Sciatica Exercises: Not Always Hamstring Stretching

Sciatica Exercises: More Than Just Hamstring Stretching

Sciatica Exercises Are Not Simply Doing Hamstring Stretches

Features of a standard program of sciatica exercises may include several components ranging from trunk strengthening and conditioning, stretching targeted at the joints, soft tissues and nerves, neuromuscular education regarding static and dynamic postures, as well as aerobic conditioning.

  • Trunk strengthening and conditioning exercises for management of sciatica are prescribed with the purpose building endurance and strength around the spine. Such exercises inevitably play a role in most low back pain and sciatica management rehab programs.
  • Mobility and stretching exercises such as hamstring stretching exercises, the yoga cat and cow movements as well as the cobra (or prone push up or as it is also known the “Mckenzie press”) are frequently prescribed sciatica exercises by physiotherapists and other medical practitioners. Stretching is appropriate to use as a treatment approach when looking to increase circulation, manage pain and implicated when relevant tissues are tight. Tight tissues can potentially restrict normal motion in and around the trunk. Introducing stretch-based sciatica exercises can in some situations aggravate symptoms, therefore appropriate professional advice is advised when starting a stretching regime to help manage sciatic symptoms. This is especially so when introducing neural stretching exercises as the nerve is a very sensitive tissue and once aggravated can take quite some time to settle and cause substantial discomfort.
  • Neuromuscular retraining regarding the learning of and reinforcement of appropriate movement patterns and postures. This is important in offloading aggravated structures and reducing the risk for recurrences of any sciatic symptoms. Neuromuscular education addressing movement patterns like bending, lifting, sitting, changing postures… are ideally a part of any sciatica exercises routine and really important in the restoration of achieving normal activity levels whilst avoiding flare ups.
  • Aerobic conditioning needs with sciatica exercises will depend on the individual. The duration of disability plays a large role here, as the longer someone has been suffering for then the more substantial their physical conditioning decline is likely to be. In situations where someone has had chronic low back pain and or sciatica for an extended period, then the more relevant aerobic conditioning will be. Aerobic and muscular conditioning in an attempt to return an individual to pre-injury levels or, ideally improve on their pre-injury level of conditioning if this was deemed at be a potential risk factor in the original cause of their sciatica. Doing this can be a challenge for the patient and therapist, safely introducing an increase in activity levels without triggering a flare up and often is not given enough attention in chronic pain situations with more of the focus commonly going towards building core strength, tissue mobility, posture… and less attention on actually conditioning tissues and the body to have the endurance and tolerance of repetitive loading.

Sciatica Exercises Should Be A Daily Routine Just Like Brushing Your Teeth

Managing and ultimately eliminating sciatica symptoms though sciatica exercises does not necessarily mean your exercise regime can end just because the pain has gone. Strength, flexibility, and physical conditioning gains do not occur overnight, and risk factors do not vanish simply because the pain has subsided. Addressing risk factors that contributed to the onset of the sciatica can take time. Sometimes this requires prescribed exercises to become part of a daily routine in the medium to long term just like brushing your teeth.
Enlisting the help of an appropriate health professional like a physiotherapist prior to starting sciatica exercises to help obtain the correct diagnosis behind their sciatica and set up an action plan is the fastest way to recovery. Equally when looking at stopping any sciatica exercise regime being assessed to see if the perceived risk factors have been mitigated rather than simply stopping the program because the sciatica pain has dissipated is the best way to avoid any relapse.
Frustratingly it can take a significant period of time and effort to correct any imbalances in the body and change bad habits. Frequently pain subsides prior to any weakness, tightness, and poor movement patterns… sorting themselves out. Quite likely this plays a large roll in why I see several individuals in our Sydney and Randwick physio practices requiring treatment following a second, or even third bout of sciatica. I feel a failure to fully commit to addressing an individual’s risk factors be they poor sitting, lifting and exercise technique, lifestyle behaviors, muscle strength or mobility imbalances… whatever they may be, a failure to address such variables is one of the greatest predictors in someone suffering future bouts of sciatic pain.

Some Quick Tips For Helping Prevent Sciatica

Some key things to consider when looking to minimise pain associated with sciatica and ultimately prevent some of the common causes of sciatica can include:

  • Avoid prolonged periods of sitting, specifically situations where sitting well is difficult such as when driving the car and is especially pertinent with regard to sitting on the sofa.
  • Move more and move often. This is specifically relevant with regard to the above point. When sitting in non-desirable postures and just sitting in general always try to move more often. Constantly changing posture is almost always a good idea.
  • Attempt to maintain good posture where possible, be it standing, lying, or moving postures, but more specifically try especially hard with sitting and lifting postures.
  • Avoid heavy lifting when possible if you are not conditioned to this activity and always try to get assistance when lifting heavy objects particularly if they are an awkward carry. This includes taking care or getting assistance when the lift will require twisting or moving through tight spaces.

This is by no means an exhaustive list with regard to preventing sciatica and the above information relates more towards one of the main causes of sciatic symptoms (lumbar disc bulges). In my opinion if more care and attention was taken regarding the above few tips then the number of episodes of not only sciatica but also low back pain would more than likely dramatically decrease. We are designed to bend, lift, move and these things should be embraced not feared, however to do these activities may require some adjustments to enable necessary frequency or loads to be absorbed without incident. And the relevance of body and tissue conditioning to these activities is another important factor and can not be undervalued, as we are not all seasoned furniture removalists and shouldn’t expect out body’s to be capable of such without appropriate conditioning…

Disclaimer: This information is provided as an educational service and is not intended to serve as a substitute for personalized medical advice. Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned in this post. Anyone seeking specific advice, or assistance regarding “sciatica exercises” should consult his, or her physiotherapist, orthopaedic surgeon, general practitioner, sports medicine specialist, or otherwise appropriately skilled medical practitioner.