When working through sciatica pain, it is important to start at the original site of pain which is often the lumbar spine (low back). But once you work through all the available motions for the spine (forward/backward bending, side to side, rotation) it is time to look at the other areas of the body further down the chain.
This is my favorite hip stretch to allow maximal motion at the hip and minimize motion at the spine. But what about the knee and ankle? The knee is responsible for bending/straightening, so I don’t usually spend much time in this area, unless it calls for it.
The ankle is an often overlooked joint in sciatica pain because it seems “so far” away from the spine. Tight ankles are often present with tense/inflexible calf muscles (the back of your lower leg). If you have tight calf muscles, you will often be limited in the motion called “dorsiflexion” or pointing your foot up towards your face. This is a crucial motion because it helps us stand with our feet pointing straight ahead and it also helps with the push off phase of walking.
If we don’t have enough dorsiflexion in our ankles, our standing is affected by the following: Feet turned out, hips internally rotate (knees in), and the pelvis can rotate forward (increasing the arch in the low back). None of these motions are bad in isolation, but too much of anything can result in pain and dysfunction.
When walking, if we don’t have sufficient motion in the ankle, it will result in our feet to turn out on the “push off” portion of walking. This further enhances the positional changes that occur in the paragraph above. But you will also add in speed and load (body weight) resulting in an increased likelihood of irritation.
You can check how flexible your ankle is by a simple knee to wall test: Stand with your big toe facing the wall (only one leg in front, other is back). Keep your heel on the ground and see if you can move the knee forward to touch the wall. If you can make contact, move the foot back by 1 inch. Keep repeating this process until you can no longer keep the heel on the ground. Optimal distance is around 5 inches from the wall.
So tight calves/ankles are more of a contributing factor that can predispose people to developing pain. It is important to look at this ankle to see how it is moving. You can address tight calves/ankles through a simple runners stretch (90 seconds to 2 minutes), but the draw back behind this type of stretch is that sustained stretching can actually reduce muscle activity. Which is why in the video, I recommend moving in and out of tension.
But another fantastic way to loosen up the calves for optimal function is by rolling it out with a lacrosse ball of foam roller, like this video. I’m a huge fan of dosing about 90 seconds 2 minutes, because that is the sweet spot for change.
How tight are your ankles? Do they need to be worked on? What strategies have you tried to improve your flexibility?