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.)

A Pain in the Neck

Have you ever had a pain in your neck?

Not counting your kids, in-laws, coworkers, unruly pets, etc.

I’m talking about that pain that makes your neck ache or causes a humongous knot at the top of your back or between your shoulder blades.

Chances are that in this day and age, not only have you had it before, but you may put up with that pain almost every day. Some attribute the pain and knots to stress. But, likely, the most prevalent cause is poor posture. And let’s be honest; you know that your posture stinks. I bet you started sitting up straighter as soon as you first saw the word ‘posture’.

Well done, your pain is magically gone. Oh, if only. Postural corrections are rarely a quick fix. You’ve kept that poor posture all day, every day. Correcting and especially maintaining proper posture takes work and perseverance.

How often when you’re looking at your phone are you looking straight ahead? Pretty much never. You’re looking down. Having your head leaning forward for extended amounts of time puts a huge strain on your neck. Soft-tissues at the back of your neck become overstretched and weak, while the ones at the front become short and weak. (Because gravity is the only thing that’s strong in this scenario).

Y’all…our heads are heavy. And the neck was designed in such a way as to have it balance on top, not out in front like a tomato on a tomato plant with no cage. (You gardeners should get that one).

As for that upper body posture…ever seen The Hunchback of Notre Dame? Rounded shoulders and a rounded upper back.

These are postural positions that we tend to be in for extended lengths of time, so the body just figured it should stop fighting change and adjust to the new normal. Working at a desk with the arms extended in front, driving with our hands on the wheel in front of us, washing dishes, and folding laundry. Many tasks we perform with our hands are not only repetitive but stationary as well.

We get into that position and stay there for a while. The muscles of the back aren’t engaged actively in the task, so we let them take a break, instead of allowing them to act as the stabilizing muscles that they are.

Just like in the neck, the soft-tissue of the back becomes overstretched and weak. So overstretched that the muscles try to prevent it by ‘knotting up’ and fighting against the pull of gravity. (It’s like our bodies know what’s good for them, even when we don’t. Weird…).

Conversely, the chest muscles and shoulder flexors become extremely tight, sometimes so much so that it’s nearly impossible to draw the shoulders back to their proper place. And if you look around, you’ll notice that almost all of us are in the same boat. Even I can only think of one person I know who I would say has proper posture. (Y’all, she’s got Downton Abbey level good posture).

“So, what now?” you say.

I’m so glad you asked.

Like many step-wise progressions, Step 1 is realizing you have a problem and deciding you are tired of living with chronic pain. (Ain’t nobody got time fo’ that).

Step 2: Get the soft-tissues released. You can’t strengthen properly if the tissues can’t move optimally to begin with.

I can help you at this point. You’ve already made it this far through my post, so I’m assuming you think I’m somewhat trustworthy and knowledgeable. Go click the ‘Book Now’ button and set up an appointment once you’ve finished reading. (‘Cause I worked hard on this. You better finish).

Step 3: Re-educate those muscles.

They haven’t worked properly in a while and need a reminder of what to do. These are simple exercises focused more on endurance than strength.

Step 4: Practice maintaining proper posture.

And I do mean practice. It’s something you will have to do repeatedly. I don’t tell clients to simply start having better posture. Those are vague instructions and not goal-based. I tell them that the next time they notice themselves having poor posture (oh my gosh, I’m slumping so much right now!), start the clock. Correct the posture and count to 30. Every time you notice poor posture, correct it and hold it for at least 30 seconds.

With consistent practice, your posture will improve and maintaining correct form will eventually start feeling less like work and more normal. And I bet you’ll be surprised at how much better you feel because of it.

Muscle Pain, Go Away

I was chatting with a client the other day, and she made a remark about how when she goes to the doctor, a lot of different health issues are talked about, but there’s rarely anything said about muscles and other soft-tissues (tendons, ligaments, fascia, nerves).

Sure, the doc is concerned about your overall weight and fitness level, but do they ever ask about how well you’re moving? Or do you mention to them that you’ve had tight hamstrings since you were in middle school when you failed the sit-and-reach test, or that you get a huge knot between your shoulders after sitting in front of a computer all day at work and it’s super annoying, not to mention painful?

These are things we tend to not mention to anyone, unless it’s your significant other who’s heard you complain about it a million times before and gives you a super-sympathetic, “uh huh, yeah, sorry your back hurts. Did you rake up the leaves yet?”

The truth is that we tend to suck it up and deal with all the aches and pains of moving around. At least until it gets so bad that you’ve missed the window for conservative intervention and skipped right to needing medications, shots, and even surgery (go big or go home, right?).

Any idea how much our collective stubbornness costs? Here are some stats for you.

  • In 2011, the cost of treatment and lost wages associated with musculoskeletal disorders was $213 billion.
  • In 2012, 25.5 million people lost an average of 11.4 days of work due to back or neck pain, for a total of 290.8 million lost workdays in 2012 alone.
  • The average annual cost per person for treatment of a musculoskeletal condition is $7,800.*

Y’all, that’s a bunch of money and productivity that we lose. And before you flip out and say those stats also include disorders such as arthritis, consider this. If you don’t have a family history of arthritis, preventing it is mostly about maintaining healthy joints, which means keeping the joints’ support structures (muscles, tendons, ligaments) healthy and strong.

That’s where I come in. I specialize in a technique called Active Release Techniques®, or ART. It’s a manual therapy (I use my hands to fix you) that targets muscles, tendons, ligaments, fascia, and nerves. I locate the tissue that is tight, stuck, pinched, etc., and apply some pressure and tension while you perform a motion specific to the area I’m working. Clients normally get significant relief of symptoms during the first session and issues can be fully resolved in only a few visits.

Add in a few maintenance, strengthening exercises that you can easily do at home, and boom, you’re good to go.

No more missing work, missing out playing with your kids, being unable to work out because of a nagging injury, and no more eye rolls from your significant other (well, at least not for complaining that your back hurts).


* American Academy of Orthopaedic Surgeons. “One in two Americans have a musculoskeletal condition: New report outlines the prevalence, scope, cost and projected growth of musculoskeletal disorders in the U.S..” ScienceDaily. ScienceDaily, 1 March 2016. <>
**And I thought I was done using MLA citations when I finished college. Sigh.

The clothes make the athlete. If only it were so simple…

You’ve done it. You know you have. Justified the purchase of new athletic clothes or gear by telling yourself that you’ll be more consistent with training or be able to finish faster simply because your outfit is awesome or you have the latest workout gadget. But in reality, how much will that purchase actually affect your training or, ultimately, your race?

Once the novelty wears off, is it really going to motivate you to:

  • get up at the crack of dawn for a training run when you still hurt from yesterday’s
  • push past that horrible, sluggish feeling you have during every first mile
  • keep moving despite that nagging pain you have in you hamstring, or foot, or knee…or all three
  • actually be consistent with your training plan the whole time, instead of petering off when your weekday runs become as long as your long runs were in the first few weeks

Are your new shoes or shorts or gadgets going to help you then?

Now, don’t get me wrong; I fall into these same traps. I’m a pro at justifying athletic purchases. Those new shorts will absolutely make me want to run more. But if I’m honest, they don’t make a bit of difference when my hamstring starts nagging me ten minutes into a training session.

My point is that it’s not the clothes that make the athlete. It’s the motor, the machine. IT’S YOUR BODY.

So why haven’t you been investing in it?

You shouldn’t decide that you’re going to do a half-marathon and only add training runs to your schedule. Your body is going to be under a lot more stress than normal. Muscles, ligaments, and tendons are going to be screaming at you wondering what they’ve done to deserve this type of treatment. They say, “weren’t we all happy just chillin’ on the couch?”

If you demand more of your body, you have to invest more in it. But, oh! Invest, what a scary word!

Calm down, it’ll be fine.

I’m not talking about endless treatment sessions where you shell out a mountain of cash. It’s kind of like cleaning your house; if you do a little bit every now and then, you’ll save yourself a headache later. Take care of your body before, or at the first sign of, discomfort, and keep from getting injured later.

My point is this:

Yes, your new running outfit makes you look super legit and intimidating to others. But your body is what’s going to get you across the finish line.

Don’t just train it, MAINTAIN it.