When this form of nerve pain strikes, runners should take these precautions
Your sciatic nerve starts in your lower back and runs through the buttock and into the leg and foot. It is the longest and widest single nerve in your body. When compressed or irritated, it can create a condition called sciatica. When a runner has sciatica pain—described as sharp, burning, and like an electrical shock—running can be unbearable. This happens because the adjacent muscles connected to your sciatic nerve manage motion and propulsion. It is possible to run with sciatica. Adhere to the proper care and precautions first.
Is It Sciatica or Piriformis Syndrome?
While runner’s injuries are related to joints, ligaments, bone, muscle, or tissue, nerve injuries happen. Piriformis syndrome occurs when the piriformis muscle compresses the sciatic nerve. This makes it initially difficult to distinguish from sciatica. It also means that a runner can have piriformis syndrome and sciatica.
“Because the sciatic nerve runs underneath or through the middle of the piriformis muscle, contraction or inflammation of the tissues in this area may compress the sciatic nerve and develop sciatica symptoms. This is one of the main reasons sciatica and piriformis syndrome are often misdiagnosed,” Dr. Alexander Jimenez, an El Paso, Texas chiropractor, explains on his LinkedIn blog.
If you have piriformis, you may not feel discomfort while running, but sitting, climbing stairs, and doing squats as part of your warmup can be painful. Piriformis feels tender in the buttocks and legs. Pain centralizes and typically stays in the middle of the glutes. This makes piriformis pain different from sciatica. When a runner has sciatica, it’s usually a symptom of a larger issue like a herniated or degenerated disc.
Does Running Cause Sciatica
While running uses the muscles in the back, legs, and feet—areas affected by sciatica—running does not cause sciatica. Running with sciatica does, however, involve movement that can irritate the nerve.
Tips for Running with Sciatica
Since sciatica involves a pinched sciatic nerve, the following tips can help you to run without adding stress and pain to the injury.
Shorten your stride. When you run with shorter strides between heel strikes, you keep the sciatic nerve from fully extending, which causes pain when you’re running with sciatica. New York City-based sports medicine physician, Jordan Metzl, MD suggests this method to reduce the “bounce” in your run, which lessens the impact on your lower back.
Change Surfaces. If you run on sidewalks, asphalt, or other hard surfaces, consider running on softer surfaces like grass, trails, or your local track, which may be made of a soft synthetic material. “Things that induce compressions within your back, like landing on a hard surface repeatedly, will cause these things to worsen,” Metzl says.
Stretch Your Hamstrings. Your body naturally protects itself and the hamstring will contract to safeguard the injured sciatic nerve. Stretches like high knee lifts and lunges will warm your hamstrings up before you run. Tight hamstrings put pressure on your lower back and make sciatica worse if they aren’t stretched. Dr. Cathy Fieseler recommends “improving your core and hip strength and flexibility, with special attention to the piriformis and hamstrings” in order to continue running with sciatica.
Don’t Overdo It. You may need to alter your training schedule when you have sciatica. Running too frequently can exasperate the nerve and cause more pain and extend the length of time that you have pain.
Change Your Shoes. Some people advocate running barefoot or wearing minimalist shoes as the best way to run with sciatica, there are other factors to consider when choosing the right shoe. You’ll want to make sure that your shoes fit. They should hug your feet and feel comfortable. Any shoe too wide, big, tight or small can create an imbalance in your gait causing pain in the back. Your shoes should provide support and cushion for your feet to reduce impact. The best running shoes have built-in “shock absorbers." If you are able, go to a running store and have your foot custom-fit for a shoe, especially if your chiropractor or physical therapist has determined that your pain is sciatica. As your shoes wear down, be sure to purchase a new pair to keep your back in alignment.
If you feel your pain could be sciatica (or piriformis syndrome), make an appointment to discuss your condition with your doctor. You’ll get a complete physical to determine the root cause of your pain. You can then discuss whether or not to stop running if you have sciatica. If you are cleared to run, be sure to properly stretch your hamstrings and lower back prior to taking off. In addition, ask your doctor about a training regimen that is right for your condition. Take it slowly. Depending on the cause, sciatica heals itself in one to three months. Your doctor may give you a treatment plan that includes hot and cold therapy, stretches, and over-the-counter medications. Once sciatica is treated and healed, you can get back to running without pain and restraint.