The Sciatic Nerve: Guilty Until Proven Innocent

Wait a second, that’s not how the saying goes. Who switched it?!?

If only it could speak up for itself, maybe it wouldn’t be the subject of so much ridicule. Because, to be honest, in the world of soft-tissue pain, the sciatic nerve gets more than its fair share of unjust accusations.

Really, I think of it like this: Sciatic is just a kid with some jealous friends who take advantage of him when they are overlooked and forgotten. I’ll explain.

In a fully functioning scenario, Sciatic is the mightiest of nerves. In fact, it’s the largest nerve in the body and can be as thick as a #2 pencil in some places. Its job is to provide sensation and movement signals to your hip, the backside of your leg, and all the way down to your foot. But along its journey, a few muscles have the potential to use its power to draw attention to themselves. Enter Piriformis and Biceps Femoris.

Piriformis is a small muscle deep to your gluteus maximus and part of a group of muscles that perform hip external rotation. We tend not to give this muscle a whole lot of love. We forget about it, allowing it to become weak and not move the way it should. Well, in about 80% of people, the sciatic nerve runs just underneath and perpendicular to the piriformis. So when Piriformis gets forgotten, this close proximity makes it easy for Sciatic to get compressed or entrapped.


Image source: Visible Body
Sciatic nerve running under the piriformis.

The same can be said of the hamstrings, specifically Biceps Femoris. When Sciatic leaves the hip and enters the leg, it dives under Biceps Femoris, which originally lays over it diagonally before running parallel to it all the way to the knee. When the hamstrings are shortened, as they so often are in this Age of Sitting, Biceps Femoris also has the capacity to entrap Sciatic.

Source: Visible Body
Sciatic nerve running under the biceps femoris.

Both of these scenarios can hinder Sciatic’s ability to provide sensation, thus creating numbness or tingling, and also movement, thus causing weakness. It’s really not Sciatic’s fault at all; it’s just Piriformis and Biceps Femoris using its power to draw attention to their own needs.

So, what’s to be done? Naturally, I’m all for using manual therapy to release the problematic muscles and restore order. Once those muscles are released, if you show them a little more TLC on a regular basis, such as stretching and doing strengthening exercises, they should cooperate and not use Sciatic against you.

Something that can be used in conjunction to manual therapy, or by itself, is a technique called nerve flossing. In the attached video, you can see it in action.

All-in-all, sciatic pain doesn’t have to mean the end of the world. As with most things though, the sooner you get it fixed, the better.

(Disclaimer: there are many reasons that a person would experience sciatic nerve pain. I’m only talking about one. Be smart and find out if your pain is due to a more serious condition by seeing your health care provider about it.)

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