When sciatica strikes, runners should take these precautions
Your sciatic nerve starts in your lower back and runs through the buttock and into the leg and foot. It is the longest and widest single nerve in your body. When compressed or irritated, it can create a condition called sciatica. When a runner has sciatica pain—described as sharp, burning, and like an electrical shock—running can be unbearable. This happens because the adjacent muscles connected to your sciatic nerve manage motion and propulsion. Still, it is possible to run with sciatica as long as you adhere to the proper care and precautions first.
In this Article:
Is It Sciatica or Piriformis Syndrome?
“Because the sciatic nerve runs underneath or through the middle of the piriformis muscle, contraction or inflammation of the tissues in this area may compress the sciatic nerve and develop sciatica symptoms. This is one of the main reasons sciatica and piriformis syndrome are often misdiagnosed,” Dr. Alexander Jimenez, an El Paso, Texas chiropractor, explains on his LinkedIn blog
If you have piriformis, you may not feel discomfort while running, but sitting, climbing stairs, and doing squats as part of your warmup can be painful. Piriformis feels tender in the buttocks and legs. Pain centralizes and typically stays in the middle of the glutes. This makes piriformis pain different from sciatica. When a runner has sciatica, it’s usually a symptom of a more significant issue like a herniated
or degenerated disc
Does Running Cause or Aggravate Sciatica?
While running uses the muscles in the back, legs, and feet—areas affected by sciatica—running does not cause sciatica. Running with sciatica does, however, involve movement that can aggravate the sciatic nerve.
Tips for Running with Sciatica
Since sciatica involves a pinched sciatic nerve, the following tips can help you run without adding stress and pain to the injury.
Shorten your stride.
When you run with shorter strides
between heel strikes, you keep the sciatic nerve from fully extending, which causes pain when you’re running with sciatica. New York City-based sports medicine physician Jordan Metzl, MD
, suggests this method to reduce the “bounce” in your run, which lessens the impact on your lower back.
Change Surfaces. If you run on sidewalks, asphalt, or other hard surfaces, consider running on softer surfaces like grass, trails, or your local track. “Things that induce compressions within your back, like landing on a hard surface repeatedly, will cause these things to worsen,” Metzl says. If running on a track, be sure to change directions (i.e., a few laps clockwise and counterclockwise) to help balance your running.
Stretch Your Hamstrings.
Your body naturally protects itself, and the hamstring will contract to safeguard the injured sciatic nerve. Stretches like high knee lifts and lunges will warm your hamstrings up before you run. Tight hamstrings put pressure on your lower back and make sciatica worse if you don't stretch them before running. Certified personal trainer and running coach David Pigott
, CPT, says to “try dynamic warmups, which are activities performed to mimic the sport and are best used before the run.” He also advises using “post-run static stretches, the ones where you hold the stretch for a period of time are better suited to aid in the recovery. Foam rolling before and after exercise has been shown to help with sciatic symptoms.”
Don’t Overdo It. You may need to alter your training schedule when you have sciatica. Running too frequently can exasperate the nerve and cause more pain and extend the length of time you have pain. Piggott says, “Keep a running and training log to detail activity levels. Keep an ongoing tally of how often you increase training frequencies and load.”
Change Your Shoes.
Some people advocate running barefoot or wearing minimalist running shoes for sciatica
as the best way to stay active. There are other factors to consider when choosing the right shoe. You’ll want to make sure that your shoes fit. They should hug your feet and feel comfortable. Any shoe too wide, big, tight, or small can create an imbalance in your gait, causing pain in the back. Your shoes should provide support and cushion for your feet to reduce impact. The best running shoes have built-in “shock absorbers." If you can, go to a running store and have your foot custom-fit for a shoe, especially if your chiropractor or physical therapist has determined that your pain is sciatica. As your shoes wear down, be sure to purchase a new pair to keep your back in alignment.
Best Running Shoes for Back Pain and Sciatica
New Balance 990 sneaker (models 990 up to 999). “As a board-certified podiatrist and foot surgeon practicing for over 20 years, I have found, from my experience, that many people who suffer from mild sciatica can benefit from wearing a New Balance depending upon their foot type, activity level, and biomechanical considerations,” says Bruce Pinker, a podiatrist at Progressive Foot Care in White Plains, New York.
“The 990 series is a running sneaker with significant cushioning and support to accommodate some who suffer from mild sciatica, typically coupled with the intervention of one of the health care professionals mentioned above.
“The New Balance 990 series is available for women and men and is easily found in stores and online. It is not necessary to be a runner to wear this sneaker, as many find it comfortable for walking and everyday usage.”
Brooks Ghost Series (e.g., the Brooks Ghost 13) are available for both men and women and are a “great running shoe choice for those with sciatica due to their impact on running form and spine orientation as well as their ability to dampen ground reaction forces,” says Jordan Duncan, owner of Silverdale Sport & Spine, a sports medicine clinic specializing in difficult to treat musculoskeletal pain conditions located in Silverdale, Washington.
“Shoes with less cushioning, for example, shoes from the Brooks Ghost series promote a contact pattern close to the body. This pattern creates a more equal swing in front and back of the body, and ultimately a more neutral trunk orientation. This neutral trunk orientation, as stated earlier, is great for runners with sciatica due to a herniated disc.
“Herniated discs that cause sciatica tend to be irritated by movements and postures which involve flexion of the lower back. Therefore, running with an upright posture is ideal for those with this condition. Upright running posture is determined by several factors, for example, the ability of the leg to swing equally in front of and behind the body, as well as landing with the foot close to the body. Striding too far out in front of the body is often associated with trunk flexion and a forward torso orientation. Shoes can have a major impact on these factors, which in turn influences the amount of lumbar spine flexion and, ultimately, sciatica.
“Shoes with heavily cushioned midsoles tend to allow the runner to overstride and contact the ground far out in front of the body. This stride pattern and associated torso orientation make swinging the leg equally in front and back of the body more difficult, which in turn promotes more lumbar spine flexion. Therefore, running shoes which promote a stride that contacts close to the body, encouraging an upright spine, are best for those with sciatica,” he says.
The Hoka Bondi “has a wide fit, and slightly rolls you forward with each step with its meta-rocker geometry, which may help alleviate some strain,” says Jenny Bradley, assistant manager of A Snail’s Pace Run Shop in Fountain Valley, California, who added, “I deal with countless people and their ailments, including sciatica. I would recommend a soft, high cushion shoe. Not only is a high cushion shoe durable, but they are also incredibly luxurious underfoot, and the extra padding is shock-absorbing for someone in pain.”
The New Balance 1080 “fits more like a standard run shoe, with an ultra-soft cushion and more narrow upper,” says Bradley.
The Brooks Glycerin “seems to fit all foot shapes well and is great for runners who like a little firmness, or ground feel, in each step,” she adds.
For Milder Cases of Sciatica
Vivobarefoot Primus for Men and Women “may be the best shoes for any runner with mild sciatica. They are perfect for alleviating stress and irritation while running as the heel and toe are kept level. This helps keep your body in proper alignment when you are standing, walking, or running,” says Liam Coultman, athlete performance coach and certified PICP coach with The Speed Project.
“Shoes with a high heel or cushioned-heel designed to increase stability and comfort are actually a poor choice. When the heel is kept elevated above the front of the foot (even a little), the alignment of the body actually becomes skewed as it is tilted forward.
“This level of imbalance then forces the body to compensate, leaving you constantly in some degree of flexion, which can cause great discomfort and pain, especially after long periods of time. With these shoes, your foot is kept in a natural position which aids stability and reduces tension.”
Vibram Five Fingers Running Shoes (KSO EVO Womens & KSO Men’s) “are as close as you can come to running barefoot, and they really feel more like wearing a sock than a shoe. They mimic the benefits of barefoot running. This allows your feet to take their natural shape as opposed to being squashed and having movement constricted as they are in most ordinary running shoes. This freedom allows the toes and individual muscles of the foot to function as designed. Using them in such a way will build muscle in your feet and increase stability in your ankles. Weaknesses in the feet and ankles can cause further irritation or inflammation of the sciatic nerve. Correcting these weaknesses can help alleviate the pain. Using these shoes will help build strength, increase flexibility of the ankle joint whilst also gaining natural stability,” says Sam Watson, functional movement specialist and writer with Start Rowing.
“One word of caution,” she warns. “If you start wearing these, be careful if you are used to lots of cushioning and support from your shoes. These will help you use your feet better, but you may have to relearn how to use your feet in a way. If possible, start by running on the grass. And if the area is safe, you can even try running barefoot.”
If you feel your pain could be sciatica
(or piriformis syndrome), make an appointment to discuss your condition with your doctor. You’ll get a complete physical to determine the root cause of your pain. You can then discuss whether or not to stop running if you have sciatica.
“Enlist the help of a medical professional, chiropractic doctor, physical therapist, and personal trainer. Be sure to go to a professional who understands the demands of the sport and who spends time treating those athletes,” recommends Piggott.
If you are cleared to run, properly stretch your hamstrings and lower back before taking off. Also, ask your doctor about a training regimen that is right for your condition. Take it slowly. Depending on the cause, sciatica heals itself in one to three months. Your doctor may give you a treatment plan that includes hot and cold therapy, stretches, and over-the-counter medications. Once sciatica is treated and healed, you can get back to running without pain and restraint.
Updated: June 5, 2021