PUSH Fitness & Rehabiliation
Welcome !! PUSH-as-Rx ®™ is leading the field with laser focus supporting our youth sport programs. The PUSH-as-Rx ®™ System is a sport specific athletic program designed by a strength-agility coach and physiology doctor with a combined 40 years of experience working with extreme athletes. At its core, the program is the multidisciplinary study of reactive agility, body mechanics and extreme motion dynamics. Through continuous and detailed assessments of the athletes in motion and while under direct supervised stress loads, a clear quantitative picture of body dynamics emerges. Exposure to the biomechanical vulnerabilities are presented to our team. Immediately, we adjust our methods for our athletes in order to optimize performance. This highly adaptive system with continual dynamic adjustments has helped many of our athletes come back faster, stronger, and ready post injury while safely minimizing recovery times. Results demonstrate clear improved agility, speed, decreased reaction time with greatly improved postural-torque mechanics. PUSH-as-Rx ®™ offers specialized extreme performance enhancements to our athletes no matter the age.

Herniated Discs: Definition, Progression & Diagnosis

What is a Herniated Disc?

Herniation of the nucleus pulposus (HNP) occurs when the nucleus pulposus (gel-like substance) breaks through the anulus fibrosus (tire-like structure) of an intervertebral disc (spinal shock absorber).

A herniated disc occurs most often in the lumbar region of the spine especially at the L4-L5 and L5-S1 levels (L = Lumbar, S = Sacral). This is because the lumbar spine carries most of the body’s weight. People between the ages of 30 and 50 appear to be vulnerable because the elasticity and water content of the nucleus decreases with age.

The progression to an actual HNP varies from slow to sudden onset of symptoms. There are four stages: (1) disc protrusion (2) prolapsed disc (3) disc extrusion (4) sequestered disc. Stages 1 and 2 are referred to as incomplete, where 3 and 4 are complete herniations. Pain resulting from herniation may be combined with a radiculopathy, which means neurological deficit. The deficit may include sensory changes (i.e. tingling, numbness) and/or motor changes (i.e. weakness, reflex loss). These changes are caused by nerve compression created by pressure from interior disc material.

Progression of Herniated Disc 

The extremities affected are dependent upon the vertebral level at which the HNP occurred. Consider the following examples:

  • Cervical – Pain in the neck, shoulders, and arms
  • Thoracic – Pain radiates into the chest
  • Lumbar – Pain extends into the buttocks, thighs, legs

Cauda Equina Syndrome occurs from a central disc herniation and is serious requiring immediate surgical intervention. The symptoms include bilateral leg pain, loss of perianal sensation (anus), paralysis of the bladder, and weakness of the anal sphincter.

DIAGNOSIS OF A HERNIATED DISC

The spine is examined with the patient laying down and standing. Due to muscle spasm, a loss of normal spinal curvature may be noted. Radicular pain (inflammation of a spinal nerve) may increase when pressure is applied to the affected spinal level.

A Lasegue test, also known as Straight-leg Raising Test, is performed. The patient lies down, the knee is extended, and the hip is flexed. If pain is aggravated or produced, it is an indication the lower lumbosacral nerve roots are inflamed.

Other neurological tests are performed to determine loss of sensation and/or motor function. Abnormal reflexes are noted as these changes may indicate the location of the herniation.

Radiographs are helpful, but Computed Axial Tomography (CAT) or Magnetic Resonance Imaging (MRI) provides more detail. The MRI is the best method enabling the physician to see the soft spinal tissues unseen in a conventional x-ray.

RADIOGRAPHIC EVIDENCE OF HNP

The findings from the examination and tests are compared to make a proper diagnosis. This includes determining the location of the herniation so treatment options can be reviewed with the patient.

Written by Edgar G. Dawson, MD; Reviewed by Howard S. An, MD

Dr. Alex Jimenez D.C.,C.C.S.T’s insight:

Herniation occurs when the (gel-like substance) breaks through the (tire-like structure) of an disc (spinal shock absorber). For Answers to any questions you may have please call Dr. Jimenez at 915-850-0900

English EN Spanish ES