How to SAFELY Stretch if you have Sciatica
Stretches for Sciatica, safely – One of the most common things I see in our clinics are patients presenting with sciatica. Interestingly enough, this is not a diagnosis but rather a syndrome. A syndrome is a collection of symptoms (ie, pain, loss of strength, etc). A diagnosis implies a certain physical structure is injured.
So, sciatica is a bit of a vague term. We know the symptoms are being mediated by the sciatic nerve but it doesn’t tell us what is causing this. There are actually many answers for that… sometimes a herniated disc could compress the nerve roots as they exit the spine, sometimes the muscles in the back of your hip are tight, or maybe there is bony narrowing of where the nerves exit the spine (called spinal stenosis).
However, when it comes to stretching for sciatica, I have found two common thing holds true: DON’T aggressively stretch it during the early (acute) stages of the onset of symptoms AND once it does start to settle, stretch the leg muscles before you stretch the lower back!
The muscles in the leg that we typically need to stretch are those that run down the back side of the leg. The reason we try to stretch or relax them is because if they are tight, they could cause further compression of the sciatic nerve and lead to persistent symptoms (pain, numbness, etc).
So, to keep things simple I usually recommend you start at the feet and work your way up. With that in mind, here is the list of muscles that typically need to be stretched:
GASTROCNEMIUS (your calf muscle)
*be careful with this one as bending your foot towards you, reaching with your hand towards your foot, or rounding your lower back can all lead to more symptoms. If you start to feel a burning behind the knee then you know this is likely the case. This is by far the most sensitive of any of the stretches – so start gently on a lower object (like a stair or step stool) and progress to higher objects as you are able
Hamstring stretch properly (Left) and then improperly (Right)
GLUTEAL Muscles (your butt muscles!)
One of the most important muscles to stretch is the piriformis (SEE PICTURE BELOW).
I usually recommend people do this in sitting instead of laying on your back because when you lay on your back and pull the leg towards you, it typically causes rounding of the lower back and further sciatic nerve irritation.
Proper sitting Piriformis stretch (Left) and then improperly while laying on back (Right)
Once again, remember that the sciatic nerve runs right underneath this muscle so less is more. Don’t start at a crazy high intensity of stretch.
FINALLY… TO FINISH you might be able to now gently stretch your lower back into a forward bending position – HOWEVER, if you have a disc injury then this position would not be advisable – Talk to your PT if you are in doubt.
There are a variety of ways to stretch the back into lumbar flexion, downward dog, standing toe touches, child’s pose, and seated toe touches. Generally, I recommend starting with the stretches where your knees are bent (child’s pose and seated toe touches) as the bend in the knee puts slack on the sciatic nerve. Once your symptoms calm down, you might be able to progress towards a standing version.
Seated forward bend
So, why do we stretch the leg muscles before the back?
Because if you don’t and you try forward bending stretches like those above, you’ll likely just feel the stretch in your legs anyways and won’t likely be getting any type of stretch in the lower back.
For non-symptomatic people, you can try this test – briefly try a forward bending stretch while standing and see where you feel the stretch, then do all of the leg stretches above and then re-try the standing toe touch. Do you feel it differently now? If so, then your leg muscles were likely causing a mild bit of sciatica.
Standing forward bend
As a reminder, all of the above information is for general knowledge and is not meant to substitute for a proper medical exam from either your physician or physiotherapist. If in doubt – always get sciatica checked out by a regulated healthcare professional.
That’s all for now!
Registered Physiotherapist, Co-Owner of Thrive Now Physiotherapy