Amanda Oswald from Pain Care Clinic explains why fascia tightening can cause pain in runners and how to relieve it:
Fascia is the main connective tissue in the body forming a fluid 3-D web wrapping round and through everything else, including muscles. Fascia tightens through overuse, causing restrictions which refer pain, such as sciatica.
What is it?
Sciatica affects many runners but it is actually a symptom not a condition, usually caused by a tight piriformis The piriformis is one of six deep muscles in the buttocks that help rotate the leg laterally (or out) as part of the movement of running. The sciatic nerve passes close to, or through, the piriformis meaning that when the muscle is tight it puts pressure on the nerve.
What are the symptoms?
Sciatica is characterised as pain that can be felt along the line of the nerve anywhere from the buttocks to the back, side or front of the thigh, into the lower leg and even the foot and ankle. Typically people feel pain in some of these places, but not all, and it usually restricted to one side.
How is the runner affected?
The repetitive nature of running means that the piriformis and gluteal muscles in the buttocks can become restricted as the fascia around them tightens and becomes irritated. In this sense, it is a repetitive strain or overuse injury. The resulting pain makes it difficult to fully extend the leg and running or even walking becomes uncomfortable. Often people also find they can also experience pain when sitting for prolonged periods, for example at a desk or driving.
What is the treatment?
Myofascial release therapy progressively releases restrictions in the fascia and allows the body to return to normal pain-free function. A course of myofascial release treatments, combined with self-help exercises at home, can help to loosen the tissues that are causing the problem and take pressure off the pain sensitive areas.
What is the prevention?
Regular myofascial stretching can help to prevent the build-up of restrictions that cause piriformis syndrome. Fascia is a slow releasing tissue and responds more the longer you stretch it. A fascial stretch is one long progressive stretch and the following 2 exercises stretches should be held for 2-5 minutes to allow the tissue to release.
- Spinal twists stretch all the fascia and muscles in the hips to release restrictions and improve range of movement for running. Keep both shoulders on the floor throughout and support your top leg with a pillow if it doesn’t naturally reach the floor at first.
- Sit on a myofascial (or small) ball on your glutes, using your bodyweight to apply pressure to a tight spot without forcing or rolling around.
Unlike muscle work, fascial stretches and ball work only need to be performed once each, as the benefit is in the length of the release, as opposed repetition. Regular daily practice will help to keep your fascia fluid and pain-free.