# Piriformis Syndrome



## SpesVitae (Oct 20, 2005)

Has anyone ever experienced or is experiencing this now? I believe I am, and it's frustrating me because it hinders me from jogging as regularly as I'd like.


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## lunareclipse (Mar 15, 2007)

Ugh, yes, I know far more than I'd like about that one. I need to go run (literally) but I'll check back later on. If you have specific questions about causes or treatment, let me know and I'll answer as best I can.


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## SpesVitae (Oct 20, 2005)

I've heard that the best treatment is just to avoid anything that exacerbates it, so does that mean I just shouldn't jog anymore?  
How did you treat yours? Thanks!


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## Panic Prone (Mar 5, 2006)

have you tried a deep tissue massage?


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## SpesVitae (Oct 20, 2005)

*Re: re: Piriformis Syndrome*



Panic Prone said:


> have you tried a deep tissue massage?


How do you do that?


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## lunareclipse (Mar 15, 2007)

There's a lot of good info on medical websites, just Google it and you'll get some good technical info on the problem. Sorry it took so long to write back, I've been crazy busy lately.

Anyway, here's what I know of Piriformis Syndrome. 

-It involves the sciatic nerve becoming trapped & pinched beneath, or as it runs through, the piriformis muscle, which lies beneath the glutes. In some people the sciatic runs through the piriformis muscle, in others beneath it; you're probably more likely to be susceptible to piriformis syndrome if it runs through the muscle.

-It can hurt just in the lower-outer part of your butt (where it pinches) or the entire branch of the sciatic nerve can tingle or go numb. Usually you feel it tingling down your leg but sometimes it imitates "true" sciatica, and you'll feel where it inserts in your lower back on the affected side.

-A common cause is keeping your wallet in your back pocket; sitting on the wallet will irritate the nerve. If that's the case it's an easy fix - don't sit on your wallet! Aside from the wallet thing, if you're putting unusual pressure on the affected side -with a bad chair or if you're not sitting straight - that can be a cause too.

-Running can certainly cause trouble, especially if you have tight hip flexor muscles. Make sure to stretch well to maintain good flexibility, since running strengthens but can also tighten your glutes, hamstrings, etc. If you're having trouble with your sciatic (such as piriformis syndrome) stretch gently. 

-Limit your activity to things that don't make the problem worse. If it gets more inflamed after running or stretching, especially if it feels worse the next day, walk for a few weeks or jog slowly, keeping your stride short enough that it's not painful.

-I'd suggest avoiding hills while your sciatic is bothering you. Anything that requires a high knee lift - such as running uphill - really makes it worse from my experience. I actually injured myself in the first place running up a hill while racing a half-marathon - then made it worse because I didn't want to take a break from running afterward.

-As Panic Prone wrote, deep tissue massage can help, as can ultrasound - they may help break up scar tissue. I also know people who sit/roll around on a tennis ball; that helps if the piriformis is spasming. 

-If it doesn't resolve in a few weeks, go see a physical therapist who specializes in athletic injuries. They can help with teaching appropriate stretching exercises, giving ultrasound therapy etc.

Just really be careful you don't overdo it and make it worse! Better to take it easy and let it heal with "active rest" than do too much and end up with a chronic injury.

So, my non-expert recommendation is to walk or run very gently until you see some improvement; stretch your hips and the back of your legs - hamstrings, calves, achilles tendons, even plantar fascia (the connective tissue on the bottom of your foot) - regularly; and ice for 20 minutes after exercise (always with a barrier such as a washcloth between skin and ice!) If it doen't improve, see a doctor or exercise specialist P.T.

Good Luck!
Luna


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## SpesVitae (Oct 20, 2005)

Thanks, Luna! I've done my googling and tried out the recommended stretches, and unfortunately, nothing has really worked yet. It just frustrates me that while the pain can improve after periods of less rigorous exercise, it still manages to creep back in after I intensify my workout, especially if I run. I was hoping that this would go away on its own, but I think I'll have to visit some professional. How did you treat yours and do you still feel it every so often or is it completely gone?


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## lunareclipse (Mar 15, 2007)

Well, I've had two bouts with piriformis syndrome. One went away completely, the other hasn't.

The first was 7-8 years ago. It came on gradually, and went away gradually when I learned about the causes of the problem and avoided fast running and sitting in ways that exacerbated it. Took maybe 6 months total from onset to complete resolution of symptoms, other than the occasional flare-up from sitting too long on bad airplane seats. 

The biggest single change I made was avoiding airlines with uncomfortable seats, believe it or not. In particular Northwest had these old 747-200's; even the business class seats hadn't been replaced in decades (they still had the old armchair ashtrays!) Every time I went on an overseas flight (which is every few months) my sciatic nerve would flare up, kill when I ran the next morning, then feel totally better after about a week.

Finally I switched to United, Singapore etc - any airline with a fairly new A340, 747-400 or other nice plane on the long trans-Pacific flight. Finally Northwest replaced their old 747 with an A340 on Portland-Tokyo so now I'll take that flight too. Always go business class and I move around andget up & stretch pretty often. I'm pretty small, around 5"4" 115-118 so that makes fitting in and airline seat in a variety of sitting positions easier!

This second bout has been a lot more stubborn, and I just don't know what to do at this point. This is the injury from the 1/2 marathon last fall, and it just won't completely go away. I took a couple of months off running, but working out is my best way to relieve anxiety and I finally couldn't stand it anymore. I did the stretching, ultrasound etc. with a physical therapist and it did get much better. 

The one exercise that really doesn't bother it is the elliptical trainer. I can get my heart rate way up on that for an hour (then the machine shuts down automatically, lol) with no piriformis/sciatic flare-up. I listen to music but I still find it pretty boring and nothing like running outdoors though.

For the past couple of months I've been back up to 25-35 miles/week without much trouble (yay!!) - I just can't run too fast. I made the mistake of hammering out about 5 really hard miles last night and my sciatic's really tingling now - NOT good. Just have to be disciplined about not running too fast and I'm alright. Haven't tried running really far (nothing over 8 miles recently) or going any higher with my weekly mileage - don't want to push my luck.

I kow it's not the best answer - I wish this thing would go away completely, but at least I'm running again and as long as I don't run flat out fast it doesn't get any worse - I don't usually feel it at all unless I overdo it (like last night). Just have to be disciplined and avoid really hard running and racing, I guess. It's frustrating - there's a hilly half marathon coming up that I really want to run with a friend - but it's a whole lot better than not being able to run at all and having shooting pain down my leg, which is where I was a few months ago.

If you find an effective solution please let me know!


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## Panic Prone (Mar 5, 2006)

*Re: re: Piriformis Syndrome*



SpesVitae said:


> Panic Prone said:
> 
> 
> > have you tried a deep tissue massage?
> ...


go to a massage therapist and massage on the muscle. I would try the trigger point approach first.


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## yjessop (Mar 2, 2011)

*Invaluable info*

The information I have read today on this site is invaluable, thanks to everyone who posted.

This is my first bout of Piriformis Syndrome - I have been running for 11 years now and have almost every injury known to runners but this is by far the worst! I have been unable to walk properly for 3 weeks now, been to the doctor twice and told to take anti-inflamatory drugs, when it first happened I couldn't actually lift my foot off the floor and had to be carried out of our local leisure centre and then to the door at home - very embarrassing. Today it seems to have gone very warm and I think it feels less painful and I can almost walk without a limp! Does it usually stop as quickly as it starts?

Yvon


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## Brightpaperwarewolf (Oct 16, 2008)

This stretch is necessary for runners:


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## tyciol (Mar 21, 2011)

Is it one of the hip flexors?


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