Cheeky Little Ligament!

Being my alter ego as I often am, Superwoman, I hate to admit I went "Wii!" -- and Wii!-ed myself right into a lot of pain.

Yes, there are lots of warnings on the box, and yes, I am not 16 anymore. But it was so much fun hitting fake homeruns and beating the girls at bowling, I didn’t stop, warm up, hydrate or anything else.

Next morning, I had some serious fun trying to do massages.

It felt like something between a groin pull, a hamstring pull and a possibly serious symptom of visceral disease in the pudendal area. The act of sitting down hurt. Sitting hurt. Standing hurt. It hurt to touch the gas pedal. It hurt to move my foot to the brake. It hurt to lie in bed. It hurt to toddle off to the bathroom. It DEFINITELY hurt to use my feet to push during a massage!

That night I spent a few hours soaking in Epsom salts, trying to treat myself. The groin was painful, but the adductor magnus, gracilis, and the hamstrings were at my “normal” length. The piriformis wasn’t sore, nor were the glutes or low back. Psoas had my normal range. Puzzled, I slathered Epsom lotion on the medial thigh for the overnight cure: eight hours of sleep.

Next day I was no better, if not a little worse. Lately my massage trading buddy and I had been too busy for our weekly trade. Now I begged for some table time.

My trading buddy, who thought my predicament moderately hilarious, had me go prone on the table. Some palpation of the sacrum, the hammies and pretty soon he had found where the pain lived. In the inside lower cheek, just above the leg and next to the gluteal fold. He gently pressed the area, and I felt the pain flood my groin.

“Aha! The sacrous-spinal ligament!” he said. “That recreates the pain!” I said.

After about 10 minutes of trying to remember the name of the muscle also possibly involved – go-gos, Gemmullus? Obturator? – we are both kind of old hands – he called it out – quadratus femoris!

“Forcible lateral rotation of the foot!” he said. Sounded like Wii bowling to me. Somehow when putting some extra English on one of those bowling ball deliveries I’d managed to nail the right foot into forcible external rotation – and I had missed guessing at the cause by a mile. It wasn’t a groin injury at all.

Later that evening, with some relief finally setting in, I checked the internet and found some interesting citations. First, I found a paper on surgical decompression of the ligament in a woman with a long history of intractable sciatica. Lo and behold, the sciatic nerve toodles right on by that the sacrous-spinal ligament and the quadratic femoris, and might just be really annoyed by sudden torsion or injury. Another citation fingered the ligament as a cause of pudendal pain in women. Another paper blamed the sacrous-spinal ligament as culprit in people who have symptoms of disc disease, but don’t have any findings upon X-ray.

As they say in professional wrestling, school was out. With 15 years beside the massage table, I had yet another epiphany about the body, it’s complicated anatomy and my own enthusiasm for winning at any cost. Yes, I too have Gung-Ho Disease.

Lessons learned:
1. Don’t expect to be able to spot the problem when treating yourself.
2. No slacking on the weekly massage schedule.
3. Leave the Wii! world championships to people who are less competitive and more flexible.