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Video transcription

Hi, I'm Nicole Aleskas, Licensed Massage Therapist and today I'm going to be showing you massage techniques for the sciatic nerve. The sciatic nerve comes out of the lumbar spine, comes through typically through the piriformis muscle which is this pizza sliced shaped muscle from the sacrum to the hip joint. It comes down the back of the leg and then to the front so someone having an issue with the sciatic nerve either with inflammation or there's an impingement in the lumbar spine or the piriformis muscle is tense and presses on the nerve or even in the hamstring area, you can have issues like pain, numbness or weakness or tingling. It can start from all the way from the lower back. Typically I see it starting at the gluteus muscle and it will come down the back of the leg and in more aggravated cases I will see it wrap around the front of the leg, through the knee and all the way to the foot or to the ankle. So depending on what the person is experiencing if they have a herniation, I want to be aware of that. It might not be appropriate to massage that area. If they have a bulging disc, I want to support the muscles around the lumbar spine. If it's the piriformis muscle, I'm going to work on any adhesions going on there or loosen any tension using stretches and also the massage techniques that I'm going to be showing you. So I usually like to massage the whole line. I'm going to be incorporating it with a full body massage anyway. So let's start at the lumbar area. If it's not true sciatic impingement, it could be the quadratus lumborum which attaches at the lower rib, the floating rib to the top of the iliac crest. It's kind of a rectangular shaped muscle here and they can have a lot of trigger points that mimic sciatic pain even going into the hip and the leg. So I'm going to start with some effleurage here just kind of leaning back into the motion, bending my knees and just letting my hand conform to the area. I can do some petrissage to further warm up the tissue and then I'm going to hook into the edge of the muscle. I'm using the tips of my fingers and putting some inward pressure and then easing up a little bit. I don't want to put too much pressure on the edge of the ribs so I'm just going to find an area of tension and then friction down across the muscle fibers. I can also come to the edge of the spine and hook into the edge of the key well where that little dip is with my thumbs like this and push out. I might find a trigger point in there and I'll just apply pressure for a few seconds and then again go in and flush out the area. If it's the piriformis muscle, again I'm going to start with some effleurage. I can do this from across the table or the same side. I just want to show you what it looks like so I'm going to be doing it from over here. I can do stripping this way. The hip joint is here coming into the edge where it dips in a little bit and there's some tension there, stripping up into the muscle. I can isolate around the hip and do some frictioning. It's great to do around the origin and insertion of the muscle, getting blood to those tendons. There's usually some ischemia there, lack of blood flow. You can also come into the gluts. It might be putting more tension on the piriformis because I'm stripping upwards and I can friction where I find some adhesions there. I usually work around the whole iliac crest, all along the origin and insertions doing some circular friction and then I can work the hamstrings. If there really isn't an issue there, I might just do some regular relaxation. Again I'll do some stretching when I have the person turn over, some straight leg or cross leg, depending on where it is on the body. If there is hamstring, I'm going to stretch the hamstrings and also the piriformis muscle. So, it really depends on what the person is presenting. You want to do a good evaluation, find out where the issue is coming from. If they are presenting with an issue like a herniated disc, you just want to make sure that it is appropriate to do massage. For more information, you can go to my website at Totalbodyharmony.com. Thanks and be well.