Just to make it clear: I’m not a Physician. At least not in a Western sense. But this week something was going wrong in my own body. Laying in bed overnight on Monday I could feel some sciatic pain in my right leg and the sacroiliac joint on that side was a little tender. I changed my yoga practice on Tuesday morning to include ‘pigeon pose’ in the hope of stretching the occasionally troublesome piriformis muscle.
That helped a little and I gave a massage on Tuesday morning without any problems. I noticed the soreness overnight again. By the end of Wednesday morning’s yoga practice my lower back was complaining at each movement. Thursday morning yoga was out of the question. Although it was more mobile by the evening I reluctantly decided not to go to the class. My body was trying to tell me something and I had not been listening.
Finally I decided to try to do something about it. Physician heal thyself and all that! Anything that caused movement around the SI joints hurt, and finally my abdominals were starting to ache where they attach to the pubic bone, I think from the stress of trying to stabilise the area. I tried some seated forward folds but everything was just too tight and sore. I wanted to try and mobilise the sacrum as we’d been shown on the recent Thai massage for lower back pain course – but of course I couldn’t use those techniques on myself. Instead I lay on the floor with a tennis ball under my sacrum and then used my own bodyweight to press down on the ball and move it around.
Once I was fairly sure that it was moving (the movement is probably less than a millimetre) I rolled the tennis ball off to the right onto the piriformis muscle. WOW! I hadn’t felt any pain or tightness from that muscle until I did that – but the moment I was on it I felt it all right. Not only in the muscle, but shooting down the leg too. Resting as much of my weight on the ball as I could stand I gritted my teeth until the little bugger finally started to relax. I worked the ball all round the area finding tender spots and working out the tension. Then I slid the ball out and lay on my back letting everything settle.
Talk about magic! I sat up and did a forward fold over my legs – my chest met my knees without a single murmur from my back. I experimented with a few other moves. Back bends, forward bends, twists, all easy.
So what was up? Of course I can’t be sure but here’s what I think happened. The superior part of the right SI joint can get slightly misplaced. This causes a little soreness and tension in the mass of ligaments which keep it in place. The body detects this instability and attempts to stabilise the area. Its tool of choice in this area often appears to be the piriformis muscle, which starts on the sacrum and passes through the pelvis and onto the top of the leg near the hip joint. The nerves which control the muscle leave the spine under the L5 vertebra, between it and the sacrum, and some others exit the sacrum near the top. Right by the joint that is already inflamed. What’s more, parts of those nerves, along with others coming from higher in the spine, combine to form the sciatic nerve. This passes right behind or in some people through the piriformis muscle. No wonder that both sensory and motor functions of these nerves can get messed up when something goes wrong in this area. The ‘pigeon pose’ from yoga can stretch the muscle, but if the muscle is in spasm and you can’t feel it then it might just pull even more on the sacrum. It is also quite easy to do this pose without actually targeting the piriformis if the thigh is insufficiently externally rotated.
What was quite remarkable was the way that everything calmed down in that area once the problem was resolved. The joint was able to go back to its natural position, other muscles let go their tension and freedom of movement was restored within minutes. Yet I’ve noticed that even in that short period I had learned to move with care. Today I keep getting up and expecting a twinge which doesn’t come. This behaviour will take a little time to un-learn.
“Sobo 1909 295” by Dr. Johannes Sobotta – Sobotta’s Atlas and Text-book of Human Anatomy 1909. Licensed under Public domain via Wikimedia Commons