Thread: Sciatica-Back Injury Troubles

A lot of posts on here are good information for a healthy person taking their fitness to a new level. The problem is, once you are injured, understanding what inflames and aggravates an existing injury may not be the expertise of the bodybuilders posting. I am a trained PT and my previous jobs had me taking people with back injuries & rehabbing them to a normal strength and flexibility.
If you have sciatica, that means the nerve is sending abnormal symptoms, typically pain or numbness down a leg. To me, I would want to create an exercise plan that allows for strengthening without inflamming the damaged area. and the damaged area is around the herniation. Just because you have a herniation, doesn't mean you are abnormal. Over 30% of the population has a herniation that would be diagnosed but are symptom free.
One thing to remember while exercising is posture. Posture with all your exercises is paramount, especially when there is an injury. Poor posture can lead to additional damage to the area and pain and suffering as a result. If you've gone for therapy, I'm sure they taught you how to tighten your abs in a "neutral position". This is defined as a mid point between arching and flattening your back. Its a comfortable mid range that you hold stiff by tightening your abs. This is a skill you need to remember while exercising as it will keep you from causing damage. Second thing to remember is do not combine motions. You are either flexing/extending, or rotating. Do not combine them all..this is a sure way to cause damage. Personally, I'd skip out on the rotation exercises because I just can't think of any that are essential for your rehab..can't think of any that would make a significant improvement in your goal or getting back to normal.
Intensity of exercise. Depending on your exercise, it might be too soon for you to be pushing yourself to the point of valsalva. When you have to almost hold your breath and push down really hard. Remember, there are fluids in your body that circulate around you spinal column and brain and when you do this grunting-holding your breath-maximum pushing it messes with the pressure and flow of this fluid.. You might have heard of cerebro spinal fluid when people talk about migraines-headaches...its the same thing. I'm not exactly sure how this would effect you, but if it causes pain for you and hindered your progress, its just not worth it to do these heavy exercises so soon.
After exercising, even if you aren't in pain or feeling more symptoms, assume you have inflammed things. Although muscle contractions help wick away inflammation, the stress you are putting on yourself may also be causing symptoms you will experience later that evening..lets treat it before it hurts. This means, put yourself in a therapeutic position that will "undo" the damage of your workout. Best position is on your belly, on your elbows similar to how kids watch tv. They say the best thing to do is to spend the same amount of time in this position as you spend in a potentially hurtful position. I say, if you can tolerate a 30 minute citcom with an icepack on your back, you will be taking down internal swelling and repositioning the herniation so it doesn't cause symptoms that will ruin your night.
There's your free consult. lol If you went to PT, I'd be billing out atleast $150 an hour, teaching this to you, and giving you a stabilization home exercise program. Progress cautiously and even if you arent feeling pain, it would be smart to continue with the prone on elbows and icing until you get rid of the sciatica. You should notice it will recede back up your leg and eventually localize..that will be a good thing. If you have any questions, you can IM me,,therapy is more of a hobby these days for me than anything. Good luck to you.
oh, and I almost forgot. flexibility. stretching your hamstrings. Don't forget to do this, but do it in a safe way..like laying on your back in a doorway with one leg through the doorway and the other leg up the wall. work your butt closer and closer to the wall..that's the best way for a back injury. Dont forget this stretch. Its important.

wow, this is good stuff. Thanks for the info.