Charlie Clements Physiotherapist (FCP) ‘Athletic Sciatica: navigating your symptoms’

In episode 371 of the Physical Performance Show, Charlie Clements, a first contact physiotherapist and specialist in musculoskeletal care based in the UK shares his expertise on the topic of sciatica, particularly as it affects athletes, discussing the prevalence, causes, and different types of leg pain associated with the condition.

Charlie explains the role of disc injuries, inflammation, and nerve root irritation, and provides practical advice on when imaging and interventions like nerve root blocks may be appropriate. Charlie emphasises the importance of patience, staying active through alternative forms of exercise, and seeking qualified healthcare support when needed.

This episode also offers guidance for clinicians on managing sciatica and highlights the value of reassurance and a holistic approach to care. 

Listen in as we delve into the following

• Charlie’s background, clinical role, and interest in spine and leg pain
• Discussion of the prevalence and causes of back pain and sciatica in athletes and the general population
• Defining sciatica and differentiating types of leg pain
• Common causes of nerve root irritation, such as disc bulge, herniation, inflammation, and arthritis
• Explanation of somatic, radicular, and radiculopathy pain
• When to consider imaging for sciatica and related symptoms
• Nerve root blocks/injections: indications, process, and expectations
• Neurodynamics: what they are and their role in treatment
• Case study: managing a runner with sciatica and practical exercise advice
• Signs and symptoms of sinister pathology (e.g., cancer) and when to seek help

Quotes

“Give it time. So be patient. Don’t expect sort of really quick, fast responses, because often you might be left feeling a little bit disappointed.”
“Try to keep active and moving.”
“If in doubt and you are worried or concerned, that’s when to consult seeing somebody.”
“Treat the system rather than the symptoms. Kind of what I mean by that is prioritise your physical health, your mental wellbeing, your social relationships outside of other aspects of your life.”

To Follow Charlie Clements

LinkedIn: Charlie Clements
Instagram: @Thethreadphysio

Timeline

00:00 Introduction to the episode and guest (Charlie Clements, physiotherapist)
03:06 Charlie’s background, clinical role, and interest in spine and leg pain
06:27 Prevalence and causes of back pain and sciatica in athletes and the general population
09:21 Defining sciatica and differentiating types of leg pain
11:15 Common causes of nerve root irritation (disc bulge, herniation, inflammation, arthritis
16:28 Explanation of somatic, radicular, and radiculopathy pain
23:43 When to consider imaging for sciatica and related symptoms
27:50 Nerve root blocks/injections: indications, process, and expectations
34:10 Surgery for sciatica: when it’s needed.
38:14 Neurodynamics: what they are and their role in treatment
43:18 Case study: managing a runner with sciatica and practical exercise advice
48:00 Charlie’s top three tips for athletes with sciatica
49:49 Top three tips for clinicians managing sciatica
51:08 Charlie’s physical challenge for listeners
53:44 Signs and symptoms of sinister pathology (e.g., cancer) and when to seek help
59:23 Finish

People Mentioned

Tom Jesson – Researcher
Annina (Nina) Schmid – Researcher
Dr Neil Cochrane – Neurosurgeon & Spinal surgeon

For questions and comments about this Episode Send to the Show Host @Brad_Beer (Twitter) and Huw Darnell @huwdarnell(Instagram)