Feeling tightness that stretching just won't fix?
If you're a runner in Washington DC or Georgetown dealing with nagging leg, buttock, or back issues, it could be more than a muscle problem.
Many runners experience calf, hamstring, or lower back tightness and assume they simply need to stretch or foam roll more. But what if the real problem isn't the muscle — it's the nerve?
Conditions like sciatica, where the sciatic nerve becomes irritated, can cause pain, tightness, weakness, or tingling. These symptoms often mimic muscular problems like piriformis/buttocks pain or calf tightness but can usually be sorted out during a clinic exam by looking at where you feel the pain, what it feels like, and with simple tests like a straight leg raise.
When it comes to figuring out what’s really going on, a good conversation and a few physical tests often tell us more than fancy imaging. Signs of a nerve issue include one-sided leg pain that’s worse than back pain, pain that travels down to the foot, numbness, and certain movements that make the pain worse. Scans like MRIs usually aren’t needed unless something more serious is suspected (like an infection or tumor) or if surgery might be considered after trying other treatments for 6–8 weeks. (Koes et al)
Common Misconceptions About Sciatica-Like Pain
Sciatica refers to irritation of the sciatic nerve, which runs from the lower back through the hips and down each leg.
In runners, most overuse injuries (like tendinopathy, bone stress injuries, or IT band syndrome) happen not because of one big trauma, but because of small, repeated stresses that the tissue can no longer adapt to properly.
The same thing can happen to nerves.
Nerves, like tendons or bones, are supposed to tolerate and adapt to normal mechanical stresses (stretching, moving, compression). (Shacklock Neurodynamics)
But if the loading becomes abnormal or excessive — because of poor movement, training plan progression- the nerve can become sensitive over time.
Many people assume that if they feel tightness, foam rolling or stretching the area will solve the problem. However, healthy nerves are designed to stretch, glide, and move without causing symptoms. When their mobility is restricted, the tissues around them are inflamed, or sensitivity is heightened, stretching and foam rolling the area alone won’t address the root cause.
Why Traditional Treatments Aren't Always Enough
Traditional physical therapy often focuses on stretching, manual therapy and basic strengthening. These tools are helpful — but when it comes to nerve issues, they don't always dig deep enough.
That's why at Norton Physical Therapy in Washington DC, we take a different approach. Medications, injections, or surgery can be helpful for some people, but they aren't always necessary to relieve nerve symptoms.
How We Treat Sciatica-Like Nerve Sensitivity
Our approach follows three key steps:
1. Mobilizing the joints and muscles along the nerve pathway.
We start at the spine and work all the way down to the foot, ensuring the nerve has freedom to move. This reduces muscle guarding and joint sensitivity.
2. Restoring nerve mobility.
Nerves, like muscles, need to move to stay healthy. We use gentle, progressive techniques to restore nerve motion and reduce sensitivity. (Shacklock, 1995)
3. Building resilient, real-world strength.
Weak links in your movement patterns can allow nerve symptoms to linger or return. We identify and strengthen these gaps so you move better — not just feel better.
A Real Example: Jake's Story
Jake, a marathon runner training in Washington DC, came to us with persistent calf tightness.
By treating Jake's back, hip, and calf to free up his nerve mobility and calm surrounding tissues, we cleared the pain that had been holding him back and set the stage for to make him a stronger more resilient runner.
At first glance, he looked strong on traditional tests like bridges, sidelying hip lifts, and manual muscle strength tests.
But at Norton PT, we go further. By challenging Jake with real-world tests like a 10-rep max single-leg deadlift and Bulgarian split squat, we uncovered a hidden 20–30% strength deficit from side to side — something traditional physical therapy testing would have missed.
Jake's personalized strength program didn’t just keep him pain free — it made him a better, faster runner.
Key Takeaways for Runners in Washington DC and Georgetown
If stretching and foam rolling aren't fixing your tightness, it could be nerve-related.
Proper evaluation and progressive treatment can often resolve nerve symptoms without medications, injections, or surgery.
Addressing both nerve health and functional strength is critical to long-term recovery and peak performance.
You are not broken or fragile. With the right plan, you can return to running stronger, healthier, and more confident than ever.
If you're dealing with nagging tightness, back pain, or sciatica-like symptoms and you're in Washington DC or Georgetown, we’re here to help.
References:
Koes (2019). Sciatica: Symptoms, Diagnosis, and Treatments. BMJ Clinical Evidence.
Vroomen, P.C., de Krom, M.C., & Wilmink, J.T. (2000). Diagnostic Value of History and Physical Examination in Patients Suspected of Lumbosacral Nerve Root Compression. J Neurol Neurosurg Psychiatry.
Shacklock, M. (1995). Neurodynamics. Physiotherapy.
Dunaway, J. February 2025. Persistent Pain Management. Institute of Clinical Excellence