Episode 2
Is it sciatica, or a tight hip pretending to be sciatica?
How to tell in two minutes, and what changes if it is the hip.
5 min listen15 min on the floorWith Lee Albert, NMT
Lee Albert says a deep buttock ache is often the hip, since true sciatica means the nerve itself is involved. He suggests three quick questions to tell them apart, then the same gentle plan either way: knees to chest, figure four, sphinx, a short-step low lunge and a glute bridge. If a movement sends symptoms further down the leg, come out of it and take the smaller version.
Sciatica or a tight hip
Jessica talks with Lee Albert, NMT · about 5 minutes
Both voices are AI-generated. Lee Albert reviewed and approved the script and the recording.
Tonight, in order
5 movements, about 15 minutes
All of them are in the Vinys library. Each one has a smaller version, and a chair version if getting to the floor is the hard part.
- 1Knees to chest30 to 60 sec
The floor holds the spine, and it tells you quickly whether the back is irritable.
- 2Figure four1 min a side
If the hip is the problem, this one usually feels like relief. It is the muscle the nerve passes under.
- 3Sphinx30 to 60 sec
A test as much as a stretch: watch what happens afterwards. If leg symptoms draw back toward the spine, keep it.
- 4Low lunge, short step30 to 60 sec a side
A short hip flexor tilts the pelvis and loads the back of the hip from the other side.
- 5Glute bridgeSmall, a few lifts
The muscles that should be doing the work, and in a lot of hip trouble they have gone quiet.
Find the versions that fit your back. First practice free. No account. No card.
The conversation
Read it instead
Is it sciatica?
Jessica
Lee, someone has a deep ache in the buttock, sometimes running down the leg. They've read the word sciatica. Is that what it is?
Lee
Maybe. Often it's a hip. The word sciatica gets used for anything that runs from the back of the pelvis down the leg. But true sciatica means the nerve is being irritated, usually where it leaves the spine. A tight hip can feel almost the same. The deep muscles at the back of the hip sit right on top of that nerve. When they're short and guarded, they ache. Sometimes they squeeze the nerve too. So it's rarely one or the other. It's a question of which one is leading.
Is there a way to tell at home?
Jessica
Is there a way to tell at home?
Lee
Three questions. About two minutes. First, where does it go? If it stays in the buttock, the outside of the hip, or the top of the thigh, think hip. If it travels below the knee, into the calf or the foot, think nerve. Second, what does it feel like? A deep, dull ache is usually muscle. Burning, tingling, pins and needles, or an electric quality is more nerve. Third, what makes it worse? Coughing, sneezing, or bending forward point toward the back. Sitting a long time on one side, or crossing the leg, points toward the hip.
What if it is a mix?
Jessica
And if it's a mix?
Lee
Then treat both gently. That's common. The plan is the same. Settle the back. Give the hip some length. Wake up the muscles that should be doing the work.
What can I do about it?
Jessica
Walk me through it.
Lee
Start with knees to chest. Lie on your back. Draw one knee in, then the other, or both together. Thirty to sixty seconds. The floor holds the spine. It tells you very quickly whether the back is irritable.
Lee
Next, figure four. Still on your back. Cross one ankle over the opposite knee. Draw the lower leg toward you until you feel it in the deep buttock. Stay a minute, each side. If the hip is the problem, this one usually feels like relief. It's the muscle the nerve passes under.
Lee
Third, the sphinx. On your stomach, propped on your forearms. Let the low back settle. Thirty to sixty seconds. This is a test as much as a stretch. Most people's backs prefer this direction, but not everyone. So watch what happens afterwards, not during. If the leg symptoms draw back up toward the spine, that's good. Keep it. If they spread further down the leg, that's not your direction today. Skip it.
Lee
Fourth, a low lunge with a short step. Kneel, step one foot forward, closer than feels natural. Settle the hips forward until you feel a mild stretch at the front of the back hip. Thirty to sixty seconds each side. A short hip flexor tilts the pelvis and loads the back of the hip from the other side.
Lee
And last, a glute bridge. Knees bent, feet flat. Press the feet down and lift the hips a few inches. Small on purpose. Lower slowly. These are the muscles that should be doing the work, and in a lot of hip trouble they've gone quiet.
What should I notice?
Jessica
Five movements, about fifteen minutes. What should people notice?
Lee
Less ache sitting. Easier getting up. The leg feeling lighter. If a movement sends symptoms further down the leg, come out of it and take the smaller version. More pain after you start is a signal to reduce. Not to push on.
When should I stop and get it looked at?
Jessica
Is there anything that means don't do this at all, and call someone?
Lee
Yes. Pain after a fall or an accident. Pain with a fever, or feeling generally unwell. Pain that wakes you at night and doesn't change when you move. Weakness in a leg, a foot that drops or catches, not just pain. Get those looked at. One needs same-day attention: numbness around the groin, or any change in bladder or bowel control. Nothing in this episode applies until that's been ruled out.
How do I stop tomorrow being the same?
Jessica
Last question. How do we stop tomorrow being the same?
Lee
Two small things. Don't sit on a wallet or a phone. It sounds trivial. It tilts the pelvis and presses right where the nerve runs. And change position every thirty to forty-five minutes. Stand, walk to the door, even fifteen seconds. Sitting isn't the enemy. Staying still is.
The answers are Lee Albert's own, neuromuscular therapist, creator of Integrated Positional Therapy, author of Live Pain Free, and the clinical advisor behind the Vinys method.