L5-S1 issues from paddling

Chee-to

Michael Peterson status
Jan 11, 2002
1,823
11
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squidley said:
Ch-ch-ch-cheeeeeto said:
Haven't surfed in a month plus, crippling pain still coming and going. Just about any exercise seems to set it off. Had a lumbar/coccyx x-ray today and I start PT in the next couple weeks.
Did you try tennis ball massage? Try it or stop hounding. It costs $1.50.

Another possibility is, stop sleeping on your stomach with your legs splayed. Sleep on your side with your knees together. This one takes a week.
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Yes, I've tried tennis ball massage, lacrosse ball massage, foam rollers, and the tightly-rolled up T-shirt. They mildly help until any exercise flares it again. I've been sleeping on my back with a pillow under the knees, might try the side.
 

Mike_Jones

Miki Dora status
Mar 5, 2009
5,631
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Ch-ch-ch-cheeeeeto said:
squidley said:
Ch-ch-ch-cheeeeeto said:
Haven't surfed in a month plus, crippling pain still coming and going. Just about any exercise seems to set it off. Had a lumbar/coccyx x-ray today and I start PT in the next couple weeks.
Did you try tennis ball massage? Try it or stop hounding. It costs $1.50.

Another possibility is, stop sleeping on your stomach with your legs splayed. Sleep on your side with your knees together. This one takes a week.
.
Yes, I've tried tennis ball massage, lacrosse ball massage, foam rollers, and the tightly-rolled up T-shirt. They mildly help until any exercise flares it again. I've been sleeping on my back with a pillow under the knees, might try the side.
Tennis ball massage takes two weeks, three times a day. Exercising while the piriformis is still inflamed is counter productive. It causes more inflammation.

Explanation: The piriformis, with the sciatic nerve, goes through a hole in the pelvis called the sciatic foramen.. Collagen wraps around the piriformis/nerve complex. The collagen gets broken and inflamed. It causes the complex to swell. The swelling traps the sciatic nerve against the pelvic hole preventing movement.

If you move it anyway then you cause more damage. Massage breaks up the spent collagen, and shrinks the piriformis. The sciatic nerve gets room to move without rubbing on the sciatic foramen. Then you can exercise.

This is all a vestige of the fact that humans evolved an upright gait while living in cool water. The sciatic foramen did not need to be large because the piriformis never inflamed. On land it's a different story.
.
 

hammies

Michael Peterson status
Apr 8, 2006
3,450
85
48
Autoprax said:
try massaging your psoas.
My chiropractor showed me how to stretch my psoas. I do it regularly and haven't seen him in a couple of years now.
 

Chee-to

Michael Peterson status
Jan 11, 2002
1,823
11
38
squidley said:
Ch-ch-ch-cheeeeeto said:
squidley said:
Ch-ch-ch-cheeeeeto said:
Haven't surfed in a month plus, crippling pain still coming and going. Just about any exercise seems to set it off. Had a lumbar/coccyx x-ray today and I start PT in the next couple weeks.
Did you try tennis ball massage? Try it or stop hounding. It costs $1.50.

Another possibility is, stop sleeping on your stomach with your legs splayed. Sleep on your side with your knees together. This one takes a week.
.
Yes, I've tried tennis ball massage, lacrosse ball massage, foam rollers, and the tightly-rolled up T-shirt. They mildly help until any exercise flares it again. I've been sleeping on my back with a pillow under the knees, might try the side.
Tennis ball massage takes two weeks, three times a day. Exercising while the piriformis is still inflamed is counter productive. It causes more inflammation.

Explanation: The piriformis, with the sciatic nerve, goes through a hole in the pelvis called the sciatic foramen.. Collagen wraps around the piriformis/nerve complex. The collagen gets broken and inflamed. It causes the complex to swell. The swelling traps the sciatic nerve against the pelvic hole preventing movement.

If you move it anyway then you cause more damage. Massage breaks up the spent collagen, and shrinks the piriformis. The sciatic nerve gets room to move without rubbing on the sciatic foramen. Then you can exercise.

This is all a vestige of the fact that humans evolved an upright gait while living in cool water. The sciatic foramen did not need to be large because the piriformis never inflamed. On land it's a different story.
.
That makes sense, but how do I tell when the piriformis is no longer inflamed? It's obviously not as simple as "pain gone, feel normal again" because the pain can go away for weeks and then come back immediately after moderate exercise.
 

Mike_Jones

Miki Dora status
Mar 5, 2009
5,631
55
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Ch-ch-ch-cheeeeeto said:
squidley said:
Ch-ch-ch-cheeeeeto said:
squidley said:
Ch-ch-ch-cheeeeeto said:
Haven't surfed in a month plus, crippling pain still coming and going. Just about any exercise seems to set it off. Had a lumbar/coccyx x-ray today and I start PT in the next couple weeks.
Did you try tennis ball massage? Try it or stop hounding. It costs $1.50.

Another possibility is, stop sleeping on your stomach with your legs splayed. Sleep on your side with your knees together. This one takes a week.
.
Yes, I've tried tennis ball massage, lacrosse ball massage, foam rollers, and the tightly-rolled up T-shirt. They mildly help until any exercise flares it again. I've been sleeping on my back with a pillow under the knees, might try the side.
Tennis ball massage takes two weeks, three times a day. Exercising while the piriformis is still inflamed is counter productive. It causes more inflammation.

Explanation: The piriformis, with the sciatic nerve, goes through a hole in the pelvis called the sciatic foramen.. Collagen wraps around the piriformis/nerve complex. The collagen gets broken and inflamed. It causes the complex to swell. The swelling traps the sciatic nerve against the pelvic hole preventing movement.

If you move it anyway then you cause more damage. Massage breaks up the spent collagen, and shrinks the piriformis. The sciatic nerve gets room to move without rubbing on the sciatic foramen. Then you can exercise.

This is all a vestige of the fact that humans evolved an upright gait while living in cool water. The sciatic foramen did not need to be large because the piriformis never inflamed. On land it's a different story.
.
That makes sense, but how do I tell when the piriformis is no longer inflamed? It's obviously not as simple as "pain gone, feel normal again" because the pain can go away for weeks and then come back immediately after moderate exercise.
Good question. There are no guarantees. Some people have more piriformis trouble than others. This isn't a permanent cure. If this is piriformis syndrome then you have to knock it back every time it crops up.

GP's employ some of the same strategies regularly. Diagnose the condition according to a familiar model. Apply a treatment designed to improve the malady as it confirms the diagnosis. In the vast majority of cases the malady improves. You save money, and your condition gets better fast. In the 1% of cases when the malady doesn't improve at least the process narrows the diagnosis.

Good luck.
.
 

Mike_Jones

Miki Dora status
Mar 5, 2009
5,631
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.
One of the biggest problems in the U.S. is the number of doctors eager to diagnose these cases with back surgery. Yes, tugging on a frozen piriformis can jack the sciatic nerves out of the L 4/5 disk, and deform it. Often the disk adequately recovers if you can get the piriformis diagnosis, and start massage.

Also there is a large contingent of patients who won't listen to a doc who tells them they have to do any work to treat themselves. They won't admit it, but they are demanding surgery. I would rather do the work.
.
 

feralseppo

Nep status
Feb 28, 2006
763
9
18
Tennis balls won't do shat if its a disc issue, which you probably can't figure out without an MRI. I have 4 discs in my lumbar with significant bulges. I have permanent numbness on the inside of one of my calves and other issues associated with it. I had pain so bad that I couldn't walk for almost a month about 2 years ago.

I use stretches from a book called The Permanent Pain Cure by Ming Chew. You can get it off Amazon for about $10. The guy is a PT who has worked on pro athletes. A friend of mine went to see him in New York and he was able to avoid shoulder surgery and fixed his back up as well.

I wake up with a stiff back most every morning and the stretches get rid of the pain. The book has a series of stretches for the back along with specific stretch routines for things such as sciatica. I've turned other people on to the book who have said it changed their life. It takes a while to learn the stretches properly. He also has a section on food and supplements aimed at reducing inflammation and getting rid of scar tissue caused by injuries.

One of the things that helped me when I was in agonizing pain is I hydrated myself, which is what the book recommends before starting the stretches. I started drinking about a gallon of water a day instead of dehydrating with wine and coffee. Lots of disc issues can be caused by dehydration. The disc shrinks and then slips out.

That's my 2 cents. Otherwise, there is always dead lifts, cutting gluten and going no carb.
Hot yoga about 5x a week has kept everything in check for me ever since.
 

dk1973

Grom
Jun 11, 2011
145
0
16
I had the same issues thought it was the L5 -s1 however turns out it was the nerves in the lumbar facet joints the was causing the stiffness and nerve pain in my left leg. Go to a good orthopedic and have him look at your MRI and check your l5 and l4 facet joints.
 

Autoprax

Duke status
Jan 24, 2011
32,429
417
83
Vagina Point
My sister took my dad for an injection, since my mom had just died, and he killed himself a few days later.

My sister was like WTF?

Couldn't he have killed himself first?
 

Chee-to

Michael Peterson status
Jan 11, 2002
1,823
11
38
First couple PT sessions under my belt. Literally. After an x-ray and some diagnostic tests they're treating it as as a pelvic floor issue and not a back issue, which matches my original thought when it popped up last year: https://forum.surfer.com/forum/ubbthreads.php?ubb=showflat&Number=2860353

Autoprax, if you're looking for a PT that will finger your starfish to hit the trigger points, I can recommend that you (a) go to mine and (b) avoid the procedure altogether if anything else brings you relief. It sucks.
 

Chee-to

Michael Peterson status
Jan 11, 2002
1,823
11
38
Yeah, I think so. I surfed yesterday for the first time since early June without much pain. We'll see how today feels.
 

VonMeister

Tom Curren status
Apr 26, 2013
10,629
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THE TERRORIST OF TERRAMAR
Pain is an experience that reflects the perception of threat.

Pain is one of our many survival mechanisms, but it does not reliably reflect the status of our tissues. As with so many things, context is important. Stimuli that may not be painful in some contexts might be quite unpleasant in other situations where we feel threatened. For example, a friend punching you in the arm while you are joking around is not nearly as painful as that same punch from someone who is angry or being aggressive towards you. The same physical insult results in a different experience based on many biological, psychological, and social contextual factors.

Our thoughts and expectations are important in managing pain and injury. The more threatened we feel and the more convinced we are that something is “wrong” that needs to be “fixed” the more debilitating painful experiences can be. While there are many variables we cannot control, our learned responses to pain and injury are things we can alter. Reminding ourselves that most tissue injuries heal within days to weeks and doing things to facilitate that process can be helpful. Catastrophizing—amplifying the negative aspects of our experiences and engaging in worst-case thinking—can exacerbate painful experiences. Pain is not just in your head. Nor is it just in your tissues. The interactions that result in the emergence of pain are enormously complex. Working to approach our pain with positivity and a confidence that the situation can improve is important. We can experience substantial discomfort in the absence of tissue pathology, and this understanding can be useful as we adapt and self-manage our injuries.