How Extremes Like HIIT and Sitting All Day Can Bring on Hip Pain (AKA Sciatica)
"Sciatica is an umbrella term that refers to a shooting pain that goes down the leg, typically from the back though the buttock and the back of the thigh and all the way down the leg," says Charles Kim, MD, assistant professor in the Departments of Rehabilitation Medicine and Anesthesiology at NYU Langone, adding that these symptoms can be caused by a number of different things. Some common culprits? Hip problems and lower back irritation, or more seriously, a pinched nerve or herniated disk in your back. What's more, sciatica is commonly diagnosed in those who are active. "Even the healthiest people get sciatica, the fittest athletes get sciatica," he says, noting that he's seen patients who run the full spectrum of activity levels.
There may not be a one-size-fits-all predictor for what causes sciatica or who might wind up with it (though there appear to be genetic factors), but there are certain exercises that can exacerbate it—some of which happen to be the most popular in the current fitness climate. "With the explosion of high intensity interval training that we’ve seen in the last five to 10 years, there have been many forms of HIIT that involve deep squats, lunges, box jumps, and things of that nature," says Benjamin Domb, MD, an orthopedic surgeonand founder at The American Hip Institute . This can be problematic because these types of moves involve a lot of flexion of the hips and back. "When we repetitively flex our hips and back that far, particularly with added weight, we put a lot of strain on them," he says. These double-whammy moves can lead to something called "hip-spine syndrome," which can eventually lead into sciatica.
In fact, as HIIT training has become more popular, Dr. Domb notes that he's seen an increase in sciatica-induced back and hip problems coming into his office. "I’ve seen the symptoms of sciatica become more common," he says. "To be clear I’m not against HIIT training, but I think things we can do to minimize these kinds of injuries with HIIT training, including a more gradual entry into new training regimens." You know, maybe don't jump straight into doing 40 high-speed sumo squats if it's your first day in the gym. But HIIT isn't the only one to blame. DR Domb says that he also sees sciatica as an issue in Crossfit athletes, golfers, and tennis players, and Dr. Kim warns that it's also common in rowers and hardcore spinners.
So what's your best bet for avoiding it? "I would try to limit the extremes—extreme inactivity and extreme activity," says Dr. Kim. In addition to not overdoing it in the gym, it's important to keep sitting to a minimum—if you're stuck at a desk all day, get up and stretch every 20 to 30 minutes or invest in a standing desk. It's worth noting that if you are ever shouting "ouch, my back," it's worth checking in with your doctor—especially if your pain is accompanied by any feelings of imbalance or weakness, which could be a sign that something more serious is going on.
The good news is that most of the time sciatica will go away on its own—symptoms usually don't stick around for more than a month or so. "If there’s a particular activity that brought them on, common sense medicine says ‘back away from that activity’ sooner rather than later before the symptoms get worse," says Dr. Domb, adding that sciatica is not a situation where you want to "play through the pain."
Recovering from your workouts really is as important as everyone says it is, and there's an entirely new crop of fitness tech on the market that's making it easier than ever. And this is the magic number of days you can skip the gym before your body starts to suffer.
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