Left leg sciatica / numbness in foot

[Dan Humphreys]

Hi 

I'm looking for some advice / second opinions on my road back to graceful movement. I believe I am on the right track from my reading across the forum, particularly this thread and Kit's post here: https://kitlaughlin.com/forums/index.php?/topic/475-l5s1-disk-herniation/&do=findComment&comment=3111&_rid=6637

For context, in 2018 I had a microdiscectomy on my L4/L5 disc which herniated during a deadlift (but after years of abuse in rugby and the gym) causing terrible sciatica where I couldn't stand straight and rolling over my side in bed caused agony down my legs. I'm pleased to say it was a success and since 2018 I've had minimal reoccurrences and been back to golfing, stretching and GMB training. However, over the last few weeks, I've experienced some tingling in my left foot and some numbness / weakness. This was after doing a daily Foundation Training video for a week (here: https://www.youtube.com/watch?v=oVOnXIiPgM8&list=PL-nbvpESi_3kudOjVmLaQ77goxT7XE9ew&index=1) which I consider has aggravated parts of my lower back / glute med as my glutes were probably not firing as they should be.

The discoveries I've made during my training and meditation and with my PT are:

• My glutes have struggled to activate so my lower back / glute med picks up the slack (we are addressing this with slowly building up clams)
• The numbness in my left foot appears when I walk for 5-10mins or stand up straight on the spot for a minute or two.
• The numbness in my left foot gradually reduces during the day. For example I walk the golf course in 4-5 hours and don't have these feelings after the first few holes. This leads me to believe it's likely muscular (piriformis / glute med) and releasing as the muscle warms up.
• When I do the seated piriformis stretch (this one: https://www.youtube.com/watch?v=wT4948tW2hw), I get a tight sensation in my left groin which limits the stretch I feel in my piriformis. edit: from further searching on here, that groin stretch is a normal sensation in this stretch and putting a higher cushion under my left leg and extra stretching on the left leg will help with this.
• I previously had dry needling in my left glute med which dramatically reduced the pain almost overnight so I've added a glute med stretch (here: https://i.ytimg.com/vi/Z9btIzLWlKw/maxresdefault.jpg) but I'd like a stronger version of this stretch I can be in for longer periods (it's quite arm intensive this one I'm currently doing).
• When I sit in a squat and bring my chin to chest, I get a stretch between my buttocks, it feels like a vertical strength. A week ago I stayed in this position for 10minutes and overdid this stretch, my lower back and sit bone were sore for a few days so I've backed off this. I think it's a stretch I need to do but for shorter periods and balanced with back extension work.

Currently, I'm continuing anything that doesn't cause the numbness as I understand moving in pain free ways is the key to improvement. At the moment that includes ST Starter Course going through part 3 again, GMB training, plus my rehab work. I have a PT who I trust and has recommended the following 3x a week:

• Foam roll ITB and glutes and hip flexors 
• Massage ball on tight spots either side of spine, QL and TFL
• Hip flexor wall stretch
• Glute med stretch
• 3 sets of 15-20 side leg raises - yellow band
• 3 sets of clams - 1 normal *15, 1 feet in the air *15, 1 side kick to fatigue
• 10 sciatic nerve gliding each hour

 

I'd appreciate your help and responses to the questions I've asked through this post. Let me know if there's any additional information that would help clarify.

[Kit_L]

@Dan Humphreys: do please search for "piriformis" on my YouTube channel—it's extremely common for piriformis syndrome to exist together with disc pathology. There is quite a long history on this, which I will not recapitulate here.

Try all the variations gently (you must learn to be gentle with yourself if stretching as a solution is to be of any use diagnostically).

https://www.youtube.com/@KitLaughlin/search?query=piriformis

Try and report back.

[Dan Humphreys]

Hey @Kit_L

Thanks for taking the time to help out, I've found this stretch from your YouTube the most helpful: https://www.youtube.com/watch?v=ZYveZMmgslY 

It avoids any knee pain and I feel a deep stretch in my hips. Unfortunately, while I feel looser after doing this stretch for the last few weeks I'm still experiencing numbness in the left of my left foot and left side of my calf as well as aches in my left hammie and glute.

Current advice from my physio is that it's likely my disc has moved a few mm and I need to wait for my body to reabsorb that material over the next 6-12months. In the meantime keep moving as much as I can pain free (GMB, swimming and walking mainly for me), focus on stretching and foam rolling and in particular back extensions, gentle back bends and nerve flossing.

I'd appreciate if anyone has anything else they think may be helpful.

 

[Kit_L]

@Dan Humphreys: your physio has given you excellent advice (and it's pretty much what I argued for in Overcome neck & back pain, many years ago). Reabsorption is a real thing, as long as you keep moving. I would add a hip flexor, and hip flexor/quadriceps stretch to what you have planned, because loosening these reduces the compression force in the lumbar vertebrae. 

https://www.youtube.com/@KitLaughlin/search?query=hip flexors

Let us know how you go.