Earlier this week I shared with you exercises that can help heal a herniated disc and exercises that can make a herniated disc worse. Today I’m going to share with you exercises/stretches that have questionable impact on herniated discs. Not to say that these moves are useless, but they may not have the impact on the disc that you think they do.
We know that exercises designed to improve a herniated disc are theorized to bring the bulge back in towards the middle (like back bends), and exercises designed to worsen a herniated disc are theorized to increase the herniation (like a forward bend). But the following exercises really address the position of the structures outside of the spine, which may have an indirect impact on how the spine moves. We are looking at specifically the piriformis muscle and the hamstrings.
The first exercise in question is the piriformis stretch, also known as the pigeon stretch. The idea is that when you bring your knee up and out towards the side, then twist your leg so the shin is running perpendicular to your body (the common yoga stretch); your piriformis will get stretched out. I’ve written in detail on the impact of this stretch. A lot of articles will say that this will help heal a herniated disc, but this may not be the case. If anything, this stretch is addressing the hip joint itself. If you are stretching out the hip, there is little to no motion at the spine. Hence, there is not much of an impact on the disc itself. However, this stretch can help if the piriformis muscle is the true culprit to your sciatica pain. Stretching out this muscle will result in relaxation which can take the pressure off of the sciatic nerve as it travels past your buttock and down the leg. However, if the prifiromsi muscle is irritated because of a herniated disc, this stretch will only address the symptom, and not the cause of your pain.
Will the piriformis stretch help with hip motion? Yes. Will this address the disc itself, probably not. Improved hip mechanics and motion may result in a reduction in extraneous motion at the spine, which can help with healing as there will be less opportunities for the disc to be irritated (so this would be more of a prevention/return to function stretch, rather than a symptom mitigator)
The hamstring stretch is another commonly used exercise to help relieve pain with a herniated disc. It is thought that time hamstrings were a common culprit in low back pain and sciatica. However a meta analysis (highest level of evidence) showed that hamstring flexibility did not have a role in pain. So why are we stretching this muscle out? How does a tight hamstring have anything to do with a herniated disc? And why are clinicians still telling their clients that tight hamstrings is the cause of the pain and repeatedly prescribe this as an exercise? There is no agreed upon answer/consensus. In some cases, with an irritated sciatic nerve, the hamstring stretch can actually be quite irritating, as when you stretch out your hamstrings, the sciatic nerve gets stretched as well. A stretched nerve gets deprived of oxygen which can actually make the pain worse.
The hamstring stretch may help if the tight hamstrings are preventing movement at the hips, and that lost motion gets made up at the spine, resulting in an increased likelihood of forward bending at the spine (which can make a herniated disc worse).
When you are dealing with pain, the key is to finding the positions/stretches/exercises that provide the most relief. When working with clients privately, we start at the spine and then work our way down (to the hip, knee, and ankle). To jump right into 5 exercises addressing the hips, without looking at the back is going to be a disservice, allowing opportunities to be missed.
If you want to increase flexibility and function of both your hips and hamstrings, these are the two common activities recommend (90s to 2 minutes is a good start)
I’m a huge fan of soft tissue work. It will bring a tight muscle back to baseline, improve blood flow, and provide some extra movement without having to stretch for long periods of time.
If you would like more guidance on how to find the right stretches and exercises so you can go back to living your life free of pain, check out the Sciatica Protocol. We just added a free 3 day trial, and then only $9.99 per week after that. You can cancel anytime. This is perfect if you don’t have time to meet with a professional, as well as if you are waiting weeks to months to be working with a professional. This is designed to help you go through the same process when working with a professional, without waiting in line, and at the fraction of the cost of seeing someone. The good news is that it only takes 10-15 minutes per day, and you can literally start right now. To take the free survey to see if you qualify, click on this link.
I’m hosting a free webinar on how to manage your sciatica pain on your own, on February 15th at 7am, pacific time. There will be a workshop and Q&A session. I hope to see you there. You can RSVP at this link.