Sciatica and the Athlete of Aging: You Will Prevail!

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What is sciatica? Sciatica and Pyriformis syndrome are related conditions that often afflict Athletes of Aging. Dr. Sullivan discusses the relevant sciatic nerve anatomy, symptoms of sciatica and pyriformis, treatment options, and why you should not despair.
Sciatica can result in compression of the sciatic nerve--the largest nerve in the body--or one of its component nerve roots, while pyriformis squeezes the nerve trunk between muscles of the "rotator cuff of your ass." Symptoms can be similar but are wide-ranging, and call for a history, physical exam, and sometimes imaging. Treatment options depend on the individual case, but will almost always require analgesics, rehabilitative exercises, and possibly injections or surgery.
The most important thing is to KEEP MOVING. Physical therapy, individualized light training with barbell movements you can tolerate, appropriate but aggressive use of analgesics, massage, stretching, heat therapy and cryotherapy, and a positive attitude are essential. If you are an athlete afflicted by one of these syndromes, just know that you WILL come back. Movement is medicine: keep moving and you will prevail.
WRITTEN AND PRODUCED by Jonathon Sullivan MD, PhD, SSC
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[@tkremarkTK]

5:16 of the video, that is exactly what I have. and I know it was irritated when sitting on a new chair but the front of it dug into my glute and probably pinched that pyriformis. It seems a lot better now but still have remnants of the discomfort. I am not sure why but it seemed to clear up when I reprogrammed to Texas Method as I was nearing the end of my NLP. Pretty sure working on the edge of tolerance has helped me overcome it.

[@GreySteel]

Excellent. Glad you kept moving and came back.

[@tkremarkTK]

@@GreySteel I lost of lot of progress in my training because of this. I even took a month off to see if it would heal and it did not. I did those exercises that were shown by PT's on youtube. Still nothing. So I bit the bullet and kept doing my NLP and sometimes it was murder but when I pushed up to the very end of my NLP (had to do NLP in 2021 again as I took 2020 off, (there was a good reason)) and then switched to Texas Method it seemed to dissipate greatly. Maybe the combination of volume, Day 1 then light day 2 then intensity Day 3 had something to do with it. Strictly anecdotal though.

[@yyxy.oncesaid]

NLP..?

[@c.g.arnold6504]

@@yyxy.oncesaid I believe it means Novice Linear Progression, the training regimen.

[@martystrasinger3801]

1983-ish, in the Navy, I started to have horrible debilitating pain that would present sometimes on one leg, sometimes the other. Being the Navy, the docs thought I was faking it. Eventually I was diagnosed with a schwanoma on my spinal cord which was surgically removed. Took some time to recover! But now at 64 I squat and deadlift with no issues; hoping for PRs on both this year.

[@barbellgardener]

Had a terrible bout of this 5 years ago and recovered in 2+ months. Terrible pain and DARK times but, yes, there is a light at the end of this lesson. You are NOT broken.

[@GreySteel]

Thanks for sharing that, Gardener!

[@W4YN30]

I had 2 bouts of sciatica in the past 12 months. What I have found that has really helped me is regular foam rolling. Feel great after these sessions.

[@gregorymccoy6797]

Wow. Another thing to keepe awake at night. I'm way past my warranty period. Thanks for the instruction.

[@damianlang1855]

Strength training is like an extended warranty:)

[@K4R3N]

Thanks Sully

[@ralphlazio505]

Thank you for this excellent illustration Coach. I’m 50 years old and I have pulled this sciatica nerve three times so far…. It is the absolute worst😅😭.

[@dinavanwyk30]

I'm 52. I have had 2 spinal fusions ( all L an S joints )with a lot of damage leftover. I have both problems mention in this video. The only thing that stopping pain is lifting heavy. 😃 I can not use pain killers, I have only 1 kidney. So posterior chain strong muscles is all that keeps the pain away... I feel stronger now than I did at 40 when I had the first fusion.

[@rido6147]

Richard,.I do on line!.in the privacy of my home.alot of research to find the right information and people who knows what they are talking about on excersize, and mobility its important to keep core muscles strong using Dumbells weights to do squats etc at home.and nutrition supplements eating real food.listening to lots of couches,and professors, Doctors,.physio therapists, etc. For my health and wellbeing.

[@rido6147]

Richard,.I have been diagnosed having right sided sciatica lower back.

[@Rick-se5qm]

Brings back memories...two severe bouts of sciatica in the past 20 years. No surgery, copious amounts of PT and chiropractic to become functional. Docs repeated most everything in this video, except I should never expect to lift heavy again. I hear their voices every time I do. Need to work on turning that off.

[@GreySteel]

You DO need to turn that off. They did you a disservice by telling you that.

[@Rick-se5qm]

@@GreySteel I credit this channel for getting me on the right path. Thanks for that.

[@dannychang1807]

I love the post workout chalk on the shoulders. #stayworkn

[@richardgreene6810]

This is the only thing that is keeping me from buying your book. I sooooo much want to lift. I wish I could perform squats and deads. But I've had 2 surgeries and 3 injections for 2 herniated discs (plus arthritis) and still have weakness and numbness (though the pain is greatly reduced). So, I've been afraid to lift. Can I keep from injuring my back further with squats and deads?

[@GreySteel]

Only one way to find out--preferably with the assistance of a coach. Properly coached and programmed, these exercises will make your back BETTER--not normal, but better. You can have back trouble and be strong, or you can have back trouble and be weak. I chose the former. :) Whatever you choose, I wish you the very best.

[@richardgreene6810]

@@GreySteel Thank you, Sully. I just ordered your book.

[@mohammads.shukairy7810]

Nice summary sir!

[@GreySteel]

Thank you, sir!

[@tkremarkTK]

ha, I had mentioned pyriformis issues I had in a comment on another video you made. i hope that also triggered you to discuss it. Thanks Got mine from sitting on it, I am pretty sure

[@oller7113]

My history is that I had an accident as a teenager when I hurt L-4. When I was 60 I finally had an operation where they removed the disk between L4 and L 3. I healed while doing a hefty recovery program. After about one year I could go back to golf again. The last 7 years I have been working out extensively with a lot of abdominals and other strength training under professional supervision. I am 80 now and in a form like never before. The only problem is that Schiata is back to hurt me again. I continue with my training and it is not getting worse. But I use voltaren for my pain. What more can I do?

[@mathewboyd3746]

I wish you were biased in my country - I've always loved weight training exercises for decade. However, now I can no longer do squats without getting back pain coming on about a day later and will stay for a week or more if I then rest. The pain use to be just numbness in my thigh or shooting pains in.my sleep. now days its all these plus pain in the core of my spin. after watching this I think I've got a herniated disk.

[@pooch6178]

Any precautions from having bilateral knee replacements. I did very well post surgery and was released the next day. Also any sugestion on both protein and vitiamins supplements? Does DHEA provide any benefits? Thank you. Have a safe and wonderful day.

[@charlesoneill466]

I have this sciatica periformas. Doctors put me on stretching with physical therapy. I now do it at home after 4 years. I also do weight lifting . Not very heavy. 135 pounds on squats and bench, deadline 205. I am new to this channel. I thought he was going to say , go heavy. Anyone cure sciatica by weight lifting? Thanks

[@giovannip.1433]

With this discussion, would doing excessive squats with weights above the hips potentially do more damage than squats with weight on the hips? Obviously there is the squat machine, however the hips, legs and body are not straightened - they are bent. Are there any bars and harnesses available where you can do a standing squat with weights loaded on the hips and not the back? There are many non compressive back exercises which can strengthen the back without excessive compression of the discs...

[@malikdosani1086]

The audio is very poor, can you please redo this with better audio 🙏🏼

[@congoose100]

Great educational video! Could sciatica or piriformis refer pain to the front of the legs (e.g. quads or tibialis)?

[@GreySteel]

That would not be the typical scenario. In medicine, anything's possible, but I have not seen this presentation.

[@stevearttus8164]

I have to say doc, your handwriting is actually quite legible....are you sure you are a doctor.....🤔🤔 😅😅 great content, I hope to continue to find more useful information from your videos!

[@kimdavis7812]

What about doing inversion table ?

[@GreySteel]

It helps some people. If it feels good, do it.

[@arborata]

Thank you for very special video, are you doctor?