Sciatica Explained: What Trainers Need to Know

Sciatica is one of the most misunderstood diagnoses in fitness and rehab. Many clients hear the word and immediately think they have a “slipped disc” or that surgery is inevitable. In reality, sciatica simply describes irritation of the sciatic nerve and the cause can vary widely.

In this episode we break down what sciatica actually is, why so many MRIs create unnecessary fear, and how trainers can confidently work with clients who have low back or radiating leg pain.

You’ll learn the anatomy of the sciatic nerve, the most common causes of symptoms, and how to think through assessments involving the lumbar spine, hips, and movement patterns. We also discuss how the biopsychosocial model of pain plays a major role in recovery and why movement, education, and proper programming can often be more powerful than rest or passive treatments.

If you’re a personal trainer, coach, or fitness professional who wants to better understand back pain and help clients move with confidence again, this episode will give you a practical framework to approach sciatica without fear.

Become a SUCCESSFUL personal trainer w/ SUF - CPT the fastest growing personal training certification in fitness. 
sciatica, sciatica explained, sciatic nerve pain, sciatica exercises, low back pain, lumbar radiculopathy, nerve pain leg, personal trainer education, fitness education, biomechanics, movement assessment, back pain training, pain science, biopsychosocial model of pain, lumbar spine anatomy, exercise science, physical therapy concepts, strength training with back pain, injury prevention, trainer certification, show up fitness, SUF CPT, personal training podcast, coaching clients in pain, anatomy for trainers

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Transcript

Partnering With Prehab Experts

What Sciatica Is And When To Refer

Stop Aggravating Stretches

Pelvic Tilts And Hip Extension

Prone Extensions And Persistence

Nerve Glides Progressions

Assessment And Physio Collaboration

ROI Of Teaming With Therapists

Resources, CEUs, And Closing Push

SPEAKER_00 0:02

Welcome to the Show Up Fitness Podcast, where great personal trainers are made. We are changing the fitness industry one qualified trainer at a time with our in-person and online personal training certification. If you want to become an elite personal trainer, head on over to showupfitness.com. Also make sure to check out my book, How to Become a Successful Personal Trainer. Don't forget to subscribe, rate, and review. Have a great day and keep showing up. Not fun to have. Some of the things that we're suggesting may not be most optimal. So let's listen to some people who've helped people because we have great teams and physical therapists, specifically the prehab guys. And I'm going to be referencing their page. We are partners with them. We have talks, they're within our platform. If you do not have their exercise library, I highly suggest getting it. You get a 20% discount as well. Show up 20%. That's something I use on a regular basis. Send out to my clients for exercises they can use instead of the old school stick figures that a lot of people send to their clients. So technically it's referred to as lumbar ridiculopathy, which is just going to be some type of nerve pain down your leg. So most of the time, treating sciaticas within our scope as personal trainers, we're not diagnosing it, obviously. And that's why you want to have a physical therapist on your team. Because if you ever hear about any type of symptoms such as change of bladder control or bowel, worsening of muscular weakness in that area. So maybe you're doing some squats and they just can't do them anymore because the pain is getting that much worse, or any other signs of neurological deficits, clumsiness or balance issues, repeated falls, make sure to refer out to your team physical therapist. Have them at that assessment if you don't feel comfortable, because we don't treat that as trainers. We can give some exercises that will significantly help, but we don't want to be practicing as a physical therapist. Respect their scope. So one of the things that a lot of people do is like a pigeon stretch or some type of toe touch. And what happens is it makes it worse over time. It may feel okay for the time being, but you have to ask how long you've been stretching for? Well, the last couple of months and it hasn't gotten any better. Yeah, let's stop doing that. Let's get some movement involved. So what you can do with your desk right now is put your hands on your hips, that front bone ASIS, anterior, superior iliac spine, and that posterior superior iliac spine. And what we can do is we can just rotate anteriorly and posteriorly and take the pelvis through that rotation. That can help loosen up that discomfort that your clients are experiencing down the leg. Not confuse with low back pain, where it's specific to like your L4, L5. The sciatic nerve is one of the largest nerve roots in the human body, like right around L4 to the S3 region. And so it gets irritated from compression, overload, traumatic incidence, a lot of different things can cause that irritation, but we're not confusing it with like L4, L5 disc protrusions or herniations or whatever, specific to just the low back. This is going to be peripheral discomfort. So it's shooting, it's coming out of that root and it's going down the leg. It's great to start with the pelvic rotations, anterior tilt, posterior tilt, and just to kind of groove that pattern. You can do a lot of those reps sitting at your desk, stand up, you know, get some hip extension, true hip extension, where you really fire up the glutes and you work on that mind muscle connection. What we don't want is to irritate it again and again and again. So if you do like a knee pull and you're like, oh yeah, I really feel it in there. It doesn't feel great. Yeah, stop doing that. We don't want to keep on irritating it. We want to find exercises that may have a little bit of discomfort, like a four or five max. But then when you're done, it gets significantly better. Another great one to do is when you're in a prone position on the ground and you do like little sphinx pushes. So you're going to get hyperextension in that low back area. And a lot of times you stick to a range where there's no discomfort. So the range of motion could just be a couple inches, but you're just grooving that pattern and you're allowing the brain to communicate with your system that it's okay. I like to call it like the sword and the stone theorem or the pickle jar, where you have someone who's been retching at that pickle jar for the last 15 minutes and then you give it to Granny and she finally opens it. What the hell? It's really common with sciatica, where you have that discomfort, but you have to keep on doing the exercises. Because even though it may not be getting better tomorrow, 30 days down the line, you wake up and you're like, holy crap, it's gone. That's that sword in the stone. You finally wedged it out, and that pain and discomfort is gone. Remember, when it is gone, you still want to do these exercises because you don't want it to come back. There's nothing worse than having a constant nagging, shooting pain down the leg. So do these consistently. And some of the best ones are going to be these nerve glides. So you're on a massage table, you look down and you bring your foot out, and then you dorsi flex on the way back. And then you can incorporate some neck movement as well. So you can look down and flex the neck while your leg is out in front of you. And then when you bring it back, you're looking up. And what this is, that's why they call it a nerve glide, because you're helping the nerve get some blood flow and you're kind of working on that quote unquote tight area. Some people call paraformis syndrome, because the paraformis, which is an external hip rotator, sits right on top of that sciatic nerve. So what we're doing is kind of grooving that pattern and you're just taking it through a full range of motion. And sooner or later, it's just going to unlock and it's just going to, those symptoms are going to reprieve. And when you progress that, you can lay on the on your back in a supine position. So you're looking straight up at the ceiling and you have one leg, the unaffected leg, straight out in front of you. And then you're going to grab the back part, which is your hamstrings, you pull it to your chest. So you're about 130 degrees of hip flexion here. And then you're going to point your toe up in a dorsi-flexed manner. And then when you pull your knee back down with knee flexion, you're going to work with plantar flexion. So by going back and forth with this nerve glide, it can really help those symptoms that you're experiencing with sciatica. Find the root cause when it started. Do a thorough assessment. If a client hasn't seen a physical therapist, I'm always going to suggest, why don't you meet with them? Or even better, if someone inquires about your services, because you should be paying for your assessment process. If you charge$150 and the first one's half off at$75, and they tell you they've been experiencing some burning down the leg, reach out to your PT and say, hey, could you be there for the first 10, 15 minutes to make sure it's within my scope, but also tell me any contraindications for what they're presenting? Pay your therapist, invest into your business. Because now that therapist is going to be getting money from you, and then they're going to be sending you more clients because when they're done with their services, four, eight, 12 sessions, whatever it is, therapists don't want their clients forever. Great trainers keep their clients and retain them for long periods of time. So it's an investment into the future. If you're a great trainer, which you are, because you're listening to this, you know you've had clients sign up again and again and again for 12 sessions. If you're paying 100 bucks per hour for your services, that's 1200 bucks. You pay your therapist a couple hundred bucks to come in for that assessment. That client's gonna say, guarantee it, I've never had this type of service before. My last trainer had me do a bunch of stability ball squat curl presses and told me that I was dysfunctional and I actually got worse. You, you took the initiative and brought a therapist into that assessment. Holy moly, that's phenomenal. They're gonna sign up for a year. So 1200 bucks, 1200 bucks over the course of a year, that's$12,000,$14,000 from one client. You paid your therapist$200. That ROI is insane. That's a growth mindset. So just to summarize, when it comes to sciatica, give your client hope. Very common. I work with the prehab guys. Yeah, I have a great app, their exercise library. Let me send you these exercises that I just talked about because it's within the app. And then get to our monthly calls with the prehab guys. You get 0.1 CEUs for free. The next one's gonna be on Wednesday at 10 a.m. for pickleball elbow with Dr. O'Rosh. You get a free 0.1 CEU. I know we love to be frugal. We want everything for free. So come to these and learn from the therapist so you know what's in your scope. You're gonna learn a ton about lateral and medial elbow discomfort. We will have them in the future around Sciatica. So make sure to get to that. Throw this into your story. We love those five-star reviews. Just got a few different emails in this past week. We are in the top hundred best personal training podcasts, but I am not satisfied with that. I want to be number one. So people need to know there's great podcasts out there, and we really appreciate it when you throw this into your story so other trainers can hear how to better serve their clients. And remember, having sciatica sucks. Better is not to have it and keep showing up.