#RiderProblems: Sciatica and Piriformis Syndrome

Generally speaking, humans are not anatomically perfect. This is kind of a bummer when it comes to horseback riding–and specifically when it comes to the discipline of Dressage, which has been described as the art of taking an asymmetrical person and an asymmetrical horse and making them both straight.

But straitening a naturally asymmetrical body is not an easy task considering the sport that aims to do so can cause a lot of physical issues in the process, in addition to the ones we may have just inherited. The fact is that riding is demanding on the body, and when you don't counter-balance your rides with cross-training, stretching, and other supportive and restorative therapies, problems arise. Many riders ignore these problems their whole lives, and end up nearly crippled by age 70. We all know an old trainer who can barely walk. But it is extremely common to see even young riders suffering from lower back pain, hip pain, numbness in their legs, etc.

Hopefully our horses are being maintained in a way so that they do not feel pain after a life of demanding work...But how to properly support your equine-athlete is a whole other topic for a whole other post. Today I want to talk about some of the physical issues that arise for riders, how to identify them, and how to work towards reversing or minimizing their impact with proper support. I'm going to focus on sciatica, which is extremely common, and piriformis syndrome, which is related. 

Obviously, I am not a doctor or physical therapist, so please don't let your research on these issues end here. This is meant to be an introduction to this topic and a discussion of these issues as they relate specifically to horseback riders, since we are a group in which these issues are common and yet I rarely hear these things talked about in our community. 

So what are we talking about when we talk about sciatica and the piriformis? Well, one is a muscle and the other is a nerve, and they are next-door neighbors in our bodies. Paraphrasing from an article on piriformis pain on the Health Post website:

The piriformis allows us to move the hip, upper leg, and foot outward from the body. This muscle covers the sciatic nerve, that runs from the lower back down into the legs. The piriformis is not only important for hip and leg movement but it is a key part of our overall balance while upright.
One end of the piriformis is attached to the front part of the sacrum, the triangular bone at the base of the spine. It’s the only pelvic muscle that attaches to the front of the sacrum, providing balance between the pelvis and legs. Its counteraction with the psoas muscle at the front of the pelvis and the gluteus maximus at the back maintains stability.
An impeded piriformis limits both mobility and balance. Sciatica is a condition in which the sciatic nerve is pinched in some way, causing pain.

If you want to determine whether or not a pinched sciatic nerve or tight piriformis might be the culprits of any back, hip or leg pain you might be experiencing, I found a couple great Youtube video that demonstrate a few positions to try. The doctors are pretty hilarious. They're worth watching just to hear their intro-music...

By now you might be able to tell if you fall into the camp of having some or all of these common rider problems. Or you're simply interested in preventing these problems from arriving. So, what can you do? 

1. Get serious about a yoga practice. From body awareness to relaxation, from breath-control to increased strength, flexibility and alignment, the list of benefits that yoga offers us is long. Regular yoga can reverse the issues we're talking about in this article, as well as prevent future issues like slipped disks that could otherwise require surgery to fix.

Ideally, find an instructor with a therapeutic-yoga license or at least a detailed knowledge of anatomy. Steer clear of instructors who focus purely on flexibility or the flashy, athletic poses. Acrobatics will do very little to fix your pain or improve your riding, and it's likely to cause additional problems and injuries. 

If videos/online is your only or best option, the same cautions apply. I personally really like the website of Certified Yoga Therapist Olga Kabel. Here is a list of her videos and practices that apply to the issues discussed here:

Three Types of Butt Pain and What to do About it
Yoga Practice for the Hip Flexors
–And conversely, Stretching the Hip Flexors is Not Always a Good Idea
Yoga Practice to Release Piriformis Tension

2. See a chiropractor and/or acupuncturist regularly. Muscles can actually pull our skeletal structure out of whack, so getting adjustments from time to time helps ensure we're not going around with one leg an inch longer than the other. Acupuncture is extremely helpful for healing injuries and calming nerve and muscle pain. 

3. Stop ignoring pain. Pain is a signal from our body that something is wrong, and we should use it as a tool to inform our decisions and actions. 

Let's continue the conversation: Do you struggle with pain while riding? What therapies have you tried, and what have you found helpful?