Older trainee: Pain in the vicinity of sciatic nerve while bench pressing?

[Geoff Bischoff]

So I'm training this battleaxe of an old lady. A real tough, smart broad; Master's prepared nurse with 15 years of ER experience before she took to teaching undergrads, raised kids, built houses with her bare hands, made enough quilts to keep Alaska warm. On the whole, not a complainer, especially about pain.

(Hi mom!)

We're on session 2 today, which is her first run at bench pressing. So by this time she's squatted twice, pressed once, and deadlifted once without issue.

On bench: She gets into position with feet flat on the floor and can't hold the position due to intolerable pain in the exact middle of her right glute (looks like exactly where the sciatic nerve is in diagrams I've seen, but I hesitate to call it "sciatica"). She finds relief by lifting her legs; felt best when she sets her feet up on the bench. Stability in that position is always crap, so I convinced her to try with flat braced feet, but shimmed her feet up with plates until they were about 3" off the floor-proper. In this position, she reported pain but said it was bearable, and we continued with the bench session at her pace.

Says the pain manifests whenever she lies supine. Says she's had this pain for 41 years, ever since her pregnancy with her first and best son (hi mom!), and has just come to accept it as normal, and drive the hell on. Good for her! She's reported it to doctors through the years as she's gotten checkups, but none of them has worried much about it, perhaps because she's not overly worried about it.

The questions:

1) She benched just fine, in pain but tolerable pain, when I shimmed her feet up. Just keep doing that?

2) Any of the smart guys in the room heard of this before and know a fix for it?

Thanks;

Geoff

[Mark Rippetoe]

No telling what it is. Just block her feet up about an inch higher than where the pain stops, so she has a little room for comfort.

[Andy Baker (KSC)]

Very common with older folks. Shim the feet. Help them off the bench. Usually goes away with time. In severe cases where it won't go away with shimming, switch to Incline Bench pressing. That position is usually more comfortable.

[Jeff Leonard]

I had a similar situation when I benched. Turns out I have a bit of arthritis in my left hip, it flared up pretty bad once last year is how I figured it out. I always felt a pain/ache in the hip that I just thought was some sort of cramp issue. I built small 3" tall blocks to put my feet on and no pain.

[JFord]

Very common with older folks. Shim the feet. Help them off the bench. Usually goes away with time. In severe cases where it won't go away with shimming, switch to Incline Bench pressing. That position is usually more comfortable.

Andy, could this be ischial tuberosity bursitis or piriformis syndrome? The former would be treated with heat, massage, capsaicin and the latter with piriformis stretches. Either way, I agree that training through with the most comfortable position consistent with safe and effective technique is indicated.

[porcopedico]

Often it is just a tight rectus femoris or psoas that arches your pelvis and therefore your lower spine when you lie flat. If pain subsides whem you put your feet on something its highly propable... just do regular stretches

[Mark Rippetoe]

Absurd. The rectus and/or the psoas is stronger than the lumbar erectors? Evidence?

[porcopedico]

Not absurd. Lumbar erectors erect the spine, thats why they called erectors spinae. But this erection translates to lumbar hyperlordosis.
Rectus and psoas flex the hip anteriorly. This also translates to lumbar hyperlordosis.
So both muscles work on different joints. But in this case have a synergistic effect.

Therefore it is irrelevant whether the detector spinae or the rectus/iliacus are stronger because none can antagonize the other.

[Mark Rippetoe]

Thanks for clearing this up. Your position. But you are incorrect. The fact that the psoas and the r. femoris cross the hip joint is irrelevant to the lumbar erectors' ability to maintain isometric control over the lumbar lordotic curve, and the contribution of the anterior abdominal musculature must be considered wrt their function in controlling spinal extension/flexion. The classic PT nonsense about a "shortened" psoas and r. femoris awaits your evidence. Specifically, by what mechanism do these muscles get "tighter"?

[porcopedico]

It is too easy calling for evidence and providing none. My theory is supported by medical textbooks. The Thomas test assesses exactly this problem. Hip flexor get shorted with sedentary lifestyle. And abdominal muscle do not contribute to spinal stability but during voluntary contraction