Running with Sciatica: Treatment and Prevention

When it comes to running injuries, we tend to think of ailments related to bone, muscle and other soft tissues. One of the more common injuries runners encounter, however, deals with nerve pain.

Because there are so many different running injuries, it can be hard to determine if it is truly a nerve issue you’re dealing with. Learn more about sciatica from running and how to handle it.

What Is Sciatica?

Sciatica refers to a sharp and sometimes numbing sensation that travels the length of the sciatic nerve, from the low back through the buttock and into the leg. While it's not usually a season-ending injury, it often warrants a trip to your physical therapist to figure out the root cause.

Since "sciatica" is sometimes used as a catchall term for leg pain, it's important to first determine if it is truly a nerve issue you're dealing with.

Sciatica Symptoms

"The most common symptoms are numbness, tingling or burning pain in the leg or weakness in the muscles of the leg or foot," explains Ann Wendel, a physical therapist and athletic trainer in Alexandria, Virginia. "Some patients have back pain, but not all."

For many people, sciatica feels like lower back pain that shoots down the back of one leg. Symptoms are worsened by prolonged sitting. Sciatica is often caused by a bulging disc, bone spur, or narrowing of the spinal canal. A doctor or physical therapist can help you diagnose whether or not your pain is sciatica.

MORE: How to Treat and Prevent Lower Back Pain for Runners

Sciatica Itself Is a Symptom, Not a Cause

It is important to understand that sciatica is a symptom of a larger issue in the kinetic chain. Depending on where the nerve is pinched or inflamed, an athlete may experience discomfort in different parts of the back, leg and foot. Perhaps the most common cause of sciatica is a herniated disc, which irritates the nerve. Similarly, disc degeneration can also inflame the nerve at its root, causing pain and discomfort.

In runners, piriformis syndrome is another common culprit. A muscle located deep in the hip area behind the gluteus maximus that goes from the pelvis to the femur, it sits adjacent to the sciatic nerve and, for a small portion of people, runs directly through the muscle. The piriformis aids in the rotation of the hips during running and can cause pain when it gets tight or inflamed during training. Since this phenomenon is quite complicated, even the top experts aren't in agreement in regards to how and why this is a problem for some people and not others.

"The best course of action is to consult with a physical therapist when the back or leg pain begins so that they can help you identify contributing factors," advises Wendel. "Physical therapists are musculoskeletal experts who can evaluate you and make necessary referrals based on your symptoms."

Indeed, the sooner you get in to see an expert, the less likely you'll end up with a bigger problem in the future.

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Running with Sciatica

Running with sciatica varies on a case-by-case basis. Whether or not you’ll be able to continue running with sciatica depends on pain level, location, and cause. Most of the muscles you use while running are attached to the sciatica nerve, so it is critical that you listen to your doctor’s recommendations to avoid worsening the issue.

Typically, if the cause of your pain is unidentifiable, you can continue light running. However, if your sciatica is caused by a medical condition such as a bulging disc, running may not be an option.

How to Treat and Prevent Sciatica

If you do continue running, minimize pain by adopting a consistent and thorough warm-up and cool-down. Stretch your hip flexors and glutes. Use hot baths and ice packs to treat the affected area to loosen surrounding muscles. If pain worsens during running, stop and seek help from a professional.

To prevent sciatica from recurring, focus on using proper running mechanics and maintaining good posture when sitting or standing.

Sciatica vs. Piriformis Syndrome

Piriformis syndrome is often confused with sciatica. The difference is in pain location. If you feel pain in the lower back and buttocks only, it may be piriformis syndrome. If, however, the pain extends into the lower extremity, it’s probably sciatica.

Both injuries deal with the sciatic nerve. Piriformis syndrome is actually the compression of the sciatic nerve around the piriformis muscle.

For runners with piriformis syndrome, it will likely be recommended that you cut back on your running mileage. Since the piriformis helps rotate your hips with each step, you stand to make the problem worse by continuing to train as usual.

"A general rule that I use with my runners is that they can [run when] pain-free and have to stop as soon as they start to feel pain," says Wendel.

Conversely, she also emphasizes that too little movement can be a root cause of sciatica. "People who sit at a desk all day should stand up at least every 30 minutes and move a bit," she adds. "This can be a quick break of one minute, but the important thing is to stand and then sit down in a slightly different position."

In addition to making an appointment with a physical therapist, foam rolling and stretching can help resolve this issue. By simultaneously stretching and massaging the tense muscle fibers around the sciatic nerve, a foam roller may reduce symptoms. It is important not to irritate the nerve by pinching it via the roller, however, so be sure to avoid any areas that present numbness during this practice.

MORE: 9 Causes of Hip Pain During and After Running

Traditional low back, hamstring, piriformis and glute stretches also often provide relief. By restoring healthy movement to these areas, sciatica symptoms usually subside as long as you don't continue to train and inflame the area. Similarly, depending on your diagnosis, strengthening these same muscles can play a role in reducing pain. When one of these major running muscles lacks strength, it relies on another to pick up the slack. The result is an overworked muscle, which is a recipe for injury.

While each case of sciatica is unique, it is always a symptom of something else going haywire. By identifying the root cause, you not only relieve nerve pain, but you also avoid other related injuries down the line. Heeding the call of your body to step back from training and figure out how to best move forward will always save you pain and suffering in the long run.

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