Sciatica can truly be a pain in the butt. It can also radiate into your leg or even to your foot. Technically, sciatica means the sciatic nerve is irritated, it’s not a diagnosis, rather it is a description of the location of the pain. Sciatic pain has many causes, including pregnancy, injury, herniation of a disc, or spinal stenosis, and more. The good news is that sometimes sciatic pain can be reduced with targeted stretches. The bad news is that if the condition has progressed too far, stretches alone may not be sufficient. As with any self-care procedures, you should cautiously test the stretch to make sure it agrees with your body. Of course, if your symptoms persist or worsen, you should consult a healthcare provider.
Symptoms of sciatica:
- Buttock pain
- Thigh pain
- Lower leg or foot pain
- Weakness in the leg or foot
Common causes of sciatica:
- Mechanical irritation
- Compression
- Stenosis
- Spondylolisthesis
- Facet arthropathy/arthritis
- Piriformis syndrome
If your sciatic pain is due to muscle contraction, like piriformis syndrome, it is probable that self-care procedures can help you. Targeted stretching, specific exercises, and soft tissue compression treatments likely will provide you with some relief. At Olympic Spine and Sports Therapy, we have found that most patients respond best to the sequence of compression, then reactivation then finishing with stretches. Compression/self – myofascial release helps to work out trigger points, and release local areas of increased muscle contraction. Reactivation exercises are used to restore strength to muscles that are week due to lack of use or inhibited due to pain.
Dr. Mark Shelley explains how spinal disc problems can often contribute to sciatica pain.
Stretches help to lengthen shortened muscles and restore normal length/tension ratios of the muscles.
Compression/Self-Myofascial Release
Stick Roller
Use a stick roller to release the quads which will reduce inhibition and range of motion of the glutes. Start just above the knee cap, pressing into the quad with as much force as you can tolerate. Roll up towards your hips slowly. Perform passes on the medial, central, and lateral regions of both quads.
Foam Rolling
Foam roll the glutes and deep external rotators to release the muscles and potentially decrease pressure on the sciatic nerve. Start by sitting on the foam roller with on leg crossed over the other. Move your weight onto the hip of the leg that is crossed onto the other and begin slowly rolling forwards and backward. If this too much to tolerate initially, start without crossing your target leg over the other.
Lacrosse Ball
Use a lacrosse ball on the glutes and deep external rotators of the hip as an alternative to foam rolling. The lacrosse ball gives you more targeted pressure on hard to reach muscles. Once placed against the wall, bring your feet away from the wall for more leverage. Push into the lacrosse ball and slowly roll it from the tailbone to the outer hip.
Peanut
Peanut compression on glutes and deep external rotators for multiple contacts of release. Place and use just like a lacrosse ball.
Reactivation Exercises for the Core
Dead bug
The Dead bug will help you build isometric strength in your core while you coordinate with your limbs. This improves your ability to keep your core strong and stable while performing full-body movements. Start with your hips and knee bent to 90 degrees with arms pointed at the ceiling. Extend the opposite arm and leg while the other two limbs do not move. Pull extended limbs to their start position and then do extend the other two limbs.
Glute Bridge
Glutes play a large roll in the stability of the hips, and subsequently, the spine. The two are closely connected via the sacroiliac joint. Building strength in your glutes and hips is critical for maintaining stability in the hips and low back.
Start on your back with hips and knees bent. Drive your hips into the air without bending your spine. This means as your hips come off the table, so does your spine entire spine up to the base of your neck.
Clamshell
Chronic low back pain can repattern muscle coordination in the low back and hips. The clamshell helps coordinate the muscles of the lateral hip by firing all 3 muscles in the gluteal group with the deep stabilizers of the hip.
Start on your side with your knees, hips, and shoulders all in a straight line. Lift your top knee as high as possible without opening your hips up to the ceiling. Keep heels touching. Squeeze your hips muscles at the top and slowly lower your knee.
Stretches
Pigeon Pose
Pigeon Pose targets all of the external rotators in your hip, but the muscle we are really after is called the piriformis. In 15% of people, the sciatic nerve actually penetrates the piriformis muscle. When it gets overly tight, it can compress the sciatic nerve and create typical sciatica symptoms; hip/glute pain, stinging or throbbing pain on the backside of the leg, etc.
Hip External Rotation – FABRE
This stretch is great for opening up your groin muscles and testing how much passive external rotation you have. Place your heel on the outside of the other knee and slowly allow your knee to drift away from your midline. Hold the end position for 30 seconds to 1 minute. You will feel a stretch in your groin and possibly the front of your hip.
Hip Internal Rotation – Roadkill
Stretching the external rotators of your hips is very difficult to do while in hip extension. This stretch will help you gain internal rotation by stretching all your external rotators!
Place a dumbbell on your lower foot with a bent hip and knee. Bring your top knee up so that your hip is flexed to 90 degrees. Push your top hip down towards the floor. Relax into this position until you feel a stretch in your hip.
Door Frame Decompression
This version of manual decompression can be a great way to open up (decompression) your low back. Grab the top of a door frame and slowly begin to hang. If you grip can’t hold you up, that’s okay, keep your toes on the ground! Try to breathe slowly until you feel a stretching in your low back. If you have a good grip, try straightening your legs and placing your feet on the ground in front of you or elevating your feet in front of you onto a box while hanging. This will give you increased disc space on the back of your vertebral column which could relieve some pressure.
Hip Flexor Stretch
When the quads get very tight, they can limit the functionality of the glutes, which could give you hip and low back instability!
By releasing your quads with the two stretches below, you may be able to clear up low back pain and/or sciatica! Start with the first variation of this quad stretch. If it is easily achievable, advance to the second by bringing your foot up the wall. Focus on driving the hip joint forward to achieve a stretch.
What to do if self-care doesn’t work
Hopefully, cautious and consistent use of these self-care therapies will provide relief. If they don’t, if your symptoms persist more than a few weeks or progress, you should be evaluated by a healthcare provider. Sometimes a single intervention is sufficient. Chiropractic adjustments, Physical Therapy, or Massage may do the trick. Sometimes, a more comprehensive treatment approach is necessary.
At Olympic Spine & Sports Therapy we have the ability to provide a combination of treatments for a more complete care approach. We offer Non-surgical spinal decompression, High dose laser, Chiropractic care, Trigenics skilled manual therapy, Massage therapy, and Physical rehabilitation. In addition to on-site therapy using state of the art equipment, we custom tailor home therapy plans for each patient. Our goal is to provide relief with results that last.
Don’t hesitate to reach out to us if we can be of help. We offer in-person and teleconferences for consultations free of charge. You can reach us at 425-967-6426.
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