The Sciatic Nerve is quite large, in fact, it is the largest and longest peripheral nerve found in the body, and is as thick as a finger where it leaves in the lower spine. It extends from your lower back through your hip and under your buttock, and continues down your leg where it splits into two at the knee.

Each leg has its own Sciatic Nerve.

‘Sciatica’ simply means the Sciatic Nerve is is inflamed. The Sciatic Nerve provides information about leg movements, and transmits that information about sensations up to the brain.

Like most other nerves, the Sciatic Nerve performs two important roles.  It sends messages to the muscles of the leg from the brain, and it collects sensory information from the legs and sends it back to the brain.

Conditions such as Sciatica that affect the nerve will change these normal functions. This usually appears as either weakness of these leg muscles… pain in the legs and thighs… or both.

Symptoms of Sciatica.

• A cramping or burning sensation in the thigh.

• Shooting pains from the buttock, down the leg

• Tingling, or pins-and-needles sensations in the legs and thighs

Some with Sciatica may notice a worsening of their symptoms with actions such as squatting or coughing. These actions can increase pressure around the nerve and escalate the symptoms of Sciatica.

The pain from Sciatica is felt along the Sciatic Nerve and can be felt deep in the buttock, with pain that travels down the back of the leg, sometimes as far as the foot. There may also be tingling, ‘pins and needles’, or loss of feeling, and sometimes, weakness in the leg.

Usually, Sciatica effects one leg at a time. Occasionally, a feeling like an electric shock may be occur. The pain can range from a mild ache to severe pain.

Sciatica pain is often felt when you sneeze, cough, or when you’re sitting, and lower back pain may be present as well.

What is the cause of the pain?

A Tight Piriformis is the most common cause.

Sciatica and Piriformis Syndrome are one and the same condition.  The medical community is starting to call the condition by the muscle (Piriformis) that is involved instead of calling it by the name of the associated nerve.  So now you have a choice… a syndrome or a condition.

The Piriformis is a muscle that lies deep underneath the Gluteal muscles of the buttocks. The function of the Piriformis muscle is to externally rotate and stabilise the hip. The Sciatic Nerve passes directly underneath the Piriformis and with some people, it actually passes through it.

Sciatica (aka Piriformis Syndrome) occurs when the Piriformis muscle becomes tight, goes into spasm, or swells. When this happens it compresses the Sciatic Nerve.

Pregnancy can be a cause of pressure on the Sciatic Nerve.

Treatment:
Stretching is a good start, and Deep tissue massage is  also hard to beat in treating Sciatica (aka Piriformis Syndrome).  The best  technique is without a doubt, a darn good active release. It’s a very precise technique that’s used to remove any adhesions that might have formed within the Piriformis or between it and the Sciatic Nerve. A deep tissue massage can help if the masseur is familiar with the anatomy of the Deep Gluteal Muscles.

If you’re experiencing the pain we’ve talked about in this article, call and make an appointment today.  A Remedial Massage could be all you need to relieve the condition.

Iliotibial Band Syndrome is sometimes referred to as Runners Knee and Iliotibial Band Friction Syndrome.

The Iliotibial Band is a band of thick, fibrous tissue which attaches to both the Iliac Crest of the Pelvis (aka hip bone) and the Tensor Fascia Latae muscle. It then runs down the outside of the thigh and inserts into the outside surface of the Tibia (aka shin bone). Its function is to extend or straighten the knee joint as well as abducting the hip or moving it out sideways.

The Tensor Fascia Latae (aka TFL) muscle is a muscle that works over your hip joint. If you put your hands on your hips as if you had your hands in your trouser pockets, your palms should be sitting over the TFL.

As the Iliotibial Band (aka ITB) passes over the lateral epicondyle (a bony part of the femur of the outside of the knee) it is subject to friction. At an angle between 20˚ and 30˚ the Iliotibial Band flicks across the lateral epicondyle. When the knee is being extended or straightened, it flicks in front of the epicondyle and when it is bent, it ducks back in behind.

Iliotibial Band syndrome is frequent in runners because 20-30˚ is about  the angle the knee is at when the foot strikes the ground when running. In people who run regularly this may lead to aggravation of the ITB commonly known as Iliotibial Band Friction Syndrome.

What causes IT Band Syndrome?

Certain factors may make you more susceptible to developing Iliotibial Band syndrome:

• A naturally tight or wide IT band.

• Weak hip muscles such. as Gluteus Medius.

• 

  Trigger points within the IT band and Glute muscles.

• Over-pronation (foot rolls inward)

• Overuse.

• Excessive hill running.

• Running on an uneven surface.

• Different leg lengths.

Symptoms of Iliotibial Band Syndrome:

• There will be pain on the outside of the knee (at or around the lateral epicondyle of the femur).
• A tightness in the Iliotibial Band (ITB)
• Pain normally aggravated by running, especially running downhill.
• Pain during flexing or extending the knee, worsened by pressing in at the side of the knee over the sore area.
• Tender trigger points in the Butt region may also be present.
• Weakness in hip abduction.

What can the athlete do to prevent Runners knee?

• Rest.
• Avoid painful activities like downhill running.
• Use ice to reduce any inflammation.
• Always stretch the ITB after training.
• Massage can also be very helpful in correcting excessive ITB tightness.

Therapy:

Massage that involves specific stretching is a good start and frequent Iliotibial Band stretches should be maintained even after symptoms have ceased.

If you haven’t tried Remedial Massage and you’re experiencing pain in your Iliotinial Band… make a call today.  Arrange an appointment and experience the many benefits that Remedial Massage has to offer.

I’m not referring to your nagging wife or lazy husband.  This is all about pain in that muscle tucked in behind the Glutes… the Piriformis, and someone in the world of the wise has named it the Piriformis syndrome.

The Piriformis Syndrome effects countless numbers of people daily, and doctors refer to it as neuropathic entrapment.  That means that a muscle deep under the gluteal area called the Piriformis is tight or inflamed which decreases the performance or flow of the largest nerve in the body (the sciatic), which passes behind it.  Sometimes, it goes through the muscle.  Tightness in the Piriformis  will cause pain can be in or around the muscle, and along  the sciatic nerve, usually in the back of the thigh, and possibly all the way down into the foot. Shooting pain along the sciatic nerve distribution is called sciatica.  Pain can also be referred up into the lower back region.

If you have pain walking uphill or up stairs, along with pain after prolonged periods of sitting, it’s quite possible you have a dicky Piriformis.

Where is it?

The origin of the muscle is the front the sacrum.  The sacrum is that triangular shaped bone at the base of the spine between the two hip bones, forming the pelvic girdle. The Piriformis Muscle then goes through the greater sciatic foramen (that’s a hole in the pelvis) before it blends into its tendon and inserts onto the top of the Femur at the Greater Trochanter ( hip bone).

The sciatic nerve travels through the greater sciatic foramen (that hole I told you about) behind the Piriformis Muscle.  In about 15% of the population, the sciatic nerve goes through the Piriformis muscle. It’s no surprise then that those within that 15% would be much more likely to experience Piriformis syndrome. Regardless, a tight and/or inflamedPiriformis will eventually lead to a condition known as Sciatica.

Function?

The function of the Piriformis is to abduct and laterally or externally rotate the femur. Abduction of the thigh means to move the leg out to the side away from the body. Lateral (a.k.a. external) rotation means to rotate the hip such that your toes are pointed out to the side instead of forward.

Runners, cyclists, and weightlifters usually experience the condition. Another cause is sitting for prolonged periods with the hips abducted and externally rotated. This can occur at one’s desk, but it is also very common while driving for long periods of time.

Treatment:

Stretching is good.  Deep tissue massage is  also invaluable in treating Piriformis Syndrome.  Undoubtedly, the best  technique is an active release. It’s a very precise technique that’s used to remove any adhesions that might have formed within the Piriformis or between it and the Sciatic Nerve.

A deep tissue massage can help if the therapist is familiar with the anatomy of the deep gluteal muscles.  If you’re experiencing the symptoms of Piriformis Syndrome or tight Gluteal muscles, make a booking and feel the difference Remedial Massage can make.  With any massage however, it’s advisable to wear comfortable underwear that’s not too tight.

Iliopsoas

The Iliopsoas is sometimes classified as two muscles, Iliacus and Psoas major, with Iliacus arising from the Ilium and Psoas from the vertebrae.

Action:
Flexes and laterally rotates hip as well as flexing the  torso when the legs are fixed (e.g. laying to sitting).

Typical use:
•    Climbing a step.

Sartorius

The Sartorius is a two joint muscle and so is weak when the knee is flexed and the hip is flexed at the same time. It works better during single movements.

Action:
Flexes, abducts, laterally rotates thigh at hip. Flexes, medially rotates leg at knee. Abducts the hip and externally rotates the hip as it flexes the hip and knee.

Typical use:
•    Sitting in a cross-legged position.

Rectus Femoris

The Rectus Femoris muscle is part of the Quadriceps muscle group.

It is the only muscle of the group which crosses the hip joint and is a powerful knee extensor when the hip is extended, but is weak when the hip is flexed.

Action:
Extends leg at knee. Flexes thigh at hip.

Typical use:
•    Kicking a football.

Gluteus Medius

The Gluteus Medius is an important muscle in controlling the level of the hips.

Weaknesses in gluteus medius often result in a trendelenburg sign, an abnormal gait cycle where the hip of the swinging leg drops down, rather than raises up.

This results in increased degrees of knee flexion in order to clear the ground.

Action:
Abducts and medially rotates hip. Tilts pelvis on walking.
The posterior fibres externally rotate the hip.
The anterior fibres internally rotate the hip.

Typical use:
•    Stepping sideways out of the bath.

Gluteus Minimus

This is the smallest of the three gluteal muscles and sits underneath the gluteus medius.

Action:
Abducts and medially rotates hip. Tilts pelvis on walking.

Typical use:
•    Getting out of a car.

Gluteus Maximus

The Gluteus Maximus is the largest and most superficial of the three gluteal muscles which forms the rounded shape of the buttocks.

Action:
Extends and laterally rotates hip and keeps the knee extended via iliotibial tract

Typical use:
•    Extension phase of walking upstairs.

Piriformis

The Piriformis muscle is an important muscle. The sciatic nerve passes underneath this muscle on its route down to the posterior thigh.

In some individuals the nerve can actually pass right through the muscle. This can lead to sciatica symptoms due to a condition known as piriformis syndrome

Action:
Laterally rotates, abducts and stabilises the hip.

Typical use:
•    Taking the first leg out of the car.

Biceps Femoris

The Biceps Femoris is one of the three muscles which form the hamstring group forming the back of the thigh.

The muscle is often described as having a long head (the attachment from the ischium) and a short head (attached to the femur).

Action:
Flexes and laterally rotates knee and laterally rotates the hip when the knee is flexed. The long head extends hip.

Typical use:
•    Bending the knee to step over something.

Semitendinosus

When running the hamstrings act eccentrically to slow down the knee extension motion.

Hamstring strains are common in individuals with chronically tight hamstrings or who do not warm-up thoroughly.

Action:
Flexes and medially rotates knee, and extends the hip.

Typical use:
•    Bending the knee to step over something.

Semimembranosus

The Semimembranosus is the most medial of the three hamstring muscles.

Chronically tight hamstrings are often a contributary factor to lower back pain and knee pain.

Action:
Flexes and medially rotates knee, and extendsthe  hip.

Typical use:
•    Bending the knee to step over something.

Pectineus

The Pectineus is positioned between the Iliopsoas and Adductor Longus muscles and is part of the short adductor group with adductors brevis and longus.

Action:
Flexes, adducts and medially rotates the hip.

Typical use:
•    Kicking a football.

Adductor Brevis

The Adductor Brevis is the smallest and shortest (hence the name brevis, meaning short in latin) of the three short adductor muscles.

Groin strains are common injuries to the adductor muscles, which occur without a thorough warm-up or in individuals with chronically tight or weak adductor muscles.

Action:
Adducts and flexes the hip.

Typical use:
•    Bringing your second leg into the car.

Adductor Longus

The Adductor Longus is the middle of the three short adductor muscles.

Groin strains are common injuries to the adductor muscles, which occur without a thorough warm-up or in individuals with chronically tight or weak adductor muscles.

Action:

Adducts, flexes and medially rotates hip.

Typical use:
•    Bringing your second leg into the car.

Adductor Magnus

The Adductor Magnus is the largest groin muscle and is one of the two long adductor muscles (gracilis is the other).

It is usually decribed as having two parts, hamstring and adductor parts.

Action:
Adductor portion: adducts, flexes and medially rotates hip. Hamstring portion: extends hip.

Typical use:
•    Bringing your second leg into the car.

Gracilis

The Gracilis is another muscle which works in conjunction with the groin muscles, or adductors.

Action:
Adducts hip. Flexes knee and medially rotates the hip when the knee is flexed.

Typical use:
•    Sitting with the knees pressed together.