Piriformis Syndrome

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trailgumby
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Piriformis Syndrome

Postby trailgumby » Sat Sep 24, 2016 5:32 pm

I've been out of action this week with what looks like Piriformis Syndrome.

Damn, it's painful. If a dislocated shoulder is a 9 on the pain scale, there have been periods where I've been somewhere between 6 and 7.5. Fortunately stretching and anti-inflammatories have got me heading in the right direction, but it's been, shall we say, a period of self-examination.

After a few items were knocked out by tests (eg, DVT), the rather eccentric but astute physio my GP referred me to put his finger on it being the piriformis. So far we've changed orthotics and been doing stretching exercises, along with rolling the muscle with a hard rubber ball, and it has been gradually heading in the right direction. However, walking and standing for more than a few minutes is still acutely uncomfortable. If nothing else, it has breathed new life into "Shut up, legs!"

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A_P
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Re: Piriformis Syndrome

Postby A_P » Sat Sep 24, 2016 7:17 pm

I have had this on and off for a couple of decades , interesting that i can usually get back on the bike well before i can stand up straight and walk normally.
Rest, stretching, anti-inflamms.
My initial injury was overuse / rowing related.

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redsonic
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Re: Piriformis Syndrome

Postby redsonic » Sat Sep 24, 2016 7:35 pm

I get piriformis pain secondary to sacro iliac problems, and have found pressure point release with a Theracane really helps.

Image

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foo on patrol
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Re: Piriformis Syndrome

Postby foo on patrol » Sun Sep 25, 2016 6:31 am

That ^^ looks like a Medieval torture devise, Red. :shock:

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Re: Piriformis Syndrome

Postby mikesbytes » Sun Sep 25, 2016 9:29 am

What was diagnosed as being the reason?
If the R-1 rule is broken, what happens to N+1?

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Re: Piriformis Syndrome

Postby trailgumby » Sun Sep 25, 2016 11:16 am

mikesbytes wrote:What was diagnosed as being the reason?
That's a complex question. There are several factors that hve compounded together.

I have had an undiagnosed lower leg deformity since childhood that leads me to over-pronate the left foot. The resultant muscle recruitment patterns to stabilise and compensate have led to a number of left-side "challenges" that have surfaced this year, including ITB friction at the knee since late April

I had a bike fit a few weeks ago and this has led to me working my glutes a lot more, which is a desirable outcome as I had traditionally been over-using my quads. ITB friction syndrome fixed. However, the weaker left-side glutes have been worked pretty hard and probably haven't built up enough yet and the poor little piriformis was just getting over-worked and under-recovered until it reached a certain threshold and decided it was time to let me know it wasn't happy.

Because of my tendency to pronate, my shoe heels tend to wear in an unhelpful pattern, and I am at the point where they need replacing. My running shoes were also identified as having a heel cushioning design that exacerbates the problem. They've been replaced.

Sitting on my arse a lot through a very challenging end of financial year with long hours requiring high levels of concentration in front of a screen has no doubt also been a contributing factor.

The weird thing was the pain started in the outside of my left calf and crept up my leg from there, leading me to think it was a DVT last week, but that was ruled out thankfully. The final straw was the skills day last Sunday. Lots of standing around was just too much for it, and then it really started to yell.

Riding is fine though. Speaking of which, the sun is now out...

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Re: Piriformis Syndrome

Postby mikesbytes » Sun Sep 25, 2016 1:00 pm

Do some research on the Sciatic nerve, might explain why the pain started lower down and worked it way upwards. A tight piriformis can press on the sciatic nerve causing pain at other areas of the sciatic and its branches.

Are you getting any lower back pain?
If the R-1 rule is broken, what happens to N+1?

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Re: Piriformis Syndrome

Postby DG1984 » Sun Sep 25, 2016 1:37 pm

I've got a bulged disc at the moment...so I can sympathise with your plight. Been out of action for just under 2 weeks with zero sign of improvement. Everything with the exception of sitting or lying on my back hurts and I can't walk without having a burning pain throughout my calf and sometimes glute/butt. The sciatic nerve is the worlds biggest jerk.

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Re: Piriformis Syndrome

Postby trailgumby » Sun Sep 25, 2016 4:36 pm

I'm fairly confident mine is not disc related, but I do have a history of left SIJ issues. Both the GP and the physio are pretty confident it is nether of those though as I can easily and comfortably bend forward and touch toes.

As an experiment I pumped out a somewhat sedate 50km today (under 26km/hr moving average) from my place to St Ives and Duffys Forest and found my left leg was rather weak (40/60 power split). Probably that's because I've been favouring it all week. :|

The piriformis was fine on the bike but a bit fussy when I got off, and the roller and stretching was giving only temporary relief. A long hot shower has helped settle it down, though. I have a little bit of ITB friction creeping back - probably from the ITB being under tension all week from the continued intense pain.

I'll hit up the physio for a second set of orthotics for the work shoes I leave in the office on my ride-to-work days.

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Re: Piriformis Syndrome

Postby mikesbytes » Mon Sep 26, 2016 4:49 pm

The lower back pain question was more related to the sciatic nerve than having an actual back problem.

What stretch's have they recommended for you?
If the R-1 rule is broken, what happens to N+1?

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Re: Piriformis Syndrome

Postby vosadrian » Tue Sep 27, 2016 10:28 am

I am curious about piriformis syndrome. I have done some google for some symptoms I have in my left leg and came up with piriformis syndrome (ages ago and then seeked treatment on that basis). It seems that this name for a syndrome has two quite different sets of symptoms. In one case people get a lot of pain in the muscle itself in there butt. In the other case, the piriformis puts pressure on the sciatic nerve and this causes radiated pain down the leg. It seems you can have onr or the other or both.

In my case I have only minor pain in the muscle itself. Enough that it is not a bother, but I get a radiating pain down the back of my leg that builds up over time of having the leg in certain positions. One such position is to sit on a chair with the bad leg crossed on top of the other knee (ankle on knee,,, simlar to a piriformis stretch). After a minute or so this radiating throbbing pain comes up. I get similar symptoms when I sit on a massage ball on the piriformis or even if I perform a ham string stretch. The pain sort of works its way down my leg starting from the piriformis, down the back of the thigh and back of knee down the back of the calf into my heel and arch. Normally as I start feeling this happening I move to stop it and it disappears as slowly as it came, so for me the inconvenience is more in limiting positions I am comfortable in and does not effect my bike riding much (though there have been some times I have felt it on the bike). I have had scans of my back done (MRI, CT) with no nerve compression showing. I had an MRI done of my piriformis that showed no issue (but my position in MRI was not a position that causes me pain). I have done stretching of the piriformis and massage ball stuff with no improvement. I have given up as I have bigger issues to conquer at the moment, but I would like to sort this out at some point.

Anyway, I was just curious if you had any symptoms similar to mine? I would like to find a good practitioner to work through this with. My GP ordered the scans and they came back negative. A physio had me doing stretchs and they did massage but no improvement noted. Most seem to think that piriformis is not my issue since I have not much pain in the piriformis itself. I am quite certain it is related to the sciatic nerve, and there are a few places it can get aggrevated between the spine and mid leg including the piriformis.

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