Are you making your sciatica worse by doing this common hamstring stretch?!

Hi, I’m Dr. Fergus with Cornerstone Health in downtown Evanston. Today, I’m gonna show you a common hamstring stretch that might be irritating your sciatic nerve, versus stretching your hamstring.

We’re gonna show you how to differentiate between those two items, the hamstrings and the sciatic nerve. And if it is a sciatic nerve, we’ll actually show you a better way to reduce tension in that nerve. If this test causes a lot of discomfort for you, you might want to give us a call at the office so we can evaluate before you try the exercise.

If you are stretching your hamstrings and you feel like they’re tighter than they should be, and the more you stretch them, they don’t always improve the way you’d expect them to, you might actually be stretching your sciatic nerve, and that’s an important distinction that we’re gonna show you now.

Try this test at home!

We’ve got a patient sitting in a standard toe-reach hamstring stretch. So why don’t you slowly reach forward as far as you can comfortably go toward your toes with your arms. He’s reaching a limitation here, and that might be hamstrings, but to differentiate, we’re gonna have him point his toes, and when you point your toes, you don’t do anything to the hamstrings, but you do put some slack in the sciatic nerve. Does it feel like the same stretch, or less of a stretch?

Less of a stretch.

Less of a stretch in this position. Can you go any further? Great, so when he points his ankles, it feels like less of a stretch and he can go further. So come on back. That means that with the ankles bent, that limit he first feels is his sciatic nerve, and not the hamstrings. It might feel like the hamstrings, but if pointing the ankle reduces the tension and you can go further, that’s your sciatic nerve.

Now here’s why that distinction is important. Hamstrings, they like to be stretched occasionally, they like to be exercised in a long position. But your sciatic nerve does not like to be stretched and it does not like to be compressed. And your hamstring stretch activity might actually be irritating the sciatic nerve that runs under and through the hamstrings. Now the good news is, there is a great stretch, or mobility exercise, that your sciatic nerve does like, and it might even make your hamstrings feel looser.

Let’s demonstrate that. Go ahead and lay on your back.

Try this stretch instead!

We’re gonna demonstrate a movement or an exercise that you can do that improves the ability of the sciatic nerve to glide back and forth between the low back and the foot. Remember, the sciatic nerve leaves the back, runs through the back of the leg, all the way to the foot. So we don’t want a pure stretch of the sciatic nerve, but we can use this gliding movement to restore its normal function and make the back of your leg feel looser and more comfortable.

You’re gonna lie on your back with your back flat, no arches needed in the back. You’re then gonna lift up your leg that feels the most tight and hold the back of the thigh with your arms. We’re gonna start with a 90 degree angle at the hip, at the knee, and at the ankle. Now this part you need to do slow and carefully. Slowly straighten the knee until you first start to feel a stretch or symptoms. We’re gonna pause there, take a breath in, a breath out, and then we’re gonna point the ankle, and that’s gonna feel a lot better with the ankle pointed. Take a breath in, take a breath out, and then we’ll reverse the process back to the start. Bend the ankle, bend the knee. That’s one repetition.

Now this is why this works so well. Let’s picture this blue band as the sciatic nerve. Initially, the nerve roots leave the low back from the lower lumbar spine to the upper sacral spine. Then they form a bundle that we call the sciatic nerve right in the gluteals. That runs up the back of the leg, back of the calf, all the way to the toes. So when I bend the ankle, I’m pulling the sciatic nerve away from the spine towards the ankle. As I stretch the leg up, I’m increasing some tension in the nerve, but I’m really sliding it away from the back and towards the foot. Then when I point the foot, I allow that band of nerves to slack and slide back towards the spine. So during the activity, the nerves are sliding back and forth, rather than stretching. They don’t like to stretch, but they respond really well to gliding through those tissues. Let’s show one more repetition.

From the beginning, ankle, knee, and hip bent to 90 degrees, slowly straighten up to the first signs of tension, pause for a breath, point the ankle, pause for a breath, and reverse to the start. You can do 10 repetitions of this and then re-check your hamstring stretch, and if it’s feeling better, this might be a strategy for you that you can use that will have less irritation of the sciatic nerve and better results overall.