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PhysInc Pilates

How to Combat Sciatic Nerve Pain

Sciatic Nerve pain is a complaint I hear about quite a bit. I even have flare-ups myself after a week of heavy hiking. Luckily I know what I need to do to get rid of it! And now so will you after reading this post.


Not sure what it is or if you've got it? Nerve pain in general feels like a zap of electricity (I like to call them "zingers"). Sciatic nerve pain typically runs from the lower back or the glute and down the back of leg. It can be very sharp and sudden or sometimes dull and achy. It can also cause tingling and numbness in your legs or feet.

Why does it happen?? The most common cause for sciatic nerve pain is a tight piriformis muscle. This muscle is a deep external rotator of the hip and when it becomes tight or inflamed, it can compress the sciatic nerve, which lies right next to it. This compression is what causes those "zingers." Tight hips in general can also tighten the piriformis muscle, so I've addressed this as well in the stretches.


I've put together some releases, exercises and stretches that can help alleviate sciatic nerve pain. If you practice these steps consistently, you can lessen the frequency of flare-ups!


Releases: Perform these releases before starting your exercises.

1. Foam Roll Hip Flexor/Upper Quads

2. Lacrosse ball Glute and Piriformis Muscles

**See my previous post Self Muscle Release & Mobility for demos


Exercises:

1. Inner thigh squeezes. In a supine position, place a mini stability ball or soft pillow between your thighs. Imprint your spine into the mat so that your lower back is pressing down into it. On an exhale, squeeze the ball with your inner thighs and pull your abdominals inward and upward toward your spine and heart. Perform 3 sets of 10. (This exercise can also be done seated in a chair. If you choose this option, just keep your spine neutral).
















2. Internal Hip Rotation. In a side-lying position, bend your knees at a 45 degree angle. Keep the knees together and lift the top foot. Think about turning your femur bone inwards toward the pelvis as you lift the foot. Do 2 to 3 sets of 10 on EACH leg.




Stretches: Perform these stretches in the order provided. Long static stretches should be done last (after exercises, not before).

1. Hip Flexor (Psoas) Stretch. In a kneeling lunge position, slightly tilt the pelvis posteriorly on your back leg (give your back buttock a gentle squeeze). Lift the arm on the same side as the extended leg up towards the ceiling. Lift the sternum for a deep stretch of the psoas muscle. Hold for 30-60 seconds.














2. Supine inner thigh stretch/butterfly stretch. Lying on your back, bend both knees and open your hips (like a butterfly). For extra support, place a yoga block or a pillow under the outside of each knee. Relax and hold this position for 30-60 seconds.



3. Supine Piriformis Stretch OR Pigeon Pose (more advanced)

Supine Piriformis Stretch: Lying on your back, with bent knees, cross one leg over the other in a figure 4. You can assist opening the hip of the crossed leg by placing your hand on your knee and applying gentle pressure. For a deeper stretch (picture 2), pull the bottom leg up towards your chest. Hold for 30-60 seconds.



Pigeon Pose: **This is a more advanced stretch and may not be appropriate for everyone. Start with the supine stretch above and progress over time to the Pigeon Pose). Keeping the hips squared as best as you can, bend the front leg in front of you and extend the other behind you. If you feel some torque in the front knee, you can pull that front foot closer to you. Ideally you want it to be more perpendicular but it really depends on your level of flexibility. This is a difficult stretch for me personally, but I continue to include it in my personal programs because it really helps loosen up my hip flexors and piriformis muscles. Part 1: Place your hands at your sides and lift the sternum up to open the chest. Part 2: Let your torso bend over the front knee. Try and hold each part of this stretch for 30-60 seconds. **The pigeon pose stretches the piriformis muscle of the front leg and the hip flexor/psoas muscle of the back leg.




4. Lower Lumbar Rotational Stretch: With knees bent at a 90 degree angle (or as best as you can get there), let both knees drop to one side. Open your arms in a "T" shape and direct your head towards the arm opposite your knees. Hold for 30-60 seconds and repeat on the other side. Note: Try your best to keep the back of both shoulders touching the mat. Palms up towards the ceiling. This not only stretches the lower back, but also gives you a nice pec stretch.





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