After a 7-year battle with piriformis in my left, er, hip, I'm feeling the same signs on my right side. I'm still doing the PT exercises that got the left side under control, but something's obviously not working since the other side is going out. What's the best way to make this go away before it becomes a real issue? Thanks in advance.
what kind of PT exercises were you or are you doing for the left side??? I always have piriformis problems. If not my left then my right. I have si joint problems though, but I am curious what PT exercises you do.
Squats & clams (can explain this one if you need). Used to do bridges, but always ended up working the quad rather than the butt. Key to the squats is pushing from the heel, not the toes.
Piriformis is a muscle...so it's always going to be there. The thing is, you are doing exercises to tighten an already tight muscle. You need to see a good massage therapist, so that they can loosen the muscle so that it is not compressing your sciatic nerve. Stretching the piriformis is also a great idea. Like sitting on the ground with one leg extended and the other leg bent over the other, the knee straight up. Hold your bent knee in towards your chest without pulling too hard. Hold for at least 40 sec. Another stretch is to sit on a couch or chair with both legs at a 90 dgree angle. Rest one ankle on the opposite knee and lean forward into stretch. These stretches should loosen up the piriformis muscle and open up the hips.
I have a general question-- is the pain you feel with piriformis syndrome at the piriformis AND/OR is it referred pain somewhere else (~butt bone)?
This isn't an easy answer because the body is complicated. Piriformis syndrome is also known as pseudo sciatica because the referral pain is sent down the back of the leg in the path of the sciatic nerve. The piriformis muscle gets too tight and puts a lot of pressure on the sciatic nerve. I don't know what butt bone you are referring to because there is your ilium which is your pelvis and then there is your femur which attaches to the pelvis. Most of the butt muscles, (lateral rotators) attach to the femur at the greater trochanter. Uh, this sounds messy. Anyways...each individual muscle can develop trigger points which can send referral pain in many different directions. It depends on the muscles. So, I don't know if that cleared anything up. Sorry.
I meant the ischium. I fell in a race a few months ago, and I think I pulled my hamstring muscles where they originate on the ischial tuberosity. I still feel it with stretching, core exercises, sitting for long periods, etc., but there's no palpable pain. I feel what I think is scar tissue right at the ischial tuberosity-- I try to massage it out either manually or with something else like a golf ball! Fortunately, it's really not a problem with running.... just an annoying 'pain in the butt' that's always there.
I keep thinking there's a problem somewhere else (scar tissue.... muscle impinging the sciatic nerve....?)-- I haven't figured it out. I've had problems here before (~stepping off a curb), so maybe it's all hamstring issues.
jaguar1 wrote:
I meant the ischium. I fell in a race a few months ago, and I think I pulled my hamstring muscles where they originate on the ischial tuberosity. I still feel it with stretching, core exercises, sitting for long periods, etc., but there's no palpable pain. I feel what I think is scar tissue right at the ischial tuberosity-- I try to massage it out either manually or with something else like a golf ball! Fortunately, it's really not a problem with running.... just an annoying 'pain in the butt' that's always there.
I keep thinking there's a problem somewhere else (scar tissue.... muscle impinging the sciatic nerve....?)-- I haven't figured it out. I've had problems here before (~stepping off a curb), so maybe it's all hamstring issues.
A very difficult kind of injury to handle. Had this (ischial tuberosity) back in 1988, finally went away after more than 2 years. Now been plagued with a piriformis scenario since 1993 (mildly) now quite bothersome since 2005. Honestly feel my hamstring pull back in /88 altered my running mechanics & created a swackload of problems which linger on now.
Good news....since taking on 3 morning paper routes involving a lot of walking, ascending & descending steps, etc., I find my chronic hip issue is getting better, or that area of my glut is improving with this different kind of x-training ie walking, some cycling, etc.
Haven't tried the golf ball application, was all last year having accupuncture, deep tissue, etc. These would help if I backed down my running.
I've had problems with my piriformis on my left side three times and have gotten rid of it each time (but it came back about a year later each time). Anyway, mine was pretty mild since I did not have any shooting pains down my leg or other severe symptoms. If your nerve is really irritated it will probably take a great deal of work to get it back to normal. My first suggestion would be to see a good Active Release Technique therapist (probably a chiro). You might compliment that with some ultrasound stuff from a PT and definitely with some stretches. If ART doesn't work, you are screwed.
I have a question. I've got a pretty bad case of piriformis over Labor Day - my sciatic hurt so much I was begging for drugs.
I've been seeing a message therapist and stretching. I'm pretty much out of pain, except in the morning when it aches down in my butt and down the back of my thigh.
The biggest thing I'm experiencing is that my strength is very low in my affected leg. I still cannot go up on my toes on the affected side. I've been trying to get back to running (i've basically shut things down) slowly (say 2-3 miles), but I cannot push off on that side and I'm running at a 9 minute pace when my normal pace is in the 7:30 range.
Knowing everyone is different, wondering what other people have experienced? This has probably put a damper on any hope of a fall marathon. Thanks.
Thank you for the link! Funny because I actually do a lot of the exercises in the link and have felt a bit better (although the pain persists). I'll do the exercises in the link that I haven't tried yet.
those exercises have saved me...this one also seems to have been effective.
http://www.runnersworld.com/article/0,7120,s6-241-285--11642-0,00.html
it says it's for ITB but it seems to isolate all of the hamstring muscles that lead to the piriformis.
Haha, I have a rope and do that too!:) I do the rope stretching of the hamstrings/gluts 3-4 times a week after a run and the core exercises twice a week for 45 seconds per exercise (x2).
i've been doing these rope exercises by locking the knee straight till i just feel a slight pull, then tensing up my quads for a couple of seconds 20 times. i'll do this with the foot straight, turned out - like the picture snows, and then turned in. there are 3 hammy muscles and there is a different feel with the foot in each direction.
if you go to the gym...find the sitting leg press machine. do one leg at a time with the foot turned in each direction. i find that my bad side is weaker than the good side and i can't go into as deep a squat. so, i quit trying to go lower and now only go to the point where there is no pain, and do as many i can till the muscle is fatigued.
i also have tight adductor mucles and i gotta think that could be part of the piriformis problem. so the other core stuff besides the article is to get in pushup position with your toes on the ball. once you are good at balancing in that position, lift up one foot and balance on one set of toes. you'll feel it in your hips and adductors.
I'll also stretch the adductors doing the 'legs out in front in v-position'. same strategy as with the rope. stretch the legs out only until i feel a pull and then tense up the quads 20 times for about 2 secs each.
i have been able to keep the issue under control. speedwork still makes me sore the next day but a couple of easy days with the exercises and i'm feeling pretty good.