Navigating the Return to Running After Sciatica
I’ve never been one to learn things the easy way. That’s not necessarily something I’m proud of (life would be easier if I learned by watching and listening more so than doing). But, the fact remains that the best way for me to learn something is to do it. Failure is a fantastic teacher.
Running Into Sciatica
Unfortunately, that’s exactly how I am a bit too familiar with returning to running after sciatica. Last year, I was training for the Chicago Marathon. My race date was October 8, 2023. Everything was on track. I did all the things. And, I did them correctly. Heck, I even wrote a whole blog post about how I was applying what I knew!
And then, things hit the fan. Part way through my 17 miler, I thought my shoe was a bit too tight (spoiler alert: it wasn’t – it was the beginning of symptoms). So, I compensated by moving my foot a bit funky. About an hour after that, I had quite a bit of pain. I’ve struggled with IT band syndrome in the past, so I figured this was a mild case of that.
Let’s just say I was very wrong. Fast forward a week of thinking it was IT band syndrome and continuing to attempt running: my symptoms BLEW UP.
Not Sleeping, Worrying, and An Epiphany
While I wish I could say that was an exaggeration, it wasn’t. I couldn’t sit, stand, walk, or lay down without excruciating pain. There was one position – about 30 degrees slanted to my left – where I could lay with tolerable pain that allowed me to sleep (with a hefty dose of medication). Anytime someone bumped or even touched my leg, the pain radiated down to my foot at a borderline intolerable level. Needless to say, I was not a happy individual.
At the worst of it, I couldn’t perform a basic prone press up or nerve floss without making my symptoms worse. These are two of the most gentle exercises you can do for sciatica. They are supposed to calm things down, not make them worse. My nerve wasn’t just irritated, it was incredibly pissed off.
Despite knowing what I know (the nerve was chemically irritated and I needed time and gentle movement to decrease the irritation), my thoughts still spiraled. What if this doesn’t get better? Why does this hurt so bad? What on earth is going on? Will I be able to race? Is it smart and try to run? Did I permanently screw something up? (and so on…)
In those moments (in truth, it was almost a week of misery), I realized This is what it feels like. These feelings – what I am experiencing – are the same feelings that my clients experience. Except, they don’t have a tiny physical therapist voice in the back of their head telling them they will be okay. No wonder people get scared, worry, and I spend a good chunk of my job reassuring people they aren’t broken!
Now, this isn’t to say I haven’t had serious injuries. I have. It’s just been a bit (since 2017) where I had something that caused my entire life to come to a screeching halt. And, it’s not that I didn’t know all those things – I just experienced them – and internalized them – on a level that I hadn’t before.
The Beginnings of Running After Sciatica
Looking back, I should have thrown out the Chicago Marathon about two weeks into this whole ordeal. But, because I am stubborn (and because I had run over 640 miles for training since January), I pushed forwards.
A key concept when training for longer distances is “time on feet.” This means that even if you can’t run – for whatever reason – you want to spend an equivalent amount of time on your feet to minimize training losses. So, this is what I did (to the extent my symptoms let me).
In the beginning, I could walk (at a slow pace) for about 45 minutes before the numbness (which was always there) increased to moderate. About a week later, I could do 60. Two weeks after that, my baseline numbness was gone.
Some key principles I followed during this time that allowed me to continue to move while healing
- Starting at activity when numbness was 3/10 or less (0 = no numbness, 10 = miserable numbness)
- Stopping activity when numbness was 5/10
- Decreasing my walking speed or taking a small break when numbness reached 4/10 to bring it back down
- Monitoring post-activity symptoms and adjusting for the future. Anything > 5/10 meant the volume or speed during activity was too much.
Actually Running After Sciatica
Once I was able to walk for an hour without any numbness at all (no baseline numbness, no numbness while walking, and no numbness afterwards), I moved to walk:jog intervals. Initially, it was 1 minute of jogging followed by 4 minutes of walking. Then, I progressed to 1 minute of jogging with 3 minutes of walking and eventually to 2 minutes of walking.
When I worked my way to 1 minute of jogging, 1 minute of walking, I was elated! I was so incredibly proud of myself for running 25 whole minutes (it had been 6 weeks, after all! Just ignore the fact that I was comfortably running 15 miles previously).
From there, healing started to pick up considerably. I reversed the walk:jog intervals and moved to 2 minutes of jogging with 1 minute of rest. After working up to 4 minutes jogging with 1 minute of rest for a full hour, I transitioned to jogging for an hour straight.
It felt SO GOOD to run without stopping. One of my favorite parts about running is the flow state you can get into. You can run – just run – without thinking, without perceiving, and before you know it (although I’m told if you hate running this is not the case), you’ve run 6 or 7 miles!
Putting the Finishing Touches on My Sciatica
My first non-interval run happened on October 22nd. The month after that, I still occasionally got symptoms if I progressed my volume too much, picked up the pace too quickly, or didn’t prioritize my recovery. It took until the end of November for me to be able to run whatever distance I wanted at whatever pace I wanted and not have tingling or numbness later in the day (granted, my lungs and legs limited me, but this I was okay with).
Furthermore, I know my recovery isn’t fully done. I still have a side-to-side difference in how far my nerve will extend. My left leg has my normal amount of limited hamstring flexibility. But, my right leg is still noticeably more limited than my left. I’ve been regularly incorporating the following two exercises to fully restore my nerve mobility.
My plan is to continue to work on my nerve mobility until I’m equal side to side. From treating a considerable amount of folks with nerve issues, I know from experience that if you don’t fully clear a nerve up, it will come back. And, (shockingly) I’m really not interested in repeating what I went through this past fall.
Returning to Running After Sciatica
My journey back to running was difficult, frustrating, and quite emotional at times. Despite the fact that I am a physical therapist, I opted to work with a physical therapist throughout the duration of the process. Why is that?
The answer is simple. Because even though I know what I’m doing, having someone who can objectively make decisions, hold me accountable, measure progress, and keep me from getting in my head is invaluable. It makes the process faster and minimizes the inevitable ups and downs that occur when you’re healing.
If you’re trying to get back into running after an injury, we’re your people. We get it (we’ve unfortunately been there) and we’d love to work with you! Take the next step and fill out our free consultation form!