Yoga Therapeutics – Yoga for Sciatica
by Michael Stein

When viewing yoga as a healing practice we may feel the most immediate benefits when an isolated muscle group needs to be stretched to relieve chronic pain. Since nearly two million Americans are known to suffer from some form of Sciatica it can be a blessing to use asanas, rather than medication, to find lasting relief.

The sciatic nerve is the longest nerve in the body. When this nerve becomes irritated or inflamed a shooting pain will typically radiate from the lower back, through the hip, and down the leg. When the irritation is due to a herniated disc in the lower back (where the sciatic nerve originates) then the healing process may take many months or years. However, if the nerve is being compressed by tightness in the deep hip muscles then we can often find some relief after only a week of steady focused practice, depending of course on how tight the hips have become.

The “deep six” hip muscles, as they are often called, are the six small muscles that lie deep beneath the large gluteal (buttock) muscles. Of the deep six it is the Piriformis muscle that we are most concerned with when speaking of sciatica pain (a.k.a. Piriformis Syndrome when the root cause is in the hip area). Although all of the deep six muscles act together as lateral rotators of the hip (turning the thigh bone out to the side), it is only the Piriformis that runs perpendicularly directly over the sciatic nerve. So when this pear-shaped muscle becomes overly tight, often due to either driving or running long distances, it presses upon the sciatic nerve, causing intense pain to be felt anywhere along its pathway, from the hip to below the knee joint.

A regular routine of stretches for the deep six area will open the Piriformis, thereby releasing the sciatic nerve from its grip. I’ve listed three of the many great hip openers that Hatha Yoga has to offer. If your Gluteals and Piriformis are both hyper-tonic (extremely tight) then you will need to utilize cushions or blankets as props in order to feel these stretches in the proper place.

One legged pigeon pose (Eka Pada Kapotasana) with Ankle to Knee pose:

Starting from a comfortable cross-legged seated position, keep your right knee bent and swing your left leg behind you until the left leg is straight with the toes pointing back. Work towards squaring your hips to face forward even as you lower the front of your left hip towards your right heel. Try to avoid caving in onto the edge of your right hip, stay balanced by using your hands for support,. This will stretch your right hip muscles, but to isolate the Piriformis you’ll need to take your right knee further to the right side and your right foot slightly forward, thereby opening the knee joint (Fig #1).

This is a challenging stretch for most people, but by placing a folded blanket underneath your right hip you will be able to move into the posture slowly and then take your forearms or chest to the floor (Fig. #2).

After holding this pose for at least ten deep breaths swing your left leg around again, center it and try to place the ball of your left ankle over your right knee. Allow your left knee to drop over your right ankle. In Ankle to Knee posture we are trying to touch both ankles upon both knees but once again props and modifications are usually essential. By shifting your blanket under your sit-bones to raise your hips you will find it much easier to move your legs. It also may be necessary to place a pillow between your left knee and your right ankle before completing the pose (Fig. #3).

If you still feel restricted then simply slide your left ankle over your right calf muscle instead of the knee so that your feet are much closer together. Once you find the asana that works for you, breath slowly and try to walk your hands out in front of you until your hips tell you to stop (Fig. #4). Repeat this sequence on the opposite side, starting with the left knee bent out to the left and the right leg straight back behind you.

Herons pose (Krounchasana)

Another wonderful therapy is known as Krounchasana. Often thought of as an advanced yoga pose this can also be approached easily with the use of props. Start by sitting on the front edges of your sit-bones with your legs straight out in front of you. Taking hold of your right ankle, bend your right knee and fold your right leg in half by placing your right heel against the outer edge of your right hip, with the top of your foot against the floor toes pointing back (you may need to roll out your calf muscle and sit up on a block to do this).

Then bend your left knee towards the sky until you can interlace your fingers around your left foot. Slowly start to straighten your left leg. If this seems impossible then wrap a belt around your foot, close to your left heel, hold the belt with both hands and let it slip through your hands only until the left leg is straight (Fig. #5).

Once in the asana look up towards your left big toe and attempt to bend your elbows, gently taking your chin towards your shin bone and your chest towards your knee (Fig. #6). Keep your back straight and don’t worry if you never get anywhere near the shin bone just use it as a directional.

Once you find your rhythmic breathing work deeper by moving your straight left leg just slightly to the right, thereby taking the thigh bone away from the Piriformis muscle to increase the stretch.
As with anything new these positions may feel awkward at first, but they will create mobility for your knee and hip joint. Remember that after years of tightening it will take some time to release the sciatic nerve but the freedom of movement will be worth the effort.