Sometimes running and sciatica go hand in hand.
What are Sciatica and Piriformis Syndrome?
Sciatica is a nerve pain that is felt throughout the sciatic nerve. The nerve runs from the lower back, through the buttocks and hips, and down the legs. Sciatica is generally felt on one side of the body, and it is usually a result of a bone spur or herniated disk compressing the nerve. This compression may cause hip pain, inflammation, and numbness in the leg. Conservative treatments for a few weeks usually help with sciatica. Surgery is rarely required.1 With piriformis syndrome, the sciatic nerve is also affected, but this “uncommon neuromuscular disorder” is caused by the piriformis muscle compressing the nerve. The piriformis muscle is at the top of the hip joint, in the buttocks. This muscle is crucial for walking, allowing a person to maintain balance, and it is necessary for rotating the thighs and for lifting as well. Pain, numbness, and tingling in the buttocks are the early symptoms of piriformis syndrome, and it can trigger sciatica. Piriformis syndrome may be caused by actions such as sitting in a car, climbing stairs, or running. This syndrome, however, is not the typical cause of sciatica.2
Running and Sciatica
Runners and athletes may develop sciatica. Most of these cases are due to the spine, and “nerves in discs in the back compress the discs themselves, causing them to bulge out”. Runners experience a “constant pounding” and they do not have a lot of “padding in the (buttocks)”, leading to tight muscles that “squeeze in on the discs, affecting the sciatic nerve”. It is not that running is the cause of sciatica, but it does make the problem worse. Runners need to find the cause of the problem. Foot dropping indicates damage in the lower back. Night pain also indicates nerve damage in the lower back. Lack of control of the bowel or bladder demonstrates nerve damage that is severe.3
Treatments and Exercises
Recent research has shown that steroid shots do not resolve sciatica. Any slight improvements in mobility and pain were insignificant and provided no long-term relief; therefore, conservative care is the recommended approach.4 Runners may try a piriformis stretch to determine if their sciatica is related to piriformis syndrome. This is done by lying on the back and pulling the knee toward the opposite shoulder, holding it for a half a minute. If there is tingling on the outside of the leg, that may indicate piriformis syndrome. Pain could be a caused by “poor running mechanics, improper footwear, or overuse”, so patients may wish to “pull back on running” and “strengthen some muscles”. Additionally manual therapies that address trigger points can provide relief. Massage therapists and chiropractors are able to provide that body work.5 Piriformis syndrome can be alleviated by stretches and with strengthening the gluteal muscles by engaging in hip strengthening exercises. Runners may also wish to sleep on their sides, with a pillow between the knees, and “sit with their knees straight”. When running, they might consider a “midfoot strike pattern”.6