Other/Mixed Training with Sciatica

[North Coast Miller]

Interesting observation maybe, am a couple weeks into swapping low pull round back Zercher for my hinge exercise. So - very low hinge, elbows just inside and slightly lower than the knees. Lumbar is flexed, shoulders foreward.

At start of pull, am actively hinging up against upper back shrug, am using 2" hardwood dowel wrapped in dense rubber for a bar.

On my third week of this am starting to get that ol sciatic dull ache about an inch to the right of my tailbone, three inches down from the hip. Mostly when sitting.

My stock use of roundback is to train it seldom, in my opinion once you have a technique groove, you're better off strengthening the surrounding muscle with a neutral back.

I did notice somewhat different recruitment muscle patterns, but gonna leave that alone. Will train it once a month or so just to keep active if needed for work.

 

[Kenny Croxdale]

I am working with an individual who has diagnosed with sciatica. Their doctor has basically said it's there and it'll go away eventually,

Eventually

I have had a sciatic nerve issue twice.

I received treatment from a Chiropirator the fist time and a Physical Therapist the second.

It didn't appear that either one really decreased my recovery time or my pain.

My feeling is that it is like the common cold. It takes about three day to get over it, no matter what you do.

Time is the primary factor with Scirtic Nerve Pain, as well.

In quizzing the Chiropractor about when I'd get past it, his reply was "Who know?"

Here we get a little off topic...

Root Canal

Years ago, I had a root canal on one of my teeth.

I was prescribed an opiod afterward for pain. Rather than take it, I opted to see, how bad the pain might be before taking it.

With that said, I opted for another solution for pain control.

The Tylenol-Ibprofin Coctail

My wife, a nurse, suggested that I try the Tylenol-Ibprofin Coctail that they used at time in the hospital for pain.

1,000 mg of Tylenol combied with 600 mg of Ibprofin, every 6-8 hours. That completely eliminated the pain.

What is the best painkiller for toothache relief?

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This precribes the Tylenol-Ibprofin Coctail with a somewhat different dosage...

The best is to take anti-inflammatory medicine, such as Ibuprofen. To get better control of pain, combining Ibuprofen 600-800 mg (depending on weight ) with 500 mg of Tylenol every 4-6 hours can take control of sharp dental pain.

This cocktail is approved by the FDA for pain management...

Advil Cocktail Stack

Advil Dual Action: Acetaminophen & Ibuprofen | Advil

Discover Advil Dual Action, an FDA-approved over-the-counter pain medication that combines acetaminophen and ibuprofen in a powerful single dose.

www.advil.com

The first and only FDA approved pain relief medication to combine Acetaminophen and Ibuprofen. Combining these two allows you to take a lower maximum daily dose of each medication and now get up to 8-hours of powerful relief. So whether it’s headaches, toothaches, backaches, menstrual cramps, muscle pains, or minor pain of arthritis, this combination will fight them all.

Synergistic Effect

"The sum is greater than its parts"

In plain English, it amount to adding 2 + 2 and getting 5!

As noted above, you maximize the pain management results with Lower Dosages.

Squatting with Sciatic Nerve Pain

As we know, performing Squat or something like it with sciatic nerve pain isn't possible.

I decided to try taking the Tylenol-Ibprofin Coctail. It took about an hours to start working.

I was able Squat and perform other lower body training without any pain. I had no pain for around 6 hours after taking it.

I had no altercation from taking the Coctail and Squatting.

Eventually, my Sciatic Nerve issue disappeared.

Take Home Message

The Tylenol-Ibprofin Cocktail is an effective tool that should be considered for pain management.

 

[Cyrus-II]

I live with it too. For me though I know the root cause, which is in my left SI joint. Heavy focus on stretches that keep this area limber have helped immensely. Also, trying to keep things "aligned" in day to day activities too have also made a big difference. I also have a chiro friend who knows how to adjust this and it makes an immense different when I'm having an acute issue, but I've also learned to stretch this area out it often will self release on its own and it's more just maintenance adjustments at this point. *(Link to technique below)

A couple other items of note;

- 1H swings have a tendency to exacerbate the issue. But I've been training through that and making good progress, but for awhile I had to stick to 2H swings. I think I could have expedited this by doing longer rep sets of 1H swings at a lower weight. Still, there are some days I just call it early and stick to 2H swings, or string out my sets and just do them GtG style. I figure it's better to get in the reps.

- I also recently worked with a SFG certified trainer who gave me a few pointers on my swing form and by getting a little deeper into the hike that's made a big improvement too. It's a little more "squatty" now, but still shoulders above hips above knees. This took some more force off of my lower back that he thinks was adding a lot of torsion to my SI joints.

- As I've been experimenting with stretches that help this area (mainly QL, hip flexors, piriformis), I have found that the 9 Min Challenge and other mobility drills between training days as active recovery make a huge difference. Just marching, crawling and deadbugs have helped a lot.
Some days I just need to warm up a little longer than other days too. So my main stretches that seem to make a big difference is 90/90, some form of QL, shinbox, deep prying goblet squat can also help...or annoy it too. It's a matter of just feeling it out that day. But all of this experimentation with stretches and mobility movements has helped me better understand what makes it better and what makes it worse. Because of this I've started gravitating toward more and more bodyweight training with a gymnastics background as it really seems to help with alignment issues like this. I'm in the middle of adding the gymnastics bridge into the 9MC challenge and it seems to be useful, for example. Front lever experiment is next.


SI joint release (method 3@7:27):



Disclaimer: Just because it helps me doesn't mean it will anyone else. I had to sort of learn this by trial and error. I never force it to realign either. Some days are just tight and I focus instead on other stretches and mobility movements and give it a day or two.

 

[bluejeff]

I would suggest getting your client to find a physical therapist if it doesn't improve in a couple-few weeks. Then I would advise asking your client to get you in touch with their newfound PT, even if it's as simple as having them write out recommended exercises and emailing it to you. Having contact with the PTs of clients would be of great value, if it is doable in any fashion.

For the time being, you can never go wrong as a trainer by expanding your knoweldge in the realm of biomechanics. Too many folks, imo, have a very basic understanding, but not an in-depth understanding as to how the whole body works as a system. Lots of people report sciatica improving with certain stretches and exercises, but many report that it comes back. Something like a stretch can improve symptoms but if the individual has something "dysfunctional" or compensatory going on with things like breathing and walking (which they do ~10000x more often than the stretch), that stretch is only a band aid.

A good physio will (hopefully) address the "why" but a good trainer with knowledge and education can select exercises and learn to bias those exercises towards improved biomechanics for their client.

These are not necessarily suggestions for training options, or medical advice, obviously. But they might give you some insights. Conor Harris uses a lot PRI-inspired drills, but the explanations of things that are going on are always awesome. Zac Cupples is another awesome resource for some free education.





These are not about sciatica, but a good breakdown of movement in the relevant area is always helpful.

Hip Biomechanics in Movement

If you want clarification on how the hips work when you squat and shift, and navigate through common hip mobility restrictions, meet your post!

zaccupples.com

Pelvic Gait Mechanics

A deep dive into gait mechanics with a pelvic focus. Learn what normal is, and how to assess deficits.

zaccupples.com

 

[ironsimple]

"Hello,

I am working with an individual who has diagnosed with sciatica. Their doctor has basically said it's there and it'll go away eventually, but hasn't really provided any "guidelines" for training. This individual still wants to come in and train, but I'm kind of unsure/hesitant how to move forward with them. I've never had sciatica or worked with someone who has.

What tends to irritate sciatica? What tends to decrease symptoms? Are there training exercises or strategies to avoid during a "flare up?" Or any thing to include during a flare up that can help?

Obviously, I'm not a medical professional and I'm not looking at getting or giving medical advice, but I am looking for hopefully a better understanding of this so I can train my client better.

All the best and thank you in advance for your thoughts!"

John,
Probably the best thing you can do is to convince your client that the Sciatica issue needs to be addressed above all else. I speak from experience as a former Competitive Olympic Weight Lifter, long before the days of Crossfit, etc. I have suffered greatly as a result of a ruptured L5 / S1 Disc and took me over a decade before I was healthy enough to move freely with out pain, etc. I spent days popping prescribed pain killers, NSAIDs and Ice / Heat therapy, etc. and I steered clear of surgery... but that was sheer dedication on my part. and with the help of a physiotherapist at the time. Certainly, you can train around a Sciatica issue, but it would be a disservice to your client if the Sciatica issue is pushed to the side, and ignored. AS or today, I am no longer weightlifting heavy anymore, but I do kettlebell workouts year around. There is a website that might be of interest to you and your client. Here is the web address ... backfitpro.com There you will find a book that might answer all of your questions and concerns the title of book is Back Mechanic: The Step-by-step McGill Method to fix back pain. If I recall correctly, Pavel T. collaborated with a world class expert on back issues and biomenchanics Ala' "Dr. Stuart McGill" who resides in Ontario, Canada. Side note: I was once a member of the old DD forum, back in the early 2000's. I recall mentioning of nerve flossing in one my post (2003?) and it's been very helpful ever since. The book I recommend is tops for anyone, and it's an easy read and understand without all the constant barrage of medical terminology and jargon. Well, that is my two cents worth here.
All the best, ironsimple : )

 

[DocMike]

Hello,

I am working with an individual who has diagnosed with sciatica. Their doctor has basically said it's there and it'll go away eventually, but hasn't really provided any "guidelines" for training. This individual still wants to come in and train, but I'm kind of unsure/hesitant how to move forward with them. I've never had sciatica or worked with someone who has.

What tends to irritate sciatica? What tends to decrease symptoms? Are there training exercises or strategies to avoid during a "flare up?" Or any thing to include during a flare up that can help?

Obviously, I'm not a medical professional and I'm not looking at getting or giving medical advice, but I am looking for hopefully a better understanding of this so I can train my client better.

All the best and thank you in advance for your thoughts!

j

Look up the Stuart McGill protocol. Great info. I also recommend reverse hyper be involved in training

 

[Whosonfirst]

So, I don't use a traditional wallet, I use a card carrier. And while I'm in my office I will every hour take the elevator to the first floor, walk around the building, and then take the stairs back to my office. When I run a meeting on the Amphib base I like to do meetings at, every 45 minutes I take a 15-minute break and get a quick walk in. Nerve issues suck! You can't become a slave to them. It's best to move as much as you can, when you can.

My old(WWII era pilot) osteopath, D.O. told be to stop keeping my thick wallet in my trousers when I sat at my desk. Even though I was frequently walking or standing in a mfg. plant, that helped alleviate my sciatica, but not a cure-all. I've since carried my 'roll' in a front pocket like a wise-guy.

 

[jmoran01]

Hello,

I am working with an individual who has diagnosed with sciatica. Their doctor has basically said it's there and it'll go away eventually, but hasn't really provided any "guidelines" for training. This individual still wants to come in and train, but I'm kind of unsure/hesitant how to move forward with them. I've never had sciatica or worked with someone who has.

What tends to irritate sciatica? What tends to decrease symptoms? Are there training exercises or strategies to avoid during a "flare up?" Or any thing to include during a flare up that can help?

Obviously, I'm not a medical professional and I'm not looking at getting or giving medical advice, but I am looking for hopefully a better understanding of this so I can train my client better.

All the best and thank you in advance for your thoughts!

j

It really depends on where you are in the recovery process and your form on the swing. Also I would see a physical therapist asap.

 

[Boris Bachmann]

For the time being, you can never go wrong as a trainer by expanding your knoweldge in the realm of biomechanics. Too many folks, imo, have a very basic understanding, but not an in-depth understanding as to how the whole body works as a system. Lots of people report sciatica improving with certain stretches and exercises, but many report that it comes back. Something like a stretch can improve symptoms but if the individual has something "dysfunctional" or compensatory going on with things like breathing and walking (which they do ~10000x more often than the stretch), that stretch is only a band aid.

A good physio will (hopefully) address the "why" but a good trainer with knowledge and education can select exercises and learn to bias those exercises towards improved biomechanics for their client.

I agree w. most of what you've said, but I get very triggered by the "it's just a band-aid" argument against methods of relief. I say and write this often but whenever the "OH THAT'S JUST TREATING SYMPTOMS - YOU'RE NOT GETTING AT THE ROOT CAUSES!" chorus begins, I can't help but think "Well, but symptoms can KILL you....".

Pain is a complex beeeyotch. Sometimes you need to alleviate it FIRST to get at the underlying issues whether those are physical, social, psychological, emotional, or some combination of all.

 

[bluejeff]

I agree w. most of what you've said, but I get very triggered by the "it's just a band-aid" argument against methods of relief. I say and write this often but whenever the "OH THAT'S JUST TREATING SYMPTOMS - YOU'RE NOT GETTING AT THE ROOT CAUSES!" chorus begins, I can't help but think "Well, but symptoms can KILL you....".

Pain is a complex beeeyotch. Sometimes you need to alleviate it FIRST to get at the underlying issues whether those are physical, social, psychological, emotional, or some combination of all.

I hear you. I didn't mean to sound like things that make symptoms better are useless. I have had to find ways to manange symptoms of a movement disorder. All I meant to communicate was that if the thing you're trying to correct keeps coming back, then you haven't addressed why it's there in the first place. Anything that treats symptoms is a tool in recovery. Improved symptoms means it's easier to ingrain better movement patterns so that the issue doesn't keep recurring. Plus I would rather address symptoms than not because it means improved quality of life.

 

[Boris Bachmann]

Circling back to this thread now because I seem to have developed this specific issue. I've kind of been trying to address it in training but I'm getting the feeling that what it needs is rest...

For me, it feels like someone knuckle-punched my glute hard and I have a numbness that runs down the back of my leg, sometimes to the foot, often feeling like the leg is falling asleep. It's not pleasant, but not unbearable, and apparently I've been careful enough not to let it travel upstream and mess up the lower back. Stretching helps some. Hip circles feel good. Bulgarian Split squats w. the weight held in the contralateral hand feel good. A massage gun helps some - a massage therapist would be infinitely better, but I don't have someone now.

I can squat fine after heat rub and warming up, and haven't really altered my training much since it started about a month ago, but I plan to give the lower body only very light work, stretching/mobility, and a little NSAIDs (which I almost never take at all) until next Tuesday.

We'll see. Criticism is warranted. I'll post updates if there is interest.

 

[John K]

Circling back to this thread now because I seem to have developed this specific issue. I've kind of been trying to address it in training but I'm getting the feeling that what it needs is rest...

For me, it feels like someone knuckle-punched my glute hard and I have a numbness that runs down the back of my leg, sometimes to the foot, often feeling like the leg is falling asleep. It's not pleasant, but not unbearable, and apparently I've been careful enough not to let it travel upstream and mess up the lower back. Stretching helps some. Hip circles feel good. Bulgarian Split squats w. the weight held in the contralateral hand feel good. A massage gun helps some - a massage therapist would be infinitely better, but I don't have someone now.

I can squat fine after heat rub and warming up, and haven't really altered my training much since it started about a month ago, but I plan to give the lower body only very light work, stretching/mobility, and a little NSAIDs (which I almost never take at all) until next Tuesday.

We'll see. Criticism is warranted. I'll post updates if there is interest.

Sounds kinda like sciatica.

 

[Joel the Savage]

Circling back to this thread now because I seem to have developed this specific issue. I've kind of been trying to address it in training but I'm getting the feeling that what it needs is rest...

Irritated nerve = dont irritate it more, it will probably become pissed.

For me, it feels like someone knuckle-punched my glute hard and I have a numbness that runs down the back of my leg, sometimes to the foot, often feeling like the leg is falling asleep. It's not pleasant, but not unbearable, and apparently I've been careful enough not to let it travel upstream and mess up the lower back. Stretching helps some. Hip circles feel good. Bulgarian Split squats w. the weight held in the contralateral hand feel good. A massage gun helps some - a massage therapist would be infinitely better, but I don't have someone now.

I can squat fine after heat rub and warming up, and haven't really altered my training much since it started about a month ago, but I plan to give the lower body only very light work, stretching/mobility, and a little NSAIDs (which I almost never take at all) until next Tuesday.

Tried any neurodynamics?
I.e. the slider here:


When you pull on something (read stretch) you activate a "stretch reflex", it is sorta pain relief for 10-20minutes, so it usually feels good. BUT it might aggregate the issue in the long run.
In the video above, look at the slider, its not a tension exercise (they have those in the video as well, but don't start there)
Do 10 of those every or every other awaken hour for a week and see if you are miraculously healed.

//Joel the physiotherapist (by trade)

 

[Rygor the Swoleman]

I have had sciatica a few times. I figured out it was triggered when I was doing a lot of mountain biking, especially from long, slow slogs uphill (I live in Colorado so there are a lot or those). I think it was a combination of sitting on a bike seat combined with the repeated pushing against pedals at the angle I was seated likely inflaming the nerve on my right side. It hurt like hell for a couple months the fist time. I could barely put on my shoes and socks as it hurt so bad to bend over and lift my leg. I couldn't squat while I was having the pain, but interestingly deadlifts were okay due to the shorter range of motion.

What helped me the most were lower back stretch with my legs against the wall (lie on the floor and scoot your butt against the wall and just relax with legs straight up on the wall), and also the Pigeon Pose, which is a glute stretch on all fours putting one foot in front of opposite knee and stretching the glutes forward and back (targets the hips, as well). Scroll down here and you'll find it, plus can try the others here, too: 6 Best Glute Stretches to Try | The Output by Peloton

 

[Steve Freides]

I've been careful enough not to let it travel upstream and mess up the lower back.

IDK if this is you, but one of the McKenzie lessons I learned is that if - a big "if" - the issue is in your back and creating pain and numbness that feels like it's somewhere else, that pain is often called "referential." And in the case of referential pain originating in your back, "centralizing" the pain, which means your back hurts more and your leg feels better, is a definite sign of progress. Again, I don't know if I'm reading things into what you said that aren't there, but it never hurt anyone who hasn't done so already to read McKenzie's "Treat Your Own Back" - as I've mentioned here many times, my first copy was handed to me by my doctor, a low back MD orthopedist, and I thought so highly of the book that I went out and bought 12 copies so I could give one to anyone who had back pain.

A story:

My back injury happened in 1997. I have a laterally herniated L4-L5, and while it's certainly a whole lot better than it was in the first months and years after it happened, it's still a thing for me. (I did not have surgery.) At the time I lost all the feeling in the inner portion of my right thigh, and the muscle mass along with it, and while most of that has returned, not all of it did. For these last 27 years since then, I have continued to work on my strength, flexibility, and movement quality.

One of my compensations for the lower back injury on my right side is a tendency to be tight in my right shoulder. That's important to my story because, although I work a lot on trying to loosen up my shoulders and t-spine, there are limits because I'm still protecting my back.

So, a few weeks ago, I'm sitting on the sofa in the evening with my wife, and doing what I usually do which is, per McKenzie, wearing a rolled-up sweater around my waist to serve as a lumbar support cushion to keep my lower back from rounding too much when I'm sitting for extended periods of time. And while I'm sitting there, I noticed two things: first is that my lower back, right where my disc herniation is, feels like someone has put a too-hot heating pad on it. Not exactly what I'd call pain but rather an odd sensation in a place where I don't usually feel much of anything. And simultaneously, my right shoulder is relaxed in a way it hasn't been since, well, it was so long ago I can't remember when, but I could tell that real lot of tension had relaxed in my t-spine and right shoulder. What seems to have happened, 27 years post-injury and at age 69, is that some of my work over all these years has resulted in progress.

So far, anyway, there is no downside. I'm going to a PL meet in a few weeks and all my lifts in training are where they were at this distance out from the meet when I set lifetime PRs, IOW, some training lifts at 90+%.

Hope advice and the story is helpful to you, @Boris Bachmann, or someone else reading along.

-S-