3 ways to Relieve Sciatic Pain

Once again someone told me I was a miracle worker, which while flattering is completely false.  No miracles come from me; I simply understand movement.  Before the “miraculous” session started this client was having sciatic pain, and after the session his sciatic pain was gone.  Hence the miracle worker moniker…Now as a way to dispel the miracle myth, I wanted to share my exact thought process during this session.  It involves listening and problem solving in collaboration with my client.  I am not fixing anything, I am simply listening.

When someone comes to me with an ache or pain, I simultaneously begin two separate thought processes.  First, how can I help provide some relief, and secondly what is causing the pain.  Both of these thought processes are important.  They must exist together to make change in the body.  If a practitioner only addresses pain relief without finding the cause, then he is simply putting a band-aid on the wound.  But, on the other hand, if he spends all of his time thinking about the cause of the injury without pain relief, then the pain will impede the body’s healing process. 

When my client came into The Pilates Studio with hip pain, I first started him with a "sciatic pain relief magic trick," which I developed after learning from Tom Myers.  In a class about the pelvis Tom Myers talked about sciatic pain often being caused by a Piriformis that is too long.  Pulled taught like a rubberband.  Hmmm I thought, “The clam shortens the Piriformis." 

The clam (an exercise) shortens the Piriformis by taking the femur in and out of external rotation.  So when somebody comes to me with hip pain, we do the clam on the side that hurts.

Thanks Ivy for demonstrating the clam for us

The next thing Tom talked about in this class is the relationship between the Piriformis on one side to the Piriformis on the other side.  They work together and adjust to keep balance in the spine.  As I was in this class, I thought, “maybe when someone is experiencing sciatic pain they should stretch the other hip.” So the next step in this “magic trick” is to do a Piriformis stretch with the leg that isn’t feeling pain.

Cross the ankle on the pain free side over the other thigh and hug your knees to your chest

Working asymmetrically is a tricky business.  So at the end of this magic trick series I work hard to turn on the “lateral brakes” of the hips.  This is the gluteus medius.  So after the first two exercises we do sidelying leg lifts on both sides.

After teaching this series to my client his pain had been relieved, but I was not convinced that it might not come back if he were to go on another seven mile walk (which is what brought it on in the first place.)

The entire time that we were working, we were reviewing his injury history.   We were speculating why the Piriformis was acting this way.  What support might it need?  I was sure that the pain was relieved for now, but we had simply provided support to the taxed part of the body.  We hadn’t changed the pattern.  It’s at this point in the process that I feel in collaboration with the client.  Yes I may know a heck of a lot about the myofascial system, but the story of the body comes from the client.  It was my job to listen to his insight, because I can never assume to understand someone else’s body as well as they do.

During these conversations together we both came to rest on a ruptured achilles tendon that happened years and years ago.  We speculated that limited range of motion in that ankle, may have caused some compensation patterns during the walk that after time caused pain in the hip.  We finished the session with this as our working theory…

He left the session with a strategy to relieve the pain in the moment.

I taught him two more series one for foot agility and one for Hamstring release, which you can follow the links above to read about each of these exercise sequences…

Are we done?  Did we fix the problem?  No because in my opinion the entire idea of “fixing” the body steers us away from listening to the story of the body.  The story that will tell us where to go; the story that highlights the way…

Next week we will continue to listen to the story, in my mind I am currently wondering about his spine, and the balance front to back, and side to side….These are the thoughts I will bring to the table, we’ll see what his insight is and move from there!

Katrina Hawley C.M.A, PMA, CPT

Director of Instruction at The Pilates Studio