Piriformis Syndrome and Sciatica in Runners
Sciatica is the general term used to describe pain and/or numbness along the sciatic nerve on backside of the leg. A disc herniation or a piriformis muscle spasm can cause sciatica in runners.
Cause of Sciatica in Runners
The most common cause of sciatica in runners is a piriformis muscle spasm, which is referred to as piriformis syndrome. The piriformis muscle is located over top of the sciatic nerve (or sometimes the sciatic nerve pierces through the muscle belly). Therefore when the piriformis muscle goes into spasm, typically due to over use, it compresses the sciatic nerve leading to sciatica.
A disc herniation can also cause sciatica in runners. The material that forms the intervertebral disc can lead to compression on the nerve roots leading to pain and/or numbness down the backside of the leg.
Treatment of Sciatica in Runners
Most cases of sciatica, whether due to a disc herniation or piriformis spasm, the treatment approach for runners is conservative.
Joint manipulation and mobilizations to the lumbopelvic region can be helpful to reduce pain and muscle spasm associated with sciatica. Manual therapy, such as pin and stretch or Graston technique, to the glutes and piriformis muscles can also help runners recover from sciatica.
Improving the stability of the lumbopelvic region is the primary focus of rehab. Since the muscles of the hip and pelvis need to stabilize the lumbopelvic region with each stride, it is important for these muscles to be strong. Starting out with traditional hip and core exercises, such as glute bridges and clamshells, can be a good place to start but these exercises need to be progressed to more challenging exercises. The exercise progression for runners should eventually end up in a single leg position because this is when the stability needs to occur.