The sciatic nerve is the largest (thickest) and longest nerve in your body and supplies nerve feedback to the back of the thigh, the leg and has further branches all the way down to the foot so you can see why it is such an important part of our anatomy. It has both sensory and motor functions and arises in the lumbosacral region in your back and travels into the pelvis via the greater sciatic foramen, then inferior to the piriformis (it goes underneath this muscle) through the gluteal region (under the gluteus maximus) and into the posterior aspect of the thigh deep to the biceps femoris. In plain English, it goes down from your low back, through a hole in your pelvic bone, under your biggest bottom muscle into the back of your thigh). It ends deep within the hamstring muscles and adductors and finally into the back of the knee where it divides into two branches and continues all the way down to the feet. Sciatic pain is a symptom of other causes such as vetebral disc degeneration through arthritis, causing spurs that press into nerves that run along the spine and even a simple issue such as sitting too long causing a tightening of the muscle. It is therefore imperative that you find out the root cause of your Sciatica before you practice these exercises.
The nerve is sometimes injured when a person is medicated an IM (intramuscular) injection. The nerve is also vulnerable if a person dislocates their hip posteriorly, has a fracture of the pelvis or during hip surgery. If there is an injury further down the nerve, where it divides at the back of the knee, the person will not be able to extend the thigh backward or flex the knee to the full extent due to a paralysis of the hamstring muscles which are supplied by the sciatic nerve. An injury in the area at the back of the knee where the sciatic nerve branches into the Tibal and common Peroneal nerves may cause a loss of all movements below the knee, including foot drop and a high stepping gait. The Sciatic Nerve also supplies sensation to the skin of the leg and foot and therefore if there is injury here, there can be loss of sensation in the whole of the outside of leg and foot.
The condition is characterised by a shooting pain in parts or the whole of the pathway of the Sciatic, Tibial and Peroneal Nerves. It can occur, because the lumbar disks bulge enough to compress and irritate the nerve roots at any vertebral junction from L4 to S3. The sciatic nerve can also be compressed against the femur when a person is sitting for long periods of time which causes an unusual stretching in the area.
The Piriformis muscle can irritate the nerve if it presses on it which causes pain in the buttocks, back and referral pain along the back of the thigh and this is a cause of Sciatica which we will be particularly paying attention to in class this week. Here is the location of this muscle, which may tighten against the Sciatic nerve to cause lower back, buttock and referral pain all along the route of the Sciatic nerve:
This is a useful article which explains more of the background to Sciatica and it’s causes. You can also try the F.A.I.R. test (in which the thigh is Flexed, Adducted, and Internally Rotated) to see if it is your Piriformis causing the condition: Lie on your side with the affected leg on top. Is it painful in your hip to have the top leg bent with the knee resting on the floor in front of you? Does it hurt especially when you try to lift your knee away from the floor against a small amount of resistance, such as a bag of rice? Sharp pain in the hip is a sign that the piriformis may be causing the sciatica. We will be adapting this test in our class today as a pandiculation.
SOMATIC YOGA FOR SCIATIC PAIN
We are aiming to repattern the muscles to stop the pressure on Sciatic Nerve and to decompress the discs between the vertebrae to free up the nerve and release the body from pain. The Piriformis, Hamstrings and Glutes are culprits for tightening up when we are sitting for long periods and can make for worsening symptoms of Sciatic Pain. However, the last thing we want to do is to instigate the stretch reflex in any of these areas by holding a big stretch and pulling on the muscles for too long which causes a knee jerk reaction in the body to protect itself by increasing the contraction further.
Instead, in Somatic Yoga we aim to pandiculate the muscles to teach the sensory motor cortex to let go of the restriction in the muscles. Therefore we use the signature technique of somatics to help release the tight muscles causing the pressure on the Sciatic nerve. The intention in a pandiculation is to isolate a specific muscle (eg the Piriformis, the hamstrings or the Glutes or sometimes a group of muscles together as in some of our Somatic Flows this week) and mindfully contract that muscle then SLOWLY and SMOOTHLY release the contraction, then return it / them to a neutral position. The result is an increased range of motion and often as the movements re-educate the brain, the movement also becomes smoother and less jolting.
Even if you don’t have the diagnosis of Sciatica, it is useful to keep the hip bones and spine free by releasing the muscles that tighten to misalign the joints and potentially cause issues of limited range of movement which may eventually lead to a pinching of the nerves. Low back pain also be released by this week’s practice. An added bonus this week is that we get to practice with all the forms of equipment you are required to bring to my classes and sometimes end up dragging them all home without using them! We are using block, brick AND strap this week so well worth all the lugging about! And just to push the boat out… you need a chair too!
We probably need to awaken the spine after a period of little or no practice and some of us may have experienced aches and pains in the lower back from sleeping on different beds or being seated more than normal or rushing around after everyone else! Try not to rush the checking in process before or after the flow sequence – the mindfulness in this checking in process is as much part of the practice as the flows themselves…
So we begin class this week with ‘Around The Clock’ (tilting the pelvis forward, back and side to side which will increase the sensory awareness of the lower back and improve spinal co-ordination before we move on to movements that require us to be warmed up spinally.
Our next movement is a low bridge action which first contracts, then releases the hamstrings as well as encouraging the spaces between the vertebrae to soften and become spongy again, releasing the compression on the spinal nerve.
We can also squeeze and release the buttocks each side by deliberately contracting them underneath us, then trying to slowly release the contracting and feeling them flatten against the floor.
This was the last of our bilateral movements. We moved on to unilaterally elongating down the right side of the back, buttocks and backs of legs. We do this all on one side first to concentrate the release and this is where Somatics differs from Hatha and other forms of Yoga. First the release of the big glute muscles:
Initially, in order that other tight muscles are to be released, we need to pay attention to releasing the hamstrings in a way we have often done in class previously. After the two week Christmas break, it will be unlikely that any of us, unless we have been practicing Yoga every day, will not have suffered some tightening in this area from the additional sitting that we have experienced over the season of celebrations so I’m hoping this will be a welcome feeling of stretch for you all…
The photos show the different positions your leg might come to and none of them is the right one. The right one is whichever one your leg comes too. Having long hamstrings like the last picture, doesn’t necessarily mean that the muscles aren’t tight, even if they are long, so don’t assume they are not in need of some attention if your leg looks like this.
We aimed to open out the hip in this next movement:
And lengthen both Glutes and Piriformis in the following pandiculations
The first of which involves the F.A.I.R test mentioned above in regard to Piriformis Syndrome:
Our final supine movement, is a lying down version of the Yoga Pose Gomukhasana or Cow Face Pose which really reaches deep into the Piriformis Muscle
At the end of our lying down Somatic Yoga Flows, we check in to see what action doing this has had on the side of the body we have been working. The brain loves to learn by contrast as we know! How close are the backs of the thighs to the ground when lying down for instance and how turned out is the hip?
After check in to detect the effect of doing this supine work on the right side of the body, we repeated the sequences on the left side before moving on to standing and seated Somatic Flows.
The following standing twist is a warm up for the seated work we will do later. You need a chair and a wall. Ideally your R leg is at right angles, next to the wall. You are using your hands on the wall for balance and to deepen the twist:
We complete our standing section with the opportunity to elongate our hamstrings further in this version using a chair:
This seated twist is a deeper version of the standing twist we started with and is normally primarily about spinal rotation but because of the addition of the leg position and we are using pandiculation with the opposite arm, we are adding an extra element of piriformis elongation in this week’s class:
Sitting on a block during the flow will help you keep your spine long and the pelvis tilted forward which is required for twisting movements to be comfortable. We will repeat this sequence 5 or 6 times in a slow meditative manner and each time, you will notice that the spine can rotate a little further and the knee gently come in toward the centre line a little further with each pandiculation.
We move on with some very difficult leg work to ease out the tightness in the hips that the holiday period may have brought you. If it proves too much of a challenge for unhappy knees, the alternative is to use a single leg as the photo demonstrates or to perform it sitting in your chair. Your piriformis will be further lengthened by a forward fold with the legs in this position. You will notice that it is much more difficult to perform Gomukhasana in the seated position because gravity is weighing down on you!
Possibly our biggest challenge in class this week for you will be our Somatic Pigeon, beautifully demonstrated with three different options by the lovely James Knight on my Advanced Somatic Training in September 2016:
Be sure to keep the back as flat as you can in either alternative – aim at the chest coming toward the thigh and not the crown of the head.
After all that effort it will hopefully be enjoyable for you to assume the lying tree pose before relaxation which is also useful in helping Sciatic pain:
Namaste and love to you all