What’s up folks! Patrick Lerouge here from Evolve Restorative Therapy. You can find me at livepainfreeprocess.com. Today, I want to talk about that pain in your butt that tends to run down your leg, also known as sciatic pain. I am going to show you what you are dealing with so you can clean up the pain. Therefore, I won’t be going into detail on how to clean up your pain. Instead, I’m going to make you aware of what’s happening. So when people get sciatic pain, it may not always be a nerve issue. Many things, such as trigger points and hamstrings that run along the leg, can give you similar sensations to sciatic pain. For this tip, I am going to show you where your sciatic nerve is, what can be clipping the nerve, and where you could be clipping it.

So where is your sciatic nerve? It runs from your lower lumbar vertebrae all the way through your sacrum. However, when you have pain, the areas you want to focus on are your lower back, hip, sacrum, the length of your leg, and the arch of your foot. There are many muscle tissues that run through there so you can be clipping the nerve at the butt or in the lower back. How do you distinguish between a muscle and bony impingement? That’s very difficult to discern without an X-ray. So instead, focus on where you are getting the most tightness and where the symptoms begin. This will give you the best indication of what kind of impingement you may have. If it’s in the lower back, your entire butt will ache down to your leg and foot; this indicates a bony issue. If the pain is just in your butt cheek and runs down, the problem is muscular in nature. This also means the muscle in your butt, the piriformis, is not aligned.   This muscle can get overused due to the kind of lifestyle we can have. If you stand up straight and see one of your feet slanted out, your muscle is not doing its job. Since it has a different job from the glute, it starts to get more active because your foot is pointed out. This leads to a tighter muscle and decreases the room the sciatic nerve has, causing inflammation where the nerve and muscle conjunction is located. Consequently, you now have two issues with your butt pain: the piriformis muscle is down and the sciatic nerve is inflamed. Let’s show you what I mean by this.

Your glute is a massive superficial muscle within the butt and the piriformis is the muscle underneath that runs diagonally from your hipbone to your sacrum. It starts to get bigger and then pinch the sciatic nerve that is underneath it and in rare cases, right through it. If you are getting symptoms lower in the leg and not in the butt, you have a problem with piriformis and thus it is a muscular issue. At this point, we are racing to stop the piriformis from working so hard, because it is not functioning properly. Whatever is happening is happening for a reason. It’s not wrong or broken, just doing more than it has to. Now we know it’s a bony issue, with pain in the lower back. If this occurs, your back will be tight all the time and you will start leaning to one side. The majority of the time, it’s opposite from the side where pain resides, to prevent the nerve from being pinched and putting pressure on the leg. Eventually, if the pain clears up on one side, the same thing will occur on the other. This is called the ‘chicken or the egg’ syndrome because it keeps happening around the body.

To clean up pain in your lower back and butt, you have to get the area to stop doing what it’s doing. In my routine, I like to get your hip flexors to start working first. By getting them to open with your foot straight, your glute can start moving properly. This is where most people make their mistake. They instantly start going into stretches when the area does not want to move. Yet you give it a reason to move by removing its blockage, in this case, the hip flexors. You can then get it to start moving, increase the blood flow, and eventually heal. This is the key.

First, find out what is happening. You can get symptoms all the way down your leg and behind your knee. Focus on getting something to move first, then learning how to contract properly. Afterwards, you can start foam rolling and stretching. When you do those stretches however, do them with a fluid and slow movement. Don’t push your body to do the things it doesn’t want to, because then it is going to protect itself. So that’s our tip for this week. If you have any thoughts or comments, please respond. I will see you next time! Bye.