HOW TO RELIEVE SCIATICA SYMPTOMS WITH PILATES
What is Sciatica?
Back pain can materialise in many forms and can be a very individual experience, your own history, age, posture, lifestyle, genes etc could all be a factor with the very same condition creating symptoms in one individual and not in another.
With increasing sedentary lifestyles, be it at work, driving long distances in the car, using digital devices, all contribute to the current increasing volume of back pain patients.
Men and women tend to experience back issues in equal measure, its common with c. 80% of people having back pain at some stage and in most cases, it remedies itself with good, proactive self-care.
If the pain continues for a period of time, seeking medical advice could be useful so if you have concerns, visit your GP as a starting point.
We sometimes forget, as we get older - whether we like to accept it or not :-)- the insides of our body start to show wear and tear, just like the grey hair and wrinkles on outside of our body, resulting in degeneration of vertebral disks, or slipped or ‘herniated disks’ - as one example - again, the majority of older adults will show some form of degenerative disk issues under scan, its just down to plain old living.
When pain radiates out to the extremities, be it into the hip (glute area) thigh, knee or foot – the catchall name is often referred to as sciatica.
The sciatic nerve is one of the largest nerves in the body, it extends from the lumbar spine and sacral plexuses in the lower back and runs through the glutes via the sciatic notch, typically running under the piriformis muscle and into the thigh, down the leg, splits at the knee to innervate different parts of the lower leg (the Peroneal nerve and the Tibial nerve) and down into the foot.
Due to its length and pathways, symptoms can be present at different places, depending on the root cause and where the issue is.
Common causes of sciatica:
There are various causes for sciatica where pressure has been put on the nerve but commonly it is due to;
- A disk in the spine degenerates or herniates
- Lumbar Spinal Stenosis - the narrowing of the spinal canal in the lower back
- Spondylolisthesis - where one vertebra slips forward over another one
- Osteophytes (bone spurs)
- Impacts to the sciatic notch through a fall or injury
- Pregnancy - hormones like relaxin can cause a change in ligaments where they become looser and stretched, impacting the structures.
- Soft tissue is also a factor; if the piriformis muscle is overactive this can cause pressure on the nerve or, for example, if the position of the pelvis is altered due to shortening of soft tissue, this can also create pressure on the nerve due to the position of the boney structures onto the nerve or nerve roots.
Common symptoms of sciatica:
- Is usually experienced as a sharp pain, as opposed to a throbbing or dull ache. Words people often use to describe sciatic nerve pain include burning, searing, sharp, or electric-like pain
- Starts in the low back or buttock and radiates down the back of the thigh and typically into the lower leg and/or the foot
- Commonly occurs on one side of the body, but can affect both sides
- Is usually worse when standing or sitting still, and feels better lying down or walking
In addition to pain, other common symptoms include pressure, numbness, tingling, or a prickling sensation that radiates down the leg. Leg or foot weakness may also be present.
BENEFITS AND WATCH OUTS FOR EXCERCISE WITH SCIATICA
Pilates is a very considered and gentle form of exercise and the right teacher should be able to provide the knowledge on do’s and do nots when suffering from disc problems and/or sciatic pain caused by other restrictions in the body’s make up.
Its also a very versatile form of strengthening and stabilising, it has many adaptations to support clients at whatever stage of injury or rehabilitation they're at.
There is a chance after living with sciatic pain for long periods the brain tends to protect its body from movements, compensating in other areas which can result in broader problems for people to deal with at another time.
Pilates is great for learning about how you move, your imbalances and how to address these through awareness and education. I absolutely encourage clients to do exercises at home when they can, movement should be embraced, not be shied away from - especially with modern lifestyles seeing us moving less and less.
Current advice on injury recovery encourages active engagement and movement of joints and soft tissue as part of the process to recovery, the key, is to find the right one for you and build up at the right pace.
BENEFITS OF PILATES
- Develops core strength - we rely on these muscles to act as our body's foundation. When the core is working well, the frame of the body is supported
- Joint mobility and disassociation - learn to create the right relationship between the hips and lower back. Identifies and challenges joint range.
- Strong spine health and length - creating space and support into the spine, helping correct poor posture and mobility
- Increases flexibility - Pilates focuses on a safe range of motion providing the right amount of mobility in the soft tissue needed for everyday life
- Awareness of your body - become more 'tuned in' to your body and how it moves (or not), Pilates brings attention to this connection developing a focus on how to improve movement
- Increased energy - Pilates uses your breath and movement together increasing circulation and stimulates your structure and soft tissue without needing to jump about. A gentle but challenging feel food session.
WATCH OUTS/THINGS TO AVOID
- Overstretching - it could feel good and a natural thing to want to do to relieve the 'tightness' but intense stretching can further aggravate the sciatic nerve so think about modifications to bring down the intensity.
- Forced and continuous flexion of the lumbar spine - flexion can pull the lumbar vertebrae into a position which creates further compression on to sensitive or damaged discs. Be mindful of pelvic position (see diagram) and create just the right amount of flexion without recreating discomfort.
- Overloading the lower spine too soon - avoid weight-bearing exercises that load into the lumbar spine i.e. deadlifts/squats. Bring these back in very slowly and in a considered way - and under the supervision of a rehab trained fitness partner - and only when you have been given the ok by your medical professional.
- High impact - running or high-intensity training (HIIT) is a no go directly after sciatic issues. When you are given the all clear why not try walking or swimming, alongside a low impact / strengthening focus will give you a great balance to get back on track.
Any programme needs to consider sciatic is a nerve injury so it's important not to aggravate the nerve. If a herniated or bulging disc has been cited as the aggravator, over recruitment of glute/hip muscles, including the piriformis (an external rotator of the hip) which, if overused, can compress the sciatic nerve due to its positioning so working clients in a 'Pelvis Neutral' position is the best starting point and utilise typical ‘imprinting’ of the lumbar spine or 'Pelvis Tucked' position through posterior tiling of the pelvis only when needed for additional support. In general, when doing Pilates, try to avoid doing any exercises in a 'Pelvis Arched' position as this does provide the level of support needed to perform exercises safely, equally, if you find you are unable to maintain a neutral or imprinted pelvis, bring the exercise down a notch until your abdominals are able to support.
A common soft tissue contributor is the hamstrings when at a 'shortened' length due to the muscles 'pulling' the pelvis into a position where structurally it puts more pressure on the nerve. I have seen clients where releasing these muscles fibres through soft tissue work has successfully calmed symptoms (alongside regular Pilates sessions) however this is not always the answer. Sometimes no amount of hamstring stretching will help with sciatic pain or in fact increase it depending on what type of stretching you are doing.
The hamstrings can 'protect' a tense sciatic nerve, so to determine the real issue of tight or short hamstrings or nerve tension try a straight leg raise and sense what you feel first, the nerve or the hamstrings?
Consider the relationship between our nervous and muscular system - they are intrinsically linked and affect each other....as does the rest of our human body's make up.
I meet many clients who live with sciatic pain in one form or another and everyone’s experience – albeit has similarities – is a personal story with varying degrees of impacts. Some significant and debilitating, others an annoyance, that comes and goes but does not fundamentally change what they can and cannot do every day.
Understandably people seek reassurance that Pilates or soft tissue work will not aggravate their symptoms, my honest response is to try, start low and slow and see how their body responds. It's their body and only theirs, other factors are commonly present and can contribute and impact how people feel their pain or discomfort - its seldom just a physical thing albeit it may have started that way.
Keeping moving can help ease the pain from sciatica due to exercise itself increasing blood flow and releasing 'feel good' endorphins. Take one step at a time; its the best place to start.
The following videos offer a starting point for anyone living with sciatica or lower back pain due to disk/vertebrae issues.
This can work alongside a rehab programme, if you are in current support with a physio/osteopath/chiro or consultant, check in with them or your GP if you have any concerns with trying Pilates or soft tissue work.
“Change happens through movement and movement heals.”
Joseph Pilates
Pilates for Sciatica: Part 1
This first part of the series focuses on pelvis placement and disassociating hip movement while building abdominal stretch. Suitable for absolute beginners or anyone looking for a gentle routine.
Pilates for Sciatica: Part 2
This second part includes exercises which challenge stability in the trunk and building strength into the hip. Sciatic pain can cause pain and/or inefficiencies in movement at the hip. Suitable for absolute beginners or anyone looking for a gentle routine.
Pilates for Sciatica: Part 3
This third part includes 4 point kneeling (hands and knees) exercises to help you articulate the full spine, working on mobility at each vertebra + additional stability work of the trunk and core challenge.
If you want to find out more about Koru Bodyworks for either Pilates or soft tissue work or both! Call Amie on 07765 836 252 or email me below. I look forward to hearing from you.
