If you’ve been diagnosed with sciatica and have been recommended exercise as a solution then this post will help you make better decisions on what works and what doesn’t and perhaps more importantly, why.
Sciatica, in all its derivations, is thought to occur as a result of nerve route compression although the relationship between what is seen on a scan and a person’s symptoms is certainly variable.
Even less clear is the effect that exercise can have with none showing reliable benefits. It’s no wonder therefore that you are searching the internet for information.
In studies on exercise, the biggest variable is always the individuals to which the exercise is applied. Each with their own unique set of circumstances that will have led to the manifestation of their symptoms.
Couple that with term ‘exercise’ being so loose as to be largely meaningless. I’ve seen studies applying stretching protocols, core stabilisation programmes, general walking and even ‘arm swinging’ under the umbrella of exercise.
It is possible however to apply two basic principles that will provide you with better solutions to your situation.
The first is that every injury, be it chronic or acute, is a mismatch between what your muscular system is capable of tolerating and the demands you have imposed on it.
Let me give you an example; a new client recently decided to increase his running mileage from 2 miles a week to 10. All this within 7 days. He came to see me the following week with pins and needles around the lateral aspect of his lower leg.
Following a range of motion assessment it was obvious he had large limitations in his ankle, hip and trunk on his symptomatic side.
The rapid increase in mileage had given his muscular system no time to adapt to the forces imposed upon it and as a result his central nervous system had inhibited those muscles at risk of overload.
His ability to absorb force through his symptomatic side was now greatly compromised and as a result he had given his body no choice but to move in such a way that a nerve route was seemingly being impinged upon.
So if the problem has it’s roots in a mismatch between what you’re asking your body to do and what it’s capable of, you have two choices; you can either reduce your activity levels, or get stronger.
For some people reducing their activity levels will not be possible as they are already operating at a minimal level. In this case the choice is easy!
So how do you get stronger?
In order to get stronger you have to know what is weak to begin with. This brings us to the second principle, muscle tightness is secondary to muscle weakness.
Restrictions in motion around a joint give an indication that some of the muscles in the area are not contracting particularly well. These muscles will be contributing to your situation. Rather than stretch to increase range of motion, think about very gently pushing in the direction you can’t presently go.
For example, if you find you can rotate your trunk further one way than the other, have a partner resist your efforts to very gently rotate further in the direction you are restricted. Hold the contraction 6 seconds and repeat 6 times. You will see your range slowly increase as you improve the ability of muscles in your trunk to contract.
While it is not possible to provide a solution to your situation within a blog post, applying these principles will begin to add strength and stability to your body and help you make better decisions regarding sciatica and exercise.
Always ask yourself when considering any treatment approach, is this going to make me stronger? And does it match my current capabilities? If you can answer yes to these 2 questions, you will begin to see progress.