The three poses in this video (Yoga for Sciatica) are safe for most clients, even in the presence of acute pain. As always, encourage your students to move slowly and with awareness. If the level of pain takes their breath away, or if their faces indicate intense sensation, movement may not be appropriate at this time. Utilize breath awareness practices instead.
- Always begin with a few moments to collect awareness. It is helpful to create an attitude of attention but compassionate detachment. Remind the student that no one exercise can fix the problem. This is an approach that requires patient unwinding of the patterns that created the problem initially. Observe the student breathing. Be alert for signs of reverse breathing, chest breathing or holding of the breath.
- The sacral clock exercise is one encouraging somatic connection. The movements should be subtle, slow and done without holding the breath. Some students are better able to imagine the movements using a compass analogy. Anatomically, you are stimulating the sacroiliac ligaments, sacrotuberous ligament and pelvic floor connective tissue. The biodynamic web of fascia is a rich source of movement information for the whole human system. It is especially fundamental in the area of the pelvis. This is also why slow, natural breath is essential so that the nervous system allows neuro-muscular reprogramming. The breathing pattern intimately and immediately informs as to whether this movement is worth repeating automatically. More time can definitely be spent in each quadrant to smooth out the level of sensation.
- Ardha appanasana (half knee to chest pose) is inserted next to release each individual ilium (hip) bone from the sacrum. Again, ligamentous tissue communicates great ease to the entire network. Alert the student that this is not a time to exploit their flexibility and hug the knee aggressively. Often pain is caused by over-stretching connective tissue and leaving the supporting musculature over-lengthened and not as strong. It often feels good, or more familiar, to really pull the back muscles into greater length, but that may not be helpful in alleviating pain or increasing range of motion.
- Supine kapotanasana (reclining pigeon pose) is a classic stretch to ease piriformis tightness. About 70% of sciatica cases are related to tightness in this large hip rotator muscle. The sciatic nerve passes through this muscle and in some bodies is embedded almost. A lot of sitting (such as on a long drive) or conversely, an increase in activity (like training for a new sport) can aggravate the relationship. This type of sciatica is easier to treat and will probably cure itself in about three weeks. It is essential that you guide the student to follow the direction not to pull on the legs and maintain neutral spine during all parts of the stretch. If the natural lumber curve is maintained, the stretch will be concentrated more in the piriformis, not the lower back muscles. It is especially important if the sciatica is more due to compression at the level of the lumbar spine, which occurs often enough. Rounding out the back on the floor and pulling the legs in will possibly irritate that already tight spot in the spine that is rubbing on the nerve. Sciatica that is originates at the spine can be chronic and more difficult to treat. Protocols in that case would focus on spinal strengthening and core integration. There are tests to try and determine the source of the sciatica, but these movements address almost all cases.
- Nerve flossing is a technique that can help a patient release the part of the nerve that is rubbing or stuck on their own. There is a separate video to demonstrate a simple seated technique. Form is very important here : neutral spine, breathing with movement, going slowly, etc.
- Caution against aggressive massage (ie foam rollers, yoga tune up balls) or stretching (ie full pigeon pose) techniques when the nerve is in full flare up. These movements pulls or irritate the nerve further. The techniques may be quite helpful for maintenance later on.