Wednesday, April 6, 2011

Understanding the Piriformis

It's a wise man who knows his own muscles, especially those so crucial to full motion, by walking, running, or dancing; and full rest, by sitting.
Unfortunately, it's taken me a very long time to come anywhere near a full knowledge of the muscles and nerves that govern those uses of my anatomy, especially when it comes to stretching, as essential as that should be from the beginnings of physical education, and it's downright humiliating to realize that the errors are so simply overcome, that the secrets are so natural and easily teachable. And it's all but infuriating to realize that this most fundamental piece of physiological wisdom has need neither of a sophisticated gym or fitness centre nor a yoga studio, especially when it comes to the piriformis and the three gluteals,  all of which, although they are a full leg's length away from the feet, nonetheless seem to affect their efficiency. The body, as divisible as it may be to a surgeon, insists on functioning as a single unit.
All you really need for this overhaul is a good armchair - or couch-potato's sofa - and a good book or DVD. Or even a CD and a glass of beer!
Long before I was old enough to drink beer, I had both the chair and the book, and the sweetest little perfectly elastic LEFT piriformis in the Western Hemisphere. I almost never had to spend any time sitting at table or desk, hunched over my homework sitting in a straight-backed chair with my feet flat on the floor and getting hardly any stretch anywhere. After a late afternoon full of exercise of one form or another, with perhaps a bit of after-supper cavorting thrown in, I invariably read for an hour or so, sitting in the family living room, with my left leg crossed over my right. Thus, lots of stretch for the left piriformis, the left glutes, even the left quads and hamstrings.  God and Nature's gift to the juvenile bookworm and future philosopher. Absolutely lovely, as far as it went.
But of course it went only half-way, and not the more stressed half at that. My right leg was forever busy blasting away at a soccer ball, a football, pushing off the bases, propelling my side of the scrum, and was probably the principal power leg on my bike, or chopping wood, or propelling pucks or tennis balls.
There was of course no yoga in the schools in those days, or even on the racks with the other sports magazines, nor in school or public libraries, at least in the youth sections. So I grew up with a very tight right knee, and all sorts of annoyances in my right hip and right lower back. There was indeed a medical problem in my lower vertebrae, as I have mentioned, but it was not the whole story, as learning of the pelvic tilt has demonstrated.
And when I did start to take up a little yoga, forty years ago, I gathered no clues as to how to deal with my personal ignorance, nor, I am quite sure, would I have come upon yoga teachers sensible enough to show me the solution I have now. The East, like the West, has so many ways of being unable to penetrate to the real epicentre of the problem. One of the largest studios I know of locally simply refuses to use any props, for example, and probably would not allow an easy chair to even be classified as a prop. I asked once about props, got a rather closed look and verbal response, so I did not go on to any questions about mattress yoga. And that is interesting, because I instinctively knew to do calf stretches in bed as soon as I started running, and for a couple of years or more Shawn has been instinctively employing the kind of hip stretches that work both the piriformis and the glutes while sits up in bed in the mornings reading her breviary. This is by no means the first time my wife had made me feel like an idiot.
I also have always crossed my legs at the ankles when lying in bed, or sitting up to read, and I realized this morning that as simple and comforting a posture as this - a little extra gentle stress when sitting up - registers precisely on the top of the femur, the greater trochanter, where the piriformis inserts. To make it really hum, I further discovered, just this morning to my shame, that if you cross the legs at the KNEES it works so beautifully it just about makes you cry. The more you work at physical conditioning, the more you realize that the fast food approach is only damaging, and the real genius is in any strategy that can extend stress time gently.
All this sudden clarification has happened, as surprising discoveries so often do, from an accidental event. My skateboard shoes, my totally flat heel boarders, unbeknown to me as shoe style until my little grandson came to stay with us six years ago, had finally started to wear down around the heels. Shawn took them, along with a pair of her own shoes to our neighbour repairman, who to my surprise said he could do something. (I had assumed I'd simply have to buy a new pair.) While the boarders were in the shop, I took the life of my left ankle into the battle zone and set out for a long walk in my dear old brogues, which, in an act of faith in the future, had been recently re-heeled. Just in case, I put my dojo shoes in a small pack. It was only several months ago that even a short ramble in the oxfords had caused problems.
But, lo and behold, almost five miles later, the dojos were still in the pack, and my ankle was registering no appreciable discomfort, aside from the simple fact  of its being the more collapsed of the two, both in need of Birkenstock inserts. Miracle, plus a determined attempt at prognosis. What had I recently been doing right?
Two months of early morning dancing had probably helped. (Still Emmylou, then changed to the  Robert Plant and Allison Kraus Grammy winner we picked up last year. It'll probably be Doc Watson next.) This caper is the keeper for weight control, by the way, as far as I'm concerned. A minimum of impact on the joints, a maximum of inspiration to get you up and at it. The ever vigilant Divine Personal Trainer had been suddenly stingy about the rowing and running. Another source of input was better stretches for both dancing and my much reduced rowing schedule, principally the more regular use of the split child pose. (Only one leg folded, the other straight. This one is also good for reading, as long as you keep your back as low as possible.)
But I think the primary source of the new, improved, ankle came along about a month ago when MT and I fell into looking up the piriformis in the Trigger Point Therapy Workbook by Clair Davies. A great deal of new light broke through, thanks to the fullness and clarity of the discussion therein, and also as a result of my finally being able to unite negative experience with recovering techniques.
To be frank, I had not paid very much attention to the piriformis. I knew it was one of the six or seven interior, or deep, pelvic muscles concerned with hip rotation, but I had no sense whatsoever of it being something of a lone gun, operating because of its peculiar location, as an indicator as well as a governor of correct procedures. Or, incorrect, as in my case, because, literally for some years, I've had so much mildish irritation around my left trochanter that I quite regularly, and quite sadly, had to ponder the possibility of a plastic hip. After all, the right had been the irritating side, which I had been used to for decades, so what else could the left promise?
Yet when I actually spoke, quite recently, with someone who had undergone a hip replacement, and he described the very considerable pain that he'd had to live with previously, I was sure my problem was not the same. But what was I dealing with?
Ironically, thanks to my respect for hatha yoga, I was dealing with the simple fact that my attempts at across legged sitting, or the Tailor Position, while they had been good for some things, were not going to solve the problem, which in fact, on a fifty-percent basis, I had known the solution for, all my life.
In my grand success at solving to a considerable, although not yet complete, degree, the ancient and annoying tightness of the right side from my lower back to my knee, I had pretty much neglected the left, almost never falling back on the old youthful happiness of crossing my left leg over my right knee when I sat down for a nice, long, utterly therapeutic, session of reading, reflecting, watching a BBC detective series, or simply drinking a beer. But with the right side coming along nicely, and myself rigidly in favour of balance in all things, I had sensed a need to equalize the left.
And then my beloved boarders showed signs of needing some TLC, and the rest, as they say, is history.
Had I suffered from the inspiration to study more guitar smarts, I might have left myself in better shape in this regard, but the pressure to grasp the keyboard has been nothing if not rampant. It is not a little significant that with the keyboard pretty much in hand - has anyone out there solved the mantra riddle yet? - I have returned a little more determinedly to my first love, even thinking kindly of beginners' chords - and if the mood keeps up, the left piro and glutes will indeed acquire all the bounce of a lacrosse ball. (That was one sport I did not play, but I've always admired the remarkable bouncing ability of the ball the players pay so much attention to.)

1 comment:

Rebecca S. said...

Oh, I know that glute muscle well, and am very glad you are finding solutions for yours. Galen received the package in the mail yesterday and has lots of work on the piano to enjoy. I've been doing lots of different stretches for my hip/glutes and as always, must keep working on the one that doesn't complain - just to keep the balance.
We often use props in our yoga class - even chairs!