Sleeping w/pillow between knees...Why?

[KathiCville]

I have a question that maybe one of TE's talented PT's can answer?

For the past couple of years I have not been able to sleep at night without a pillow between my knees. (I'm a side sleeper for the most part.)

I also have had a nagging backache, especially on the right side, that I haven't been to shake--possibly tight quads, tight IT band?? So far I haven't hit gold on finding a stretch that works....:( (I just discovered KnottedYet's "Soft Shotgun" exercise, which I'm going to try daily for the next week or so! My BF thinks my SI is part of the problem.)

At any rate, the back pain is worse at night. I absolutely *hate* having to roll over or shift position in bed because I get a jag of pain in my upper right hip at the back. I bought a good mattress last year, but it hasn't done much to alleviate things. The pillow at least gives me some relief.

Anyway, I've been wondering what problem(s) the pillow-between-the-knees 'fixes' or at least addresses. Because, ideally, I'd rather fix the problem itself than continue to *have to* use a pillow at night. I'm thinking that if I can get to the root of whatever is too tight, misaligned or whatever, I can get rid of both the back/hip pain AND get a decent night's sleep again.

Thoughts?

[Biciclista]

all i can say is when my L5 (lumbar) went out 3 weeks ago and i had a disk bulge, that pillow thing really helped me.
I'm better now, can sleep normally.
are you doing daily back exercises, stretches? you probably need to.

[KathiCville]

The back ache started more than a year ago---right about the time that I began nudging my mileage up to rides in the 20+ mile range, so I think the cycling is almost certainly the 'big' factor. (I've fiddled with my set-up, particularly the seat height, and *think* it's about as ideal as it's going to get. Could easily be wrong, however!....)

Figuring that stretching might be the key, I started doing yoga again almost daily back around Christmastime. I've been doing a little bit of Pilates, too, to try to get my core in better shape. (I just ordered a Stott Pilates DVD that specifically targets strengthening the back....) I probably should take a Pilates course, rather than depend just on the videos.

I also do a couple of passive quad and IT band stretches 2x-3x weekly that my cycling BF taught me and that I've also seen here on TE.

One is flat-on-back, with legs hanging off the edge of the bed just far enough to provide a bit of 'tug' on the quads. That one I have to be careful with because if I'm too far off the bed it actually hurts my back!

The other is basically the same, but done lying on my side.

When I can, I do Pigeon Pose and a couple other yoga-based stretches for long-but-gentle holds while I read.

I've been to a couple of chiros but nothing they've done seems to make a difference. :(

[Kathi]

Last summer my lower back started locking up when I bent forward. I hurt for a week or 2 then it would calm down. Throughout the summer into the fall and winter I'd get this locking even with simple forward movements. My right knee and foot also hurt so I consulted an ortho, podiatrist and physiatrist. No one could explain why my lower back was locking like it was. I also had pain in the area of my piriformis. An MRI only showed some arthritis in my hip and right SI joint, 4 months of PT didn't help and the exercises made me hurt worse. I too got so I could only sleep on my side with a pillow or on my back with a pillow under my knees.

This spring I saw a different PT for a bike fit, instead he looked at me. He discovered my left SI joint was locked which he loosened, gave me a couple of exercises and I've been pain free ever since. No more foot (I can walk barefoot again) or knee pain, no locking of the lower back. I sleep comfortably with no pillows. No pain on the bike.

I'm still holding my breath afraid this will all come back but I've been pain free all summer.

I did have my fitter check my bike fit. He suggested changing my saddle because it was too much of a Y and wouldn't allow my hips to form over the saddle and I was riding forward on the nose. I don't think the saddle caused the issue but the new one is more T shaped, is a better fit and gives me more power on the bike.

My 1st PT suggested I try Pilates but it made things worse.

If you haven't had a bike fit do so, however, I suspect there is something going on with your body causing the pain. I never realized how debilitating back issues can be until this started. It may take some time to determine what is causing it but keep searching until you find an answer.

[tongue_tied]

Anyway, I've been wondering what problem(s) the pillow-between-the-knees 'fixes' or at least addresses. Because, ideally, I'd rather fix the problem itself than continue to *have to* use a pillow at night. I'm thinking that if I can get to the root of whatever is too tight, misaligned or whatever, I can get rid of both the back/hip pain AND get a decent night's sleep again.

Thoughts?

The pillow between the knees fixes your hip alignment. I don't normally sleep with a pillow between my knees, but I know that some nights, there's a hip pain and I read somewhere that this "fix" helps.

[KathiCville]

Thanks, Kathi and Tongue Tied!

Good points.......I know that the pillow is a great way to put the hips in better alignment, but I guess what I'm trying to figure out is the root of the problem. Tight hip flexors? Quads? IT band? An out-of-whack SI that needs to be persuaded to move back into position and stay there? A combination? Something else?

I figure I slept without a pillow between my knees for 49 years. :) Only in the last two years have I needed it. So what happened--probably cycling-related--that changed how my body feels when I'm trying to sleep? What can I loosen up or otherwise 'fix' that will take care of the back ache and the need for the pillow?

Addendum: I should add that I had this same back ache with my old bike, ridden for 18 months, and for which I had TWO professional fittings. Which is one of the reasons that I think the problem isn't with my bike set-up so much as my carcass! I haven't had a professional fit on my new bike, but my bicycle-crazy BF has done all kinds of good tweaking in the past couple of months to give me a pretty comfortable set-up. :) At this point I'm thinking the culprit is not the bike as much as it's some kind of tightness or lack of balance in terms of muscle strength? But, of course, I could be dead wrong, LOL!

[Kathi]

My PT suggested that I probably had a hard fall on my left side sometime in my life that caused the joint to lock up.

One symptom that I noticed about 5 yrs ago is that sitting for long periods caused pain. I drove from Cincinnati to Denver and when I got out of the car I had a hard time straightening up and my left glute was very painful. I blamed the car seats. I felt more comfortable with the seats slightly reclined. 3 years ago I tore my right acl skiing and after that I noticed that I was sitting primarily on my left hip. I also sit slightly sideways on my bicycle saddle unless I do my exercises right before I ride which seems to help my alignment.

Things got so bad that I was dragging my right foot when I did a lot of walking. I thought I was going to have to give up all my activities, skiing, biking, hiking, strength training (I'm now easing into this).

When this all started it was my right knee and I thought I was dealing with Chondromalicia! (I was diagnosed with this many years ago and most problems occurred in the right knee) In retrospect, the SI joint most likely has been the problem all along.

Sadly, I think this is an issue a lot of people associate with getting old and they think nothing can be done. I'm so glad I found the right therapist who was able to identify the source of the the pain, help me to understand it and get my life back together.

[KathiCville]

Good for you, Kathi! (Funny to write out my own name, properly spelled, but addressed to someone else!) Finding the right help is such a relief! I'm still looking.:)

I *have* been very lucky the past couple of years to have a cycling BF who is also trained in massage therapy. For years my main problem area was my shoulder/neck/arms from too much lousy posture at the computer. Got myself totally jammed up with trigger points and general tightness. He has slowly worked out many of the major kinks. And now I'm starting---finally---to lift weights to build up my almost-non-existent upper body strength. Long overdue. I'm appalled by how weak I am!

Sooo, it's been especially frustrating to have this new problem develop in the LOWER half of the body!:eek:

Yesterday I tried KnottedYet's 'soft shotgun' exercise 3x during the day. It's hard to believe that something so subtle might be so powerful, but I *think* I noticed a bit of relaxation around my SI when I went to bed last night. (Yay!) I'm going to keep at it for at least a couple of weeks and see what happens.

Any other tips, suggestions, biomechanical explanations would be welcomed!

[tulip]

I'm pretty wary of Pilates DVDs unless you've had a really good course with a classical Pilates instructor (not fly-by-night taught instructor). You could be doing something just off that could lead to injury. If you can possibly take a good classical Pilates course, I would recommend it. That's just from my experience; I'm not a PT or anything.

[KathiCville]

Thanks, Tulip....You're probably right. I need to find or make time to get to at least an introductory course. Fortunately Charlottesville is chock-a-block with yoga and Pilates classes......In the meantime, I dug up some additional gentle stretches for the SI area. Did 'em yesterday late afternoon and immediately felt a bit of relief. And when I woke up this morning I discovered that I had moved my 'knee pillow' out of the way last night at some point while asleep. (And I *stayed* asleep---no small thing.) Possibly a good sign that I'm headed in the right direction! I'll keep doing them and see what happens.....:D