I began experiencing sciatica a year ago April. Having suffered through bilateral bursitis of ischial tuberosities, I demanded X-rays and then had an MRI and was diagnosed with a slightly herniated L5-S1 disk on left side of my back. Problem was, sciatica was on the RIGHT side. After poking around, I figured out my piriformis was a mess, and that probably its shortness was putting pressure on the sciatic nerve.
So even though you have a herniated disk, what I believe can happen as a secondary effect is that the kinetic chain of muscles gets messed up, and then you need to undo everything (in reverse order, of course), learn about what signals your body gives you that tells you things are messed up (which happens from time to time, for example, I did a little too much running last week so things are acting up), learn how to work on yourself in addition to having a good sports massage therapist or perhaps ART practitioner work on you.
For me, here is how my breakdown occurs, I believe: iliopsoas tightens up QL maybe joins the party and tightens up hip rotators attempt to stabilize the hip due to the iliopsoas/QL tightness piriformis might put pressure on sciatic nerve causing seeming hamstring tightness -OR- quadriceps appears to tighten up while attempting to stabilize the leg due to weak/tight iliopsoas
So, when I sense the least bit of hamstring or quad tightness, I attack my iliopsoas with extra stretching. And I have my massage therapist work on it. And I work on it myself (using the book “The Trigger Point Therapy Workbook” as a guide; utilizing hand/thumb pressure and/or a tpmassageball).
When I had it bad last year, I found a series of stretches, which I amended, slightly, that got me back running within 2 weeks. I stretched both sides of my body (I think depending on your “handedness” even if a herniation is on one side, it may be the OTHER side of your body that’s affected, as is the case with me). PM me with your email address and I’ll send the stretches along.
Now my self-maintenance routine includes: Stretching 15-20’ daily. During this time, I check various parts of my back and glutes to see if something needs “extra” work, and I do self-trigger point work there. A fairly advanced core routine (I’ve been told it ain’t easy) to keep my mid- to lower-back and abs very strong. I can email this as well. Weekly massage, where I provide updates as to what I think needs work, and then he also looks for stuff I might not be aware of. He also does assisted stretching to me, which is excellent. There is some stuff you just can’t do yourself. Attention to posture, especially sitting. Sitting tightens up the back, hips, glutes and hamstrings, so if you sit a lot and don’t compensate for that extra tightening (which gets added to the sports stress), this can cause you extra trouble. I use a lumbar cushion in my office chair and have a regular kitchen seat pad in my car’s bucket seats (bucket seats will aggravate any back problem).
Sometimes, despite my best efforts, I experience some problems. When that happens, I back off on running intensity and/or volume for 1-2 weeks (which never seems to hurt me), and I am fine. I also notice empirically that when my biking volume picks up, I tend to have less trouble with my back/glutes/hips.
You will improve to the extent you are diligent about your self-care. It might also pay to have a biomechanical analysis done so that your strength program can be enhanced to address your limiters. In my case, I have no ACL in my left knee, so I believe that my right side (and I am right-handed) is constantly overcompensating for that issue. Nothing I can do about it except stay on top of things.
Last year from the time I had the MRI I was back running in 2 weeks. I took 2 weeks totally off, and stretched 2-3x daily, and then I eased back into running and was full strength in another 2 weeks. I did a sprint tri a month later and had some good sprint to HIM races during the summer.
It’s better to know what you are working with so you can copy with it!
Good luck!
