Iliopsoas and Piriformis Stretches

I promised once to write a post on how I take care of my lower back. This is it.

Note, I'm not selling anything in this post. I am going to recommend a book at the end, but the advice on taking care of your lower back will cost you nothing unless you don't own a tennis ball. In that case, I am going to suggest you buy one somewhere. If you have lower back pain or sciatica and have never tried the two stretches recommended here, there's a halfway decent chance you'll find significant relief today!

I've done a lot of research on this because both my parents had bad backs, and I've had problems since I was in my 20's. Worse, My wife had two years worth of sciatica. We tried everything. We bought back programs, and we saw two different chiropractors and two different muscle therapists. We paid for treatments from a really impressive machine that gave my wife the equivalent of traction.

Most of the things we tried helped some. The problem was that she had a ruptured disk that was directly on one of the nerves that becomes part of the sciatic nerve. She ended up needing surgery to remove the debris from the blown disk. (We were thrilled to get Dr. Kevin Foley and his "minimally invasive" surgery. It seemed miraculous.)

Despite the fact that she needed surgery, we learned a lot along the way. I also took up long distance running as a 40-year-old so that I had my own sciatica and knee issues. The stretches I'm recommending here have a long history of being effective not just on me but on friends.

The Iliopsoas Muscle and the Psoas Major

Almost unbelievably, we have a muscle that anchors on the bottom six vertebrae of our spine. Yeah, really! Here's a picture of it!

From Wikimedia Commons, public domain

That's the psoas major. It is one head of the iliopsoas muscle. The other head attaches to the inside of the pelvis, which isn't so bad.

The psoas major is the reason you've been told not to do situps with your legs straight. In fact, nowadays most trainers don't recommend situps at all, just crunches. When you do a crunch, you lift just your shoulders off the ground and tighten your ab muscles. As soon as you lift your lower back off the ground, you engage the psoas major and yank right on the bottom of your spinal column!

That's not too bad with your legs bent, as the angle is better. With your legs straight, however, you have terrible leverage and your psoas major is mostly just compressing your disks, not lifting.

The other problem with the psoas major affects office workers or those who drive a lot. You can probably tell from the picture that if you sit down you are going to greatly shorten the muscle. That's not a problem until you stand back up. If you sit most of the time, when you stand back up the psoas major is going to be tight and feel like it's being stretched. As a result, it will squeeze those six vertebrae together, compressing the disks between them. That can lead to both a sore lower back and to nerve pain.

So here's how you stretch the psoas major:

Piriformis

The piriformis muscle helps rotate your leg. It runs from your tailbone to your femur at the hip. It is buried under your gluteus maximus, so it is very difficult to "palpate" (i.e., touch). In other words, you can't massage it. You can't really massage the psoas major, mentioned above, either. That's part of the reason they give so many problems.

I am going to tell you how to get a little bit of massage on the piriformis below, though.

The problem with the piriformis is that it sits directly on the sciatic nerve. If it gets tight and sore, it can press on the nerve and give you sciatica, which is shooting pains down your leg and sometimes numbness. In some people the sciatic nerve even goes right through the piriformis. (And some people don't have one!!!)

The piriformis can get irritated in anyone. Runners typically have problems with it. I'd imagine bike riders do, too.

I'm going to show you how to stretch it, and then how to massage it.

First, the stretch:



The stretch is simple enough, but I had somewhat minor sciatic pain from my piriformis for years in my late 30's. When someone showed me this stretch it was such a relief I almost cried for joy.

You can also massage the piriformis by sitting on a tennis ball on the floor. Massage therapists say that the piriformis basically runs right where the middle of your back pocket would fall when you're wearing jeans (assuming you're not "sagging").

You don't need to move around a lot. Find the sore spots and just put as much pressure as you can COMFORTABLY stand. Don't make it horribly painful. It's amazing how such "acupressure" relaxes the muscle.

You may find there's a lot of sore spots around your bottom and hips that are helped by such pressure.

WARNING: Just be very careful to sit where muscle is on the ball, not bone. It's really just your tailbone, the top of your femur (your hip joint), and the bottom of your pelvis that you need to avoid. Those are not hard to find.

Ok, I hope that helps.

Oh, wait. I promised to recommend a book. Instead, let me recommend a web site, where I think the best and cheapest amount of information on taking care of muscles and joints are. I've been using this site to help others for about 12 years, with immense success. The book I would recommend from that site is any of the "Pain-Free" series. "Pain-Free Living" is the most comprehensive, but it's also the most expensive. You'll find the other books, even though they're specialized for runners and triathletes, espouse the same principles and will apply to you, and they're cheaper.

The website is julstro.com. I get a commission if you buy anything from her site. I never feel better than when I'm recommending a julstro product.

Of course, try out what I wrote above and what's in the videos above. I'll bet 30% of the people who read this, assuming you're over 30, will find significant benefit from the stretches. Others will have friends who would benefit.

I've got a number of stories about people who've been helped by this advice that you can read at my Christian history site. I don't want to write a bunch of stories here and make this page longer.

Chemo Fingerprints and Tapering Again

Rather than start with something serious, let's have a little fun at my expense.

I'm bald again.

Why? Well, this has a lot to do with it:

Need a clearer view?

I decided that I had little enough hair that I could just trim it myself with the beard trimmer. It looks okay with a modern-style crew cut, so that's what I was going to do.

I forgot, however, to check the charge on my beard trimmer before I began, and it was completely dead by the time I was done with one side of my head.

Oops.

My trimmer doesn't run plugged in. Plugging it in is just for recharging.

We were one our way to Freed Hardeman University to finish enrolling Caleb,  and I really didn't want to show up there as a punk rocker. On the spur of the moment, all I could think of to do was to use the razor that doesn't require batteries. My good ol', three-blade, disposable razor.

It took a little while, but I got it. My disposable razor doesn't have a setting for "3-day beard" or anything like that, so bald seemed to be the only choice.

Everyone seems to agree that I look ten years younger bald, so I like that, but I'm not staying bald. Here's a picture in better light. I'm not mad; I'm just squinting at the sun and trying to hurry because I'm not supposed to be out in the sun ... especially with all that forehead exposed!

Resolving Last Week's "Seizure of Persons"

I was trying to think of a Christian way to deal with the events of last week. My arrest was not a big deal. I brought that on myself. My son's arrest, however, was ridiculous and leaving the issue alone so that it could happen to the next person did not seem like an option to me.

A couple days ago, I was struck by what should have been obvious. Just go talk to the sheriff, and see if he'll do something about the situation!

So yesterday I dropped in to make an appointment. He was in, and he saw me immediately.

I added this picture just to
have something pretty to contrast
all the pictures of me.

We went back and forth a little bit, but in the end, I think I have to acknowledge that there is no way for the sheriff's office to double check the warrants that are issued to them. He offered to show me the stack of warrants that they have outstanding.

They do have to be double checked, though, and some attempt needs to be made to contact those, like my son, that obviously don't need to be picked up in the middle of the night. Protection against unreasonable warrants is a right that the constitution says "shall not be violated."

The place that needs to happen, however, is in the county clerk's office, where the warrants are issued. As it turned out, the sheriff had already talked to my lawyer, and both of them had already talked to the county clerk's office. They are already putting a system in place so that appeals, which happen at the circuit court in the middle of town, are registered with the justice center, which is on the bypass on the edge of town.

I think they were embarrassed that no system was already in place, and they're rectifying that as fast as possible.

Does no one appeal decisions in this county? Is this really the first time this has ever come up? Maybe there's just not much reason to appeal a general sessions court ruling, and it happens very rarely.

I also talked to him about the condition of the jail cell, and the sheriff told me it's already their policy to clean the cells between prisoners. He promised to leave his office and go straight in to check on the condition of the cell I was in and ask about what happened last week.

So overall I was pretty happy with that. Our lawyer is involved in the discussions with the county clerk's office, so I'm confident he'll make sure the system they set in place will never again put him in the position of having one of his clients arrested while the case is on appeal.

Chemo Fingerprints

One thing I forgot to tell you was the great difficulty they had fingerprinting me last week. Fingerprinting has come a long way since I was fingerprinted every time I moved in the military in the 80's. No ink is involved now. There's a scanner, and it puts a picture up on a computer monitor.

The computer kept rejecting my fingerprints. Finally, the guy doing the fingerprinting asked to see my hands. Then he showed me the crevices running the length of my fingers, including right across my fingerprints. After he showed me those, he turned the monitor my way so that I could see that not only did I have these crevices running the length of my fingers, but I had tinier ones crossing my fingertips as well. We couldn't see them, but the scanner was picking them up. It looked like someone had made a checkerboard with tiny squares all over my fingertips. Behind that checkerboard, we could see the whorls, loops, and arches that are supposed to make up my fingerprint. It was like they were covered in a mesh net on the screen.

Can you see the lines on my fingers and the web design on my index finger? The computer could see them, too; better than it could see my fingerprints.

Here's a closer view. There's a lot more lines too small to see that the computer picked up.

So we took 7 or 8 prints of each finger, and then he picked the best one. The computer itself only approved one or two.

The Taper

After the rough month of July, I was scared on Monday when we dropped back to 7.5 mg of steroids instead of 10.

Worse, on Tuesday I was very sick. I was exhausted, had diarrhea, and I was constantly nauseous. I slept a good 7 hours over three naps during the day besides what I had slept the night before, and I went to bed at 9 pm.

Wednesday, I woke up feeling as well as I've felt since I left the hospital. I got up, took one of my cars to the repair shop at 7 a.m., then walked a mile to a different repair shop to pick up our other car. It was after that I went to see the sheriff.

I guess I really was sick on Tuesday, not just reacting to the steroid taper.

We'll see. We're not tapering any further until the doctors see me again, and that won't be until September 13.

Chemo Lines Revisited

I'm doing remarkably better now that I'm back on the steroids. I do need to repeat my note of self-justification that the amount of steroids that I am on is no more than what your body is making every day.

I am still fascinated by the "chemo line" effect. I wrote a couple months ago about the chemo lines on my fingernails. Those have grown out, but now I'm dealing with the chemo lines on my toenails, as seen below:

See that big line down the middle of my big toenail. All my toenails have lines like that. Some have grown to the end, and the closer to the end the chemo line gets, the more the nail separates at the line. You can probably see how one edge of my left big toe is separating already.

I didn't take the clearest photo. I just couldn't get the right lighting. Anyway, the chemo line on the toenail of the second toe has reached the end and half of it is loose, so I cut most of that half off.

It's not really a problem on my toes like it was on my fingers. The nails get real jagged and catch on every bit of fabric there is, especially socks, but I can just tape my toes up. Then there's no problem. I couldn't do that with my fingers because I have to wash my hands all day, use my fingers to do things, etc. Toes are mostly useless except for being stubbed and for a place for bees to survive and sting when you step on them barefoot.

Notice how crowded those right toes are? I have just one bunion. I'm going to give free bunion advice to anyone who wants it. First, mine's not bad (nor is it related to chemo, but to kicking a football in jr. high school), so if you have a severe bunion, my solution may not work. Here's what a bunion looks like:

See how big the knuckle of the big toe is? That's what's meant by a bunion. Calcium builds up in the knuckle, driving the big toe towards the other toes. It crowds your toes, and it can cause pain both inside the damaged knuckle and on the side of the knuckle from rubbing on shoes.

I never had the shoe problem, but the knuckle used to ache pretty much every evening unless I was off my feet all day.

The solution? I got some MSM/Glucosamine cream from Nature's Sunshine. (You can buy it all over the internet.) I used it topically on the knuckle once or twice a day, and within a week my toe joint didn't ache at all. That continued for a few months, then I quit for a couple weeks just to make sure the cream was the source of the improvement. It was. The pain came back in a few days.

Over the next two years I tried that experiment several times, quitting for a couple weeks, and the pain always came back in 3 or 4 days.

After about four years, I hit a point where I either forgot to restock or just got lazy and quit using it, and the pain has never come back. I haven't used the cream in six years, and my bunion hasn't hurt me the entire time.

If you have a painful bunion, I hope that works for you, too.

Oh, my daughter has a bunion. It works for her as well. She uses the MSM/Glucosamine cream for a while, then quits a while until the bunion starts aching again. Then I'll get her another tube. We probably only buy one tube every two years for her.

Weird post, I know, but I am just fascinated by the chemo lines. They are caused, by the way, by chemo killing the fingernail and toenail cells, then the nails going back to growing once the chemo wears off.

Graft Versus Host Disease (GVHD) and Steroids

On July 31, I was supposed to drop completely off the steroids I was taking. I had been tapering all month. I contacted Vanderbilt, told them how things have been, and they told me to go back up to 10mg per day, which is where I was at in mid-June.

In two days, I felt like I'd been born again. Mood jumped, appetite increased, and all the intestinal warfare stopped.

And warfare is the right word. Graft-versus-Host Disease (GVHD) is my new immune system attacking my body, in this case my gut, because it doesn't recognize it as a friend. Going back up to 10mg Prednisone got my immune system off my gut.

So today we asked about when we might be able to taper off the steroids safely. (I saw "we" because my wife, who is my caretaker, goes through all this with me and handles my medications.) I learned some things about steroids I didn't know, or at least about Prednisone, this specific steroid. I also learned some things about stem cells and about transplants being rejected.

Steroids

Your body (but not mine), produces about 7 milligrams of steroids on its own everyday. The nurse tells me that because I've received so much steroids over the last year, my adrenal glands have "gone to sleep" figuring they're not needed. The taper, going off the steroids bit by bit, is to get my body to wake up and start producing its own steroids. Until then, when we may have to settle in at 7.5 mg and give my body what it's not producing. The 10 mg that I'm getting now I will only get for two weeks, then we'll stay at 7.5 for a while until we're ready to test my body again.

Transplants and Stem Cells

When a person receives a kidney, liver, or heart transplant, he or she must stay on immunosuppressive medicines all their life. Their immune system, if given full reign, will attack the new organ as foreign, and that will be as true 30 years from the transplant as it is on the day of the transplant.

Stem cells are not so.

Stem cells are more "plastic." They can be trained. So today my immune system (which is the real foreigner here), will begin attacking my gut and skin if it is given full reign. But because I have the stem cells that produced the blood system (and thus the immune system), the stem cells are learning. While the immune system is on a leash, the cells are learning whom they can live with and whom they can't live with.

Eventually, sometimes its three, four, or five years down the road, bone marrow transplant recipients can let their immune systems off the leash, it will have learned to recognize the patient's original DNA as not harmful.

Until then, the doctors let the immune system loose a little at a time, chain it back up when it snarls and bites, then let it off again later; testing ... testing ... until they get the patient off all immunosuppressives.

I'm on very minor amounts, and the stem cells I got were really stem cells. People with adult donors get "hematopoietic" stem cells, which are cells that can become any blood cell. I got cells from an infant's umbilical cord (no, not an aborted infant; donated by a wonderful set of parents after a live, healthy birth). They're completely naive, untrained stem cells, ready to make blood and learn how to take on the world.

People like me who get cord blood are in more danger the first 30 days after transplant because engrafting goes slowly, so we're completely without an immune system longer than those with an adult donor (or who are self-donors). But after 90 days, our new immune system usually gives us less problems than those who have adult donors. Wow, that would be nice. I made it past the "sorry, you're much more likely to die during these 30 days than those with adult donors" so I'm happy to try to reap the benefit of those little thriving baby cells.

This is just like being a parent. Getting those children to behave can sometimes be a real challenge.

Have a great day. Conquer every obstacle. Roar a lot when the going gets difficult. Trust God, and there's nothing you can't overcome.

A Couple Letters

My friend Jeremiah doesn't post comments on my blog. He sends me emails from his iPhone. This one, though, I needed to share. It was a response to yesterday's post:

When [a mutual friend] told me you were in bad shape (after I read your last post) I thought "he's trying to do too much." I don't think you lied to yourself in the hospital. I believe you didn't understand how much work it is for habitual overachievers not to overfill their plates.
     I guess we think God won't be pleased with us unless we have ten things going on at once. For some that may be true, but this is hardly the case with you. Please, please take time to heal. Those doctors almost killed you in an effort to cure you. You can't just jump back into this whirlwind of activity we call church life. Life will never be the same again, Bilbo. Or in your case it may be Frodo. You've been stabbed, stung, and had your finger bitten off. Think you can go back to life in the Shire? Just write for a while and leave Shire affairs to Sam, Merry, and Pippen.
     See you soon - Beorn

I had to laugh. I loved the reference to The Hobbit and The Lord of the Rings. In fact, I'm reading The Hobbit to my kids again. (One more thing I didn't mention I was doing in yesterday's post.

Second Letter and Divine Healing

Another friend wrote to encourage me to be available to seeing miracles happen around me. He referenced a blog that I read on and off called Joel 2 Generation. In fact, my friend went to Portland for a few days for some "training/outreach" that the blog owner was doing. He was present at the healing that is described in the link I just gave you.

I added the blog to my blog roll so I'd remember to read it more often.

I think I've linked Joel 2 Generation before. I love his honesty, as he does not only include success stories, but I-don't-know and nothing-happened stories as well. I've only met two or three guys with the kind of success rate in praying for healing or other miracles as the writer of that blog.

One of those people was my first boss in the Air Force, some 30 years ago. He's surely one of the main reasons I became a Christian. He started praying, and there was no getting in the way of God coming after me.

Anyway, I thought I'd tell you a couple things I told my friend.

I mentioned yesterday that I wanted to put a couple Martin Luther quotes on the quote page of my web site (which I did this morning at 4 a.m.). The reason I had a Martin Luther book is because yesterday, I was standing in my bedroom a little bewildered because I had to go to the bathroom and I knew how bad it was going to hurt.

My eyes fell on my 7-volume set of Martin Luther's sermons. I was struck with a craving to read one. Then I felt God whisper, "Go ahead, this trip to the bathroom isn't going to hurt much."

I've said before, God rarely speaks to me in words. It's more feelings, but after 30 years I've gotten pretty good at distinguishing between the Word of God in my heart and my own thoughts or gut feelings. I base that claim on the success of acting on what I hear inwardly. Levels of reliability:

1. God's Spirit in my heart
2. Gut feeling/intuition
3. My thoughts

There's a difference between those three.

I took the book to the bathroom, and what do you know, it barely hurt at all. That was miraculous enough by itself. I also read a part of a sermon that made me realize that sometimes it's not God letting you go through suffering, but it's an attack of the devil, and we should be warring, not surrendering. (Note: I only read a part of the sermon because camping out on the toilet helps create hemorrhoids, not heal them. I try to move on as quickly as possible.)

So afterword, I called for the elders of the church and ask them to come pray for me.

As I was waiting, I fell asleep. When I woke up, I had to go to the bathroom badly. This time, it did hurt, and there was more blood than I'm comfortable with. My wife and I agreed we were going to pray with the elders of the church first, call Vanderbilt later.

As I was waiting for the elders, I prayed, "God, I could really use something from you; can you send someone to give me something spiritual? I know the elders will, but I called them. It would help me to know you sent someone."

Not 30 seconds later, a young lady came in with a guitar and meekly asked, "Is it okay if I sing Papa Shammah a song?" ("Papa Shammah" is what the kids here at Rose Creek Village call me, usually until they're about 25, when they just go to calling me "Shammah.")

The song was the hymn that starts "My hope is built on nothing less than Jesus blood and righteousness," but updated to a modern version.

I was worn out, tired, in pain, a little worried, and that song was a direct answer to prayer. I cried while she sang. I said thank you, and she quietly walked out, God's little messenger, not wasting any words or speaking any but what God had given her.

The elders came later, anointed me with oil, and that helped a little.

This morning, I was not in so much pain, and I got up to go to our gathering, but it was hard working up the energy. My wife advised me to stay home and rest, and since every step was getting harder, I complied.

During the gathering, I knew they would pray for me, but in this case, I'm pretty certain I knew when they prayed for me. My energy picked up and life in general got a little brighter. I got up and did some exercises with the yoga stretch band.

So here I am writing, grateful for the touch of God. The hemorrhoids are itching, not burning, which for me is a sign of healing. For some reason the recurrent trips to the bathroom have stopped, and I've already tried everything I could think of over the last week to prevent that. I haven't done anything new.

So all of that is probably a bizarre dream world to atheists, but I learned something when Rachel walked in to play her guitar yesterday. I recognized the hymn, even though the tune was different, but I never realize that along with the statement that I wholly lean on Jesus' name, the song also says that all that crazy stuff that I hope and believe in is true. It says that God is paying attention to us, and that our hope will not result in shame. It may not say that in the words, but between the lines that message was being shouted.

Oh, taste and see that the Lord is good. How blessed is the one who puts his trust in you. Their faces shall never be ashamed. (Ps. 34:8,5)