Sciatic Pain and Shoes

Audio Transcript

Coach Dylan: Hey Runners Connect fans. Welcome to the Runners Connect Run to the top Extra Kick Podcast. I hope you’re off to a great start today and thank you so much for joining me.

As always, I’m here to answer your running and training questions so that you can train smarter, stay healthy, and achieve your goals. Today we have a great question from Norma.

Norma: Hi. My question has to do with sciatic pain and shoes. I generally use a minimalist shoe. Right now, I’m in a new balance of 1400 volume 3 and they really do work well for me.

It has a drop of about 10 millimeters and it’s a good minimal shoe because it gives me more contact with the ground, but I notice sometimes my sciatic pain will flare up.

In order to mitigate that, I do strength training and yoga, but the number one thing for me seems to be shoes. I’m just wondering what the recommendations are for runners with sciatic pain. Thank you.

Dylan: Hi Norma, and thank you for submitting your question today. As many of us have experienced, myself included, sciatic nerve pain can be cumbersome and unrelenting. This is especially true if it is left untreated.

The side of nerve runs from your lower back through your glutes and strings cabs and finally ending at your foot. This nerve controls the muscular activation within these muscles which are the muscles we all so heavily rely on when we’re running.

Without the proper functionality of these muscles, we become biomechanically inefficient and this often spurs pains or injuries related to that specific area.

When these muscles become tight or weakened, they press on the sciatic nerve which in turn causes pain. Ideally you would like to keep that sciatic nerve healthy.

The most common injury directly related to this sciatic nerve is called Piriformis Syndrome. The Piriformis is a small hair shaped muscle located deep within your gluteal muscles. The muscles’ function is to stabilize and externally rotate the hip.

As runners, we often experience Piriformis pain because of doing too much too soon. That is too much volume and too much intensity in a short period of time.

It can also be related to improperly warming up the muscles prior to exercise as well as spending too much time sitting. Now, what happens is this muscle becomes worn down or inflamed. It simply begins not to activate correctly, and it presses against our sciatic nerve.

This in turn may cause pain to feel like it’s radiating down your glutes and lower leg and you may even feel in your lower back.

An easy way to tell if your Piriformis is tight or inflamed, is to try sitting on a foam roller and cross one foot over your opposite knee in the fore position.

From here, we slightly rotate along the outer portion of your glute. For most people this will be a little tight; I know mine is.

My recommendation is to hold it for a few seconds and roll it around and find other spots along that area that may be tender or need a little extra work.

For chronic Piriformis pain, I would suggest seeing a P.T. or a Chiropractor who could perform Active Release Technique or A. R.T. or maybe they could provide what is called a Piriformis release.

This will help lessen up the affected area and release some pressure related to the sciatic nerve.

While the piriformis is likely the culprit in most runners, the sciatic can be caused by a bulging or even a herniated disc in your lower back.

In this case, a doctor’s appointment is necessary to diagnose this issue further. An M.R.I. will likely be scheduled and you’ll then be provided the next steps of treatment by a medical professional.

We’ve used a foam roller to roll out and our Piriformis still hurts. What can we do? I would suggest applying heat prior to runs. This helps loosen up your muscles and allows for more blood flow to enter that area.

I would recommend that you do this prior to your initial warm up period, prior to your run. Another option you may be interested in exploring, is to use an anti-inflammatory medication to help combat the nerve pain.

However, I would be very careful with taking an anti-inflammatory prior to running as it can often lead to G.I. issues that are not very comfortable to deal with.

However, taking a small amount of Ibuprofen or some other anti-inflammatory such as Naproxen with breakfast, dinner, or any other meal throughout the day, is likely to be your best-case scenario if you decide you want to explore this option.

Now that we’ve discussed treating the symptoms, we need to discuss finding the underlying cause and treating that. After determining the root of your problem, in most cases for runners, lies within the strength, stability, and mobility of our hips, glutes, core, and lower back muscles.

As a preventative or responsive routine, we should apply exercises such as yoga, planks, lute raises, clamshells, squats, bend locks, and my personal favorite, Jane Fonda’s to help build strength within these areas.

There are a million more exercises that we can do to help stimulate this area and to strengthen the muscles in the area that affects the sciatic nerve.

For many more of these exercises, please go to our website and search hip and glute exercises and you will find a multitude of options to employ at the gym or even at home.

Back to your question Norma, you seem to be doing many of the right things in your day-to-day life to ensure you’re keeping your sciatic as healthy and as happy as possible and that’s great.

I would suggest that you check your shoes and make sure they have not worn out over time. Minimal shoes can wear much faster than a well cushioned one. Be sure you’re replacing your shoes within a good time frame.

The traditional shoe lasts between 300-500 miles. For some, that could be two to three months and for others that could be up to six months.

You should also remember that if you’re wearing these shoes more than just your running, there is a good chance that you have accumulated much more stress to the soles and the inner linings of your shoe.

Another thing I would suggest that you should do is to rotate your shoes with another pair of shoes. Maybe one that allows for more in variability such as a cushion shoe.

That way, your foot pattern is changing every other day and you’re not gathering as much stress from the same repetitive motion that you’re getting, from that minimal shoe every single day.

I may also add that while the minimal approach can certainly help allow form to become more efficient, I must also know that less of a shoe tends to cause greater impact forces on our muscles, which can be tied to your sciatic pain.

This doesn’t take away from the benefits of running with less of a shoe; it just suggests that you could potentially explore other options in footwear or try the rotational method.

I’m also a believer in short term orthotics from a medical professional.

While I don’t believe we need orthotics all of the time, I think we can wear them for a short period of time to help restore balance to injuries that may have been related to our gait.

During this time, you could be spending increasingly more time working on running drills to help teach your body to run with your feet under your hips. A slight postural lean forward when you run.

Taking the time to allow work on your posture on a day-to-day basis, can really help lengthen those muscles and relieve some of the pressure that you have all along your sciatic nerve. These are all great ways to experiment and to make progressions in your pain management.

It seems like you’re on the right track and you’re focused on strength training and increasing your joy mobility, which may be the number one go-to method for helping alleviate your pain and finding the underlying source.

I hope you keep it up and that you can find a helpful response to your answer in this podcast. Again, thank you for your question Norma.

Thank you all for tuning in today. For those of you listening that want to have your question answered by one of the runners connect coaches, head over to runnersconnect.net/daily and click the record button to send your question over.

We look forward to hearing from you soon enjoy the rest of your day.