Jo is a Pilates and biomechanics specialist coach. Jo is also a senior trainer and the Lead Quality Verifier for Drummond Education. Her long standing industry experience in the field of corrective exercise and biomechanics brings outstanding results, for her clients with kinetic chain or movement dysfunctions. Jo specialises in developing Pilates beyond its current functional use, to an application that pushes the boundaries of science for therapy and health management.
Sciatica is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body. Pain can be severe in prolonged exposure to cold weather. (Wikipedia)
What causes sciatica?
Anything that puts pressure on the sciatic nerve or its root can create the irritation we refer to as sciatica.
- vertebral disc putting pressure on the nerve root,
- an accident or fall on your buttocks that caused a trauma to the sciatic nerve passing through the sciatic notch
- an overactive piriformis muscle tethering the nerve.
- neural tension -caused by restriction on the sheath that surrounds the nerve. Your hamstring muscles may appear tight but they are just protecting a tethered sciatic nerve which needs releasing and mobilising gently.
What can we do to will help relieve the pain?
- Protect the Sciatic Nerve in Exercise -be careful not to irritate the nerve more than it already is; Nerves can be fussy and give you lots of feedback such as tension, tingling and tightness. Any exercise/stretches should be conducted in a gentle manner paying close attention to not over activating this area.
- Avoid over-recruiting muscles that squeeze the sciatic nerve. E.G squeezing the hip extensors (buttocks) too much.
- If the sciatica is from a damaged disc then avoid going into unnecessary flexion, and sometimes extension.
- Avoid putting the nerve on stretch; so gentle range on hamstring stretches and leg circles, gradually increasing range over time.
- Avoid too much flexion [forward bending] in the lumbar spine which could irritate the nerve if there is a disc lesion. So work from a neutral spine, get things to move and relax, and get the core strong. You can do a lot of Pilates and still remove stressors on the sciatic nerve.
Pilates Exercises for Sciatica
- All 4’s exercises such as pointer
- Seesaw arms/heel slides progressing to dead bug (both together and /or lifted)
- Leg Circles with controlled range- use a band to help control or bend at the knee; hands or fingertips on the knees can sometimes get the piriformis to relax
- Knee Openers- ensure knees are at 45 degrees, avoid over squeezing, focus on mobilising and increasing comfortable range over rime.
- Shoulder Bridge exercises; focus on controlled back mobility and length through the spine as you roll down. Limit the hip lift part to begin with and gradually build up. Recruit pelvic floor muscles to help stability and avoid over squeezing the buttocks.
- Swan Dive Prep- to stabilise and strengthen the shoulder girdle area of core- avoid lifting too high.
Exercises to avoid with sciatica
- Rolling like a ball
- Large range on spine stretch, spine twist, and saw.
All releases to be done when you are warm and have been up for 10 minutes in the morning to allow the body to respond at its best.