Piriformis Injury....Looking for Insights

Before trying injections or surgery, read "The Mindbody Prescription" by John Sarno. I had piriformis syndrome/sciatic pain for a while, but discovered that it was mostly psychosomatic (hence the reason none of the physical remedies you've tried have worked). Eventually I just started running through the pain as much as possible without worrying about it. It eventually just disappeared.

I've heard people reference this before. I may take a look at it. I'm certainly anxious and stressed about the situation which doesn't help the healing process I'm sure.

Have you tried heavier lifting? Maybe you have a lot of atrophy after so much time? I've found lifting can help (not always, but worth a try after so much time). At this point I'd try lifting before injections or surgery.

Try Bulgarian single leg split squats, lunges (forwards, backwards, sideways, 45 deg), and regular squats (go deep - try getting thighs to go below parallel to floor for regular squats to engage glutes more). Focus on really using the glutes.

Going on a year and a half of pirrformis problems. Haven't tried nearly as much as you have though. Interested to hear any suggestions on this.

I got what I think was piriformis syndrome during a pure sprint work phase a few months ago. Mainly I think it was from accelerating and lifting around turns which overdevelops the piriformis. There's no way around that because its function is to stabilize the up-down tilt of the pelvis within the coronal plane (keeps the other hip from dropping down, basically) and when you're leaning on a turn it has to work very hard at that. The overdevelopment squeezes the sciatic nerve.

I was able to deal with it by strengthening everything else to shift workload off the piriformis. Glutes is one, hip adductors another. I also adjusted my running form consciously.

My current PT is pretty confident that eventually it will get better with continued strengthening and massaging (i.e. tennis ball). I'm seeing my GP tomorrow to request an MRI of my hip/pelvis to rule out other issues.

What worked best for me were the bridges, especially with one leg (all my weight resting on one foot and my shoulders, facing up), and single leg squats on a high step where I would sweep the opposite leg backward behind the standing leg (looks like a speed skater motion). It took six weeks to get over it but I figured out these exercises only after 3-4 weeks and from that point I had pretty quick improvement. I do these still occasionally and have had no problems for a year and a half now.

Brief update.

I asked my GP for a Hip MRI and she instead referred me to a Physiatrist, which is appears to be a kind of sports rehab doctor. So I met him, nice man but and after explaining the history and him looking at my MRI and doing an assessment he basically said, so dude I don't what is wrong with you. I asked about piriformis syndrome and he said it doesn't exist. He told me to stop going to physiotherapy and that some people "just hurt". Needless to say this was not the outcome I had hoped for in meeting him. He also explained that no amount of imaging will do me any good. Although he did leave on a positive note saying this will get better...eventually and that is likely just myofascial pain. Is it all in my head??

The saga continues....

Hi Keener, using terms like GP I guess you're based in the UK? I've had a long history of glute/hamstring/sciatica issues. Over the years (like 10+) I've tried everything. Last couple of years I've managed to make a lot of progress. If you have an email address I can provide info, what works for me, people who've helped me, etc.

I had this for 6 months or so and tried every conceivable exercise with little success. Then I hurt my foot (can't remember what it was) but my podiatrist told me to take Ibuprofen for the inflammation in my foot. My piriformis issues were gone in a week...so I'm thinking the Ibuprofen had to help.

avsn;lk wrote:

Have you tried heavier lifting? Maybe you have a lot of atrophy after so much time? I've found lifting can help (not always, but worth a try after so much time). At this point I'd try lifting before injections or surgery.

Bodyweight squats and lunges would be enough to start with.

My sports doc tells me runner's shouldn't go deeper than 90 degrees as we tend to have tight quads and deep can cause soft tissue damage, impacting the knees. He's quite a reputable doc, treating NFL players and has worked with Meb.

Bad Wigins wrote:

I was able to deal with it by strengthening everything else to shift workload off the piriformis. Glutes is one, hip adductors another. I also adjusted my running form consciously.

this has been my experience - lots of squats and one legged deadlifts have helped a lot. I haven't changed my form conciously, although with newly stronger quads and glutes I have gotten faster.

A tennis ball doesn't do anything for me - try a baseball or lacrosse ball - they are harder and dig down deeper.

and don't sit for more than say 30 minutes without geting up and doing some squats or some such thing.

Here is my problem: I tried 8 weeks of rolling it out and strengthening and it made it MUCH worse. Strengthening did not seem to even work at all as nothing even got stronger.

I started:

Foam Rolling twice per day, and doing the following three times a week: 2X 10 one legged bridges, a 40 sec bridge hold and 10x three way leg raise(straight up, leg bent at 90 degree forward, leg bent at 90 degree backward) with bottom leg straight from hip and bent at 90 degree back at the knee.

Mine went away. Hope this helps.

do you have link to a picture of this?? i can't quite picture this.

RoanMtRunning wrote:

I started:

three way leg raise(straight up, leg bent at 90 degree forward, leg bent at 90 degree backward) with bottom leg straight from hip and bent at 90 degree back at the knee.

.

Hey Bilbo

I'm actually in Canada. My email is

nick@powersfamily.ca

. Any info you can provide would be appreciated.

Right now, here is my daily routine:

1. Single leg deadlift (2x muscle fatigue/failure)

2. Plank (2x 1min hold)

3. Foam roll (ITB, Hamstring, Glutes, Piriformis, Quads)

4. Lacrosse/Tennis Ball Roll (~5-10min Glute/Piriformis, Psoas)

5. Figure 4 Piriformis Stretch (2x45sec hold)

6. Kneeling Hip Flexor Stretch (2x45sec hold)

6. Neural flossing (20x)

I do this routine once per day at night.

Thanks for the feedback everyone.

Brief update:

Thanks everyone for your feedback.

I am continuing to work with my PT but my leg symptoms continue to plague me. I roll on a tennis ball, do hip strength activities and have even tried some therapeutic yoga but nothing is giving me relief at this point.

I am scheduling a visit with my Family Doctor hopefully this week to get an 'MRA' of my hip. I too am leaning towards a torn labrum. But I won't know for sure until I have the imaging done. I am getting pain in the hip flexor/front of hip when raising leg and crossing leg over the other.

1. Quit sitting down so much. I noticed that when I'm on my feet most of the day my symptoms are reduced.

2. Roll on a lax ball, NOT a tennis ball. I guaranfreakintee that if you dig in the right spots then the pain will reduce.

Last october I got really bad pf/sciatic pain, and it came on the tail end of 2 weeks off work and lying around all the time. I then constantly sat on that ball when eating, driving, relaxing, and eventually on a flight. 5-10 min. May not be enough; you may have to do it for significant periods of time.

3. Strength training: enough of the body weight bs. Get in the gym and freakin overload your muscles. Research the principles behind progressove overloading. If you're lost in the sauce then invest in a GOOD personal trainer.

4. Couch stretch to open up your hips. It's gonna hurt, especially since you said that flexing your hips brings pain. I guarantee your hip flexors are tight. Look up kelly starrett couch stretch.

In summary: you gotta make some lifestyle changes in order to improve. I've noticed that you haven't changed much in your approach to this injury despite the great advice from lrc. Give my advice a try for 2-3 weeks. If it doesn't work, then I sincerely apologize for wasting your time. But you have nothing to lose, so why not change?

I recommend ready to run by Kelly starrett. I'm not a xfit guy by any means, but his stuff works.

It has almost been a year. How is it going with your hip?