Complex Case Study: Weird Sciatic Pain

About 1 month ago, someone reached out to me regarding random onset left posterior leg—as he would say-—”not really pain, but just feels weird” sensation. His trainer is a former client of mine and knew that I would be the right person to get his client back on track…or was I?

When I first met RS, I could tell he was eager to do whatever it took to alleviate his symptoms. He would sometimes experience symptoms while walking and sometimes not. He would sometimes feel it after sitting for a while and sometimes not. The only consistent trigger was squatting and deadlifting at heavier intensities. However, out of precaution, he decided to withhold both for the time being. Now it was my turn to get RS back under the bar!

In general, when it takes quite a bit to provoke someone’s symptoms, it can be tricky to prescribe the “right” exercises to restore tissue compliance and tolerance to load. I have to admit, it seemed like this would be the case halfway through my session with RS as most tests didn’t elicit symptoms EXCEPT for when he returned to being upright after bending forward at the waist; especially with knees straightened. It was hard to give him a diagnosis and I was honest about that, but it was clear which action triggered his symptoms: the transition from eccentric to concentric muscle contraction (or lengthening to shortening).

For homework, I gave RS tempo-based split squats and asymmetrical sit to stands (left leg back) just to name a few along with reverse hypers and leg press at the gym to work more specifically through that sticky point of eccentric to concentric of his hamstrings.

RS messaged me 1 week later and said he was barely experiencing pain! Still there, but considerably less and that he would be working with me and his trainer to determine a plan of action to squat and deadlift. I love what I do!