Sciatica, Piriformis Syndrome & How Tight Hip Flexors Can Be the Cause

[@cminnerick]

This is so helpful! I've been having sciatica for years (without really knowing) and finally started going to PT to address the issue. They've been having me strengthen my hip muscles and it's been improving my condition, but I wasn't sure why. This video really helped me understand how it's all connected, thank you!

[@AlethaHealth]

You're welcome! We're so happy that you found this helpful and we wish you continued success along your healing journey. Please let us know if you have any questions or how we can help! :)

[@2am561]

Thanks!

[@peterjames6620]

I think this perfectly explains my own situation....plus I have patella tracking issues and foot pain as well. I bought a hip hook a few weeks ago (for knees but hopeful that it might help sciatica) and after about 10 days of use my feet are fine and my knees are 75% fixed! (after 2 years of useless exercises and physios/chiros who couldn't sort it at great expense). One question though...my sciatica has worsened in the same period. Is this normal? Will it perhaps gradually settle down as the Illiacus / Psoas continue to loosen up? I wondered if I'd perhaps hit a trigger point or something?? Any help would be much appreciated.

[@AlethaHealth]

That's great to hear about the improvement in your feet and knees! For the sciatica, it is possible that some of the increase in pain is from referred pain in a trigger point. However, it could also be due to a tight piriformis (which tends to go hand in hand with a tight iliacus). After using your Hip Hook, have you also been releasing the back of your hip/glute with a ball and performing the pelvic realignment exercise?

[@peterjames6620]

@@AlethaHealth thank you for the speedy reply. I haven't been doing that but I will from today. I've also just watched another of your videos where you said that lying flat can stretch the hip flexors too aggressively...I've been working on computer for a couple of weeks on the floor with an arch in my lower back. I guess that will be aggravating it a lot. Thanks for the advice. Much appreciated.

[@AlethaHealth]

@@peterjames6620 you're welcome! It's great that you have become aware of that. Changing up these little daily habits can add up and make a big difference over time!

[@MI-mx3rh]

How can one know if the sciatica is from bulging disc or these muscles? Will appreciate your help Thanks

[@AlethaHealth]

Hi there. For this, it would be best determined through an in-person assessment from your physical therapist.

[@NishitShaw]

My pain started off from the hip flexor and now I have lateral shift too. MRI shows huge disc herniation but I believe that it’s the hip because the disc issue was there a long long time back. How to fix the lateral shift generated by pain?

[@AlethaHealth]

A tight hip flexor can cause an anterior rotation of the pelvis and reduced space within the hip joint. This often limits internal rotation and therefore the ability to shift into and out of that hip effectively. The body's natural compensation is to shift more into the opposite hip, which will create more imbalances to develop. To fix the lateral shift, you must improve the alignment of the anteriorly rotated pelvis and improve the ability to get into internal rotation of the side you are shifting away from. Does this make sense? An important first step before doing anything else is releasing tension in the hip flexors (your psoas and iliacus muscles) on the limited side. This helps improve the alignment and rotation ability of the pelvis and hip, which could then be further supported by corrective stretches and exercises. Our Hip Hook would be a great tool to help you start releasing these muscles on your own. Of course, it can also be great to get some help from a physical therapist for a full assessment and more guidance on your particular issue.

[@NishitShaw]

@@AlethaHealth the therapist I’ve signed up for makes me do: 1. Towel Press 2. APT 3. Lying on a bowlster and he pulls the hip downwards in the opposite direction. The shift happens because the hip on the left is pulled upwards 4. I’ve shown great improvement though 5. Piriformis stretching That’s it. What else can I add? Thanks for such a huge reply 🙏🏻🙏🏻

[@NishitShaw]

@@AlethaHealth also this video? kzbin.info/www/bejne/ioqXZ5eGYtp0fdk

[@AlethaHealth]

@@NishitShaw the video you linked would be a great addition. That is showing using the Hip Hook, which releases tension in the psoas and iliacus muscles. These muscles play a huge role in hip and pelvic imbalances and may help make the other stretches and exercises that you are doing to be more effective. Releasing the piriformis with a ball would be a great second thing to add. Also, if your pelvis seems to be twisted or rotated, then performing the pelvic realignment exercise after releasing the hip flexors and piriformis would be an awesome 3rd step. You can learn more about these 3 steps in this playlist. kzbin.info/aero/PL5lg2yCtxxpibEpmmQYy3x9LR_reTmAZP

[@NishitShaw]

@@AlethaHealth forgot to add, left leg appears to be longer than right leg but in reality there is no difference just appears to be hence the lateral shift

[@MI-mx3rh]

Heres a tough one for you that no one has been able to solve yet I get sensations in legs and feet up on bracing my abdominals, no weight no spinal flexion just tighten my abs and my legs and feet are on fire Please let me know what you think

[@AlethaHealth]

Could be that your muscles are already super tense and you may be overdoing it with the core brace. If you can learn to let your "core" muscles relax a bit and learn how to brace better, this can likely help.

[@MI-mx3rh]

@@AlethaHealth I've tried different approaches to bracing result is always same, place a weight on my belly doest the same too. Could it be that bracing worsens my mild disc bulges and my nerves fire off? Or it pressures my spine in some way? I also had an si joint problem prior to this core trouble happening out of no where but I don't have that si joint pain anymore in my hip now what would you suggest for relaxing the abdominal? I can't stretch them by arching my back is super sensitive to over extension Will greatly appreciate your help

[@AlethaHealth]

@@MI-mx3rh it is likely the additional pressure on top of an already tense core that is making bracing painful and uncomfortable. To improve this, you must get these muscles to relax. If you have a foam roller, lay over top of it on your belly and just see what that feels like. Take deep breaths and relax for a few minutes, as long as it feels okay. It's likely going to be a bit uncomfortable at first. Based on what you've described, it would be worth visiting a PT or massage therapist to assess the tension in your hip flexors. If that's something that's contributing to this issue (which seems likely), then releasing those muscles with precise, targeted pressure may help. We also have a tool called the Hip Hook that helps you reach those muscles yourself to apply pressure and release them, helping them relax and improving your core engagement and pressure.

[@barbarashapiro5271]

I have sciatica down the back of both legs. I also have stenosis and a bulging disc between L4 - L5 which I'm sure is causing this pain. I just purchased a hip hook. Besides using the hook on both sides, is there anything else you would suggest I do? Thanks

[@AlethaHealth]

Hi Barbara! Another group of muscles that is typically tight in conjunction with the hip flexors are the glute muscles. More specifically, the piriformis is a muscle deep within the glute that may compress the sciatic nerve when tight. You can release these muscles using a ball (any ball may work if you don't have our Hip Release Ball). Just like with the Hip Hook, we want to apply pressure into these muscles for at least 30-90 seconds. Lastly, there is a pelvic realignment exercise that you can perform if you find that your pelvis is rotated a bit. Linked below is a playlist that walks you through these 3 steps in more detail. kzbin.info/aero/PL5lg2yCtxxpibEpmmQYy3x9LR_reTmAZP

[@cheeseeche]

Has it relieved your sciatica?

[@barbarashapiro5271]

I did not find much release from the hip hook, but rolling on a ball on my piriformis seems to help relieve some of the pull on the back of my legs

[@alexdieter7940]

I think I have a problem similar to this. I have sciatica pain but also I have pain right under the left bony part on my lower back. (I think its the SI joint) I think my hip flexors are extremely tight causing pain for both of these things. What do you think?

[@AlethaHealth]

That is certainly possible. When the psoas & iliacus (your hip flexors) are tight, they can pull the pelvis and spine out of alignment. This places extra stress on the structures in these areas, which could include your SI joint and also the discs and joints in the lower back. The surrounding muscles may also tighten up, creating further compression on the nerves running through these areas.

[@alexdieter7940]

@@AlethaHealth Okay. what should I focus on stretching?

[@AlethaHealth]

@@alexdieter7940 we would encourage you to RELEASE your tight psoas & iliacus muscles, as well as tight piriformis and other deep hip rotator muscles. This is done with the application of direct and prolonged pressure (for at least 30-90 seconds). This is different than stretching or massaging. When there is long-standing tension in a muscle, we find that this technique of prolonged pressure is an important first step that helps make any stretches and exercises you perform afterwards that much more effective. To get into your psoas & iliacus, we recommend using the Hip Hook (www.alethahealth.com/the-hip-hook). For the piriformis and other deeper hip rotators, we recommend using the Hip Release Ball (shop.alethahealth.com/products/hip-flexor-release-ball).

[@kantnergirl08]

I have terrible piriformis !!! Help

[@AlethaHealth]

We're sorry to hear that you're experiencing pain with your piriformis. Have you ever been assessed by a practitioner for this issue?

[@kantnergirl08]

@@AlethaHealth yes but right now I live in Taiwan and none of the doctors have helped …..do u guys do zoom consults?

[@kantnergirl08]

@@AlethaHealth we go back to USA March 1, 2023

[@AlethaHealth]

@@kantnergirl08 yes, Christine (our founder, a physical therapist) does online consults. If you are interested in this, please reach out to [e-mail] and her assistant will be able to share more information with you.

[@alyssahubbell5160]

I def have right hip flexors!

[@AlethaHealth]

Do you have a Hip Hook so you can start working on releasing and loosening them!?

[@ScottYdo]

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