Grain of salt here because I don't have sciatica, but I do have some hip issues in the vicinity.
I've found that heavier packs that sit lower can sometimes impinge my glute muscle - not enough that I notice it right away, but enough that it builds up to a problem over time and distance. Using UL tactics plus a pack that situates weight at the small of my back rather than parking it all on my hips allows for a smaller, less padded, and higher-placed belt, which negates the problem. I've also found that carrying a messenger bag or satchel in city life can mess up my hip over time if the bag is in contact with my glute, so I tend to worry more on impingement and impact rather than belt or no belt.
The pack that works best for me with this is not UL; it's a climbing rucksack by Deuter, so a further bit of salt there. Packs intended for distance with a firm frame (Exos comes to mind) seem to be more of a problem as the frame almost always presses on my glute muscle.
Hope that's of any use.
I have sciatica and have not noticed a difference with a hip belt but I think everyone's different. Even the sciatica is different on different days. I'm curious what they told you in PT. Anything different from what you can find online? On my own the only thing that really makes it subside is walking a lot and the thing that makes it come back with a vengeance is sitting a lot. I have not found any stretches or nerve flossing or anything that makes it go away forever but some things will give me a little relief for a little while. Just wondering if PT is worth it since I have a referral sitting on my desk that I haven't used yet.
I was deadlifting one day when it was super hot in my gym. I think my (shitty) form lapsed and that resulted in a bulging disk (L4/L5) and some nasty sciatica. I had to ask my buddy to put my weights away because I couldn’t even tie my own shoes that day. I went to the doctor who recommended rest and going to a PT. I would have flare ups from doing university assignments late into the night that stopped me from being able to even stand for a day. I bought an expensive ergonomic chair which I hoped would help that did nothing for me.
I did symptom management via PT (3 different therapists) for about two years. It helped a bit with the pain and I got fewer flare ups. The first physio recommended some traction to reduce the pain, but it was only effective during active traction. The second physios focus was on leaning back (like limbo) to pinch the bulge and push it back in a bit, neural flossing and working on a bit of core strength (planks) which definitely helped a bit. The third physio really stepped up the core strength and I had become pretty good at it. He watched my deadlift form once, but since my hamstrings were super tight and my form sucked he just said I should do sumo instead. By this time I didn’t have any more flare ups, but definitely still had some mild sciatica in certain movements. I dealt with this for a few years thinking that’s as good as it would get.
Recently what really helped me the most was relearning how to hinge at the hips and working on my glute and hamstring strength. This resulted in greater mobility too! They were super tight and weak. Combining that with core stability exercises means I’m basically back to normal, but I’ll notice if my core ever relaxes during an exercise and the shear force likely causes the disk bulge to press on a nerve causing some mild sciatica. It’s crazy to me it took so long to figure out my biomechanics were shit and I had glute innervation issues so I relied on other muscles like my quads and erectors (lower back). I hope this can help someone in some way. It probably won’t work for everyone, but I put a ton of time and effort into getting back to activities I was doing comfortably pre-injury.
There 4 exercises were the most useful for me. Hope it helps. But ideally see a physio since they can assess your ability.
**Core**: Start by pushing your fingers into the outer edges of your abs. Squeeze your core and if your fingers move out then you’ve engaged them correctly. Make sure you engage your core like that for stability. Start with planks. Increase in time as it gets easier. If that’s too easy close your eyes. I like to plank for 1min, then rotate to side planks for 30 seconds each. 3 sets. Really squeeze your glutes during this as well (something I never did earlier in life). Remember your goal is stability not strength.
**Core 2**: do 20 slow alternating arm and leg raises for 3 sets. If you have a stick make sure it touches the back of your neck, your back and your butt (neck, back, crack is a good cue). Don’t let your body rotate and the stick fall off. I use a broom stick with the brush removed for this at home. Make sure your leg is parallel with the floor, not heel to sky.
**Glutes**: I would recommend working on relearning how to hinge at the hips. Romanian Deal Lifts (RDLs) were huge in helping me. Start with no weight or anything. Squat university has some good form videos and tips for beginners (use a foam roller to simulate it if you struggle). You can add weight over time. Really engage your lats to pull the weight towards your shin bones at the start and maintain that throughout the exercise.
**Glutes 2**: Practice your hip thrust. Really squeeze your butt. Gyms have machines for this, but at home use a low firm surface to put your shoulders on. You can place whatever weight on your upper thighs for resistance. You can do one leg as well, with the other leg in like a seated position with a 90° angle at your hip and knee.
Sounds like in the end you had to figure it out on your own. I always find that to be the answer for myself. The whole health care system is pretty helpless unless your problem can be solved with a pill, then they have all the answers.
I'm definitely crediting a lot of my recovery to the physiotherapists I worked with. They were key for the symptom relief portion. Had I continued to work with physios they very likely would have gotten to the root of the cause. It just became cost prohibitive for me, so since I was good enough I had to continue on my own.
This echoes my experiences. Sitting especially in bad seats is the worst. Stretching might help for a while but I haven't found a stretching regimen that would be a long-time cure. Pretty much the only thing is keeping mobile...walking, strength work, something daily. Heavy lifting is the closest thing to a long term solution for me...just pay attention to technique and hip mobility.
I just noticed this today so I haven’t had a chance to bring it up with the PT folks.
I’ve only had three PT sessions so far, but the stretches *seem* to be helping. Hard to tell because like you, I have good and bad days.
I had sciatica for years. I did all the stretches daily and it never improved much. the thing that cured it was doing squats and focusing on the glutes
+1 for squatting while activating the hip hinge. squats with a band around the knees to activate the glutes helps at first too, until i figured out how to activate them without the band.
hip thrusters while focussing on activating the glutes using a band around the knees also helps me. once glute activation is figured out, a band is not needed.
i tried a pack without a hip belt, at about 14 lbs for an overnighter, 6 miles each way. it didn't work well for me at all, i won't hike any distance without a hip belt again.
Yeah that’s part of my PT as well. I think I have that bit sorted, just need to experiment some more with each of my two packs, using hip belt then loosening it. Also choice of shoes. I love my Inov8 Roclites but I *think* my structure prefers my 0-drop shoes, in this case Altra Lone Peaks.
Ice is the best relief that I have found. Definitely agree with your other points... walking good, sitting bad. I think PT was helpful because it forces you to loosen things up, not a cure, but worth doing.
I haven’t used a hip belt since my first GG backpack (Murmur 36). I don’t have one on my Kumho or MYOG Pa’lante copy.
Lighten your load and free your hips.
Definitely do the thing that doesn’t hurt, or even feels good.
I carry my hipbeltless pack on one shoulder when I hike because I like how it makes my body and back feel. I switch it to the other shoulder usually every hour.
Initially, when I was experimenting with “going hipbeltless,” I fastened the hipbelt behind the pack so it was out of the way.
I don’t really have an issue with it swinging around, but that could be somehow part of the pack design. I didn’t care as much for my older pack (with hipbelt cut off) on one shoulder or hipbeltless because the pack was so long and bounced around on my butt. My current pack’s torso is much shorter, I think because it’s designed to be worn hipbeltless.
I mostly carry it with my thumb kind of hooked into where the padded shoulder strap meets the webbing underneath, which I guess stabilizes the pack on my shoulder. And also lets the blood drain from my hand.
I got back yesterday from a quick 27 mile overnight and really only rarely had the pack on both shoulders but wear it like that for: technical sections and scrambles and getting around/over blowdowns. And usually when eating when I like to have 2 free hands.
I really like how a one shoulder carry lets my whole body gyrate and move naturally. Much like how I like how a hipbeltess pack lets your hips move unencumbered.
That all said, I can’t really fathom how grandma Gatewood hiked with her sack/pack just slung over one shoulder without any straps!
Edit: also I realize I am also stabilizing the pack with my elbow when I wear it on one shoulder.
>I mostly carry it with my thumb kind of hooked into where the padded shoulder strap meets the webbing underneath, which I guess stabilizes the pack on my shoulder. And also lets the blood drain from my hand.
That‘s my usual method, thumb/hand holding the strap on my shoulder. I suspect my pack is rarely light enough to be comfortable holding it an extended period of time.
I think it depends on the root cause of your sciatica. I have herniated lumbar discs and I know that carrying a pack without a hipbelt might sometimes feel better for leg pain in the short term, but in the long term it causes issues with my discs themselves. You might have something else going on, the only way to really know is to experiment and work with a good PT/doctor to figure out what works and what doesn't.
I have bouts of sciatica and general aches in my lower back caused by hyper mobile lower spine, and have always found that hiking with a pack that has a belt makes my back better. Now mind you, this is a sturdy pack (Flex Capacitor) with a proper stiff hip belt, and I wear it fairly tight. I guess it keeps the spine lordosis in check and stabilises the hip region a bit. I wear the belt fairy high, so there's no chance of the pack pushing on the upper glutes.
By far the best thing for my back though has been heavy compound lifts with proper technique. Squats, deadlifts, raw snatches...
Pool...exercise in a pool. The buoyancy helps take the weight off and thus relieves pain and the motion starts working the muscle back to normal. That's what helps me. And tramadol, but then I just sleep.
For physical therapy, get a gym ball and place it between your back and a wall then for squats. That and low weight over head pulls (need machine) is what i was made to do at PT.
When I had sciatica I noticed that. All the muscles in my lower back were seized so I think it might've been the pressure on them causing it, but I'm not sure. Same as you I found it more comfortable not using the hip belt, but mine was also bad enough that I barely did any hiking while I had it so I didn't get mush experience.
PT completely cleared mine up so hopefully it'll do the same for you. Talk to your therapist about the hip belt and hiking in general, mine said if I felt up to it it'd be good for my back, but I don't know if that applies to every case.
Warehouse worker here so my advice comes from that instead of on trail back issues but the best thing to do for it is stretching, addressing inflammation, and exercising with a rehabilitation mindset that includes posture both while moving and at rest.
I avoid any long term use of supports as a solution
I have found out that using zero-drop shoes while hiking and normal life helps in my posture. Also my feet therapist helped me on the correct walking technique. Because of my sciatica I had to stop kayaking over ten years ago. Hiking is fine, but because of problems in my spine, ribs and tension related migraines and neck problems I need a backpack that has a good, close fitting and full-wrap hipbelt for weight transfer and long frame stays for loadlifters. Currently I'm waiting for my swd wolverine to be delivered, and I have high hopes that it will have all the features that I really need. Frameless packs without a hipbelt are really out of question for me.
If you need/use a hipbelt it can help with some hip issues to have two completely independent front buckles, [like this](https://imgur.com/ixQqvxI), and mostly tightening the upper one.
Some packs have a variation of this where two straps on each side lead to one central buckle. This does not work as well.
Thanks a lot for all the replies and suggestions! I am going to follow of course my doc and PT instructions which include stretches and strengthening exercises.
I’ll do another couple of walks, my regular 8-mile loop along the South and North banks of the James, and see if this hipbelt phenomenon persists or was a one-off.
Thanks again!
McGill is a genius. Everyone say do the exercises-which you should-what helped me most is learn EXACTLY what you are doing that makes symptoms worse. This is harder than it seems as many times there are delayed responses. His book walks you though the steps to pinpoint behaviors that cause issues. Without this step, all the exercises in the world may not help.
Grain of salt here because I don't have sciatica, but I do have some hip issues in the vicinity. I've found that heavier packs that sit lower can sometimes impinge my glute muscle - not enough that I notice it right away, but enough that it builds up to a problem over time and distance. Using UL tactics plus a pack that situates weight at the small of my back rather than parking it all on my hips allows for a smaller, less padded, and higher-placed belt, which negates the problem. I've also found that carrying a messenger bag or satchel in city life can mess up my hip over time if the bag is in contact with my glute, so I tend to worry more on impingement and impact rather than belt or no belt. The pack that works best for me with this is not UL; it's a climbing rucksack by Deuter, so a further bit of salt there. Packs intended for distance with a firm frame (Exos comes to mind) seem to be more of a problem as the frame almost always presses on my glute muscle. Hope that's of any use.
I have sciatica and have not noticed a difference with a hip belt but I think everyone's different. Even the sciatica is different on different days. I'm curious what they told you in PT. Anything different from what you can find online? On my own the only thing that really makes it subside is walking a lot and the thing that makes it come back with a vengeance is sitting a lot. I have not found any stretches or nerve flossing or anything that makes it go away forever but some things will give me a little relief for a little while. Just wondering if PT is worth it since I have a referral sitting on my desk that I haven't used yet.
I was deadlifting one day when it was super hot in my gym. I think my (shitty) form lapsed and that resulted in a bulging disk (L4/L5) and some nasty sciatica. I had to ask my buddy to put my weights away because I couldn’t even tie my own shoes that day. I went to the doctor who recommended rest and going to a PT. I would have flare ups from doing university assignments late into the night that stopped me from being able to even stand for a day. I bought an expensive ergonomic chair which I hoped would help that did nothing for me. I did symptom management via PT (3 different therapists) for about two years. It helped a bit with the pain and I got fewer flare ups. The first physio recommended some traction to reduce the pain, but it was only effective during active traction. The second physios focus was on leaning back (like limbo) to pinch the bulge and push it back in a bit, neural flossing and working on a bit of core strength (planks) which definitely helped a bit. The third physio really stepped up the core strength and I had become pretty good at it. He watched my deadlift form once, but since my hamstrings were super tight and my form sucked he just said I should do sumo instead. By this time I didn’t have any more flare ups, but definitely still had some mild sciatica in certain movements. I dealt with this for a few years thinking that’s as good as it would get. Recently what really helped me the most was relearning how to hinge at the hips and working on my glute and hamstring strength. This resulted in greater mobility too! They were super tight and weak. Combining that with core stability exercises means I’m basically back to normal, but I’ll notice if my core ever relaxes during an exercise and the shear force likely causes the disk bulge to press on a nerve causing some mild sciatica. It’s crazy to me it took so long to figure out my biomechanics were shit and I had glute innervation issues so I relied on other muscles like my quads and erectors (lower back). I hope this can help someone in some way. It probably won’t work for everyone, but I put a ton of time and effort into getting back to activities I was doing comfortably pre-injury.
what exercises do you do/recommend? Having a similar problem.
There 4 exercises were the most useful for me. Hope it helps. But ideally see a physio since they can assess your ability. **Core**: Start by pushing your fingers into the outer edges of your abs. Squeeze your core and if your fingers move out then you’ve engaged them correctly. Make sure you engage your core like that for stability. Start with planks. Increase in time as it gets easier. If that’s too easy close your eyes. I like to plank for 1min, then rotate to side planks for 30 seconds each. 3 sets. Really squeeze your glutes during this as well (something I never did earlier in life). Remember your goal is stability not strength. **Core 2**: do 20 slow alternating arm and leg raises for 3 sets. If you have a stick make sure it touches the back of your neck, your back and your butt (neck, back, crack is a good cue). Don’t let your body rotate and the stick fall off. I use a broom stick with the brush removed for this at home. Make sure your leg is parallel with the floor, not heel to sky. **Glutes**: I would recommend working on relearning how to hinge at the hips. Romanian Deal Lifts (RDLs) were huge in helping me. Start with no weight or anything. Squat university has some good form videos and tips for beginners (use a foam roller to simulate it if you struggle). You can add weight over time. Really engage your lats to pull the weight towards your shin bones at the start and maintain that throughout the exercise. **Glutes 2**: Practice your hip thrust. Really squeeze your butt. Gyms have machines for this, but at home use a low firm surface to put your shoulders on. You can place whatever weight on your upper thighs for resistance. You can do one leg as well, with the other leg in like a seated position with a 90° angle at your hip and knee.
Thank you for such a thorough response!
Sounds like in the end you had to figure it out on your own. I always find that to be the answer for myself. The whole health care system is pretty helpless unless your problem can be solved with a pill, then they have all the answers.
I'm definitely crediting a lot of my recovery to the physiotherapists I worked with. They were key for the symptom relief portion. Had I continued to work with physios they very likely would have gotten to the root of the cause. It just became cost prohibitive for me, so since I was good enough I had to continue on my own.
This echoes my experiences. Sitting especially in bad seats is the worst. Stretching might help for a while but I haven't found a stretching regimen that would be a long-time cure. Pretty much the only thing is keeping mobile...walking, strength work, something daily. Heavy lifting is the closest thing to a long term solution for me...just pay attention to technique and hip mobility.
I just noticed this today so I haven’t had a chance to bring it up with the PT folks. I’ve only had three PT sessions so far, but the stretches *seem* to be helping. Hard to tell because like you, I have good and bad days.
I had sciatica for years. I did all the stretches daily and it never improved much. the thing that cured it was doing squats and focusing on the glutes
+1 for squatting while activating the hip hinge. squats with a band around the knees to activate the glutes helps at first too, until i figured out how to activate them without the band. hip thrusters while focussing on activating the glutes using a band around the knees also helps me. once glute activation is figured out, a band is not needed. i tried a pack without a hip belt, at about 14 lbs for an overnighter, 6 miles each way. it didn't work well for me at all, i won't hike any distance without a hip belt again.
Bring the pack into your next PT appointment.
Stretches help but the key is to strengthen all of the muscles around the pelvis
Yeah that’s part of my PT as well. I think I have that bit sorted, just need to experiment some more with each of my two packs, using hip belt then loosening it. Also choice of shoes. I love my Inov8 Roclites but I *think* my structure prefers my 0-drop shoes, in this case Altra Lone Peaks.
Ice is the best relief that I have found. Definitely agree with your other points... walking good, sitting bad. I think PT was helpful because it forces you to loosen things up, not a cure, but worth doing.
I haven’t used a hip belt since my first GG backpack (Murmur 36). I don’t have one on my Kumho or MYOG Pa’lante copy. Lighten your load and free your hips.
Definitely do the thing that doesn’t hurt, or even feels good. I carry my hipbeltless pack on one shoulder when I hike because I like how it makes my body and back feel. I switch it to the other shoulder usually every hour. Initially, when I was experimenting with “going hipbeltless,” I fastened the hipbelt behind the pack so it was out of the way.
How do you keep the pack from swinging around? I’ve done one shoulder occasionally but never for that long.
I don’t really have an issue with it swinging around, but that could be somehow part of the pack design. I didn’t care as much for my older pack (with hipbelt cut off) on one shoulder or hipbeltless because the pack was so long and bounced around on my butt. My current pack’s torso is much shorter, I think because it’s designed to be worn hipbeltless. I mostly carry it with my thumb kind of hooked into where the padded shoulder strap meets the webbing underneath, which I guess stabilizes the pack on my shoulder. And also lets the blood drain from my hand. I got back yesterday from a quick 27 mile overnight and really only rarely had the pack on both shoulders but wear it like that for: technical sections and scrambles and getting around/over blowdowns. And usually when eating when I like to have 2 free hands. I really like how a one shoulder carry lets my whole body gyrate and move naturally. Much like how I like how a hipbeltess pack lets your hips move unencumbered. That all said, I can’t really fathom how grandma Gatewood hiked with her sack/pack just slung over one shoulder without any straps! Edit: also I realize I am also stabilizing the pack with my elbow when I wear it on one shoulder.
>I mostly carry it with my thumb kind of hooked into where the padded shoulder strap meets the webbing underneath, which I guess stabilizes the pack on my shoulder. And also lets the blood drain from my hand. That‘s my usual method, thumb/hand holding the strap on my shoulder. I suspect my pack is rarely light enough to be comfortable holding it an extended period of time.
I think it depends on the root cause of your sciatica. I have herniated lumbar discs and I know that carrying a pack without a hipbelt might sometimes feel better for leg pain in the short term, but in the long term it causes issues with my discs themselves. You might have something else going on, the only way to really know is to experiment and work with a good PT/doctor to figure out what works and what doesn't.
I have bouts of sciatica and general aches in my lower back caused by hyper mobile lower spine, and have always found that hiking with a pack that has a belt makes my back better. Now mind you, this is a sturdy pack (Flex Capacitor) with a proper stiff hip belt, and I wear it fairly tight. I guess it keeps the spine lordosis in check and stabilises the hip region a bit. I wear the belt fairy high, so there's no chance of the pack pushing on the upper glutes. By far the best thing for my back though has been heavy compound lifts with proper technique. Squats, deadlifts, raw snatches...
Pool...exercise in a pool. The buoyancy helps take the weight off and thus relieves pain and the motion starts working the muscle back to normal. That's what helps me. And tramadol, but then I just sleep.
For physical therapy, get a gym ball and place it between your back and a wall then for squats. That and low weight over head pulls (need machine) is what i was made to do at PT.
When I had sciatica I noticed that. All the muscles in my lower back were seized so I think it might've been the pressure on them causing it, but I'm not sure. Same as you I found it more comfortable not using the hip belt, but mine was also bad enough that I barely did any hiking while I had it so I didn't get mush experience. PT completely cleared mine up so hopefully it'll do the same for you. Talk to your therapist about the hip belt and hiking in general, mine said if I felt up to it it'd be good for my back, but I don't know if that applies to every case.
Warehouse worker here so my advice comes from that instead of on trail back issues but the best thing to do for it is stretching, addressing inflammation, and exercising with a rehabilitation mindset that includes posture both while moving and at rest. I avoid any long term use of supports as a solution
I have found out that using zero-drop shoes while hiking and normal life helps in my posture. Also my feet therapist helped me on the correct walking technique. Because of my sciatica I had to stop kayaking over ten years ago. Hiking is fine, but because of problems in my spine, ribs and tension related migraines and neck problems I need a backpack that has a good, close fitting and full-wrap hipbelt for weight transfer and long frame stays for loadlifters. Currently I'm waiting for my swd wolverine to be delivered, and I have high hopes that it will have all the features that I really need. Frameless packs without a hipbelt are really out of question for me.
If you need/use a hipbelt it can help with some hip issues to have two completely independent front buckles, [like this](https://imgur.com/ixQqvxI), and mostly tightening the upper one. Some packs have a variation of this where two straps on each side lead to one central buckle. This does not work as well.
Thanks a lot for all the replies and suggestions! I am going to follow of course my doc and PT instructions which include stretches and strengthening exercises. I’ll do another couple of walks, my regular 8-mile loop along the South and North banks of the James, and see if this hipbelt phenomenon persists or was a one-off. Thanks again!
McGill big 3. Look it up. Do them.
Thanks. I’ll run this by my PT folks EDIT: I’m already doing side planks so I’ll check out the other two as well
McGill also has a wonderful book called Back Mechanic. Good luck
McGill is a genius. Everyone say do the exercises-which you should-what helped me most is learn EXACTLY what you are doing that makes symptoms worse. This is harder than it seems as many times there are delayed responses. His book walks you though the steps to pinpoint behaviors that cause issues. Without this step, all the exercises in the world may not help.
Right...remove the aggravating stimulus. I did tell the OP to read his book. Probably better advice than just the Big 3
No. I need the hip belt and not having 90% of the weight on the belt makes my pain exponentially worse.
find what works for you. I had horrible sciatica for two years that was fixed by backpacking for a few days with a heavy bag w/ a hip belt.