Introduction
Welcome to The Fundamentals of Sciatica!
In this intro, I share exactly why I built this course. I specifically designed it for sport PTs who are either overwhelmed or a little stuck with acute sciatica patients. I share how it builds real confidence through clinical pattern recognition & lasting results.
This system will help you eval, treat, and communicate with your patients more effectively without getting lost in overcomplicating fluff.
Over the next several days, you’ll get the Module 1 video lessons from Solve-Sciatica’s online course.
You’ll get one video lesson delivered to your inbox every day for the next week.
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Timestamps:
0:00 – Welcome and who this course is for (self-doubt vs. curiosity)
0:36 – Mez’s background: from neuro + ortho roots to creating the course
2:40 – The turning point: freezing during acute evals despite tons of con ed
4:00 – Story of an early patient that left him feeling helpless
6:00 – How Martin (OMT mentor) helped him connect theory to real patient care
7:00 – Why the profession needs to move beyond pain science vs. biomechanics
8:45 – This course is a pragmatic, field-tested system, not a theoretical debate
9:45 – What this course is and is NOT
11:25 – Module 1: Pattern Recognition (The Fundamentals of Sciatica)
12:36 – Module 2: The 4 neuro-orthopedic sensitivities framework
13:16 – Module 3: Subjective exam to build patient confidence & stay grounded
13:50 – Module 4: Physical exam — checklist + flow to clarify patient patterns
14:12 – Module 5: Self-care education & communication for patient ownership
15:00 – Final encouragement + let’s dive into Module 1
P.S. The first module 1 video lesson will be delivered to your inbox within the next hour. Check your spam just in case.
Module 1.1: The Pain Science - Biomechanics Continuum
In this first lesson, I want to challenge the biggest mental trap that keeps good clinicians stuck, picking sides between pain science and biomechanics.
Back when I was in my PNF residency, I made that mistake. I got so attached to one model of motor control that it actually got in the way of my patient’s progress. Thankfully, my mentor stepped in and showed me how both models had value — I just couldn’t see it yet.
That moment changed everything for me.
In this video, I’ll walk you through that story and help you recognize where your own clinical biases might be sneaking in. You’ll start seeing the continuum between pain science and biomechanics, or any “conflicting” approach, for what it really is — a perspective to use to help make better decisions, not a side to pick.
By the end, you’ll:
See how overcommitting to one model limits growth and patient results
Learn how to catch your own clinical bias in real time
Start thinking more like a problem solver than a “method follower”
Get a short reflection exercise to help you bridge both sides
Watch until the end — the “Clinical Success” prompts I share will help you clarify where you currently stand before we dive into the next concept: Divergent vs. Convergent Thinking.
⏱️ TIMESTAMPS ⏱️
0:00 – 0:20 | Welcome to Module 1: Pattern Recognition & Divergent Thinking
0:21 – 1:00 | The pain science ↔ biomechanics continuum explained
1:01 – 1:55 | A story from my PNF residency that changed how I think
1:56 – 3:00 | How bias toward one model blocked a patient’s progress
3:01 – 3:55 | My mentor’s intervention and what it taught me
3:56 – 4:35 | The rookie mistake that every PT makes early on
4:36 – 5:40 | Reflection: which side of the continuum do you lean toward?
5:41 – 6:25 | Why it’s not about choosing sides — it’s about being adaptable
6:26 – 7:00 | How to think like “Terry,” not rookie Mez
7:01 – 8:55 | Clinical Success reflection: unpacking your own biases
8:56 – 9:40 | My “salt and pepper” analogy for blending pain science & biomechanics
9:41 – 10:22 | What’s next: Divergent vs. Convergent Thinking
Depending on where we are on our continuing education journey, I believe our own aversions or biases towards either end of any rehab approach can and will interfere with our patients' success.
P.S. Stay tuned into you inbox for tomorrow’s video…
The clinical super power that I think every physical therapist should have in their back pocket to accelerate your patient outcomes & your success in spine rehabilitation.
Module 1.2: Divergent vs Convergent Thinking
In this lesson, you’ll learn one of the most important mindset shifts every performance-minded PT needs to make before tackling acute sciatica and complex low back pain.
Too many clinicians still fall into convergent thinking — believing there’s one “right” model or one “best” approach to treating back pain. In reality, world-class clinicians operate with divergent thinking — they recognize multiple valid perspectives and integrate them fluidly to fit the patient in front of them.
Through real stories featuring leaders like Stuart McGill, Gray Cook, and Pavel Kolar, Mez shows how seemingly opposite philosophies often lead to the same clinical truths when guided by sound principles.
You’ll see how true mastery isn’t about choosing between biomechanics or pain science… it’s about learning to blend both in context.
By the end, you’ll know:
Why debates like “pain science vs biomechanics” are a trap
What divergent thinking looks like in real clinical reasoning
How the best clinicians adapt frameworks rather than defend them
And how this sets you up for the next step: pattern recognition — learning what matters most for the specific patient in front of you
⚕️Watch until the end for your Clinical Success prompts — they’ll help you uncover which model you lean on most and where your next layer of growth lies.
⏱️TIME STAMP
0:00 – 0:20 | Intro: What divergent & convergent thinking mean in clinical practice
0:21 – 1:05 | Why this concept explains the pain science vs biomechanics divide
1:06 – 2:24 | Story #1 — McGill vs. Pavel Kolar (DNS) evaluate the same athlete differently, same conclusion
2:25 – 3:36 | Story #2 — McGill vs. Gray Cook at Stanford: how debate turns to agreement
3:37 – 4:55 | Historical context: Maitland, Kaltenborn, PNF, and NDT “tribes”
4:56 – 6:15 | Convergent thinking: the illusion of one “best” method
6:16 – 7:20 | The danger of “either/or” thinking in evidence-based care
7:21 – 8:00 | Divergent thinking: embracing and instead of or
8:01 – 9:00 | Integrating biomechanics and pain science through neurodynamics
9:01 – 10:20 | Clinical takeaway: how to decide which perspective matters most right now
10:21 – 11:15 | Clinical success prompts & reflection exercise
P.S. Stay tuned into you inbox for tomorrow’s video…
I’ll share the #1 “secret sauce” every master clinician has that's more important than any other clinical skill. Get laser focused on continuing to develop this 1 skill and your clinical growth will be ridiculous.
P.P.S If you don't want to wait for the rest of the module 1 videos and would rather get the rest of this LBP course now click here
Module 1.3: Pattern Recognition: "The Secret Sauce"
In this lesson, I’m going to show you why pattern recognition is the single most important skill that separates calm, confident clinicians from those who get stuck in analysis paralysis during an eval.
If you’ve ever found yourself mid-evaluation with an acute low back pain or sciatica patient thinking,
“I could go PRI… or DNS… or McGill… or maybe McKenzie…”
and suddenly felt completely overwhelmed — you’re not alone. I’ve been there too.
I’ll share a story from one of my own evals where I had all the right knowledge, but because I didn’t yet have pattern recognition, I made a choice that actually caused my patient to flare up and lose trust in PT altogether.
Pattern recognition is what keeps that from happening. It’s what allows you to confidently know what NOT to do, reduce your treatment options down so you that you can make clear, patient-specific decisions without overthinking.
By the end of this video, you’ll know:
Understand what pattern recognition actually is in clinical practice
See how it helps you organize chaos and stay grounded under pressure
Learn how to distinguish experience from actual clinical growth
Get a short reflection exercise to help you define your own non-negotiables for subjective and objective exams
Stick around to the end — you’ll get “clinical success” prompts to help you clarify your current pattern recognition habits before we move into the next lesson tomorrow on lumbar spine mechanics and sensitization.
⏱️TIME STAMP
0:00 – 0:20 | Welcome to the Pattern Recognition section
0:21 – 1:10 | Why pattern recognition matters in acute low back pain
1:11 – 2:15 | The overwhelm every “con-ed junkie” experiences
2:16 – 3:30 | The freedom pattern recognition actually gives you as a clinician
3:31 – 4:45 | My story: when too many options led to a patient flare-up
4:46 – 6:05 | How I learned the hard way what pattern recognition really means
6:06 – 7:15 | Defining pattern recognition: linking symptoms, signs, and history
7:16 – 8:00 | Why experience doesn’t guarantee growth
8:01 – 8:50 | Experience + pattern recognition = clinical mastery
8:51 – 9:40 | The “Clinical Success” reflection exercise
9:41 – 10:30 | Next up: lumbar mechanics, discs, and sensitization for better pattern recognition
P.S Stay tuned for tomorrow's video…
I'll use patient case studies to discuss the functional anatomy of the lumbar spine, discs, and peripheral sensitization that are critical for pattern recognition in both the subjective & objective exam.
p.s If you don't want to wait for the rest of the module 1 videos and would rather get the rest of this LBP course now click here
Module 1.4: Lumbar Discs & Peripheral Sensitization
In this lesson, I break down the most misunderstood aspects of acute low back pain — the functional unit of the spine: the lumbar vertebra + end plate + the disc.
We’ll talk through how these tissues actually behave under load, why they can become sensitized even without “slipping” or structural damage, and how understanding that helps you sharpen your pattern recognition going into your subjective and objective exams.
I’ll walk you through a couple real patient case studies, a snowboarder & a gardener, to show you what load sensitivity looks like in real life, why “flexion is NOT the enemy,” and how to spot discogenic pain that shows up hours or even days after the actual trigger.
By the end, you’ll:
Understand the functional architecture of the disc–vertebra unit
Recognize the signs of mechanical vs. chemical sensitization
Know what delayed discogenic pain looks like and why it happens
Learn why discs heal more slowly than muscle and how to set better expectations with patients
Watch until the end — I’ll share my own acute low back pain story and how it completely changed how I coach patients through recovery timelines and reloading progressions.
⏱️TIME STAMP
0:00 – 0:35 | Welcome to the Lumbar Vertebra, Discs & Peripheral Sensitization module
0:36 – 1:00 | Why this lesson matters for pattern recognition
1:01 – 1:40 | Three key teaching points overview
1:41 – 3:00 | Discs and vertebrae are resilient — not fragile
3:01 – 5:30 | What cadaver lab taught me about disc structure
5:31 – 7:15 | Load, position, and why “flexion isn’t the enemy”
7:16 – 10:15 | Case Study: Dave’s snowboarding case and identifying load sensitivity
10:16 – 13:10 | How the disc and vertebra share compressive loads
13:11 – 16:45 | Micro-fractures, Schmorl’s nodes, and adaptation
16:46 – 19:45 | How strategic loading and unloading promote healing
19:46 – 21:00 | The importance of re-loading vs. avoiding load
21:01 – 24:55 | Delayed discogenic pain patterns explained
24:56 – 27:15 | Case Study: Gardening injury and delayed flare
27:16 – 30:10 | Why healing timeframes for discs differ from muscle
30:11 – 31:50 | My personal acute back pain story
31:51 – 32:45 | The mindset shift that helps patients stay the course
32:46 – 33:10 | Recap: 3 key takeaways for recognizing disc behavior
33:11 – 33:25 | What’s next: Dorsal root ganglion & “mini-brain” sensitization
P.S stay tuned for tomorrow's video…
I break down a case study of an avid yoga practitioner who struggled to find answers to her radicular symptoms. This case will help us discuss critical elements of the nerve root as it relates to peripheral sensitization that'll enhance your clinical pattern recognition at a deep level.
p.s If you don't want to wait for the rest of the module 1 videos and would rather get the rest of this LBP course now click here
Module 1.5: The Dorsal Root Ganglion ("The Mini Brain") & Peripheral Sensitization
In this lesson, I break down the most overlooked, game-changing concepts in back pain and sciatica — the dorsal root ganglion, or DRG.
If you’ve ever had a patient who didn’t fit the typical “disc” pattern — no flexion or extension sensitivity, normal slump test, and yet still had weird twitching, burning, or “my leg doesn’t feel like mine” type of symptoms — this lesson will finally make sense of those cases.
I’ll share Athena’s story — a patient who’d seen multiple specialists and was made to feel “crazy” because her symptoms didn’t fit any textbook.
Through her case, you’ll see how the DRG can create powerful chemical & mechanical sensitivities that mimic discogenic referred pain even when the spine looks fine on imaging. Athena’s case demonstrates classic radicular nerve root behavior.
By the end, you’ll:
Understand how the DRG acts as a “mini brain” 🧠 for sensory processing
Learn how sustained postures can trigger mechanical & chemical irritation
See how perception of threat, stress, and prior pain experiences amplify sensitivity
Learn how to identify a sensitive DRG pattern when classic disc tests come up clean
Walk away knowing exactly how to explain this to patients in language that gives them hope instead of fear
Stay with me through the end — you’ll see how to use these insights clinically and how to set up your next module on peripheral sensitization & the action potential threshold.
⏱️TIME STAMP
0:00 – 0:30 | Welcome to Section 5: The Dorsal Root Ganglion & Peripheral Sensitization
0:31 – 1:05 | Why DRG sensitivity matters for pattern recognition
1:06 – 2:15 | When acute back pain cases don’t fit the disc pattern
2:16 – 3:25 | Story intro: Athena’s confusing pain presentation
3:26 – 5:45 | Subjective clues — morning pain, post-yoga symptoms, leg twitches
5:46 – 7:45 | Objective findings — negative slump, pain only with sustained extension
7:46 – 9:00 | The “aha” moment: reproducing her exact symptoms
9:01 – 10:15 | Why sustained extension can irritate the DRG
10:16 – 12:25 | Anatomy breakdown: how closing the foramen increases pressure
12:26 – 14:40 | The “trash" vs groceries” analogy for venous congestion & hypoxia
14:41 – 17:00 | How ischemia leads to chemical sensitization
17:01 – 19:30 | How DRG irritation amplifies peripheral nerve sensitivity
19:31 – 21:00 | Real-world examples: massage flare-ups & chronic sciatica relapses
21:01 – 22:20 | Why sensitivity is temporary — short receptor lifespan = neuroplasticity
22:21 – 23:40 | How to create hope through felt change, not lectures
23:41 – 24:30 | Pattern recognition recap: the “Athena” patient type
24:31 – 25:05 | Clinical tip: use extension-biased slump testing for subtle DRG cases
25:06 – 25:25 | Preview: next up — Peripheral Sensitization & Action Potential Threshold
Stay tuned for tomorrow's video…
where I discuss clinically relevant physiology of sensory receptors & peripheral sensitization. Why do these receptors become sensitive? How does this show up clinically?
p.s If you don't want to wait for the rest of the module 1 videos and would rather get the rest of this LBP course now click here
Module 1.6: Sensory Receptors, The AP Threshold, & Peripheral Sensitization
In this final lesson of Module 1, I bring everything together — biomechanics, pain science, and pattern recognition — and show you how to use these ideas in real patient conversations without sounding like a neuroscience textbook.
I revisit Dave (our load-sensitive case) and Athena (our sustained extension-sensitive case) to explain how mechanical vs. chemical receptor sensitivity shows up in the clinic, and why understanding the action potential (AP) threshold and principle of summation completely changes how you coach patients on load management.
You’ll learn how to explain why back pain can “sneak up” on people by the end of the day, why load management strategies work best before symptoms spike, and how to use simple analogies like the bucket to teach this without losing patient buy-in.
You’ll learn:
How to use peripheral sensitization as an entry point for Pain Neuroscience Education (PNE) talks
Why you should start PNE with the periphery, not the brain, when explaining pain to patients who’re currently flared up
How to meet people where they are using their language (“discs,” “nerves,” etc.)
Practical strategies to desensitize the system — from load & sleep to breath work and exercise
How to avoid triggering fear responses while still empowering patients with clarity
Watch this one all the way through — it’s not just theory. It’s the bridge between your evaluation framework and how you’ll actually communicate it in real life with patients.
⏱️TIME STAMP
0:00 – 0:40 | Welcome to the final section: Peripheral Sensitization & Pain Science Conversations
0:41 – 1:15 | The goal: tie biomechanics and pain science into pattern recognition
1:16 – 2:15 | Why this lesson matters for framing patient education
2:16 – 3:30 | Introducing Dave’s case — load sensitivity and end-of-day flare-ups
3:31 – 5:00 | The coaching moment: why load management must be proactive
5:01 – 7:15 | Sensory Receptor 101 — mechanical vs. chemical activation
7:16 – 9:00 | Debunking the myth of “pain receptors”
9:01 – 10:45 | The Action Potential Threshold & All-or-None Principle explained
10:46 – 12:20 | The Principle of Summation — how small triggers build throughout the day
12:21 – 14:45 | Applying summation to mechanical load sensitivity
14:46 – 16:30 | The Bucket Analogy — teaching patients about sensitivity
16:31 – 17:45 | Introducing Athena’s case — sustained extension sensitivity
17:46 – 19:00 | Coaching Athena using the “minimum effective dose” principle
19:01 – 20:30 | How to start pain science conversations without triggering fear
20:31 – 22:10 | Why starting with peripheral sensitization builds trust
22:11 – 23:40 | Meeting patients where they are: language and tone matter
23:41 – 25:10 | Desensitization strategies: knowledge, movement, and breath
25:11 – 26:30 | Sleep, ergonomics, and environment as clinical interventions
26:31 – 27:45 | The physiology behind calming the nervous system
27:46 – 28:40 | Why movement and blood flow are your best “medications”
28:41 – 30:10 | Medications and short-term chemical desensitization strategies
30:11 – 31:15 | Reflection: connecting all sections of Module 1
31:16 – 33:00 | Clinical Success Work — reflective questions and application
P.S If you’re finding this course clinically helpful and actionable then you’ll love The Complete Solve-Sciatica system. I dive deep into the entire acute evaluation process step-by-step. From the nuances of the subjective interview, the objective exam, and active treatment strategies to help your patients find relief that actually lasts.