and poor function. Then you come 😢crying to us to fix you.

Take care of it now!

Tired of living with pain?!?


The “Little Known” Muscle That May Be The Key To Fixing Your Back Pain….AND What You Can Do To Fix It!

If you have back pain😢, there's a good chance you need to work on strengthening your multifidus!


The multifidus muscle runs along your entire back (on each side of your spine), from your sacrum to your cervical spine. It originates at the transverse process of the vertebrae and attaches to the spinous process of the vertebrae 2-4 segments above. 

When the right and left multifidi contract together👐, they extend the spine. With an isolated contraction of the multifidus on just one side☝️, the muscle produces ipsilateral (same side) lateral spinal flexion and contralateral (opposite side) spinal rotation. For example, if the left multifidus contracts, it brings your left shoulder down and turns you to the right. 

The multifidus is a deep muscle of the spine and is extremely important in spinal stabilization🏋️ Research shows that people with low back pain often have significant atrophy of this muscle. Atrophy and weakness of the multifidus will lead to decreased stability of the spine, and can result in a vicious cycle of low back pain. Break the cycle and strengthen your multifidi to avoid low back pain👍

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If you want to strengthen your multifidus, you need to first learn how to properly activate it so you know which muscle should be firing when you're doing your core exercises.

  • Start standing with one foot in front of the other

  • To palpate the multifidus, place your thumb right next to the spine on the low back

  • Shift your weight forward and allow your heel to come off the ground

  • You should feel the multifidus pop into your thumb as it contracts

  • Try to maintain that contraction as you shift your weight back to the starting position

The Multifidus lift

Below is a great multifidus strengthening exercise. It also engages many of the other core muscles that need to be strong to stabilize the spine👍

  • Start with your left knee on a yoga block or foam pad and your right knee on the ground.

  • Engage your abdominals and activate your multifidus to pull your right knee parallel to your right so your pelvis is parallel to the floor.

With the right knee down as shown in the video, you will need the muscles that rotate your spine to the left to work. As you pull your right knee up to parallel, your right multifidus will be the one working.

  • Extend your right leg back and your left arm forward to further challenge the multifidus, transverse abdominals, obliques, glute max, and erector spinae.

Multifidus walk out

The multifidus walk out is a great way to strengthen the multifidus in a more functional standing position. Since many daily activities that require spinal stabilization are done in standing, it's important to train the multifidus in that same upright position.

  • Attach a band to a secure object about chest height level.

  • Grab on to the band with your arms straight

  • Take 3 large steps to the side

  • Keep your arms directly in front of your chest the whole time--don't let the band rotate your trunk as you step to the side.

As shown in the video, as you step out to the right, the band will be trying to rotate your spine to the left. Your left multifidus will be activated to perform relative right spinal rotation to prevent the band from rotating you to the left.

Do 10 reps on each side and feel your back pain melt away☺️

Medial Knee Pain⚡️--Pes Anserine Bursitis--Part 3


Strengthening the muscles of the hip and knee 🏋️ is an important part of rehabilitation from pes anserine bursitis. As mentioned several posts ago, excessive foot pronation and knee valgus can contribute to inflammation of the bursa. These two exercises improve hip and knee strength and strengthen the muscles necessary to avoid excessive foot pronation and knee valgus (knees caving in) with activity. 1️⃣Gliders 🔸Place band around ankles 🔸Place towel (if on hardwood floor) or paper plate (if on carpet) under foot 🔸In a squat position, glide the leg out to the side, back/diagonal, and straight to the back 🔸Keep the standing leg in a squat the entire time and keep toes pointed forward 🔸You should feel both legs working 🔸Perform 2 sets of 10 on each leg 2️⃣Side steps with band around arches 🔸Place band around arches 🔸Pull arches up without rolling to the outsides of the feet 🔸Side step across floor 🔸Keep toes pointed forward, arches pulled up, knees slightly bent, and trunk still 🔸Do 2 laps 🔸If you want to really work the glutes, add another band around the knees or ankles

Online Booking Now Available!


Do you like to look at ALL of your options before you book an appointment?  Is it 11pm before you actually get a minute to think about taking care of things for yourself?  Or maybe you just hate talking to people on the phone?

We feel you!

That's why we hooked up with Jane App to introduce online booking :)

Do yourself a favor and set yourself up with an appointment asap.

Spinal Manipulations Good For Back Pain

Leading Physical Therapist For Low Back Pain In Los Angeles

If any practitioner tells you that they are re-aligning you, run.  What we do know though is that spinal manipulations create a neurophysiological affect that can down regulate pain and create a window to allow patient/client to work on performing meaningful movement with less pain.

Check out the full article here on

Is Pain A Disease

This video discusses chronic pain and the current management.

This TED talk goes into what causes chronic pain.  Real interesting stuff with an easy to understand explanation.  Chronic pain can be so devastating to those who suffer from it and the people around them.  The good news though is that PT, along with a integrated health care team approach, can and do help.

Check the 8 minute talk here. 

Best PREHAB Exercises For Your Low Back

This blog post discusses the best exercises to prevent low back pain from industry leaders in sports therapy

Side note:  Each of these authors wrote their own articles without knowing what the others were writing.  Do you see a common thread???

Shout out to The Prehab Guys for making this happen, and the rest of the authors: Zach Long, DPT, SCS, PES; Jarod Hall, PT, DPT, CSCS; Michael Mash, DPT, Cert. TMM, CSCS, FMS; Dr. Joel Seedman, PhD, CSCS, ACSM, FMS; Perry Nickelston, DC, NKT, SFMA; MoveU |The Back Pain Guys – Dr. Mike Wasilisin and Andrew Dettelbach; Mitch Babcock, PT, DPT, SFMA

The Butt Wink

This is an image of the lumbar spine with its disks and sacrum and pelvis. Do you butt wink?

The Butt Wink🍑😉 

We've been spending a lot of time on instagram talking about hip mobility, but haven't talked too much about disorders and movement faults that can happen as a result of limited mobility.  Mobility is a prerequisite for moving well, but having mobility doesn't mean that you automatically can or will move well😕  For example, let say your pelvis tilts posteriorly (butt winks) before you get to the bottom of your squat.  This MAY be because of limited glute or posterior capsule mobility.  BUT, maybe not!  What, you say?!? Listen up - you might butt wink before you run out of your actual hip range because your nervous system doesn't know how to effectively move through your available motion with a neutral spine.  Got it🤔 
Anyways, we'll get more into the strength and motor control demands in some different posts. Promise.

Your spine attaches directly to your pelvis. Whatever your pelvis does, your spine follows. What's happening when you see the dreaded "butt wink" during a squat or deadlift, is the pelvis rotating posteriorly. Your spine follows suit, going into flexion and putting compressive pressure onto the anterior part of the disc, vertebrae and facet joints. Now add whatever weight you are squatting/deadlifting and those forces grow exponentially. This is the most common mechanism for disc herniations😱☠️😱 
You can fix this by working on the flexibility and joint mobility in the hips and ankles as well as spending some time on the actual movement mechanics. 
Stay tuned to our instagram account for 🎥  of techniques to mobilize the hip and get deeper into your squats without destroying your back. 


🤗 New Year And A New Space 🤗

Our New Location At Kinesis Movement Studio for Victory Performance and Physical Therapy

A new year always brings a lot of changes and uncertainty - this one especially for a lot of people.

We're not big on New Year's resolutions or any of that, because if you truly want to change something, why wait?  But this year's New Year coincides with a big change for us and a new partnership and friendship with the Kinesis Movement Studio.  

Come visit us at our new location at 12528 West Washington Boulevard, LA CA 90066.


Stiff Ankles = PROBLEMS (Ankle Motor Control)


Movement starts from the 👟 up!  We’ve posted a few videos on how to improve your ankle ROM over the past few weeks.  This final video in the series shows you how to own that new range of motion.  Without teaching your body how to effectively use the new range, it will continue to fall into the same restricted movement patterns, and all of that stretching will go to 💩!

Eccentric strength through ankle dorsiflexion ROM is essential.  In fact, EMG studies show that the gastrocs soleus complex (our calves) are most active in the gait cycle when slowing down our tibias as they move over our feet in the stance phase.    Translation- our calf muscles need to be the strongest when controlling and slowing down our bodies during walking (during ankle dorsiflexion), and not actuallywhen we would think they are pushing us forward (ankle plantar flexion)🤔  We’ll save that though for another post though.

Stiff Ankles = PROBLEMS (2/3)

Ankle joint capusle mobilizations

If you are lacking ankle range of motion, specifically dorsiflexion, you need to look at soft tissue mobility as well as joint capsule mobility.  A previous video we posted showed you how a few ways to address soft tissue restrictions.  Here's some techniques to get at the joint.  The last video of this series will go over turning your new range of motion gains into functional, usable gains that stick.    

Stiff Ankles = PROBLEMS (1/3)

How to increase ankle mobility in stiff ankles with soft tissue mobilization and active tri-planar stretching.

If your lacking ankle dorsiflexion (shin moving over your foot), your body will compensate.  Sometimes this manifests as flat feet, or externally rotating at your femur (duck walking).  This limitation also wreaks havoc on squats = less #gainz 😉

This video shows a soft tissue mobilization technique using the handle of the @mostfitworkouts #corehammer followed by an active tri-planar stretch.  If you don't have a core hammer, use your foam roller, pvc pipe, oly bar, or even a beer bottle. 

While the gastrocs/soleus complex primarily functions in the saggital plane (front to back), there are fibers that also work in the frontal and transverse plane.  Do this mobilization and stretch complex before your workout.

Note - these techniques won’t help you if your problem is primarily joint stiffness.  Follow us for that post coming up later this week.

Hip Strength Series - Clams


Hip strengthening is the 🔑 to preventing injuries in the active population. Whether you're walking, going up and down stairs, squatting, running, or jumping, good glute strength will help to keep your joints protected. Strong glute muscles help to maintain proper trunk, knee, and foot alignment to prevent you from putting unnecessary stress on your joints. A strong 🍑 can help to prevent low back pain, patellofemoral pain, and IT band syndrome. Here are some of our favorite simple glute strengthening exercises to target the glute med, glute max, and hip external rotators