How to use Clinical Somatics exercises to alleviate sciatica and piriformis syndrome
To prevent and alleviate sciatica and piriformis syndrome, you need to release the chronic muscle contraction in your lower back and gluteal muscles, and retrain damaging posture and movement patterns that could be causing compression of your lumbar spine.
If you try stretching or getting a massage to release your tight muscles, you’ll likely find that these approaches provide only temporary lengthening of muscles. Your muscles will tighten back up within a few hours due to the stretch reflex. Static stretching and massage do not change the messages that your nervous system is sending to your muscles to stay tight—active movement is necessary to retrain the nervous system.
The most effective way to reduce the tension in your muscles is with a movement technique called pandiculation. The technique of pandiculation was developed by Thomas Hanna, and is based on how our nervous system naturally reduces muscular tension. Pandiculation is the reason why Hanna’s method of Clinical Somatic Education is so effective in releasing tension and relieving pain. Hanna created many self-pandiculation exercises that can be practiced on your own at home.
Pandiculation sends accurate feedback to your nervous system about the level of tension in your muscles, allowing you to change your learned muscular patterns, release chronic muscle tension, and retrain your proprioception. You can read more about pandiculation in this post.
If you’ve learned Clinical Somatics exercises from my online courses or from another Certified Clinical Somatic Educator or Hanna Somatic Educator, you can use this section to help guide you in releasing the muscles that are causing your sciatica or piriformis syndrome. If you’re new to Clinical Somatics, the best place to start is the Level One Course.
Here are the exercises from the Level One Course that most directly relieve sciatica:
Arch & Flatten: I recommend practicing this every day. It’s best to begin your practice with this exercise, because it gently releases the lower back muscles and prepares you for the rest of your practice.
Back Lift: If you have sciatica or piriformis symptoms on both sides, then practice this on both sides. If you have symptoms only on one side, try doing this exercise (and the following exercises) only on that side to release the tight muscles and balance out your tension and posture. To do this, turn your head away from the side on which you experience symptoms. So, when doing the full movement, you’ll be lifting up the leg in which you feel symptoms. Only lift up your leg as high as is comfortable, and if it’s not comfortable, skip it for now. Be sure to lower your leg down as slowly as you possibly can.
Side Curl: This exercise releases the obliques; however, these can play a role in sciatica if your obliques are tighter on one side, causing you to hike one hip up or bend to that side. So if you have symptoms on one side, practice the Side Curl on that side. To do this, lie down on your non-painful side, and practice this exercise curling up to the side on which you have symptoms. Really try to get a sense of the muscles on the side of your waist contracting, then release them as slowly as you possibly can—resist gravity as you lower down. Completely relax for a few moments before repeating the movement.
One-Sided Arch & Curl: This exercise gives you the opportunity to do the Arch & Curl while focusing on just one side at a time. If you have symptoms on both sides, then practice this exercise on both sides. If you have symptoms on one side, lift up your knee on that side, and practice the exercise.
Iliopsoas Release: Tightness in the iliopsoas is very common, and it can compress the lumbar spine. If you have symptoms on both sides, then practice this on both sides. If you have symptoms on one side, practice this exercise by lifting up the leg in which you have symptoms.
Hip Rotation: The External Hip Rotator Release will help you to gently release your gluteal muscles. Practice this on both sides if you have symptoms on both sides. If you have symptoms on one side, practice this on the side in which you have symptoms.
And a few more exercises from the Level Two Course:
Lower Back Release: This is a wonderful exercise that gently releases the lower back, gluteals, and hamstrings. The more slowly you do this exercise, the more benefit you’ll get.
Proprioceptive Exercise 1: This exercise helps you to retrain your sitting posture, which is important for sciatica sufferers. Practice this to become aware of your sitting posture and of tightness in your lower back that could be causing your symptoms.
Gluteal Release: This is an important exercise for both sciatica and piriformis syndrome sufferers. Practice it on both sides if you have symptoms on both sides, or if you have symptoms on one side, practice it just with that side.
Standing Hamstring Release and Seated Hamstring Release: When you’re comfortable with the Lower Back Release and the Hamstring Release, you can practice these exercises to release your lower back and hamstrings further. If these exercises are not comfortable for you, then skip them for now.
Finally, be aware of how you’re using your body as you go through your daily life. Your progress with the exercises will be slower if you continue to do activities or habitual postures that are keeping you stuck in your patterns of tension and exacerbating your symptoms. Notice the tension that you hold in your lower back, as well as how you might be using the sides of your body differently when you:
- Stand for a few minutes: Do you hold tension in your lower back? Do you lean to one side?
- Carry your bag or your child: Do you hold tension in your lower back? Do you always use the same side?
- Sit at a desk: Do you hold tension in your lower back? Do you lean to one side, or cross one leg over the other?
- Relax on your couch: Do you lean to one side or lie on one side?
- Sleep: Do you sleep more on one side than the other, or do you sleep on your stomach? Sleeping on your back is best; put a pillow under your knees if that makes you more comfortable.