One of the worst things about sciatica is how it stops you from doing the things you love. Returning to sport after sciatica can be a minefield; here’s a handy guide to getting it right!
Aims of this post:
- To give you a list of things to think about before returning to sports after sciatica
- To give you a checklist to tick off before returning to sport
- To give my own advice about when I would recommend someone returns to sport
- To detail the step-by-step method of how to do get back to full fitness
Sciatica is actually quite common in both athletes and people that take part in sport for fun (Dunn 2006).
In fact, you might find sciatica in athletic people MORE than you do in the sedentary population. This is because of the risk of trauma in certain sports, which can make a disc bulge more likely.
One thing that a lot of my clients struggle with is knowing when it’s OK to go back to the things they enjoy.
Usually, these things involve a physical component.
Maybe it’s squash that you’re missing out on? Maybe it’s running, or maybe it’s your Saturday morning game of bowls?
I have treated footballers with sciatica before too, so I know just how frustrating it can be to be told you need to wait ANOTHER few weeks before you can even think about getting back out there.
Because of the frustration of waiting around, missing out on your favourite hobby, it can be very tempting to rush things and go back to early.
Going back too early can be really dangerous – and that applies for both recovery from surgery and conservative recovery.
This post will hopefully clear some things up when it comes to returning to sport or activity following sciatica, as well as giving some general “rules of thumb” that you can follow, no matter what your sport or hobby is!
Things to consider when thinking about going back to sport
While it would be absolutely ideal if we could get everyone back to sport no matter what their injury, unfortunately it isn’t always logistically or sensibly possible.
I had a 30-year-old client before who loved extreme long-boarding.
He fell from his board one day, landing on his tailbone and causing a massive disc herniation at L5/S1.
It gave him terrible sciatica and numbness in both legs.
After opting for conservative management rather than surgery, we managed to get him 90% better in 4 months of diligent work, following exercise plans to the letter.
However, when it came to getting back on the board again, he just couldn’t do it.
It just wasn’t worth the risk.
He knew the hard work it had taken him to get better this time around and he was absolutely adamant he didn’t want to have surgery.
Although he loved his long-boarding more than anything, he was still young and he knew that one mistake could possibly lead to permanent damage on the next fall.
So he gave it up.
It’s not all doom and gloom though… he took up abseiling instead, to satisfy his need for an adrenaline rush from time to time (while keeping his back safe!)
Questions to ask yourself
After a back injury, it’s important to really consider the following questions before you fixate blindly upon getting back to where you once were with your hobby:
- Do you want to still play the sport, even though it caused your injury?
- Can you realistically return to your pre-injury sporting level?
- What does your doctor, physical therapist, or other health care provider say?
- Have you done exercises to make sure your back is strong again (after you lost a lot of strength following the injury)?
- Are you still in good general health and fitness?
- Are you pain-free when you do the movements your sport requires?
- Have you regained all or most of the range of motion in your back and leg?
If the answer to one or more of these questions is “no”, it might be time to reconsider your plans.
Remember, there are alternatives out there to replace the void left behind by that hobby, and no sport or past-time is worth risking your independence and mobility.
Getting back to sport
If you answered “yes” to all the questions above, let’s talk about how you’re going to go about getting yourself back to your favourite sport after sciatica.
First, we need to think about the activity you want to get back to.
How strenuous is it?
What movements are involved?
Does it involve contact with another person (like football or rugby) or not (like golf or tennis)?
It’s really important that you make a list of the types of movements in your sport that you will need to do, should you go back to it.
For example, if your sport is golf, you would make a note of the following:
- Long drive
- Full bend to pick ball up…
You get the idea!
Try making a bullet point list for your own sport or hobby.
The next thing to do is to circle any of those tasks within your activity that make you feel uneasy.
For example, when I treat clients who want to get back to golf, it is usually the rotation involved in a long drive that scares them most.
They fear that their back won’t be strong enough to carry out this action safely, and they may suffer a re-injury. They also often worry about spending 3+ hours on their feet at once, which is another important thing to consider with sciatica.
Once you have your list, set it to one side and save it for your first practice session.
First, though, we need to talk about when it is actually OK to start practicing again.
When is it OK to return to sport after sciatica?
There is no universally accepted time-frame for when it’s OK to return to sport after sciatica.
However, there are some studies that looked at the average time it took for athletes to get back to sport after a symptomatic disc bulge.
Iwamoto et al., (2011) stated that it took the athletes in their clinic on average 4.8 months to return to sport after their initial injury.
The same researchers stated that 79% of athletes successfully returned to their chosen sport within the studies time frame.
These authors also concluded that the athlete’s symptoms had to be at least 80% better before they started any sort of sport specific come-back.
The participants in this study were both conservative management cases and surgical cases. The success rate for both groups was similar.
My advice for returning to sport after sciatica
I feel that a few extra criteria should be met before someone returns to sport after sciatica, along with the 80% symptomatic improvement rule.
- You should have mild pain at MOST when returning to sport. If your pain goes above a 3/10 intensity I would recommend stopping immediately and only resuming once pain levels are able to calm down and stay low throughout a training session.
- You should have a 90% full range of spinal motion and flexibility in the problematic leg. Coming back to sport before you’ve achieved this is asking for trouble.
- Your strength levels should feel normal again. If they don’t, you need to work on strengthening your back and legs with exercises at home before you consider returning to sport.
- If your sport involves cardiovascular endurance, you need to make sure your fitness is 80% of normal before you return to sport. When we get tired, our movements become sloppy and injury becomes more likely, so going back to sport before your fitness is at an acceptable level is asking for trouble.
- You should also not have any symptoms like persistent numbness, lower limb weakness or bladder and bowel problems before considering sport.
This list isn’t exhaustive! You need to take into account exactly what it is your activity requires from you; the demands of a rugby player are going to be different from that of a darts player!!
How to return to sport after sciatica
You should, in all cases, follow what we call a “graduated return to play” programme.
This means that you gradually introduce the activity again, rather than diving straight in.
This involves a few components that should all be checked off:
- You need to regain a full range of motion at your spine. Do this by performing spinal range of motion exercises until you can bend, extend and rotate just as you could prior to your injury.
To learn what NOT to do when regaining your spinal mobility, click HERE!
- You need to regain strength in your back and legs. After any injury, we rapidly lose strength. It is important to slowly build this strength back up again through exercises at home or in the gym.
You also need to improve your flexibility – for my guide on how to do this, click HERE!
- You need to practice the specific movement patterns your sport demands. For example, if my sport was golf, I would practice the swing motion without a club at home, trying to perform it with the best technique I could before I actually swung for a ball.
- You need to make sure your fitness is up to scratch, by finding a type of cardiovascular training method that doesn’t aggravate your pain (e.g. cross-trainer, stationary bike).
- You need to GRADUALLY re-introduce the sport after you have checked all the above off. This will involve probably playing/training for one quarter of what you used to do first. If you play a team sport, a substitute appearance for the last 10 minutes is ideal. If you are a cyclist, try one quarter of the distance you normally go. If you play golf, try playing 2 holes only then calling it a day.
- Bit-by-bit, build it back up. If at any point you feel your symptoms worsen, you need to take one step back the next time you try your activity, then try to build up again the following week.
NB: Because this is such a detailed topic, I can only go into so much detail within this post. If you would like more detail on the steps above, you should check out my book! It walks you through this method step-by-step with detailed pictures and instructions, with the aim of getting you back to your chosen activity as soon as possible!
I hope this post has shed some light on exactly when you should be considering a return to sport after sciatica, as well as a few ideas on how to go about getting back into your chosen activity.
If you have any questions or comments about this post, why not leave me a comment below? I try to get back to every single one.
Seriously, don’t be shy!
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I hope you have enjoyed this post and I look forward to speaking to you soon.