Healthy Pregnancy 1: “Sciatica” Could My Exercise Routine Be Making The Pain Worse?

“I am 20 weeks pregnant and the pain in my right leg and piriformis is preventing me from working.” Said Heidi, a worried 34 year old who can’t recall a specific event where she hurt herself but she is now experiencing unbearable pain during her pregnancy. She is worried because she only gets 12 weeks off from work and wants to work up until the end of her pregnancy so her entire leave can be spent with her new baby. She’d been suffering from the deep achy pain in her buttock which shoots down her leg when she sits at work. She tosses and turns at night as she just can’t get comfortable no matter how many pillows she uses.

Could this be happening to you?

Sciatic problems are very common during pregnancy because of all the changes that are occurring in the joints to help prepare the pelvis for delivery. Sciatica is a diagnosis that is defined as your sciatic nerve being impinged or injured at some place along the nerve. The sciatic nerve can be injured or compressed at the level of the lumbar spine, through a disc herniation or simply through degenerative changes in the lumbar spine. There is also possibility that through pregnancy as the ligaments become more lax, there is more mobility and shearing that can happen through all the pelvic joints (including the sacrum) increasing the likely hood that the sciatic nerve could get irritated. The sciatic nerve can also be affected at the level of the piriformis muscle, often referred to as piriformis syndrome.


There are many misconceptions today about how to fix pregnancy related sciatica….


Unfortunately, like Heidi, I’ve found too many people that fall victim to poor medical advice when treating sciatica. “I have tried rest, stretching, heat and ice and nothing has helped. I am almost to the point where I will have to take pain medication, even though I am pregnant.”


Why these treatments didn’t help?


Heidi was focused on stretching her hip. That is where her pain hurt after all. What she didn’t realize is because of all the laxity in her joints, stretching was only making it worse.


Finally Hedi was able to get some relief by taking the pressure off the sciatic nerve and addressing other areas of her body that were compensating and contributing to making the problem worse. This is a phenomenon known as compensation. And for Heidi here is what we identified.

1. Tight “hip flexor” muscles (These are the muscles in the Front of the hip which can pull on the back.) This was happening because as her belly was growing her posture was changing and the muscles were getting over used.
2. An OLD Ankle injury from high school. This created one leg that was more dominate and stronger which was causing the pelvis to twist.
3. Tightness and tension on her good side.
4. Body changes from the pregnancy. The pelvis is naturally going to expand 5-7mm during pregnancy, that alone can predispose you to having discomfort as the muscles attaching to the pelvis are stretching and pulling.

Addressing these problems with a mix of:


               -Hands on therapy techniques to often the tighten muscles of her hip and                   pelvis
               - Improving the motion of her ankle from her previous injury              
               - Alleviating the tension in her tightened muscles
               - Teaching her proper core balancing exercises and techniques


As a Result?


-She’s back to working with NO pain.
-She never needed to take the pain medication
- She has even started to work on some daily exercise rituals to help prepare her for LABOR AND DELIVERY.  


By taking a big-picture, full-body Approach to rehab, Heidi was finally able to heal and enjoy the remainder of her pregnancy.


If you have been struggling with pain during pregnancy for longer than a few weeks and you want to learn more about what the ‘root cause’ could be…


At Body Motion Physical Therapy we offer a Free wellness screen at our ‘Discovery Visits’
You will have a private session with a Pelvic Expert Physical Therapist here at Body Motion Physical Therapy, where you’ll get a chance to:

-Share your concerns, problems and frustrations you may be having
-Meet us in person, to see if we’re a good fit before you ever decide to work with us
-A glimpse into your own pregnancy health to help you see exactly what could be causing your injury and tell you the root cause of WHY you may be hurting.

All you need to do is fill out this web-form, and tell us a bit more about what’s going on, and we will have a conversation about how we may be able to help.


Sincerely,
 
Dr. Allison Feldt, DPT, PT
Doctor of Physical Therapy