Sciatica is a term used to describe pain, tingling, or numbness that travels from the lower back down through the hip and into the leg due to irritation of the sciatic nerve. It forms from several nerve roots in the lumbar and sacral spine and travels through the pelvis, deep in the hip, down the back of the leg, and attaches to the heel. As the body’s largest nerve, the sciatic nerve innervates many of the muscles of the hip and leg and carries sensory information from much of the lower extremity back to the spinal cord.
Common causes of sciatica include piriformis syndrome, in which the deep intrinsic gluteal muscles and the piriformis become tight or inflamed, compressing the sciatic nerve. The piriformis is worth noting because it lies over the sciatic nerve. When the piriformis becomes inflamed or tightens, it can apply pressure on the sciatic nerve. The compression of the piriformis muscle pressing down on the sciatic nerve can cause nerve pain-like sensations throughout the legs and feet.
Injuries and deconditioning to the lower back and hips can also lead to sciatica. If left untreated or neglected, weak back and hip muscles can cause a slew of back conditions, including compressed discs, impinged nerves, or advanced forms of lower spinal degenerative bone disease, such as arthritis. The roots of the sciatic nerve originate from the lumbar and sacral vertebrae. Compression or misalignment of the vertebrae can produce nerve and muscle conditions similar to those seen in piriformis syndrome. The difference from piriformis syndrome is when compromising spinal conditions are present is that misaligned vertebrae or intervertebral discs compress spinal nerve roots that can produce sciatica symptoms for months. This condition can be a more challenging form of sciatica to treat because bones can’t be stretched or recovered the same way muscles can. Therefore, sciatica stemming from spinal impingement is a more complicated puzzle to solve than a tight hip muscle.
Skeletal muscles have regenerative properties that adapt to the workload they endure via the SAID principle, which means specific adaptations to imposed demands. An example of a specific adaptation to an imposed demand is when a person consistently performs thirty seconds of planks first thing in the morning three days out of the week, for a three-month period. The result will most likely be a stronger upper body, core, and hip adaptation because a steady dose of exercise-induced stress was executed for a ninety-day period for muscles to adapt to the stress imposed on them.
Muscle is a soft connective tissue that adapts to become stronger when put through a bout of safe, effective strength training. On the other hand, bones are hard structures that, if left unsupported by stabilizing muscles, can collapse onto the tissues between them, causing problems. In the case of spinal-originating sciatica, vertebrae can collapse onto the spinal nerve roots, producing chronic sciatica.
Strong glutes and hip stabilizers help keep the pelvis balanced and prevent excessive stress on the lower back. Deconditioning of the glutes and hip extensors forces smaller muscles, such as the piriformis in the hip and the paraspinal muscles bordering the outer lumbar vertebrae, to compensate, increasing the risk of nerve irritation.
One of the largest and most dense muscles in the body is the glutes. Comprised of a layer of dense, powerful muscles, the glutes power the lower extremities to move forward, backward, away from the body, and toward the body. A commonly overlooked function of the glutes is hip extension, which is the action that moves the hips forward while keeping the body upright, stable, and aligned under the torso.
A simple and effective body weight exercise we coach our personal training clients to perform to assist in hip and glute strengthening is the supine hip extension, also known as the “hip bridge”:
To perform the Supine Hip Extension, start by positioning yourself flat on your back on the ground with your arms extended and your knees bent. Press your feet into the ground and lift the hips upward until a brief muscular sensation is experienced in the hamstrings and glutes. Repeat this movement for five to ten repetitions.
When the glutes are strong and active, they help position the pelvis directly beneath the torso. This alignment reduces excessive arching or rounding of the lower back and creates a more balanced, supported spine. Therefore, strong glutes keep the hips underneath you, so your back doesn’t have to carry the load. Incorporating consistent daily actions that strengthen the hips have the potential to fend off and mitigate the progression of sciatica.
Sean McCawley, the founder and owner of Napa Tenacious Fitness in Napa, CA, welcomes questions and comments. Reach him at 707-287-2727, napatenacious@gmail.com, or visit the website napatenaciousfitness.com.