Sciatica can be debilitating when it takes hold. Searing, burning pain that can bring you to your knees - regardless of your age, health and athletic background! When used as a lay term it refers to pain in the back of the leg; it does not necessarily identify the origin of the pain.
True sciatica is triggered by a compression or inflammation of the sciatic nerve. This could arise due to several reasons which can include disc herniation, piriformis syndrome, vertebral osteophytes or hamstring/calf tension and compression.
Today let's explore the anatomy of the sciatic nerve and an interesting fact that most Doctor's don't know about the sciatic nerve.
Introducing the Sciatic Nerve
The sciatic nerve is the largest and longest nerve in the body, traveling from it's origin in the lumbar spine and pelvis, to the feet. It's job is to supply sensory and motor function to the muscles and skin of the posterior thigh, most of the leg and the foot.
Considering the array of muscles that cross the sciatic nerve, the most common muscle that I see clinically trigger sciatica pain is the piriformis muscle in the posterior hip. This muscle sits on top of the sciatic nerve as it exits from the pelvis and travels down the posterior thigh. In some cases (approx. 20%) the piriformis muscle may have two muscle bellies and the sciatic nerve navigates through the centre of these two bellies. Regardless, with any hypertonicity (short-tight muscle) or trigger points in the piriformis muscle, compression on the sciatic nerve increases leading to the classic sciatica experience.
Continuing a little further south, we have the large hamstring muscle group. The hamstrings also have the potential to experience hypertonicity and compress the sciatic nerve on it's pathway toward the calf muscle.
For more information on understanding the difference in hypertonic (short-tight) and hypotonic (long-weak) relationships of the hamstrings please see my previous article What You Don't Know About Pelvic Pain Could Hurt You.
What Your Doctor Didn't Tell You About Sciatica
Did you know that during movement the sciatic nerve (and all nerves for that matter) have the capacity to stretch and shorten to accommodate the movement of the limbs and local body parts?
Therefore, when it comes to the swinging motion of the legs during normal gait, if the hamstrings have excessive tension, they will essentially grasp hold and restrict the mobility of the sciatic nerve. This in turn creates an unnecessary tugging force on the nerve and it's connections above and below. Progressively, this creates irritation and inflammation of the sciatic nerve, which if left untreated, results in the sciatica symptoms of pain and immobility.
The Hamstring Hack
The best method I've learned so far to help relieve the hamstring compression on the sciatic nerve is to perform this simple nerve floss mobility. Follow my guidelines in the video instruction below.
I recommend to aim for a minimum of 10 - 30 repetitions per leg (include the non-symptomatic side). Ensure that you regulate your breathing as you perform the movement, breathing out as you raise the leg, breathing in as you lower. The goal is to repeatedly move or floss the nerve in the hamstring, as opposed to formally holding and stretching the hamstring muscle.
If you are currently symptomatic, you may find you start with a very limited range of motion. Keep it to mild-moderate discomfort, with little-to-no pain and monitor your improved range as you increase your repetitions each day.
The more symptomatic you are, the more repetitions you should perform and the more frequent you should repeat throughout your day, until the pain subsides.
It's preferable to warm the tissues up prior to performing this mobility, either through movement, applying a hot water bottle or taking a shower/bath.
Any questions, you can reach me at my clinic by phone: 403 589 4645 or email: firstname.lastname@example.org
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Yours In Muscle Health,
Jason Barlow, RMT
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