A mystery unravelled

Share your story Recovery journey
1

Hello wonderful people,

Last night I solved an enigma that has plagued me for a long time. For 10 months I have been following a pattern of locked glute-day / unlocked glute-day. They alternate, like clockwork. The locked day is so bad, that not only am I in pain the whole day, but it brings all my rehab to a complete standstill, until the unlocked day comes along. Such a long term pattern has made a considerable dent to morale and progress to what would otherwise be a solid and steady recovery. I have battled and toiled to find an answer every day for months. The timeline of my problem :wink:

• May 2023: Start of locked-glute cycle
• June 2023: Piriformis muscle relief exercises / Paul & Avgi
• Aug 2023: Started with physio Phoenix. Trip to Minehead
• Nov 2023: Started core exercises on my back
• Feb 2023: Acquisition of proprioception
• March 2023: Stumbled across diagnosis & prognosis

The solution may be an anti climax to some; piriformis syndrome / root cause = weak core (including obliques). The answer came while browsing a forum for runners on Reddit. There is an added problem of my calf and ankle following the same pattern as the locked glute, which is likely a follow-on from the glute, but some myofascial attention should address that nicely.

Many questions arise, but the fact that serious strokes lead to a severe degradation in core strength, and I have only had awareness (proprioception day was in Feb.) of my weak side for a month, explains all. YouTube did plenty to steer me away from the truth ; a standard exercise to relieve piriformis is given, but this only causes it to hurt a lot. Countless clips mentioning piriformis syndrome fail to mention core strength (or lack of), so that I never reached a remedy, prognosis etc. So, the original post from the Runners thread (runner loses core from office work and cannot run = stroked violinist cannot walk due to offline core), and all the follow on posts resonate so strongly with what I’m going through. I have just recounted everything to my Chinese Doctor, and he finally accepts this explanation… & knows perfectly well how weak my core is. How many discarded theories and explanations have I come up with, week after week? Now, I can work toward core muscles with real motivation (warning: The exercises are very hard core ; bird-dog, knee (to start with) plank, obliques). Because my core is weak, other things have to take up the slack (like my piriformis). The same goes for people who find it hard to engage their core; other components incorrectly substitute for core. The crazy clockwork cycle I was going through was because on the bad day I would do gentle exercises then step up the work on the good day, only for the body to be overwhelmed, and repeat the cycle of bad day / good day.

What is so compelling is that when I engage my core muscles, my glute starts to relax; yes it’s evening when it naturally does wind down, but I can feel core muscles engage encouraging the piriformis to give up its grip. I can’t begin to think how many stroke-survivors (not all need core strengthening) would benefit from this knowledge? If anyone would like to look at the thread that shone light it’s here;

Piriformis thread

Thanks to all who listened to me moan!! :joy:
Have fun ; supper time for me !!!
Ciao, Roland

6 Likes
2

Hi @pando

Told you so :)!

Well really I didn’t
but
I did suggest that you should experiment with stopping exercise for a few days and then gently increasing and see if that affected your glute. Outlander too - I wonder how he is getting on? Yours would be a useful post to him to perhaps. You seem to have correlated exertion to symptom but nobody could give you root cause

And now you believe you found root cause it gives you the breakthrough :). youve obviously had an extension in understanding from your recent reading

What I allude to by “told you so” is the amount of miscommunication around stroke recovery and by extension or extrapolation I would imagine every other chronic recovery need.

You’ve found a good hypothesis in the anecdotal evidence within another field. With the knowledge of how to apply it you have a recovery hypothesis that no doubt you will set about trying and time will tell you if there is cause & effect enough to announce theory .

You’re unravelling seems to me very like my recent understanding that neuroplasticity is not our friend but is a neutral by stander constantly employed by our enemy the lazy brain that seeks to compensate for our disabilities rather than educate us in what root cause issue is leading to a host of compensations with their own symptoms - You’re locked glute being one and everybody’s learnt non-use also being symptomatic

I was sent a PhD thesis to read last week. The level of comprehension of our condition and the level of findings was less than is demonstrated in the Thursday cafes each week. This was produced by a student and supervised by a professor and some post doctorals. With such a kindergarten level of discovery it’s no wonder we are the ones who are charting the course of adequate recovery strategies

I think it’s a shame that the wealth of information here, the wealth of intellectual motivation, the wealth of exploration by us all is not being used to create better understanding within the medical profession of how to offer help or where to look for it outside of our immediate diagnosis. The CPSP thread is another example. The failures of CIMT or at least it’s failure to be lock and key well matched is another example.

Personally that’s what I would feel early association that took money on behalf of those with an affliction was involved in sponsoring yet any attempt to suggest there are ways to improve our lot our met with closed mind and animosity - such an opportunity lost

I’m very glad you found a route forwards that offers you hope :slight_smile:
I too am looking for alternate organisations to embrace opportunities

Ciao
Simon

3 Likes
3

Trust me, I did try that, Simon,

The point about this mystery is that I celebrated the day I started core muscle training on the floor, because I knew my core was feeble. But it’s only been 3 weeks since interoception, meaning I could not feel my abs nor obliques before. No wonder I have so far to go, still. Anyway, I have my prognosis, and it will take months but now I am motivated and confident I’m working at the right things.

The crazy cycle needs some explaining? Possibly the stroked brain. I mean look at DOMS ; it gives me a days’ grace, then all hell breaks loose. That’s my day off (my good day). Anyway, firming up abs helped unlock glutes last night. I could feel the firm abs taking the pressure off the leg. The solution is nothing to do with the leg, unlike every clip on youtube that will convince you otherwise.

Neuroplasticity is all I have, so I won’t knock it. Lazy brain = our lazy nature. It’s up to us to cut corners, or rehab in the right way. More like lazy support. We’re on our own, really. Anyway see you at the meeting. ciao, Roland

1 Like
4

Finally someone else gets it :laughing: Pilates is a great one for working on core strength. My mum was a tailor and one piece of advice she always gave me was to “look after your back” because I have a long back. It wasn’t 'til I got older and wiser that I realised why, because it has such a knock effect to every other limb in your body.

Not only do you need to strengthen your core but you also need to unlock all the tension in your back that you don’t even realise you have.

And a good one for that is the Knee Roll
Lie on your back, arms outstretched.
Bring your knees to a table top position, as though you were sitting in an invisible chair whilst lying down.
image
Keeping your shoulders flat on the floor at all times,
Breath in and as you breath out such your belly in right down to the groin and swing your knees to the left as far as you can and turn your head to the right.
If you can, hold it there for a count of 10 then return to the middle and do the same swinging the knees to the right.
For maximum effect this is one best done towards the end of a core workout when the muscle are warmed up and stretched out a bit and you can get a deeper stretch :wink:
Be warned, you could hear some snapping, clicking and even feel some pinching in the hip. But oh does it feel sooo good afterwards, your back should feel so much looser. It also helps open up your chest cavity and allows you to take deeper breaths.

1 Like
5

Emerald,

That’s spot on for me, thanks. I’m aware that sitting too much, and my changed lifestyle is really detrimental to my health. I’ve got so far to go, and I look terrible when I walk. But with hard work, the sky’s the limit,

Thanks again,
great exercise… right up my street
ciao, Roland

1 Like
6

Hi Roland @pando it sounds like you’ve made a major breakthrough there & I hope you soon have many more unlocked glute days.

Look forward to hearing how you’re getting on.

3 Likes
7

Thank you Ann,

I know I’m on the right track, but my core is as weak as can be. Of course, now I can work with confidence that I am addressing the problem. My motivation is high. How is your job? are you finding it difficult?

Ciao, Roland

1 Like
8

Hi Emerald,

I just gave it a go; the knee roll is much better one side than the other. I can get shoulders down, but not the arms (especially the affected one) anywhere near as high as the diagram suggests. But must enter it into repertoire; will ask my physio tomorrow,

Thx, Roland

1 Like
9

Hi Roland, it’s great to see your confidence & I have every faith your hard work will win out.

My job is ok thanks…it’s exhausting but we’re hanging in there. I have an occupational health assessment tomorrow to see if any more adjustments can be made.

Kerp going you’ll make many improvements doon i’m sure.

Best wishes

Ann x

2 Likes
10

Thanks Ann,

I’m so disappointed that this has slipped through “the system”. All the research in the world on strokes is so lacking, when I have to look 10 months for this answer, and there is no guidance on weak core connected with my piriformis issue…

The concept is arms and legs incorrectly taking up the slack from an offline core.
There must be countless cases.

Research? where is it?
We really are on our own,
ciao, Roland

2 Likes
11

Hi Roland, maybe you still have a ways to go yet with that particular stretch, certainly to get deep enough. So only go as far as you can, the same for your arms. Don’t forget we are not as young and flexible as we once were :wink: But you will get there with enough practice I’m sure.

And the same can be said with Pilates exercise exercise in general, only go as far you can. When I think about, you are currently only starting to rebuild your core strength, just going from what you said above, so you don’t want to cause over reach too soon as that can slip disks and pull muscles and such. You certainly don’t want anything more to contend with.

Ideally, I would highly recommend you attend a few pilates classes to learn the correct techniques. As much of it also relies on correct breathing technique, as in when to breath in, when to breath out and clench the abdominal area and hold it whilst still breathing through the top of your lungs (and that’s mainly to protect your spin), feet/knee placement, hand/arm positioning…it’s all done much the same way as in yoga. An instructor can demonstrate and point out any corrections in positioning/placement/posture as it’s all relevant to the goal.
Actually, I’m currently half way through a 12 week pilates course run by Age UK plus a 4wk course in yoga :smile: I’m doing it as much for social aspect as for the exercise itself, you might find one in your own area :smile:

If you do this type of core workout you will find over time you will be naturally incorporating some of those moves into your daily life as they are a safer way. It will become second nature to such the belly in, keep the knees soft just as you bend down to pick something up. In the long run, it’s going to make life somewhat easier than it is now I’m sure. Good luck with it and I know you will keep us all posted :smile:

2 Likes
12

Emerald,

Hi, I find it daunting… so far to go, so weak at the moment. I do yoga on a Thu / physio on a Fri / yes maybe add in Pilates (my wife did it for years) or Qigong, which I do on my own. The core is offline on my right side, and “normal” on the other… I’m ready for the scrap yard, basically.

… and yet I’m better off now I can feel my core failing… better than not feeling it at all.
Core is everything… will I ever get it back??

ciao, Roland

2 Likes
13

As I suggested, get into a pilates class. It’s really not that far to go, I can assure you that your body is going to notice a difference 6wks from now. Of course you can build it up again, and you will rebuild your core strength Roland. If you do the exercises and do them right, there is absolutely no reason why you can’t. It will have you walking better and further, you won’t be sitting so much because you can do more and so it snowballs from there on.

And don’t you dare try telling me you are ready for the scrape heap! I’m only a couple of years older than you maty :open_mouth: :face_with_raised_eyebrow: And I’m sure your physio will think it’s an excellent idea to take up pilates :smile:

2 Likes
14

Simon. hello there,

This recent theme you have warmed to, makes a certain amount of sense to me; you can be the judge if my thinking is relevant or not: Recently I felt (literally) the importance of my core. Well, very often, when exercising the core, various parts of the body will “cheat”, and “take-up the slack” as a quick instinctive fix. Now of course the body wants to be efficient; it’s for our survival, just like birds will conserve energy or die. So, brains will find the quick fix in terms of efficiency, but this is not the long term fix (which in my case is “fix the core”!). As a tip, my physio reminded me “AVOID the path of least resistance!”. How many people compensate and cheat when trying to engage their core? We have to over-ride our instincts, and go for the long-term fix. It’s because in primitive times, efficiency was everything.
In that sense, yes, our brains have a primitive in-built efficiency, but it’s not the best long-term solution.

That solution relies on the other parts of the brain that we are endowed with. I do my research, I override my primitive instincts, and I aim for something higher, thanks to other parts of my brain, (still intact) that the good Lord granted me.

Neuroplasticity is the quick fix, and Neuro-intelligence is our ability to better ourselves. How else could you criticize plasticity if you didn’t have the power to communicate and network with others to better our knowledge, and one-up our individual knowledge? Everything comes down to communication in the end…from the cellular level, to the modern, educated man who wishes to better himself, and taps into the collective knowledge we spread.

Do let me know how much you agree / disagree ! Yes, instead of calling the brain lazy, I do partially agree, but I am more forgiving, and describe the brain / spine as behaving according to primitive instincts. It has served man well, up to now. Now we are in the era of bio-hacks, and tweaking the efficiency of our body. (At the same time we are deteriorating rapidly; infertility, 50-60 years of harvest left, depletion of minerals, pollution, sex-changing water supply… the list is never ending.)

Thank you for always engaging in great conversation, Simon. You never waffle on, and I always find your conversations rich with meaning.

Ciao, ciao, bravo! Roland

2 Likes
15

Thanks, my physio approved, this morning. She calls it the “Russian twist”. Breath out and engage core when bringing knees back up to neutral position. Arms don’t have to be super high like the diagram, they just have to be glued to the floor for stability.

Bottom line, the spine loves this “corkscrew” _my term) twist…

Thanks, Emerald, ciao, ciao, Roland

1 Like
16

If you want to improve your core strength, take a look at exercises geared towards riding horses, especially dressage. You have to have an extremely strong core to manoeuvre/ slow down a horse weighing half a ton around, without using a lot of of arm strength. Even though I have a locked thigh that doesn’t want to cooperate, I can make it do so, if my core is engaged and doing it’s job. You don’t have a have a real horse , a balance ball will do the trick just fine !!

3 Likes
17

Many Pilates classes moved over to zoom during Covid. Some are still on zoom. I did a weekly Pilates class in London for 5+ years, the last 4 have been on zoom. It works fine. It saves a trip out of the house on a chilly morning.

3 Likes
18

Anything like mine, I wonder ?
I do like the sound of core for dressage
I have already made a start with my physio today ; this speaks to me
Core for dressage

thx, Roland

2 Likes
19

Hi Roland,
I’m thinking a caveman didn’t have the luxury of a slow considered fix. It was crucial that some capability was restored asap or the outcome might be unpleasant? No water, food etc
So it’s a race to recover, not perhaps the best solution ?

I wonder why we get paralysed ? We all know that’s likely to happen after a stroke but it struck me I don’t really know why. Why does it happen if the part of the brain impacted isn’t about movement.
“The cause of stroke paralysis is a disruption in the transmission of neural impulses between the brain and the muscles.”

Cheers
Nige

3 Likes
20

Hi

Roland I agree.
I would refine a few modes of expression .

For example I don’t think it’s efficiency that’s the right word but optimisation. And then the theme is that the brain optimises for now and that is counter the interests of the long-term.

I also wouldn’t describe neuroplasticity as a quick fix but as a quality of the system that responds to the optimisation. Bad optimisation means neuroplasticity is not in our long term interests. For various reasons it is most facilitative of change in the wrong direction.

On your assertions about 50 years of crops and the grantee of your faculties I remain at the sceptical end of agnostic

:slight_smile:

2 Likes