- The sciatic nerve runs out of the lower lumbar and sacral vertebra . It runs through the pelvic bowl and out the back down the legs branching into both sides of the lower leg and foot .
Just to be clear it is extremely rare to have Piriformis syndrome which is so often blamed for sciatica . It occurs in maybe 1 % of the population . This happens when the sciatic nerve actually runs through the piriformis muscle and becomes impinged by this muscle .
The slump test is a pretty good indicator of sciatica .
There are a couple of places the nerve could be stuck and irritated .
- The mesentery
- The lumbar spine
- The hamstrings
The sciatic nerve exits an area of the spine that flexes easily and rotates very little . Armed with this knowledge we can check for a flexed lumbar spine , lumbar rotations and overactivity of the hamstrings ( synergystic dominance )
Make your corrections and then it is time to get your hands dirty .
This cartoon is just a little joke you do not have to go quite as deep as the gentleman above to release restrictions .
- The first place to check is the root of the mesentery which anchors on the lumbar spine and can cause irritation of the sciatic nerve .
- The lumbar spine with the patient in side lying raising each leg to provoke symptoms
- The glutes
- The hamstrings
Mobilise and perform soft tissue work here and repeat the slump test to check for reduction of pain .
Perform nerve slides and glides to mobilise the sciatic nerve .
For the anatomy geeks out there you will notice I mixed up my inversion and eversion I get a little nervouse in front of the camera sometimes .
Keep your eye out for my next post headaches , tennis and golfers elbow .
Have a great week .