by Shanna Small
Lets get this straight right now. I am not a doctor. This is my own chilling tale of dealing with the demon in my right leg. Use these words at your own risk.
I think I have piriformis syndrome or maybe a demon in my right leg. When I looked up “demon in the right leg” on WebMD, I didn’t get what I was looking for but this is what it said about piriformis syndrome:
Piriformis Syndrome Signs and Symptoms
Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time. Most cases of sciatica, however, are not due to piriformis syndrome.
I used to have these symptoms on most days but I have learned how to manage it and almost get rid of it. Again, I am no doctor. Maybe I just have an angry right leg but I hope that something in this article can be of assistance to you and your injury.
As a yoga teacher, I am surrounded by people who have great knowledge of the body. I have had great discussions with anatomy experts, senior yoga teachers, doctors, physical therapists, chiropractors and massage therapists. Some of the advice worked and some didn’t.
What Did Not Work For Me
Bending My Knees-this eventually led to death and destruction and is the opposite of some of the best advice I was given which I will share with you later. Bending my knees made the muscles vulnerable. I am not a doctor but I believe that it relaxed the muscles and allowed whatever movement I did to go directly to the injury. Kind of like a lax rope, there was no strength. When force was applied, it went right to the weak spot. My injury got progressively worse until I had to take almost two weeks off because the pain just would not subside. If you have a theory on why this did not work. Comment below.
Excessive Amounts of Hip Stretches-This led to the biggest set back I ever had. It was as if my hips and back seized up and I could barely move. The muscles got super inflamed. What is excessive? I used to do my yoga practice during the day and stretch at night. I had to cut the night time stretches out altogether. I used to do Yin Yoga and Deep stretch, which are stretch classes where you hold poses from 2-5 minutes. I no longer do those. Excessive movement aggravates the muscle and leads to inflammation and pain.
I still do plenty of hip work. As a first and second series Ashtanga practitioner, I still do all the leg behind the head and lotus variations that are needed to complete my practice but I don’t dilly dally in those poses. Five breaths and I am out of there.
Ignoring Pain-Lets see if I can describe this in a way that makes sense. I do feel the injury. It is there as a mild kind of pulling situation in certain poses. Until it goes away completely, this sensation will be present but I don’t push past that feeling.
Excessive Amounts of Pressure and Direct Manipulation of the Injury Site-I used to ball and foam role but I stopped because I noticed inflammation a few days later. When lounging at home or sleeping, I avoid my right leg like the plague. Even as I type this, I detect a subtle lean of my body to the left. Direct pressure makes me inflamed.
Beware of Assists on That Leg-Unless you know that the teacher is a master who knows how to work with this type of thing. If you have any doubt, don’t let them do it.
Heat is a friend and a foe-Heat is great for opening muscles but is highly deceptive. When I practice hot yoga and I get super heated, I pretty much don’t feel my injury. On days when I am feeling particularly stupid, I will ignore all the stuff listed below that I know I am supposed to do and give into the insane feeling that hot room is giving me that my injury is actually gone. In about 24-48 hours, the pain comes back times 2 and I usually experience a massive set back. If you are like me and you love practicing in heated rooms, you should be even more vigilant about doing all the stuff mentioned below. As long as you do, the heat will actually help with the healing.
What Worked For Me: Stabilization & Inflammation Management
Contracting The Thighs For Dear Life-seriously you may look like the tin man or slightly constipated as you practice but this is what took me from invalid status to about 90% healed. Why does this work? Here is my theory. When you do as Baptiste teachers often say which is “hug the muscle to the bone”, it creates a muscular tourniquet if you will. As you move, the muscles are not just “flapping in the wind” the way they do when your knees are bent or there is no tension. The tension is evenly distributed across the whole leg and it is not going directly to the weak spot. It helps to immobilize the injury and stabilize it. If you have another theory on why this works, I would love to hear it in the comment section below.
Bandhas-this is not the first thing I will share from Kino Macgregor. I think she is psychic. The big king daddy injury that started this madness happened shortly before she came to town. By the time she did her workshop, I had made it through my acute phase into the slightly annoying phase. Kino is an amazing story teller. So at some random moment, amoungst her many stories, she started to talk about bandhas and the piriformis. She said that when you practice with bandhas, the injury will go away. She was absolutely right. I recommitted to my bandhas and it went away. Why is it back? I lost my commitment to it and went back to doing the same crap that got me there in the first place but that is another story.
Bandhas bring about stabilization because they force you to contract your muscles. You cannot do Uddiyana Bandha and Mula Bandha and not contract something.
Pushing the Backs of the Legs Into the Floor-below are some great videos by Kino Macgregor and David Garrigues that describe this. I do this for all seated forward folds. Again, stabilization.
Moving Slow-In order to focus on engagement and stability, you have to move slow. If you continue to speed through your practice, I guarantee you that your injury will not go away. Do not move fully into any pose until you have down the stability practices I have mentioned. If you do even one pose without using these techniques, you will have a setback.
Ice- I love these ice packs by Mueller. They stay cold for a long time, don’t leak and don’t have condensation. Cold gets rid of inflammation. However, make sure to lightly sit on the bag and to not do it for more then 10 or 15 minutes at a time or you may put to much direct pressure to the site.
A yoga teacher who knows how to give stabilizing assists-with the right stabilizing assist, it is possible to ground the leg so much that the pose bypasses the injury. This is a skill that most yoga teachers have no clue about. Also, if you do a lot of guided classes, you are less likely to get this type of assist because it requires more time. There are two ways, that I know of, to do stabilizing assists. One requires the teacher to engage the leg into the hip joint by applying force in the direction of the pelvis that allows them to then move the leg into position. Another one, requires the student to commonly push into the teacher’s hand, chest or thigh which again stabilizes by providing tension and it allows the teacher to take the student deeper into the pose. You can also combine these techniques as well. This link to a David Keil video is an example.
The most amazing version of this assist I get is in Krounchasana pictured below. Without an assist I cannot even straighten my leg even much pull it to my head. When my teacher gives me a grounding assist, my back straightens, it goes straight and to my head and it feels amazing. A good teacher can provide assist that can help heal the injury. If you are unsure of the teachers ability, then don’ t let them assist you on this leg.
Good Food and Clean Living-There are many articles on line about anti inflammatory diets. I won’t go into detail here but I will say they all include eradicating sugars, refined carbs and processed foods and advocate a plant based diet.
Heat But Not To Much-Heat allows the muscles to open up which makes them more malleable. I talked about the dangers of heat above so be safe with it. Don’t practice when the room is cold or the muscles are cold. I sometimes even do more sun salutes and hold the poses during the warm up longer then what is required to make sure I am nicely heated. Traditional Ashtanga classes are usually not heated any higher then 80-85 degrees which is fine but honestly, I won’t go any lower then that for any type of yoga. Hot Vinyasa, which I also practice, is between 90-105 degrees, which I am fine with but I would never do my Ashtanga practice in a room that hot because the Vinyasa Krama of Ashtanga would cause me to overheat.
Sports Medicine Dudes, Chiropractors & Other Therapists-In Charlotte, we are super lucky to have some amazing doctors, physical therapists and massage therapists who deal with athletes and yogis and actually help them to get back to the circus freak practices they enjoy. Many doctors do not understand yoga or extreme athletes and give advice that is not suited for us. It is important to find someone who understands what it is that you are trying to do. Look for people who work with yogis and professional athletes because they know that their job is to get you back into playing condition. Also, doctors who are also athletes themselves are more likely to understand your obsession with using your body to do amazing things. I have had great success with electric pulse therapy(I don’t know the technical name for this), dry needling and the Graston method. Do a search on the internet in your area, call the doctor and ask questions. When my bank account has a few more zeros and recovers from the holidays, I will definitely go back to my sports medicine dude. If you live in Charlotte, try these dudes.
Please note that this is direct pressure, so if you go to the doctor or therapists to much, it can also lead to inflammation. Even though he would have made much more money if I came all the time, my therapist dude cautioned me against this.
NSAIDS –These should never, never, ever, ever be used on a regular basis. They are bad on your liver and, just like the highly deceptive heated yoga class, they give you a false sense of well being. I only use them for cases of extreme inflammation where my normal day to day tasks are being hampered. If you have to use them everyday, you are not managing your healing or your yoga practice in a healthy way. Excessive inflammation can usually be curtailed by diet and practicing in an intelligent way. The few times my inflammation got way out of hand, I took time off from my practice, let it diminish and then started back in an intelligent way. If you are eating well, drinking enough water and getting enough sleep, this shouldn’t take more then 2 or 3 days.
Anybody else with an angry hamstring? Share your experiences or ask your questions in the comments
Shanna Small has been practicing Ashtanga Yoga and studying the Yoga Sutras since 2001. She has studied in Mysore with Sharath Jois and is the Director of AYS Charlotte, a school for traditional Ashtanga in Charlotte NC. She has written for Yoga International and the Ashtanga Dispatch. Go here for more information on AYS Charlotte. For information on workshops, please e-mail email@example.com.