With the approximate thickness of a pencil and running from the low back down to the feet, the sciatic nerve is the longest nerve in the body.
It originates in the lower part of the spine, travels through the muscles in the buttocks, branches out down the leg and attaches to the foot.
It can become irritated by muscles in its path (most commonly in the buttock or leg) tightening or going into spasm, or by a bulging or herniated disc in the low back pressing into it.
It is also associated with degeneration of the spine, or spinal stenosis, which causes a narrowing of the tunnel which the nerve passes through.
This irritation causes the pain down the buttocks, leg or foot which is commonly referred to as sciatica.
It is also associated with degeneration of the spine, or spinal stenosis, which causes a narrowing of the tunnel which the nerve passes through.
A slipped or herniated disc is the most common cause of sciatica.
It happens when the outer edge of the intervertebral disc ruptures and the inner jelly-like centre pushes out and presses on the sciatic nerve.
Sometimes the outer edge doesn’t break, but the disc protrudes. This is referred to as a bulging disc and can also put pressure on the nerve.
As the bump grows, your centre of gravity shifts.
This can lead to an increased arching of the back which in turn tilts the pelvis forwards.
This can sometimes mean that the muscles in the buttocks tighten and pinch on the nerve. Some woman also find that the expanding uterus can press directly on the nerve towards the end of pregnancy, or even as the baby starts to move into position, it can rest on the nerve.
As we age, our intervertebral discs can deteriorate. Over time (or sometimes due to injury), the disc can become arthritic, narrow or shrink.
This can increase the risk of the disc rupturing and therefore potentially giving rise to sciatica.
The degenerative process could also lead to the development of spinal stenosis, a narrowing of the bone canal through which the sciatic nerve passes which in turn compresses the nerve.
Smoking has been associated with a higher risk of developing sciatica.
This could be due to the reduced blood flow to the discs, leading to degeneration.
Excessive body weight places additional pressure on the back, increasing the rate of degeneration.
This increased pressure also increases the risk of disc injuries.
The Piriformis muscle is located in the buttocks, near the top of the hip joint.
The sciatic nerve passes through the piriformis muscle and can be compressed if the piriformis muscle is tight or goes into spasm.
This can be caused by prolonged sitting (particularly on hard surfaces), repetitive action during sports (i.e. football, running) or climbing stairs.
One of the most successful treatments for sciatica is a physical therapy programme.
A key aim is to reduce the pressure on the sciatic nerve. This can be achieved by strengthening the back muscles and core strength work. This increased strength will help support the spine.
A programme should also include exercises to support correct posture.
Sports massage and stretching/flexibility work also helps by reducing inflammation and easing and tight muscles which may be constricting the nerve.
At Core Strength Studios, we include the above in our rehabilitation programmes for clients with sciatica. In addition, the root cause of the problem will be advised on, and any additional treatment included accordingly.
If you think you have sciatica and would like to speak to a specialist for an assessment and to discuss treatment options, we would like to invite you to a complimentary 60-minute consultation. To register, click here, complete the form and we’ll be in touch to make your booking.
We all know by now that strength training is good, right? It’s great for boosting metabolism, maintaining a strong core and increasing bone density, amongst many other reasons.
We do, however, get some people coming through our door who started with all the right intentions but ended up doing more harm than good though lifting weights. Here’s our short guide to what to avoid the next time you hit the gym to make sure you’re getting the best from your workout.
I know the mirrors in gyms can be a massive distraction (who wants to see themselves a sweaty, grunting mess, right?) but the reason they are there goes beyond vanity. Use the mirrors to check your technique, making sure your spine is neutral with no over-arching or bending as you lift.
Particularly important if you’re doing free weights, you need to activate and engage your core muscles as you lift to protect your spine and avoid back pain.
It’s easy to ignore niggles when you’re warmed up and in the zone (I know this from experience) or to take painkillers if you have an injury and ‘train through it’ but pain is a warning sign that we mustn’t ever ignore. It’s our body’s way of telling us that something’s up, so listen, take a rest and come back stronger when you’re fully recovered.
It’s so common – especially as summer approaches – to only want to train the parts of your body which are on show, or which respond best to training. An imbalance of strength can lead to poor posture and leave you vulnerable to injury. Train your body as a whole unit, making time to include every muscle group (especially the core which is often forgotten) and you’ll reap the rewards with a strong, balanced body.
If you go too heavy without the strength to handle it, your form will suffer. Choose a weight which challenges you, but one at which you can also maintain a full range of movement without using momentum to follow it through.
If you’ve ever had back pain, you may be familiar with that ‘rusty hinge’ feeling. You know when you feel as if your muscles are conspiring against you to stiffen you up and not let you bend Further than a few degrees? Or when the thought of being stretched on one of those medieval racks becomes ever more enticing.
Finding the right stretch to to ease this stiffness can be tricky, you end up contorting your body into all kinds of weird and wonderful positions just to find the sweet spot.
Here are a few of our favourites which we recommend to clients (and use ourselves) This combination of exercises will help stretch out your back, but also the muscles of your legs and hips which, if tight, can contribute to back pain.
Stretch to a point where you can feel it, but are not in pain. Hold for 30 seconds and then as you feel your muscles relax, increase the stretch a bit further for another 30 seconds or so.
Kneel on one leg, raise the opposite arm and rotate slightly towards the side of your supporting leg. For a greater stretch, bend to the side.
Sit tall with one leg outstretched. Bend the other and cross it over the other leg, keeping your foot on the floor. Use your arm to gently pull the bent keg into your body until you feel the stretch in your buttock.
Lie face up with one foot on the floor and use a band or towel around your other foot to gently pull your leg in towards your body, keeping your leg straight and hips on the floor.
Ok, we’ve all been there. You visit your back-pain professional, skip off with your list of exercises to do at home and what happens next is common of probably 90% of clients. Yep, that’s right, the list stays stuck to the fridge/pinned to the notice board/shoved at the bottom of a bag never to be looked at again.
And we get it, we’re busy folk. With all those balls we have to juggle, it’s amazing we remember to brush our teeth every day, let alone spend 10 minutes stretching, rolling and bending our body into unnatural positions.
So, when we work with clients on our programmes, we incorporate exercises into their daily lives, so they don’t have to take time out to do their homework and can strengthen their core whilst going about their business. Exercise without thinking about it – sounds good, right?
Try working these 5 simple hacks into your life to strengthen your core and reduce back pain
As you lift the kettle, fire up your core (scroll down to see Andy explaining how to do this) and keep the muscles engaged as you lift. Regular tea drinkers rejoice – look forward to a core of steel
When carrying bags, focus on standing tall and not leaning to one side. Again, engage your core and as you walk, try your hardest to right your body as it tries to lean towards the heaviest side.
Stand tall and swing your arms gently to change your centre of gravity. As you do so, engage your core and keep your shoulders back and down.
Engage your core (am I getting across how important this is yet?) and bend your legs and let all the strength come from your midsection. If you hold your child on your hip, really try not to bend your hip to the side – hard I know – but instead, maintain your neutral spine position and a strong stance.
If you have back pain or a weak core, this is the one which can get you. Really concentrate on the engagement and contraction as you load the machine and try as hard as you can not to bend and twist at the same time. Kneel, engage and then load the clothes.
Not just for sadists (if you’ve used one, you’ll know what I mean), our cylindrical, sometimes knobbly little friends which you find in the stretching area of the gym are fast becoming a firm favourite of ours.
We first came across them at a fitness convention way back in 2013 when we were subject to quite possibly one of the best core workouts we’ve ever done – you know the type when you’re afraid to cough, sneeze or err, get up out of bed.
Never ones to get sucked in by a sales pitch (okay, okay. It was 7pm on a Sunday night after a VERY intense 3 days of exercise and heavy learning. We were so exhausted we’d have bought anything – they certainly knew how to time it right) we headed home with our new toy under our arms.
Fast forward 5 years and what we thought might fall into the ‘fitness fad’ hole, along with slender tone belts and ab cradles (remember them?) are well and truly here to stay and we for one, couldn’t be happier. This is one bandwagon we were more than happy to jump on.
Here are our 3 reasons why we won’t be rolling off ours any time soon…
By rolling and applying pressure to your muscles and fascia (connective tissue), you can simulate the same effect as a deep tissue massage.
If you’re feeling tight, or have niggles or ‘knots’, the pressure helps to release trigger points and break down any knots or tightness you feel.
Anything which makes you unstable will fire up your core muscles and get them working. What better way to add instability than putting your feet/body/arms on a giant rolling pin?
There are loads of things you can do to combine the muscle rolling (above) with core work, so you get more bang for your buck. For starters, take a look at this page which has 5 great moves to get you going.
By applying pressure to damaged tissues, you will boost your blood flow and circulation to the tissues. As your blood carries all the goodies your body needs to recover (oxygen, nutrients) you will flood it with goodness.
Another significant effect of increased circulation is the removal of the harmful stuff. Think of flushing out toxins and lactic acid, the latter being the stuff which causes the pain the next day, so the better you roll, the less sore you’ll feel afterwards. You’re welcome.
Oh, and a bonus fourth thing – it’s portable and (after a small initial investment, they’re not expensive) free! If you buy your own you can use it anywhere, any time.
So, there you have it. Now that you also love foam rollers, why not get one of your own? We have plenty in stock and much more equipment (and even clothes) for you to choose from!
There’s a bit of a buzz word going around at the moment – ‘Future Proof’. Basically, it means something which can still be used in the future, so lots of people talk about upskilling and future-proofing their career, or future-proofing their business to increase its longevity.
But can we future-proof our greatest asset – our health?
Well, exercise – specifically strength training – can certainly help ward off many conditions which tend to make an unwelcome appearance as we age.
When we’re young, our cells break down bone tissue and regenerate new. This process slows as we get older, and we lose bone faster than new bone is created. As a result, bones become weaker, less dense and more brittle, leading to an increased risk of breakages and vulnerability to conditions such as osteoporosis and arthritis.
We reach peak bone density around the age of 30. This means that throughout our 20’s and early 30’s, we can capitalise on our bones being rebuilt and bank some bone density to help protect us later in life.
Do this by performing a regular weight-bearing exercise. Think jogging, lifting weights (particularly squats, lunges and overhead moves) and brisk walking.
Most of us reach peak muscle mass around our late 30s/early 40s. After this, we can lose as much as 3-5% of muscle mass every decade.
This means that not only do we lose strength, but our metabolism drops, and we may gain weight more quickly. By exercising regularly, particularly strength training, we can protect against muscle loss and help maintain our strength and muscle mass as the decades advance.
People over the age of 60 are more likely to experience back pain related to the degeneration of the joints in the spine, and the discs in between the vertebrae. Arthritis and spinal stenosis are the 2 most common causes of back pain in older adults.
Prevent your back from ageing by keeping your back strong. Exercise like Pilates and yoga are fantastic for core-strengthening. General aerobic exercise such as swimming, cycling and walking also helps keep the joints healthy.
As well as exercise, good nutrition can help keep the discs healthy, keeping them hydrated and providing them with the nutrients they need. By maintaining a healthy, well-balanced diet and not smoking, you can protect your discs against damage as you get older.
Studies show that following a back injury, 70% of people will significantly improve after 2 weeks, and 90% to 95% of people will recover within 2-3 months.
During this ‘acute’ phase, the focus should be on staying as comfortable as possible whilst the body’s natural healing process takes place. Passive treatments such as massage, manipulation (where appropriate), painkillers and heat can all help at this stage. It’s also important to be aware of posture, how to protect your back from further injury, and finding comfortable positions to ease the pain.
Staying active and avoiding excessive rest during the acute phase is also important to avoid rapid deconditioning of the back muscles.
The pain experienced by the 5%-10% who do not recover within this time is classified as chronic. Evidence shows that deconditioning because of pain and reduced activity in people who have chronic back pain can result in weakened muscles of the low back and spine.
It is possible for the body to be strong everywhere except the back. The back can only be strengthened when the lumbar spine is moving against resistance. Typically, if you have back pain, you will (unknowingly) change your body mechanics to protect your back, substituting pelvic motion for lumbar motion.
When we extend our trunk (go from a bending forwards position to leaning back), the muscles of the hamstrings and buttocks work to rotate the pelvis through the initial 110 degrees – as the spine remains fixed – with little activation from the lumbar muscles (fig.1). During the remaining 72 degrees of movement, the muscles of the low back take over to extend the spine.
When the lumbar spine is exercised in isolation, however (fig.2), with the pelvis fixed, it is the muscles of the low back (the lumbar extensors) which are working to extend the spine.
(Fig.1.) In a normal motion, as we extend, the leg muscles move the pelvis through the initial range of movement, with the lumbar muscles only taking over to extend the spine towards the end of the range.
(Fig.2.) In an isolated lumbar motion, the lumbar extensor muscles extend the spine, and the pelvis is fixed
A study at the University of Florida tested 3 groups of volunteers over 12 weeks; one group (the control group) did no exercise, the second performed standard back exercises, and the other group exercised using equipment which isolates the lumbar muscles by stabilising the pelvis.
At the end of the 12 weeks, there was no significant difference in the strength of the low-back muscles between the control group and the group who performed standard back exercises. The group who exercised with the pelvis stabilised, however, averaged a 120% increase in the strength of the low back muscles at full extension.
To exercise and strengthen the lumbar muscles, we need, therefore, to stabilise the pelvis and isolate the low back muscles.
The MedX Lumbar Extension machine we use for our programmes was developed to restore strength, flexibility and endurance of the low back, to reduce pain within 12 weeks and enable people to return to full function without the re-occurrence of pain.
The equipment has been designed to isolate the muscles of the low back through stabilising the pelvis and providing controlled training of the lumbar muscles through a set pain-free range of motion (fig.3)
Through performing progressive resistance exercise to strengthen the low back muscles, you can achieve a significant reduction in pain, return to full function and get back to doing the things you love in 12-18 weeks. Once full function is restored, a simple at-home programme can be followed to maintain strength in the low back and protect against further attacks.
Studies show that one-quarter of UK secondary school pupils now suffer from regular or daily back pain, and this has been linked to prolonged sitting and the carrying of school bags.
In the last 23 years, the amount of time that children aged 5 to 16 spend in front of a screen has more than doubled. In 1995, 3 hours a day were spent on screen-time, and the average now – perhaps unsurprisingly, given our technology-led lifestyles – is 6 and a half hours a day.
This, combined with the 70% of the school day which is spent seated, and a drop in activity as fewer children walk to school (in the last 40 years, the number of primary age children who walk to school has dropped from 64% to 42%) is having a detrimental effect on the back health of young people.
With studies showing that children with back pain are more likely to suffer as an adult, it’s increasingly important to educate our children in the importance of good back health to help reverse the trend of back pain occurring in younger generations.
Employers are more aware than ever of the benefits of a work environment which encourages good physical health in their workforce, but sadly schools are yet to jump on board.
As parents, we can support our children to reduce their pain and prevent further problems in several ways
As a parent, I appreciate this may be met with considerable resistance, but if you can agree together on a limit and explain the reasons why it may help your children understand. There are also apps which you can download which limit time spent on a tablet/phone.
Whilst there’s no official guidance in the UK on a maximum number of hours we should allow our children in front of a screen, general guidance seems to be no more than 2 hours a day for 5-18-year olds.
As with adults, spending too long in a seated position compresses the spine and prevents the discs expanding and contracting to absorb nutrients. In addition, when we are standing and moving, our core muscles are activated but when we stay seated for too long and use our core less, the important back and core-stabilising muscles can become weak and unable to provide our back with the support it needs.
Children should do at least 60-minutes of physical activity each day. A recent study found that a third of boys and two-thirds of girls aged 8-9 are failing to meet this recommendation.
With schools offering an average of 2 hours PE per week, we need to do more to encourage children to be more active every day.
By helping them get active by walking the dog, going out on their bikes/scooters, or playing in the garden, you will be helping ward of back pain by keeping their bodies moving and spines supple. This, in turn, helps lubricate the joints and improve the health of their discs.
One in four children with back pain experience problems because of heavy school bags. The weight of a child’s bag should not exceed 10% of their body weight.
Backpacks are the best kind of bag, with weight being evenly distributed across the back and both shoulders. Single strap bags place too much weight one side, causing muscular imbalances and compensatory problems in the back and shoulders.
If your child has a backpack, encourage them to use both straps. Carrying a backpack using just one strap is as damaging as using a single strap bag.
Check the contents of their bag regularly and encourage them to only carry the items they need that day.
If your child insists on a single strap bag, encourage them to wear it across their body do the weight is more evenly distributed.
Extra demands on young people can contribute to back pain. The pressure of school and social anxiety can lead to poor mental health and stress.
This places additional pressure and tension on the body, sometimes manifesting itself in back, neck or shoulder pain.
Exercise and increased activity, with the release of endorphins (our feel-good hormone), can help increase feelings of well-being, as can using mindfulness apps as well as talking to your child about any worries they may have.
If you are concerned about your child’s back pain, visit a professional who specialises in treating children and young adults. As their skeleton is still growing, it’s important to seek help sooner rather than later to avoid long-term problems.
Our body is designed to move. Sitting down all day can have a detrimental effect on your back, neck and muscles.
Unfortunately, though – as desk-workers will testify – sometimes circumstances dictate how much you sit during the day and it’s not always possible to spend the day on the move.
There are some simple strategies you can put in place which, if you need to spend a large part of your day seated, can help alleviate the onset of posture-related pain.
Sitting puts more pressure on your spine than standing. This leads to compression of your discs, a reduction in their absorption of nutrients and an increased risk of herniation (or ‘slipped’ discs)
Studies show that adjusting your position just every 15-30 minutes can prevent changes to your discs and the amount of time you spend seated uninterrupted is just as important as the total number of hours seated in a day when it comes to increasing your risk of back pain.
Getting up and moving every half an hour will help reduce your risk of back pain by:
The movement in your spine keeping your discs healthy
Activating your core muscles, which lay dormant in a seated position, and weaken over time. This leaves your spine less supported and more vulnerable to pain and injury
Lessening the risk of prolonged contractions of the muscles (when you maintain an unnatural position) which can pinch your nerves
In a seated position, your psoas (at the front of your hips, left) and hamstring (at the back of your thighs, right) muscles are in a shortened state for a prolonged period of time. As they attach to your pelvis and spine, in time, the position of your pelvis and back can change as they pull it in a different direction, and this, in turn, can create pain and instability.
If you spend more than a few hours of your day sitting down, stretch your hip flexors and hamstrings daily (below) to prevent long-term shortening of the muscles.
When you stand and move around, your muscles are activated and working to keep you upright.
When you’re sat for a lengthy period, however, the muscles of your core and glutes (bottom) are inactive. Over time, this can lead to a weakening of the muscles which are then not strong enough to support your body and help you move as you should.
You can alleviate this by not only moving more during your working day but by incorporating strength training into your weekly routine.
Once you know how to activate your core, you can integrate core work into your daily functional activity, activating as you do things like lifting the kettle, pick up shopping bags and open doors.
Now you’ve read about it, it’s time to put it into action!
We conducted a survey recently of people suffering from back pain and the effect exercise has on the level of pain experienced.
The type of exercise you should choose if you have back pain may vary according to your diagnosis, but here’s a quick rundown of things which are safe for the vast majority of back pain sufferers:
Pilates can help improve posture, core strength, flexibility and balance.
It involves slow, controlled exercise to work the whole body, but with a focus on the back and core muscles, making it great for people suffering with chronic back pain, as often the core and back muscles are weakened.
When you have back pain, there may be some more advanced moves which you may need to avoid.
Make sure you tell your instructor about your back so they can modify your routine.
A gentle, flowing yoga practice will help improve flexibility through stretching and relaxation techniques.
Using just your body weight, there is also an element which helps increase total body and core strength.
Again, make sure you tell your teacher about you back as there may be some moves which you should substitute.
Nikki at Urban Yoga holds lunchtime classes at Core Strength Studios.
The better supported your body is, the less pressure your back will be under.
By maintaining a strong frame, you can protect your back against pain and leave it less vulnerable to future attacks.
Free weights and functional training are great as they also work your core muscles, but be aware of moves such as burpees, kettlebell swings and other explosive moves which may aggravate your back.
Start gentle, and work your way towards more dynamic moves as you get stronger, and be very careful to use correct technique.
If in doubt, grab an instructor for some guidance.
As well as providing cardiovascular benefits, walking is ideal when you have back pain. When we move, our joints secrete a fluid to lubricate and keep them moving freely.
The movement when you walk will help the release of this fluid and make you feel looser and less stiff. In addition, your core muscles will be ‘switched on’ which helps maintain their strength which in turn helps keep your spine supported.
It’s also a low-impact workout which, if you have back pain, may be more comfortable.
To make it more of a workout, increase the pace or take in a few hills to get your heart pumping!