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MYOFASCIAL TECHNIQUES or electric sensation. The more the nerve is irritated in this region, the more sensitive the nerve here will be. Once you've found the nerve, apply gentle traction to it as your client slowly lifts her knee slightly (Image 9). This will allow you to pull the nerve distally, freeing its lower section as it passes between the hamstrings. When done correctly with a client who has sciatic impingement here, this technique can yield a sense of immediate relief. Here and elsewhere, however, it is good to keep in mind that relief from sciatic pain doesn't always come right away. Even when you've thoroughly released the connective tissue tethering that irritates a nerve, the inflammation can take time to subside. In some cases, long-term neuropathic pain (of which sciatic pain is one kind) can lead to changes in nerve function that take time to reverse. The non-noxious tactile stimulation of your work is therapeutic in these cases, so remember that you are helping the nerve recover normal function by just doing your work. In most cases, plan to address sciatica over a series of sessions, and make sure your client is aware that habitual activity modification, stretching, or exercise may be necessary to augment your hands-on work. Be sure to refer stubborn cases to medical or orthopedic examination, especially if you suspect lumbar involvement. Even if the nerve entrapment is released in a single session (which does happen), an inflamed nerve can take time to heal, so be patient, thorough, and as always, don't hesitate to email us with either your quandaries or your stories of success. Trainings.com faculty, which offers distance learning and in-person seminars throughout the United States and abroad. He is also a Certified Advanced Rolfer and teaches for the Rolf Institute of Structural Integration. Contact him via info@advanced-trainings.com and Advanced-Trainings.com's Facebook page. Til Luchau is a member of the Advanced- The Sciatic Traction Technique: use gentle pressure to feel for and distally stretch any sciatic nerve connective tissue tethering in the posterior thigh. Use your client's feedback to help comfortably locate the nerve. Image 7 courtesy Primal Pictures. Used with permission. Image 8 and 9 are courtesy Advanced-Trainings.com. NOTES 1. A. Filler et al., "Sciatica of Nondisc Origin and Piriformis Syndrome: Diagnosis by Magnetic Resonance Neurography and Interventional Magnetic Resonance Imaging with Outcome Study of Resulting Treatment," Journal of Neurosurgery: Spine 2 no. 2 (2005): 99–115. 2. Carol Otis, "What's Sciatica: A Pear-Shaped Problem," accessed September 2011, www. sportsdoctor.com/articles/sciatica3.html. 3. Stanley J. Swierzewski, ed., "Sciatica Overview, Incidence, and Prevalence of Sciatica," accessed September 2011, http://pain. healthcommunities.com/sciatica/index.shtml. 4. "Males are affected approximately twice as often as females by lumbar disc issues, except in adolescents where there is a small female preponderance, probably due to earlier skeletal maturity. White-collar and professional employees are the least likely to be affected by lumbar disc herniations, and motor vehicle drivers are the most likely. The driver who spends greater than 50 percent of the working day behind the wheel has a three-fold increased risk, whereas the lorry [truck] driver has a five-fold increased risk." From: Hilali Noordeen et al., Interactive Spine [electronic resource] Primal Pictures Ltd, 2009. 5. D. Pokorny et al., "Topographic Variations of the Relationship of the Sciatic Nerve and the Piriformis Muscle and Its Relevance to Palsy After Total Hip Arthroplasty," Surgical and Radiologic Anatomy 28, no. 1 (2006): 88–91. 6. H.T. Benzon et al., "Piriformis Syndrome: Anatomic Considerations, a New Injection Technique, and a Review of the Literature," Anesthesiology 98, no. 6 (2003): 1,442–8. tune in to your practice at ABMPtv 115