Squats and Sciatica

Oftentimes when someone complains of (literal) pain in the butt, sciatica is the first thing that comes to mind. While sciatic nerve pain is readily identifiable, its underlying cause might not be apparent. If you have sciatica, you might want to avoid squats until your symptoms improve.

Symptoms of sciatica include low back pain that radiates into your buttocks, pain along the back of your thigh and lower leg, numbness or tingling and, with prolonged nerve compression, muscle weakness.

According to the Mayo Clinic, sciatica typically affects one leg at a time. If you experience loss of bowel or bladder control due to this condition, seek immediate medical attention to avoid permanent nerve damage.

​Read more:​ Sciatica Exercises to Avoid

Your spine is comprised of stacked bones called vertebrae, according to BC Open Textbooks. In the lower back, there are five lumbar vertebrae and five corresponding nerve roots, labeled L1 through L5. The sacrum at the bottom of your spine is made up of five (fused) vertebrae. It also has five corresponding nerve roots, S1 through S5.

Nerves that supply sensation to your skin and power the muscles in your legs — such as the sciatic nerve — begin in your lower back. Nerves branch off of both sides of the spinal cord between each of the stacked vertebrae that make up your vertebral column. Compression of these nerves can lead to painful conditions, such as sciatica.

Spinal nerve compression may be caused by arthritis in your spine, bone spurs or herniation of the discs that provide cushioning between your vertebrae. Compression of the nerves from L4 through S3 are most likely to cause sciatica, according to a June 2015 study of 50 cadavers published by the ​International Journal of Anatomy and Research. ​

After it leaves the spine, the sciatic nerve passes under a muscle called the piriformis. Tightness in this muscle can compress the nerve, leading to sciatica. This condition, called piriformis syndrome, is characterized by pain in the buttocks, pain that radiates down the back of the thigh (but stops above the knee) and pain that is aggravated by changes in body position or prolonged sitting.

If you have sciatic pain after squats, you might have piriformis syndrome. According to a June 2017 article published by ​Clinics in Orthopedic Surgery, ​squatting is among the specific activities that increase compression of the sciatic nerve.

​Read more:​ Is Walking Bad for the Sciatic Nerve?

Although squats are among the activities to avoid with sciatica pain, there are other exercises that you can do while you heal.

However, it's best to know the underlying cause of your sciatic pain prior to attempting these exercises — one might be beneficial for piriformis syndrome but increase your pain with a disc herniation.

For example, the knee-to-chest stretch places the lumbar spine in flexion. This can increase your sciatic nerve pain if it's caused by a herniated disc. Hip strengthening exercises, such as the bridge, could potentially increase pain with piriformis syndrome, as this muscle contracts to assist with that movement.

Strengthening exercises target core muscles that help stabilize your spine. Hip exercises can also be performed to help maintain leg strength until you can resume your squats without pain.

Stop exercising right away if your pain increases, and consult a physical therapist for an individualized exercise program.

Stretch muscles in your hip, pelvis and lower back to relieve tension on your sciatic nerve, as demonstrated by the American Academy of Orthopaedic Surgeons. Hold each sciatica stretch for 20 to 30 seconds and repeat each three times. Stretch two to three times per day while symptoms last.

While stretches will likely be uncomfortable, do not push to the point of pain. This can increase damage to the affected nerve and delay your healing.

​Move 1: Piriformis Stretch​

1. Lie on your back with your knees bent and your feet on the floor.
2. Cross the ankle of your affected leg over the opposite thigh, just above your knee.
3. Gently press on your knee, pushing it away from your body until you feel a stretch in your buttocks.
4. As flexibility improves, lift your foot off the ground to increase the stretch on your piriformis muscle.

​Move 2: Hamstring Stretch​

1. Loop a towel over the ball of your foot on the affected leg. Hold one end of the towel in each hand.
2. Lie on your back with the opposite knee bent to reduce tension on your lower back.
3. Lift the affected leg toward the ceiling, keeping your knee straight. Use the towel for assistance.
4. Stop when you feel a strong pull along the back of your thigh.

​Move 3: Knee-to-Chest Stretch​

1. Lie on your back on a firm surface.
2. Bend your knee on the affected side and bring it in toward your chest.
3. Wrap your forearms around your knee and gently pull your knee closer to your chest until you feel a pull along your lower back.

Spinal stabilization exercises, as demonstrated by Princeton University Athletic Medicine, can help decrease pressure on your lower back and relieve the symptoms of sciatica. Hip strengthening exercises help maintain functional mobility until you can resume your normal workout routine.

Before you begin spine stabilization exercises, you need to master abdominal bracing. This maneuver should then be incorporated into the rest of your spine strengthening activities.

Hold each contraction for two to three seconds, then lower back to the start position at a controlled speed. Repeat each exercise 10 times, working up to three sets in a row.

​Move 1: Abdominal Bracing​

1. Lie on your back with your knees bent and feet on the ground.
2. Place your hands on your hips with your fingers resting a few inches inside your front hip bones.
3. Tighten your abs while picturing your belly button sinking toward your spine. You should feel the muscles under your fingertips contracting.

​Move 2: Bridge​

1. Lie on your back with your knees bent and feet flat, as previous.
2. Rest your arms by your sides.
3. Squeeze your buttocks together and lift your hips off the ground. Be sure to keep your pelvis level — the weaker side might tend to lag behind.

​Move 3: Superman​

1. Lie on your stomach with your arms stretched overhead and elbows straight.
2. Keeping your chin tucked toward your chest, lift your arms and legs off the ground as if you are flying through the air.
3. If this is too difficult, start by lifting the opposite arm and leg at the same time, and then alternate sides.