I've not been able to run since 7/9/04 and was diagnosed with Piriformis Syndrome. Has anyone ever suffered from this that can offer advice and/or suggestions on recovery and future prevention. I'm dying to get back into running!
My husband has piriformis on both sides. He is an active bicyclist, hiker and fisherman. His secret is an excellent chiropractor he sees a couple times a year, and lots of stretching. There is no reason why you should have to be sidelined for so long. In fact my husband thinks that the longer he is away from active sports the more painful his piriformis syndrome becomes. If you don't have the resources for a chiropractor or physical therapist, check the web for stretching exercises. Start slow, but keep moving. Good luck!
I'm not trying to be the bearer of bad news. This could be good or bad news,depending on how you compare to me. I just want to present my story FYI.
I've had P.syndrome since mid-1997 or so. It took self-diagnosing (through the internet) to figure it out because I'd been to 2 orthopedic docs, two neurologists, and five chiropractors and had numerous x-rays and a set of MRI's done without getting even a GUESS from one of them....although with some coaxing, the last one said he thought maybe it's a bursa. Well, that's funny because the body is full of bursae...they're supposed to be there. I assume he meant bursitis. It could be that. But, someone at a runner's forum suggested P.syndrome, and then I found lots more info on it, tested it, and found out that I exhibit all the same symptoms,and certain types of movement aggravate it in the same way as P.syndrome.
The only info/suggestions/recommendations I got from docs and Chiros were to take antinflamm's daily. I'm just not willing to take drugs every day,unless I could do it for, say, a few weeks, and be done with it. I took some ibuprofen the night before a big ride last year, and then again that morning. It didn't help at all. At the magical mile 18-20, I started to get this insidious pain at about L4,5,6 on the right side, and had to get off the bike to stretch about every 4 miles after that for the entire 60 miles. It was brutal. After riding for 16 straight years, and running off and on for 9 years, I gave both up for an entire year right after that.
Now...time's up. And it's still there, damn it! But, you haven't had yours for long at all, so it seems likely you'll heal much faster. I had mine from '97-late '03 before I finally decided to give up both running and cycling for a long period. (I had tried giving up one or the other for a few weeks at a time).
I'm not saying the woman who wrote about her husband's problem is wrong and I'm right, but everything I'm reading on the net (and everything I've done) indicates that continuing to ride a bike, run, or drive a car all exacerbate the problem. I was getting tired of not being able to go more than 20 miles on the bike anymore. There just aren't that many organized rides that short. And, after a run, the symptoms were more lingering. ( I blamed it on running because of that, but then I realized it was probably the pressure from the bike seat that started it, and running just manifested it more).
Personally, I recommend none of the above mentioned activities (well, as little driving as poss.-take mass transit, maybe?)for about a month and see if it helps. You can always go back to those things. Listen, I've always believed in working through pain, but this is not wimp stuff here. I worked through the pain for six years and now I'm in a heap o trouble because it isn't going away, and it isnt' going away. In the last year, I've gotten many massages (I think one made it worse, since she found the elusive spot and really bore down on it for a long time), I've eased my way back into weights, I've tried swimming laps regularly. None of that has helped. I think this one is about leaving it alone.
I have been bothered by Piriformis Syndrome for the last 5-6 years. It has been uncomfortable, with the discomfort radiating down the back of my legs. It has mostly caused me to feel like I had no energy at all in my legs. My feet felt like they weighed 40 lbs each.
I had begun stretching and that was reasonably effective. But when I began running again about 8 months ago, I was concerned the the problem would interfere with my progress, but quite the opposite happened--routine running and light stretching after the run has almost eliminated the problem. Another thing I did that has helped a LOT was to adjust my chair at work and in my car so that the horizontal part of the seat is not tilted up (so that the seat is like a bucket). Instead, the seat is flat, or sloping very slightly down. That has been a big help. But mostly, I think the running (and the improved flexibility the running is giving me) has helped the most.
The most effective stretch (for me) was as follows:
To stretch your RIGHT piriformis, lay on your back, bend your knees and cross your right leg over your left so your right ankle rests on your left knee in a figure four position. Bring your left leg towards your chest by bending at the hip. Reach through and grab your left thigh to help pull things towards your chest.
Here are some other stretches (keep in mind that stretching the muscle often duplicates the pain):
Hope that helps.
Marc in Melbourne FL
Hang in there, it will be a long road but it is worth it.
I suffer from identical problems and have since 2 years ago. FYI - I am 51 years old, recently (last 18 months) lost 45 lbs with a combination of diet and LOTS of exercise, which (LOTS of exercise and the diet..) exacerbated the injuries.
I've gone the chiropractor road, and love them, but it did absolutely nothing for piriformis. What finally did (is doing - it's a continuing thing) the trick is an EXCELLENT therapist, recommended by my referred sports doctor. Here's her remedy - all of the exercises mentioned in the previous posts (also look in Runner's World archives - online - for more stretches), plus weight training, plus cross-training. I do a LOT more lower body weight work than I used to do and it helps a lot. Specifically, I work the quads and hamstring with weight machines. Also, band therapy helps - check with your local sports therapist for this.
The piriformis is not gone, but it IS manageable with work on my part. I don't know if I will ever get to the level I was 15 years ago in terms of mileage and speed, but I can run again and it makes me feel a TON better.
Hang in there and stretch....
Rather than stretch the piriformis, you want to force feed blood and oxygen into the muscle. Please read the related links below.
Watch how you sit, if you allow the knees to roll out to the sides you are going to allow the piriformis to be compromised. 98% of the problems we see here in the US are on the left side of the body, because the way you sit in the car. You allow the left leg to roll outward towards the door panel and the foot curls upward under the steering wheel. This causes the piriformis and the soleus (calf area) to go into spasm.
TPT has the Total Package on sale for $110.00 versus $130.00 it's a great value.
The piriformis muscle goes from the sacrum tothe leg and can become hypertonic due to pelvic segmental dysfunction--a chiropractic problem, or leg/hip problems or too much sitting as well as a number of other things. the reason there is so much disparity amoung sufferers as to treatment is due to the different causes. No particular theyapy will work unless it appropriately addresses the specific cause.
When a muscle become chronically hpertonic it actually comprimises its own blood supply and then a chronic inflammatory pricess begins which results in fibrosis (scarring ) of the muscle fascial which is painful and causes more spasm which causes more pain and so on. the best therapyfor the muscle itself is a technique called ischemic compression wherein the therapist or chiropractor applies a substantial but -unvarrying- pressure to the belly of the muscle for anywhere from 45 seconds to two minutes until the muscle spindle cells allow the muscle to relax then a very gradual release of presssure. It is painful Re: Piriformis Syndrome but invariably people feel better almost immediatly and usually on ly one or tweo applications are necessary. BUT then if the causative stressor has not been dealt with it will come back. Ultrasound therapy is usefull and accupuncture could be useful. People who do not heal from this condition are simply not addressing the causeative stressor for exaple ; sitting on a wallet, men who sit a lot and wear a wallet in their back pocket put a direct pressure on the piriformis and twist the pelvis.
I have had recurring periformis syndrome for years. It always acts up after I increase my running distances. I have found a convenient stretch that helps and can be done at your desk. In a sitting position, cross your leg so that your ankle rests just above the opposite knee. Then slowly bend from the waist forward (still seated) and hold for 10 -30 seconds and release. Then try the other side. Hope you get relief.
I'm on my second bout of PFS (my abbreviation).
I am naturally quite flexible, so when I'm tested for ROM (range of motion), I'm typically told that I have no issues that need to be addressed by stretching, but that's not true.
This time around, I've discovered (through a ton of research) a number of things that help resolve PF:
1. Avoid running on canted roads. PERIOD. Even if you switch sides, your vulnerable side will "do the tighten up" over time. Obviously, many running races are on roads, and you can't avoid it then, so save your road running ONLY for racing.
2. Things that need to be stretched: It's not just your piriformis, stupid! Check your psoas, adductors and quads on the affected side. I bet they are all tight. Stretch them EXTRA. You may need to work to find the right stretches. Since I'm naturally flexible, I need to do unilateral (i.e., one-sided) stretches so that I can check the different ROM on each side. Some stretches just plain don't work for me. I found some really good ones here: http://jaxmed.com/massage/pirformis_stretches.htm The last one is particularly excellent, as it stretches the PF on one side and the psoas on the other at the same time. Your QL (quadratus lumborum) on the affected side is probably also tight, so work on that as well.
3. Things that need to be strengthened: Your glute medius on the affected side is probably weak. Mine is. If your adductors are tight, you may need to work on your AB-ductors.
4. Sitting is bad. If you have a desk job like I do, get up every 10 minutes and walk around. When you do sit, use perfect posture and lumbar support. If your car has bucket seats, never buy them again! But, add a cushion to get the seat so it's a 90-degree angle. If you drive a lot, take breaks and stretch.
5. Sleeping position: best is flat on your back, legs straight. Sleeping on your side isn't that bad, but if you bend your knees, you are contributing to tight psoas muscles, which is bad for the PF.
6. Massage and assisted stretching: A good sports-masseuse will both work on the muscles that need stretching (and that probably have trigger points) and should also stretch you out. Some assisted stretches will give you a much better stretch than you can give yourself.
7. Trigger point work: The Trigger Point Therapy Workbook by Clare Davies is invaluable in dianosing causes of pain and tells you how to work on yourself. You can then use this with your masseusse to help fix whatever ails you from a myofascial standpoint.
8. Activity levels--while it may seem to help to stop running, running may or may not be the root of the cause. I find that the less I sit, the better I get. So on a day when I bike a lot (I'm a triathlete), then do lots of house or yard work, I feel the best. Biking doesn't seem to aggravate this, and neither does swimming (I don't do flip turns, though, which might tend to tighten the psoas muscle).Elliptical trainer might be OK, too.
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Hey I read just recently to sit on a tennis ball for 30 seconds. It is important to find the most tender spot and let you full body weight down on the ball. This will cause a type of deep tissue massage and help relax that muscle. It was suggested to do this on a firm surface a couple times a day until the problem was better. Try it it can't hurt, well maybe a little pain with direct pressure.
I believe I have piriformis syndrome in my right leg. I get pain in the piriformis area down into my hanstrings whenever I sit for prolonged periods of time or when I'm running. I have also started experiencing pain in my right knee where my hamstrings attach. Have any of you had this in association with you piriformis syndrome or do I have another problem on my hands?
just recently diagnosed with piriformis syndrome and currently having physical therapy 2x a week, which seems to decrease the pain, but recently I've notice knee pain which I was told was related to piriformis syndrome.
i have been trying to self-diagnose this horrible pain deep in my butt/hip joint this week, which just hasn't gone away even with stretching and stopped running! this pain has actually come and gone before, but this time it's much worse, it hurts while i sit, and i couldn't sleep very well last night.
So, thanks to great internet sites and this forum, i have now come to the conclusion that it is the Piriformis Syndrome, and all these great stretches are really helpful.
but i think i have a mild case of it. do you know if i can still run once the intense pain is gone..(like i usually run thru mild knee pain w/ NSAIDS) or should i wait for 100% recovery? Agghhhh....am training for a 10k...
I wrestled with piriformis syndrome for 6 months - then it was solved. My chiropractor referred me to an ART expert - Active Release Technique - unbelievable results. After the first session I was able to walk without any pain, and after 3 to 4 more sessions I was back running and biking in full form. I now return for the occasional session if it happens to flair up, which is usually after a triathlon race.
There are a variety of web resources to help you locate an certified ART practioner in your area. Many of them also licensed chiropractors.
Dr. Al Jeffels in my city is known because of the many professional and olympic athletes he treats. ART is not known by many but is gaining popularity of late. The results have been exceptional for me.
I have had piriformis syndrome for over 2 years. I have done PT on/off, massage and seen a specialist in Manhatten. I'm going to do another round of PT with a focus on deep tissue. Has anyone considered botox injections or done surgery for this problem? I am afraid I will never be able to run, cycle or hike again. Short walks cause tingling in my leg.