Shooting, burning, tingling aches down the legs on a regular basis . . . that's the painful reality for those suffering from sciatica.
The condition is relatively common, associated with irritated nerves, bones, or disks in the lower back muscles and spine, Dr. Charles Kim, MD, a physiatrist and pain management specialist at NYU Langone Sports Health, explains.
While Dr. Kim urges those with sciatica to avoid motions and exercise that cause and increase the painful symptoms until they subside, he says that strengthening the core muscles can help prevent future sciatica flare-ups.
Sam Becourtney, a physical therapist and certified strength and conditioning coach associated with Bespoke Treatments NYC, agrees that the right moves can strengthen the soft tissue structures surrounding the spine and decrease pain.
Since sciatica greatly varies from person to person, Becourtney stresses the importance of easing into exercises slowly and getting any moves approved by your doctor. Activities that exacerbate any sciatica symptoms such as "forward flexions" should be avoided until symptoms start to subside and tolerance for this position increases.
When treating sciatica, it's important to find an appropriate balance of strength training and mobility exercises to help protect the spine and reduce further nerve root inflammation, Becourney explains.
To get you started, he's created a general exercise plan around this concept that you can try at home or in the gym.
Mobility
Prone Press Ups:
Lay on the floor on your stomach with elbows bent and hands by your armpits. Keeping your hips on the ground, press your chest off of the ground, extending the lower back to the point of tolerance. Perform three sets of 10 to 15 repetitions, with a one- to two-second hold at the top as you exhale.
Cat-Cow:
Start on your hands and knees in a quadruped position with a neutral spine. Arch your back while trying to go one vertebra at a time, and then reverse this motion to round your spine. Perform three sets of 10 repetitions, being cautious to only go in small ranges initially as there might be increased pain at end ranges, particularly when rounding.
Lumbar "Windshield Wipers":
Start on your back with knees bent, feet together and arms out to the side. Keeping your shoulders and upper back on the ground, exhale and bring your knees to one side, then back to the middle and reverse to the other direction. Perform one to three sets of 15 to 20 repetitions.
Sciatic Nerve Flossing:
Start seated in a chair with back against a chair or wall. Bring your chin down to your chest, then extend your one knee to straighten your leg in front of you. Perform two to three sets of 10 repetitions for each leg. It's important to note that the chin down, knee straight, toes pointed up combination will be the most provocative on the nerve, and thus you may need to start with a regressed version without the toes up or without the chin bent down until symptoms decrease.
Strength
Transverse Abdominis Pushdown:
On your back with both knees bent in the air in a 90-90 tabletop position, gently push into your thighs with both hands to engage the deep core musculature. Perform two to three sets of 12 to 15 repetitions, holding the contraction for two to three seconds without holding your breath.
Reverse Marches:
Start on your back with knees bent in the air in a 90-90 tabletop position and core engaged. From this position, alternate tapping the heel of each foot down to the ground one at a time, making sure to keep the core muscles engaged the entire time. Perform three sets of eight to 12 repetitions on each leg.
Side-Lying Clamshells:
Perform this exercise on your side with or without a resistance loop band just above your knees. Keep your hips stacked and feet together, and lift the top knee off of the bottom one, pushing against the band's resistance. Perform three sets of 10 to 15 repetitions per side, making sure not to allow your hips to roll back as you fatigue.
Bird Dogs:
Start on your hands and knees with hands directly underneath your shoulders and find a "neutral" spine where you are neither rounded nor excessively arched. While maintaining this spinal position, extend one arm forward as you extend the opposite leg back, then switch sides and repeat. Perform two to three sets of six to eight repetitions per side.
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