It’s been a bit over a week since I posted about my setback when I got overconfident and started exercising too much. This time I’ve been more careful coming back. I’m now about back to where I was before the setback. This time I will be much more careful not to overdo. I can ride for at least 30 minutes at a time pain-free which is enjoyable and relaxing. I can get to some pretty nice scenery around here on a 30 minute ride,

I’m also able to do well on my physical therapy. I can’t say that is exactly pain-free, but I’ve learned the important concept of “centralization” in my reading about this: when you have sciatica, the pain originates somewhere and then refers down the leg. In my case this central point of origination is the center of my hip, probably the piriformis muscle. It’s ok if you feel pain in the central area while doing PT, but it should not make the referral down the leg worse, because that would mean the sciatica nerve is getting compressed by the exercise. I’ve been doing well the last week or so following that principle.

I had to get an MRI of my pelvis because I’ll be visiting an orthopedic specialist the in a week. That turned out to be painful. For some reason it still hurts to lay on my back for an extended time, even with a pillow under my knees. But the useful information from this is that the pain was clearly originating from my left SI joint. Up till now I’d been assuming I just had piriformis syndrome (now also known as deep gluteal pain). If my SI joint is also inflamed there are additional PT exercises I should be doing. So I’ve added those which hopefully will help. I’ve also carefully started adding strengthening exercises, such as glute bridges and clamshells with bands, which is critical long-term for strengthening the piriformis muscle and stabilizing the SI joint.