Piriformis Syndrome and Sciatica

The sciatic nerve is the longest of the whole body. The piriformis muscle is one of only two muscles that connect the legs to the spine. helps with externally rotating your leg, pulling it out to the side and extending it backward. It also helps to stabilize the hip joint. These two innocent functionaries of the body can get together to create two of our most common and miserable ailments: Piriformis syndrome and sciatica.

The piriformis is a short muscle that attaches on the upper portion of the greater trochanter, a knob of bone at the top of the outer thigh. It comes across the back of the pelvis to attach on the front or inside portion of the sacrum. The sciatic nerve is formed by five nerve roots from the lower spine and enters the leg by exiting the pelvis through a space called the greater sciatic foramen. It descends along the back of the thigh until it splits into the tibial and common peroneal nerve, which innervates the muscles of the lower leg. The tibial nerve goes on to innervate the muscles of the foot.

Sciatica is a condition where the sciatic nerve is compressed due to an issue of spinal alignment and integrity such as herniated discs spinal stenosis

Piriformis syndrome occurs when the piriformis muscle goes into spasm and irritates or compresses the sciatic nerve, which passes directly behind it. In an unfortunate 10- 15% of the population the piriformis muscle is pierced directly by the sciatic nerve. This isn’t a problem in and of itself; problems will only arise if the muscle becomes injured or goes into spasm.

Pain, weakness, numbness, and other discomfort along the path of the sciatic nerve -- often accompanied by low back pain as well as a shooting pain down the outside and back of the leg are the usual symptoms of either sciatica or piriformis syndrome. In severe cases the pain can radiate down into the heel, which is the ultimate destination of the sciatic nerve after it divides.

The head is like a bowling ball on top of the spine.

The head is like a bowling ball on top of the spine. Your average head weighs 8-12 pounds. If it is balanced directly on top of the spine and evenly over the shoulders its weight will put little torque on its muscles. Look around you at someone close by. Is their head on straight? Spend the rest of the day looking and if you find five people that have their head over their shoulders I’ll give you free classes to my yoga center.

The Psoas Major: Part 1

The psoas major, the body’s main engine of walking, is one of three muscles that make up the iliopsoas muscle group. The psoas major inserts on the back half of the inner thigh, comes forward to cross over the rim of the pelvis and moves backwards again to attach along the lumbar or lower spine. The iliacus muscle lines the inside wall of the pelvis and joins psoas major to form a common tendon inserting together on the back half of the inner thigh. Psoas minor is an interesting muscle that anatomy books will tell you it is present in only 50% of people and is slowly disappearing. Though this is technically true the body has many different connections, one of them being through fascia, a connective tissue that we will go into in future articles. So even if you don’t have this muscle it is likely to manifest energetically through the fascial lines of the body. Bodyworkers often refer to feeling this muscle whether it is there or not.

Psoas major attaches at six points, the back of the inner thigh and then five different points along the spine. The first four vertebrae of the lumbar spine, which is the lower back, and the bottom vertebrae of the thoracic spine; which is anything that includes a rib. (T12). As a result the psoas spans and affects many joints as opposed to the iliacus, for example, which only crosses the one joint where the leg meets the pelvis.

The psoas is unique for many reasons and over the course of posting we will cover all of them.

Walking is a means to rebuild yourself.

Walking is a means to rebuild yourself. Our posture reflects so much of our journey through life-- from imitating those who you bonded with as a child, to bearing the compensatory scars of accidents and injuries both large and small, and the primal, sometimes crippling effect that fear, our most primal emotion, has on our muscles and bones. It is an exploration that is both a physical and emotional as we confront the why of our movement pattern and physical traits. But there is danger on this path. To quote the German writer Geothe “Know myself? If I knew myself I’d run and hide.”

Get to Know Yourself

Perhaps more than anything else, the main goal of the FitzGordon Method is to help you get to know yourself. Let’s start with a simple question: do you know how you walk? Do you understand the way you move? Is your gait fast or slow? Is it easy or aggressive? Not until you can identify these traits can you try and understand why it is you have them in the first place. The program is about unlocking your patterns by first identifying them and then making an effort to change them, to take on new patterns by choice.

The first order of business in the FitzGordon Method is to acknowledge that you have a walk all your own. Once you’ve accepted that fact, you can begin to get to know it. Observe the way you walk. One way to do that is by looking at the way others walk, examining the myriad differences in step and gait and posture. This will help you gain a clearer picture of your own movement patterns. I believe that gaining an appreciation for the hows and whys of the way we move can be an experience that is both fun and enlightening.

Moving Should be Relaxing

Every step of a healthy walking pattern involves a moment of engagement and a moment of relaxation. Ideal skeletal alignment should take a great deal of work off of the muscles. There is an opportunity with each step to align through your bones so that half of the body can release and relax while the other half engages to pull you forward.

Let’s look at the action of walking. In an ideal world standing up doesn’t take a lot of effort. It is a place where the bones should be able to take most of the load. In movement the muscle action begins. But try to imagine that in every step there is a moment where movement ceases and the bones are stacked directly on top of one another. This might not be so easy to imagine as so few of us live in this ideal world.