Piriformis Syndrome - a literal pain in the butt

TavistockToad

rebben23 wrote: »

Thank you, all! I have my PT appointment tomorrow and have been doing some light stretching every day, throughout the day (after icing). Thankfully the constant pain has subsided!

You shouldn't stretch after icing. Stretch first.

Spliner1969

rebben23 wrote: »

Thank you, all! I have my PT appointment tomorrow and have been doing some light stretching every day, throughout the day (after icing). Thankfully the constant pain has subsided!

If the pain returns, or moves down into your leg I'd go see an Ortho doc, or get a referral to one. You could also have a herniated/bulging disc. The sciatic nerve travels right near (or is it through, I forget) the piriformis muscle. In late 2015 I started having what I thought was piriformis syndrome, kept at exercising and the pain shifted down into my leg and an MRI revealed a bulging disc. I had been lifting a lot recently and noticed the piriformis pain when walking/jogging. Stretches helped but did not solve the issue. It kept coming back. Turns out I had injured the disc not the piriformis itself.

nowine4me

Timely post, I’m headed to Ortho tomorrow for the same thing. It doesn’t hurt when I’m active, but hurts like hell if I sit too long or sleep in the same position. It’s from a fall years ago and didn’t bother me when I was sedentary, but running has aggravated it. I’m hoping they’ll give me a cortisone shot, it did wonders for my plantar fasciitis. Has that helped anyone else?

ETA - chiro and stim did nothing for me.

heybales

Since chiro has been mentioned, I'll mention something else if the PT indeed says stretching is a much needed step. They may even do this now, seen a few.

Chiro's and massage therapists seem to be the ones taking the training for ART - Active Release Technique.

You mentioned perhaps there was an incident that led to this.

Basically it combines the idea of pressure point therapy, with breaking up the scarring that can occur in injured muscle fibers.

I had basically reached that point where all the stretching that should have been done for glute wasn't helping actually remove the tightness leading to a tilted hip leading to sciatica issue. I was asking a friend massage therapist if I was missing a stretch, she showed be a variation to include the quadratus lumborum which was terribly tight - and mentioned she had gotten trained in ART recently.
We talked, I researched, made sense, but skeptical as always.

Found a chiro recommended by a workmate that didn't do the standard 3 x weekly for 6 wks monkey business.
He found some spots, he stretched the muscle through them, I'm sure I cried or wanted to (cries of good pain of course) - and next day it was better.
Muscle wasn't as tight - and I think that was the only treatment for that issue.

I'd gone back for other issues after some injury or overuse, and the tell-tale signs of muscle just not seeming to stretch, especially when both sides start tight but only one improves.
1-2 sessions is it, always based on how I felt about the improvement.

For him with me, adjustments seem to be an after thought if even needed. I'm the one asking then usually, but always after a stretch of the affected region, helps get the joints moving they way they should (I don't believe in the "popped back in place", neither does he, with me anyway, but rather things should move, not get locked down).

Just an idea if the stretching still seems to leave it tight, or very soon afterwards.

try2again

heybales wrote: »

Since chiro has been mentioned, I'll mention something else if the PT indeed says stretching is a much needed step. They may even do this now, seen a few.

Chiro's and massage therapists seem to be the ones taking the training for ART - Active Release Technique.

You mentioned perhaps there was an incident that led to this.

Basically it combines the idea of pressure point therapy, with breaking up the scarring that can occur in injured muscle fibers.

I had basically reached that point where all the stretching that should have been done for glute wasn't helping actually remove the tightness leading to a tilted hip leading to sciatica issue. I was asking a friend massage therapist if I was missing a stretch, she showed be a variation to include the quadratus lumborum which was terribly tight - and mentioned she had gotten trained in ART recently.
We talked, I researched, made sense, but skeptical as always.

Found a chiro recommended by a workmate that didn't do the standard 3 x weekly for 6 wks monkey business.
He found some spots, he stretched the muscle through them, I'm sure I cried or wanted to (cries of good pain of course) - and next day it was better.
Muscle wasn't as tight - and I think that was the only treatment for that issue.

I'd gone back for other issues after some injury or overuse, and the tell-tale signs of muscle just not seeming to stretch, especially when both sides start tight but only one improves.
1-2 sessions is it, always based on how I felt about the improvement.

For him with me, adjustments seem to be an after thought if even needed. I'm the one asking then usually, but always after a stretch of the affected region, helps get the joints moving they way they should (I don't believe in the "popped back in place", neither does he, with me anyway, but rather things should move, not get locked down).

Just an idea if the stretching still seems to leave it tight, or very soon afterwards.

Thank you for this! I've been following this thread in case something new was mentioned and this sounds very promising... I'll mention it to my hubby. He had a freak accident at work that involved a large tear of his glute and lots of scar tissue. Only problem is, we live in a semi-rural area and I'm guessing it may be difficult to find someone trained in a newer technique, let alone a no-nonsense chiro like yours who doesn't view it as their job to keep you coming back! What area are you in? (Edited: whoops- never mind! Saw it on your profile!)

canadianlbs

mrsbarnett1012 wrote: »

stand on your left leg and cross your right ankle over your left knee and then while holding on the aforementioned counter, etc, sink down into a kind of squat.

just going to say that i probably wrecked something deep in my hip by over-applying that stretch. not to take from its validity, but i can't stress strongly enough how important it is to have enough support that you can control every bit of the depth . . . and to be GENTLE with it.

actually, being gentle with any muscle that's in actual spasm is critical. if you push it too hard when it's set to fight you, you increase your chances of tearing it. and then you have a whole world of brand-new troubles that could have been prevented.

/public service annoucement

heybales

It's been around since early 2000's actually, even though I didn't find it until after 2010 I think.
Most seem to be registered with the ART, not sure if that's free for them or they pay. But good place to start for search of providers.
http://www.activerelease.com/index.asp

Not sure how to tell if it's one that will do one and done - or attempt the revenue stream by keeping you coming.
Or it's my attitude coming in, they know they aren't getting much out of me.
Perhaps my cheapness, I mean thriftiness, is visible.

It may not be the solution, it's not a magic bullet, but if reason for issue is scar tissue in fibers that can be broken up by stretching through them - it can work.

try2again

Thanks for the link, @heybales !

nowine4me

just as a follow up. The Ortho ruled out PS for me (I was convinced that's what it was) and he ordered an MRI.

deannalfisher

similar to ART - if you can find a massage therapist that does myofascial release - it helps a lot of my issues

Spliner1969

nowine4me wrote: »

just as a follow up. The Ortho ruled out PS for me (I was convinced that's what it was) and he ordered an MRI.

Then maybe you caught it in time. Mine was a bulging disc, but I thought it was PS. I let it go until the pain traveled down my leg before going for help with it. Mistake. Had to be cured with rest, several steroid injections in my lower spine, and some PT/Yoga. I still do the yoga I learned to keep it from happening again, and I had to build up a very strong core to avoid re-injury. Took a while but was worth it. The added benefit of the strong core is that I can now run, and could not before without risking injury.