The Sports Doctor: Many suffer from sciatica

By Dr. Robert F Weiss

There are approximately 8 to 10 million Americans that suffer from sciatica, an irritation to the sciatic nerve. The symptoms include a shooting pain or, at times, a numb or tingling feeling starting at the hip and radiating down the thigh to the lower leg and to the foot.
It can prevent a good night's sleep as it is difficult to find a comfortable position and can end a sports program.
The prominent cause of sciatica is a structural weakness — a malalignment of bones or ligaments in the spine, resulting in exquisite and intractable pain. It may also be caused by a postural weakness — an overdevelopment of the back muscles and a weakness in the stomach muscles.
Another causative factor of sciatica is lowering of the arch by pushing off the foot in intensive workouts or pronation (rolling in of the foot) causing the leg to rotate inwardly creating a forward tilt of the pelvis, which in turn causes a cramp in the lower back.
This strain on the back results in a pull of the muscles around the hip which then creates a pressure on the sciatic nerve as it runs under the hip joint. A leg length differential may also cause a pelvic tilt resulting in sciatica.
Prevention and treatment of sciatica involves exercising and stretching of the muscles in the lower back and strengthening of the stomach muscles.
It is also important to use training shoes with good shock absorption and to avoid hill training or racing. It may also be necessary to consider orthotic foot inserts to control the excessive pronation which is causing the lower back and sciatic nerve pain.

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