Aerial Yoga and Meralgia Paresthetica (aka Tight Jeans Syndrome)
Two weeks ago I had a patient who tried out aerial yoga, aka suspension or anti-gravity yoga, for the first time. He’s one of my many active and flexible patients who I can see taking on circus acrobatics while dangling upside down on a silk sling with ease…so I thought.
Everyone knows there are tons of benefits from practicing yoga, which most notably include increased flexibility, muscle strength, and improved breathing patterns and mental clarity. Nonetheless, over the years I have also observed injuries or aggravations of conditions, most commonly in the wrists and lower back region, arising from doing yoga improperly. What my current patient experienced though, was something entirely new to me.
After his aerial yoga session, he started noticing some numbness and tingling on his thighs, particularly on the outer parts of his thighs. The numbness persisted and he was continuing to feel it on the day of his chiropractic appointment several days later. Naturally when that happens, he googled his symptoms and was able to self-diagnose “meralgia paresthetica”, which I agreed with after examining him.
Meralgia paresthetica, or lateral femoral cutaneous nerve entrapment syndrome, is caused by compression of the sensory nerve to the skin, which originates from your spine (L2, L3 levels) to the thigh region. Pressure on the nerve can cause feelings of numbness, tingling, and sometimes burning pain in the upper front and outer part of your upper leg.
The most common compression site is around the anterior superior iliac spine (the bumpy part on the front of your pelvis), where the dense fibers of the inguinal ligament runs on top of the lateral femoral cutaneous nerve. Basically where you’d normally put a belt on. Hence it’s not surprising that the most common causes are tight clothing, obesity or pregnancy. It’s also important to note meralgia paresthetica can also be due to local trauma or a disease, such as diabetes.
In my patient’s case, he described that the fabric where he suspended from dug into his thighs and the instructor did warn him that it would hurt. He thought the pain is normal so he pushed through the pain. Little did he know that it was putting pressure on his lateral femoral cutaneous nerve, a fairly superficial nerve.
Some professionals (i.e. police officers, firefighters and construction workers) who are required to wear heavy and loaded belts could also exposes the nerve to excess and repetitive pressure. Other cases I have seen in the past include a third-trimester pregnant woman, a diabetic heavier set older man, and a healthy male in his 20s who wore tight pants sitting in lectures every day.
For my hung upside-down patient, the compression was quite intense over an hour of class. Without repetitive trauma, it’s likely that his issue will resolve with conservative measures. I had treated him the day of with manual therapy to relieve any muscle tension in the area of compression and advised him to wear looser clothing, stay active so to encourage blood circulation, and to avoid performing activities that may aggravate the symptoms until it heals.
Some of you may be wondering what happened to my patients who were diagnosed with meralgia paresthetica. For the pregnant woman, her symptoms improved about 6 weeks after she gave birth. For the healthy young male, the issue resolved within 4 weeks of identifying the problem. And for my aerial yoga patient, he notices improvement over time but he’s still currently experiencing the numbness on both legs.
Not everyone is so lucky. My diabetic patient when I saw him last, was still suffering from nerve pain but his problem not only comes from mechanical pressure from his larger belly but also systemically the increase in sugar level may have caused damages to the nerve. In more severe cases, treatment may include weight management, medications to relieve discomfort or surgery.
Let’s keep in mind that not everyone is going to develop symptoms after practicing aerial yoga but for those who do, I hope this can help them identify the problem and start them on the right path of recovery — Namaste :)
Willow Glen Chiropractic
1314 Lincoln Ave Ste 2E
San Jose, CA 95125