Sciatica is the worst. In fact, I’d be so bold as to say that my SI-related pain has been a walk in the park compared to sciatic pain, and that’s saying a lot since sacroiliac pain is certainly no picnic. I have never experienced an injury as debilitating and painful as sciatica. Even worse, sciatica pretty much renders running impossible.
If you’re a runner struggling with injury-induced sciatica, allow me to share some of the things I’ve found most helpful to speed up the healing process and minimize recurrence. Please note: as is likely abundantly clear from this blog in general, I am not a medical professional so you should always consult with a pro for legit advice.
1.Figure out the cause of your sciatica: Sciatica is not a condition in and of itself. It can be brought on by a variety of back issues, none of which I’ll describe in detail. What’s critical, however, is knowing what’s at the heart of your sciatica as it will influence how to cope with it.
2.For the love of God, keep moving: Though tempting to curl up in a fetal ball, which is personally the only comfortable position I’ve found when in the throes of sciatica, remaining sedentary is about the worst thing you can do. With acute pain, short walks on flat ground are the way to go (hills are sciatica’s enemy). As pain improves, walking and cycling have been my best friends. With cycling, however, I’d recommend using spin bikes at the gym, as they provide you with a quicker escape route should you experience any extreme pain (i.e. it’s easier to hop off a spin bike and hobble to the locker room at the gym than to be a 10 km bike ride from home). As someone who brought on a sciatic attack just by changing her pants, you never know what could trigger pain; best to be in a controlled environment in the early stages of recovery.
3. Stretch, stretch, stretch: Stretching is more of a preventative strategy for me. In an acute sciatic episode, stretching is not going to feel good, nor may it actually be possible. Once the sciatic pain starts to alleviate, getting into a rhythm of stretching can start to loosen tense muscles surrounding the sciatic nerve which, in turn, lessens pressure on the sciatic nerve. I’ve also found that daily glute and hamstring stretches have been tremendously helpful, devoting extra time to stretching any time I run. I feel it’s important to emphasize that all my stretching is post-workout. I am not one for static stretching as a ‘warm up’. I’ve been advised against static stretching by any of my many, many, many physiotherapists (see #6 for more on warm-ups).
4. Do NOT foam roll (or at least be cautious foam rolling): Take it from me, someone who learned this the hard way, foam rolling over the sciatic nerve is not a good call. While wonderful for relieving muscle tension, foam rolling is an aggravated nerve’s worst nightmare. In fact, it could kickstart more acute sciatica. Foam roll surrounding muscles but steer well clear of the actual sciatic nerve. If you aren’t sure of where the sciatic nerve is located, I’d abstain from foam rolling altogether. Be particularly careful rolling your piriformis as the sciatic nerve is very close by (and, for a small percentage of the population, actually passes through the piriformis!).
5. Get your strength on: I get it, you want to get back to running and focus on maintaining your running fitness. Unfortunately, you may have to take some time out to focus on building strength. Depending on the cause of your sciatica, it could mean building strength in your back or your glutes (or both). This is where it’s helpful to seek professional consultation to figure out what’s at the heart of your sciatica so you can target your strengthening work. Who knows, you may even learn to enjoy strength training days. My physiotherapist once told me that I would learn to enjoy strength training as a legitimate workout and I scoffed at him. Cardio for life, I said. However, here I am eleven months post-injury legitimately seeing value in my strength training sessions, and genuinely excited to see my strength consistently improving. Of course, I’ll never give him the satisfaction of admitting it.
6. Warm up, damn it: Gone are the days when I could jump out of bed and into my running shoes. While static stretches are not something I’d use to warm up for a run, I have found that warm up activities are a great preventative measure. Warming up, either with walking or active stretching, is particularly helpful for SI-related sciatica. The more I can get those muscles ready to move, the less likelihood they’re going to tense up, spasm, and cause sciatic irritation.
7. Learn when to back off: When I’m running, I know the early signs of sciatica. I believe everyone has to learn their own early warning signs. For me, I’ll experience one of two early symptoms: a tight and weak-feeling calf muscle in only my right leg, or a hamstring that I describe as feeling like it’s about to snap (once again, only on my right leg). If either of these things occur while I’m running, it’s game over. No matter how badly I want to run through it and get my distance in for the day, it’s time to stop running.
No matter how you slice it, sciatica is going to mean some time off running, but if you take the time to seek the root cause of your sciatica you can get back to running much faster. Even once you’re back to running, don’t let go of good, preventative measures like building strength and stretching. Consistency truly is key. Okay, enough soap-boxing for me, show that sciatica who’s boss so you can get back to running!