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  • Jo Everill-Taylor

Pilates for Sciatica and Piriformis Syndrome

What is sciatica?

Sciatica is a set of symptoms including pain that may be caused by compression or irritation of the sciatic nerve. True sciatica will come from the compression of the nerves radiating from the lower spine, however similar uncomfortable feelings can be felt from Piriformis Syndrome.

This refers to pain in the buttock and/or posterior thigh and calf caused by pressure on the sciatic nerve as it passes through or above the piriformis muscle.

Some people are more prone to this than others due to their anatomical makeup.

It can also be caused by a tight piriformis muscle.

Symptoms include:

  • Pain along the sciatic nerve- so anywhere down the back of your leg, right down to your big toe

  • Numbness and tingling

  • Pain may be aggravated by sitting or climbing stairs.

What causes sciatica?

Anything that puts pressure on the sciatic nerve, or its root can create the irritation we refer to as sciatica.

  • vertebral disc putting pressure on the nerve root.

  • an accident or fall on your buttocks that caused a trauma to the sciatic nerve passing through the sciatic notch.

  • an overactive piriformis muscle tethering the nerve.

  • neural tension -caused by restriction on the sheath that surrounds the nerve. Your hamstring muscles may appear tight, but they are often just protecting a tethered sciatic nerve which needs releasing and mobilising gently.

What can we do to will help relieve the pain?

  1. Protect the Sciatic Nerve in Exercise -be careful not to irritate the nerve more than it already is; Nerves can be fussy and give you lots of feedback such as tension, tingling and tightness. Any exercise/stretches should be conducted in a gentle manner paying close attention to not over activating this area.

  2. Avoid over-recruiting muscles that squeeze the sciatic nerve. E.G squeezing the hip extensors (buttocks) too much.

  3. If the sciatica is from a damaged disc, then avoid going into unnecessary flexion, and sometimes extension.

  4. Avoid putting the nerve on stretch; so gentle range on hamstring stretches and leg circles, gradually increasing range over time.

  5. Avoid too much flexion [forward bending] in the lumbar spine which could irritate the nerve if there is a disc lesion. So work from a neutral spine, get things to move and relax, and get the core strong. You can do a lot of Pilates and still remove stressors on the sciatic nerve.

Pilates Exercises for Sciatica

  • All 4’s exercises such as pointer

  • See saw arms/heel slides progressing to dead bug (both together and/or lifted)

  • Leg Circles with controlled range- use a band to help control or bend at the knee; hands or fingertips on the knees can sometimes get the piriformis to relax.

  • Knee Openers- ensure knees are at 45 degrees, avoid over squeezing, focus on mobilising and increasing comfortable range over rime.

  • Shoulder Bridge exercises: focus on controlled back mobility and length through the spine as you roll down. Limit the hip lift part to begin with and gradually build up. Recruit pelvic floor muscles to help stability and avoid over squeezing the buttocks.

  • Swan Dive Prep- to stabilise and strengthen the shoulder girdle area of core- avoid lifting too high.

Exercises to avoid with Sciatica.

  • Rolling like a ball -you don’t want to roll onto the inflamed area!

  • Large range on spine stretch, spine twist, and saw- you don’t want to over-stretch the nerve!

Remember if you have acute pain, you must consult with a doctor or physio before starting any exericse regime.

All releases/exercises to be done when you are warm and have been up for 10 minutes in the morning to allow the body to respond at its best.

Always consult a qualified medical professional before beginning any nutritional program or exercise program. Any content or information provided by “Better Body Training” is for informational and educational purposes only and any use thereof is solely at your own risk. “Better Body Training” bears no responsibility thereof.

If you'd like to have supervision whilst exercising, why not join one of our classes- either LIVE streamed via Zoom or face to face in Hersham, North Surrey.

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