Cycling with Sciatica
 

I have a sciatic nerve injury on my right side. I’ve had it for almost a year now. I know that there is stretching that I can do to help it and I try to do as much of that as I can. I haven’t been able to afford to see a chiropractor yet. Anyone else have this terrible curse?

Google the "piriformis." Off and on I've had sudden lower back pain that no amount of stretching helped. Cycling friends were talking about piriformis issues and I did some poking around. I found that when I had back pain that bent me over nearly double I could get relief by finding the right spot on my butt and pressing it. It's buried deep and takes some searching but you'll know when you find it. I use a foam roller for my hamstrings and that also helps. Back pain sucks, hope this helps.

Sciatica can have a few different causes. More commonly, the nerve is being pinched by the periformus (sp?). In some cases it is a spinal issue.

In my case the issue was spinal. Core work did help a lot, but ultimately I needed minor surgery to really knock it down.

Either way, stretching the periformis or strengthening your core is probably a good thing, but you really ought to find out what the root cause is from a doctor. It took a couple MRIs to diagnose my issue.

I had it flare up on me in May 2019 and knock me off the bike for a month. I had had a knot on the right side, and took 3 advil before heading out. Just over 2 miles from home on a 40 something mile ride, I was pushing hard and cramped up. That's all it took.

I had another bout in December exacerbated by lifting something big heavy and awkward. Again, a few weeks to get it to clear up. Now, I stretch thoroughly (see these, for example: https://www.nhs.uk/live-well/exercis...-for-sciatica/ ). Stretching has kept it from coming back, and I now refuse to take advil before a ride to avoid masking anything serious.

All I have to do is turn wrong or shift my body abruptly and mine can act up. It is my right side and originated from a surfing incident when I stupidly paddled out without stretching. The original incident took a few months before I had all the feeling back in my feet. Now when it happens maybe 3-4 days of pain and then it goes away. It usually doesn’t hurt while cycling for some reason but about a week or so ago I had a bout with it after a sprinkler repair on my hill that had me turning awkwardly to check the trajectory of the sprinkler. The next day I took off on a ride and after about 15 miles I felt it after getting off my bike. I waited a few more days and fortunately it subsided and is fine for now, I just did 35 miles and no trouble. Advil works for me so I can work even if it is really acting up.

Oh man this is close to my soul. 45 years I struggled with lower back pain, right side. From age 15 to 60. At one point I was seeing a Chiropractor twice a week. An absolute miracle happened while stretching one day. Cracked what I believe was my my sacro-illiac joint. Something I heard should never be done. The relief was extraordinary. Pain free now for two years. Truely a miracle.

I have pretty severe scoliosis and have suffered from sciatic pain. Core exercises and stretching definitely help.

I'm 75. Normally I've kept my back pain in check by riding lots and working the heck out of my back at the gym. Enter Covid. Since there weren't any events or group rides to train for, I decided to get a saddle sore fixed which I've had for years. Unfortunately, the dermatologist misdiagnosed and mattreated it, hamburgered my butt so that I've been off my bike since May. And my gym closed of course. I started running to try to stay in some sort of shape, but after a month of that - sciatica! Bad, like paralyzing, shooting pain, the whole thing. I found some stretches which helped a lot, and an opioid a few times when I couldn't sleep for the pain.

Anyway, after a couple weeks of stretching, it eased off enough that I could walk. I took up walking full tilt boogie, like I do everything, walking 3-5 miles most days. I developed a method of walking with major 360° hip rotation on each side. That hip movement is fixing my sciatica, like magic. My doctor ordered an MRI for me. So there are 2 causes of sciatica, inflammation and structure. Either thing can mess with the nerve and cause pain. My case is structural, no inflammation. I have a slightly bulged disc which is pressing on the nerve. I have no idea why my walking makes the pain go away but it does.

Back to the subject of this thread. I'm anxious to get back to cycling again! I have a 10-day backpack with my wife coming up next week, 52 lb. pack for me, 42 for my wife. We've been training with day hikes and weekend backpacks besides the frequent neighborhood walks. I think I'll be fine on it, just getting really tired. We'll take a PLB with us just in case we need a helicopter to take the body(ies) out.

But seriously, we'll start riding again when we come back from our backpack. My guess is that I won't have any trouble on the bikes, single or tandem. I think position is key. I rotate my pelvis forward so that my back is straight from shorts top to neck. Other than that, back strength is really important to keep one's spine in line and free of inflammation from overwork. Thus I've been a gym member since 1979 and as I said, I focus on back work. We don't have a gym now, so I've purchased two sets of dumbbells from Amazon and we're using those, which is working well enough.

I should add that there are no clinical trials which show that chiropractic does anything for sciatica in spite of their claims of efficacy. There was one patient who has been written up who obtained some relief after 60 sessions over a period of 45 weeks. I think sciatica is something one has to deal with. First thing is to get an MRI, find out what the problem is. Second thing is to try exercises to see what makes you feel better and your core stronger. Almost every morning, I do this routine:

I start with these stretches: https://www.bikeforums.net/road-cycl...l#post15372967
Then I do McKenzie Method stretches: https://www.spineone.com/mckenzie-method-back-pain/
These ones, holding each stretch for a count of 100:
https://i.pinimg.com/originals/a4/74...1b79eb657b.jpg

Then I do one set of pushups to exhaustion, currently 30.
Then I plank for 2 minutes.
Then I do these six special sciatica stretches, which are easier to do after doing the above: https://www.healthline.com/health/ba...atic-stretches

This all takes about 30 minutes, time well spent.

the stretching exercices to stretch the pyriformis where the sciatic nerve gets inflammation

I had sciatica pain for a few years. I started doing yoga this summer and it's almost all gone. I'd say it's reduced 90%. There are specific yoga routines that address sciatic pain - might be worth a shot. However, seeing a doctor first is always a good idea in the event it's something more serious.

Good luck

Very high probability this is your problem. The sciatic nerve runs under the piriformis muscle (used to rotate the leg) and can get irritated either by cycling or so it’s noticeable while cycling. In some not insignificant fraction, the nerve actually can run through the muscle. Stretching the piriformis muscle will usually solve the problem very quickly.

I could barely walk with mine. I spent 5 minutes stretching and it was noticeably better. Advil and a week stretching and it was gone. What worked best for me was to sit down, put my ankle on the opposing knee with the leg on the floor having the knee at right angles. Slowly lean forward and you should feel a stretch on the back side of your leg with the knee on the ankle up near your buttocks. Don’t overdo it and just get a general feeling of it being stretched. It’s easy to push hard and injury yourself with this exercise so listening to your body is important.

This type of pain has a name - the piriformis syndrome - and it’s one suffered quite frequently by cyclists.

That all said, you’d be way better off spending the money to see a physical therapist for this. Those consults are generally pretty cheap and the examination can rule out if there is another issue causing pressure on your sciatic nerve. It’s very easy to cause extensive nerve damage if left untreated and nerve damage can be permanent or take a very long time to regenerate.

Finally, getting medical advice from bike forums is generally not the place to start.

As a formerly practicing neurologist I am going to add one thing to this thread. Viz, while we have no idea what this poster even means by "sciatica," the most common cause, by a huge margin, of neurogenic pain running down the back of the leg is nerve root impingement by a protruding or herniated lumbar disc. Piriformis syndrome is relatively rare.

I have 2 torn and bulging L discs and canal stenosis. These stretches have been a godsend, along with a proper bike fit with a reputable fitter. Haven't had an episode in nearly 2 years.

I think I got this injury from the gym. I can leg press a lot. The Youfit that I went to before this pandemic; the leg press machine maxed out at 630lbs. I went over that by adding 2 more 45lb plates on top. I was able to rep like 4 times but i dont think that was the cause. I think it was me being dumb and trying to do faster reps at 630lbs. I remember my legs accidently locking during that and it was already towards then back end of my workout. Like I said before, I haven't got my back checked out yet but I really think I have something wrong with ym lower back that's pressing against the nerve, Thank you all for giving me advice. The stretching has been helping and I do agree that strengthening my back and core would help.

The key to no-injury leg sledding is never letting your back round or your shorts' waistband come off the back rest. I see people all the time bringing their thighs right down to their chest and thus rounding their back like crazy. I haven't used the sled for some time, but when I was ~60 and 145, I could sled ~700 1 RM.

I used to ride a Sciatica Superleggera back in the day. Finest Italian steel ride I have encountered. (Please do not be offended at my feeble attempt at humor. In no way do I minimize your condition.)

As a physical therapist I must advise you to not take this pain for granted as sooner or later it can lead to devastating consequences. In our line of work we have treated many patients with severe sciatic pain and they ignored it for a long time which lead them to chiropractics anyway. Treat this condition as soon as possible. Learn more about sciatica treatment from Well Being Chiropractic PC blogs.

When I had sciatica due to a bulging l4-l5 disk, I found that riding a little less than I thought I could was the best way to keep riding. I was taught that the normal way to get stronger was to go a little farther and/or a little faster than I thought I could; That always caused pain, IME. Each season my strength developed more slowly than I liked, but I didn't get leg or back pain.

So, I recommend doing a little less than you think you can whenever you exercise, and see if that helps.

OP , I would recommend seeing an orthopedic surgeon rather than chiropractor - I've had lower back issues with intermittent sciatica pain and a prescribed PT program with specific exercises helped me a great deal but for bike riding questions I would run it by the doctor and/or the physical therapist .

As a reputed chiropractic professional expert, we have treated many outdoor game enthusiasts. If somebody doesnt want to visit a chiropractor than he must undergo physical therapy as there are many exercises to treat scaiatica.

This ! Get a good diagnosis and then develop a plan with someone who has knowledge and experience.
Be very careful with any 'stretching' exercises... Either disk or piriformis issues ... The Sciatic nerve has a Myelin Sheath, and you don;t want to damage that in ANY way...
lDisk injury, even slight can also be ... dramatic... ( I have been there, done that... not good, v-tough recovery - toughest...)
Get a good diagnosis, before doing anything, like 'stretching' (could cause greater injury) - I recommend starting with your 'Primary' - if they are aware of your lifestyle... IMO, I personally wouldn't start with surgeons or chiropractors...
Ride On
Yuri

Updating my post No. 8 from a year ago . . . Sciatica went and never came back. We did that 10-day backpack. Had some stiff back, but no sciatica. Back in the gym now, no problem. Back on the bike, no problem. I think the most important thing I did, more than the stretching, was the walking while rotating the hip joints. I still do that once or twice a week, just a half hour. Did another 10-day backpack this September, again some back stiffness and aches, but no sciatica. I might not have mentioned in that earlier post, but when I started the walking, it hurt like the very devil for the first mile. I had to force myself to do it. After that first mile, it steadily got better and after maybe 3 weeks, ceased to hurt at all. At the time I thought, "That really hurts, but doesn't seem to be getting worse and I'm obviously not dying, so keep on."

I did go to my PCP and he thought, as above, probably not piriformis. Horses, not zebras. Piriformis stretches were no help at all.

Core work in the Gym, and see a chiropractor who gets it as not all will. Have been through this entire deal many years ago. It is painful but you have to deal with it ASAP.

Being living with chronic back pain and sciatica for about 15 years now. Most of the time I can just "ride it off". Two things work for me: a good bike fit and stretching. I read/heard somewhere a long time ago a theory that due to cycling my leg muscle are tight and sort of "pull" my back (sorry this is a very layman's explanation). Started stretching quads/hamstrings and it made a big difference in my back pain relief. Good luck!

Sounds what I just went through. My pain started in the lower back, right side, and then progressed down as far as my knee along the back of my leg. I tried epidurals, PT (useless), but finally had surgery three weeks ago. Still recovering, but the surgery appears to have worked since the nerve pain is gone and only a little soreness near the incision remains.

If you want what my doctor called a "durable" solution, surgery appears to be the only option.