Wednesday, 10 March 2021

Exercise for Sciatica: Moves to Try and Which to Avoid

From verywellhealth.com

Sciatica is a term used to describe a collection of symptoms such as pain and an "electric" sensation felt in the lower back and hips, often radiating down one leg.

Sciatic nerve pain can have several causes, including herniated discs, a tight piriformis muscle, spinal stenosis, or a misaligned sacroiliac joint. You may have more than one of these conditions at the same time.

Unless you have "red flag" symptoms (such as losing control of your bladder, bowels, or a lower extremity) you may be able to use certain exercises to help manage your sciatic pain.

While staying active might help reduce your discomfort, there are some activities that can worsen sciatic pain. Here's what you need to know about exercising with sciatica, including which moves might help and which ones might irritate your sciatic nerve.

Exercises to Avoid

Any exercise that makes your sciatica worse or causes new pain won't provide any benefit and may cause further injury by aggravating nerves and muscles.

Here are three stretches that are best avoided if you have sciatic nerve pain.

Bent-Over Row

The bent-over row is a full-body integration exercise that targets the arms and back. While the stretch can be beneficial when done properly, it's easy to do the exercise with poor form (i.e., rounding your back when you pick up a weight bar or weights).

Performing any exercise with improper form puts you at risk for strain or injury, but moves like the bent-over row specifically increase your risk for disc herniation—a condition that could cause or worsen symptoms of sciatica.

Double Leg Lift

Exercises that require you to lift both legs at the same time engage your core and can be great for strengthening your abdominal muscles and back, but they can also aggravate sciatic pain.

It's also important to be aware of moves that can be easily over-stretched. Placing too much strain on muscles that aren't yet strong enough to properly support the movement or hyper-stretching them can exacerbate sciatic pain or cause injury.

You may injure your lower back by performing a double leg lift when you are really only strong enough for a single leg lift.

Before trying leg lifts, consider whether you're in proper shape. If your abs are weak, the weight of your legs gets taken on by your lower back. This strain can put you at risk for disc herniation, which in turn can lead to sciatic pain.

Can you lift your legs without moving your pelvis or trunk? If you can't, your abs probably aren't yet strong enough to carry the weight of your legs. Increasing your core strength will help prepare you for these exercises and may even help improve lower back pain.

Leg Circles

Exercises that involve swinging your leg in a full circle require you to stretch your hamstring suddenly, which may irritate the sciatic nerve. For example, you may want to avoid some Pilates moves, yoga poses, and circuit training workouts that engage your leg muscles this way.

You may also want to take a break from playing high impact sports such as football, which can put you at risk for further injury.

Exercises for Sciatica

You're most likely to feel sciatic pain in your lower back and hips, and sometimes down one of your legs. While sciatica usually gets better on its own with time, there are certain types of exercise that might help relieve your symptoms as you heal.

A 2012 study from the University of Southern Denmark found symptom-guided exercises improved outcomes for people with sciatica. Several patients in the study who qualified for surgery to treat sciatica found they were able to manage their pain using the symptom-guided exercises.

Here are three exercises that may help manage sciatic nerve pain.

Sitting Spinal Stretch

An irritated sciatic nerve can cause pain and tightness in your hamstrings. Try exercises like the sitting spinal stretch to ease symptoms without putting you at risk for injury. Instructions:

  1. Start by sitting in a chair with your feet slightly wider than shoulder-width apart and firmly on the ground.
  2. Put your hands behind your head. Interweave your fingers so your elbows are out to the side of your head.
  3. Tuck your chin down.
  4. Keeping your elbows out, twist your torso left and bring your right elbow to the inside of the right knee. Do not move your head. Hold for 30 seconds.
  5. Untwist your torso and return to the starting position.
  6. Perform the same movement on the other side. Keep your elbows out and twist your torso to the right as you bring your left elbow to the inside of the left knee. As before, don't move your head and hold for 30 seconds.
  7. Untwist your torso and return to the starting position.
  8. Repeat five times on each side.
Standing Hamstring Stretch

Similar to the seated version, the standing hamstring stretch can also help reduce the tightness and discomfort of leg muscles aggravated by sciatic pain. Instructions:

  1. Place your right foot on an elevated surface, such as a chair or ottoman, at or below hip-level.
  2. Flex your foot so your toes and leg are straight (it's okay if you need to bend your knee a little).
  3. Bend your body slightly toward your foot. The further you go, the deeper the stretch will be. Go slowly and don't push to the point of pain.
  4. Release the hip of your raised leg, letting it move down rather than lifting it up. 
  5. Hold the stretch for at least 30 seconds, then repeat on the other side. Aim to do five stretches on each side. 
Make this stretch easier by using a yoga strap or exercise band over your right thigh and under the left foot.

Don't overdo hamstring exercises, as repeated or intense stretching can irritate your sciatic nerve. Stick to five stretches on each side of your body.

Knee to Opposite Shoulder

The knee to opposite shoulder exercise is a simple stretch to relieve sciatic nerve pain. It helps by loosening gluteal and piriformis muscles, which are located deep in the buttocks. When these muscles become inflamed, they press against the sciatic nerve and cause pain and other symptoms. Instructions:

  1. Lay on your back with your legs extended and feet flexed up.
  2. Bend your right leg and clasp your hands around your knee.
  3. Gently pull your right leg across your body toward your left shoulder. Hold for 30 seconds. Only pull as far as you comfortably can; you should feel the stretch but it shouldn't hurt.
  4. Push your right knee back until your leg returns to the starting position.
  5. Repeat three times on the starting side, then switch legs.
A Word From Verywell

There isn't a one-size-fits-all exercise routine for managing sciatic nerve pain. Try different exercises to see which ones help you to feel better and be sure to note (and avoid) any that make your pain worse or cause new pain.

If your sciatic nerve pain continues for more than a few months, even if mild, make an appointment to see your doctor. While research has not definitively shown that it will improve sciatica for every patient, you may find it helpful to work on an exercise program with help from a physical therapist.

https://www.verywellhealth.com/exercises-that-could-worsen-sciatica-297246

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