If there's one thing that can sideline your workout, it's weight training with sciatica. While soreness in your lower back and buttocks often comes with the territory when weight lifting, sciatic nerve pain is a different story. This "pain in the butt" indicates that your nerve is being compressed.
Determine the Underlying Cause
Sciatic pain occurs when the large sciatic nerve in your buttocks is irritated. This can be caused by a tight piriformis muscle overlying this nerve. It can also occur when the nerve roots exiting your spine are compressed by arthritis, bone spurs or a herniated disc — cushioning between the stacked bones called vertebrae that make up your spine, according to the Cleveland Clinic.
Recommendations for lifting with sciatica will be most accurate if you first determine the underlying cause of your pain. Exercises that might be safe with a tight piriformis might not be safe with a disc herniation. See a doctor for a diagnosis and work with a physical therapist for a specific exercise program tailored to your needs.
Disc herniation sciatica pain often increases when you bend forward at the waist. Weight lifting exercises that put excess weight on your back, such as barbell back squats, can worsen your symptoms.
Sciatic nerve compression due to a tight piriformis — a condition called piriformis syndrome — is often irritated by sitting, running long distance and cycling. According to a June 2017 article published by Clinics in Orthopedic Surgery, squatting is one of the movements that increase pressure on the sciatic nerve when you have this condition. Consider putting these exercises on hold until your pain subsides.
Read more: Sciatica Exercises to Avoid
Sciatic Nerve Compression
The sciatic nerve is formed by nerve roots that exit the lumbar and sacral areas of your spinal cord. This large nerve then enters your buttocks region and dives beneath a muscle called the piriformis, according to a 2015 article published in the International Journal of Anatomy and Research.
The sciatic nerve supplies sensation to the back of your leg and powers muscles in your hips and thighs. This large nerve branches off at the knee to supply the muscles in your lower leg and foot.
Compression of the sciatic nerve can cause pain in the lower back, pain in the butt (literally) that might radiate along the back of your thigh and numbness and/or tingling in the back of your thigh. With prolonged nerve compression, you can develop weakness in your leg muscles.
In severe cases, sciatica can be accompanied by a sudden loss of the ability to control your bowels or bladder. If this occurs, seek immediate medical attention. This condition might require surgery, according to the Mayo Clinic.
Read more: Is Walking Bad for the Sciatic Nerve?
Gym Exercises for Sciatica
Incorporate gym exercises for sciatica into your routine to help decrease your symptoms and prevent further injury. Stretch tight muscles and perform spine stabilization exercises to strengthen your core.
Stretching tight muscles can be uncomfortable. However, if you experience increased pain or tingling in your leg, you are stretching too far. Hold each stretch for 20 to 30 seconds, then relax. Repeat three times.
Perform stretches on both legs even if your symptoms are one-sided. Tightness on one side of the body can affect the other.
Perform 10 repetitions of each strengthening exercise, holding the contractions for one to two seconds. Slowly return to the starting position between reps to avoid excess stress on your back. Work up to three sets of each exercise, in a row.
When training your legs with sciatica, perform the stomach vacuum exercise, or abdominal draw in, prior to each repetition as demonstrated by Princeton University Athletic Medicine. This maneuver will contract your core muscles to reduce pressure on your spine and sciatic nerve.
Move 1: Stomach Vacuum
- Lie on your back with your knees bent and feet on the floor, close to your buttocks.
- Rest your palms on your front hip bones with your fingers extended.
- Tighten your abs as if you are "sucking them in," pulling your belly button down toward your spine.
- Gently press your fingertips into the muscle near your hip bones. You should feel tightening if you are performing the exercise correctly.
- Hold for three to five seconds, then relax.
- Repeat 10 times.
Move 2: Hamstring Stretch
- Sit on the floor with one leg straight. Bend the opposite knee and pull the sole of your foot in toward your groin.
- Hinging at the hips (keep your lower back flat), reach both hands toward your toes on the straight leg.
- Stop when you feel a stretch along the back of your thigh.
Move 3: Piriformis Stretch
- Sit in a chair. Cross your legs, resting the outside of your ankle on the opposite thigh, just above the knee. This is a "figure-4" position.
- Gently press your top knee down toward the ground until you feel a stretch in your buttock.
- Increase the stretch by hinging forward at your hips.
Move 4: Quadruped Opposite Arm/Leg
- Move into a hands and knees position. Look at the ground between your hands to keep your neck neutral.
- Lift your right arm and left legs straight out in front and behind you.
- Lower and repeat on the opposite sides.
Weight Training with Sciatica
Avoid aggravating exercises when weight training with sciatica, such as squats and deadlifts. These movements require contraction of the buttocks muscles and increase the load on your lumbar spine.
Focus on strengthening your upper body while your sciatica heals. Consider using lever machines rather than free weights or barbells — machines stabilize the weight for you, relieving some of the burden from your core muscles.
Use proper posture during exercise and as you transition between machines. Squeeze your shoulder blades together and keep your lower back straight. When retrieving something from the ground, hinge at the hips rather than bending over at the waist. Lift one leg straight out behind you to counterbalance and help keep your spine straight.
Be sure to use proper form when resuming previously aggravating exercises once your symptoms have resolved. For example, follow these steps, as described by ExRx.net, for the front squat:
- Grip the barbell with your hands shoulder-width apart. Bend your elbows and bring them under the bar.
- Resting the barbell on your shoulders, step away from the rack.
- Assume your squat stance — often slightly wider than hip-width apart.
- Hinging at your hips, send your butt backward and bend your knees until your thighs break the parallel plane. Keep your chest up and core tight.
- Straighten your knees and stand back up. Fully extend your hips at the top of the movement.
- International Journal of Anatomy and Research: "Sciatic Nerve and Its Variations: An Anatomical Study"
- Clinics in Orthopedic Surgery: "Surgical Treatment of Piriformis Syndrome"
- Mayo Clinic: "Sciatica"
- Cleveland Clinic: "Sciatica"
- Princeton University Athletic Medicine: "Lumbar/Core Strength and Stability Exercises"
- ExRx.net: "Barbell Front Squat"