Piriformis syndrome

Squish · Postby **Squish** » Tue Apr 17, 2012 3:11 pm

Does anybody have experience running through piriformis syndrome? I am pretty sure that is what I am dealing with right now, and as my mileage is increasing (training for a half marathon at the end of May), the pain in my butt is increasing. I am icing, heating, anti-inflammatorying, rolling, stretching, not-stretching, you name it, but so far no improvement, and I am getting discouraged. I just moved to a new city, so I have finally gotten in with an RMT (tomorrow) and physio starts next week.

I am not enjoying running anymore as the pain (likely due to pinched sciatic nerve) is there with each and every step, but I am carrying on with my training schedule as planned. Am I realistic to think I can still run a half marathon in 5 weeks, given I am starting treatment this week? Can it be treated successfully rather quickly? It is my understanding that the source is tense or spasming muscles pushing on the sciatic nerve, so if an RMT can work those muscles, it can potentially be treated rather swiftly, non?

Jwolf · Postby **Jwolf** » Tue Apr 17, 2012 3:23 pm

Have you tried ART? That can really help with those muscles when other things don't work. It's hard to get in and really stretch/release them yourself.

The half is still reasonable if you can get in there and relieve the tension in that area.

fe.RMT · Postby **fe.RMT** » Tue Apr 17, 2012 3:26 pm

Having just seen someone that thought they had piriformis syndrome and in fact had a disc herniation make sure your preferred health care provider is thorough with their assessment. I can recommend someone excellent in Guelph if that's where you still are.

As to how long it will take to resolve, there are a lot of factors. ART may be helpful if the nerve is 'caught' in scar tissue but if it is just a matter of the tone of the muscle being increased that might not be the best way to go about it

Squish · Postby **Squish** » Tue Apr 17, 2012 3:52 pm

It is interesting you say disc herniation fe.RMT. I did have lower back problems a few years back, presumably a herniated disc. I have no idea what triggered my (assumed) piriformis. This is something I will definitely bring up to my RMT tomorrow, in case it is a factor that I am unaware of.

I really miss my ART-RMT from back in Ottawa right now

.

ian · Postby **ian** » Tue Apr 17, 2012 7:25 pm

Squish wrote:Does anybody have experience running through piriformis syndrome?

Yep, that one was three injuries ago. I found that pain was a pretty accurate barometer of how the recovery was evolving, therefore I could run slowly for half an hour here and there but basically kept away from high mileage or speedwork until sufficient healing had taken place (about two months in my case). Five weeks out, 21K might have to be a gentle long run, but with the whole summer ahead of you, there's no sense delaying the recovery with excessive training. As mentioned above, an informed professional opinion might modify the prognosis.

Squish · Postby **Squish** » Tue Apr 17, 2012 8:52 pm

Thank you for sharing your experience Ian. I am hoping the new RMT I see tomorrow is a good one, and we can determine the root cause of my pain, so I can decide if I should push it to run in 5 weeks during treatment/recovery. I was doing a speed track session tonight, and I could really feel the pain halfway through the session. I could feel the pain down the back of my leg, all the way to my calf, and my one leg was really sluggish which made for an unenjoyable experience. I'm just not enjoying running right now, which is helping me come to terms with my decision to back off. If I don't see improvement in the next week, after a few treatments, then I will take a step back *sob*.

Jogger Barbie · Postby **Jogger Barbie** » Mon Apr 30, 2012 2:05 pm

I struggled with this about a year ago. In my case, I did basically run through it, but with a lot of help from my ART practicioner and a lot of stretching. Not sure which of those two made the biggest difference. It seemed to help to stop and stretch periodically during my long runs if things were getting tight and painful. And I vividly recall racing ATB at the end of March, with my piriformis absolutely screaming during the last few km. That's the one time that I really did "run fast to get the agony over with". Five or six weeks later (beginning of May) I ran the Vancouver marathon with minimal piriformis issues, and they were pretty much done by the time of the Niagara Ultra in mid-June.

FWIW, I'll echo the concerns about making sure it really is your piriformis, not a disc or other issue, especially given your history.

Good luck and keep us posted.

trixiee · Postby **trixiee** » Mon Apr 15, 2013 9:55 am

suffering with this now too... after 2 hours on the bike, it becomes almost unbearable. Had RMT on Friday, with no improvement what-so-ever.

Next step - physio or chiro?

fe.RMT · Postby **fe.RMT** » Tue Apr 16, 2013 4:19 pm

trixiee wrote:suffering with this now too... after 2 hours on the bike, it becomes almost unbearable. Had RMT on Friday, with no improvement what-so-ever.

Next step - physio or chiro?

Well, one RMT appointment is not enough time to determine if the treatment is effective or not. I guess the question is what do you think you will get from the physio or chiro that you won't get from the RMT? I personally find that most patients seem willing to commit to 10-15 sessions of physio but not 4-6 treatments of massage.

piriformis syndrome has become a bit of controversial diagnosis, so whoever you decide to see, assessment skills should be high on their list of attributes

trixiee · Postby **trixiee** » Tue Apr 16, 2013 8:50 pm

fe.RMT wrote:
trixiee wrote:suffering with this now too... after 2 hours on the bike, it becomes almost unbearable. Had RMT on Friday, with no improvement what-so-ever.

Next step - physio or chiro?

Well, one RMT appointment is not enough time to determine if the treatment is effective or not. I guess the question is what do you think you will get from the physio or chiro that you won't get from the RMT? I personally find that most patients seem willing to commit to 10-15 sessions of physio but not 4-6 treatments of massage.

piriformis syndrome has become a bit of controversial diagnosis, so whoever you decide to see, assessment skills should be high on their list of attributes

Good point. I just need to find a really good RMT in Chatham. My RMT moved to Stratford, 2 hours from Chatham. I see him whenever I can, but true, it's not enough.

kab · Postby **kab** » Tue Apr 16, 2013 8:59 pm

As others state, find a good athletic therapist. Also avoid sitting for long periods.

ceileigh · Postby **ceileigh** » Thu Apr 18, 2013 7:18 pm

I had issues with this last year and it still acts up if I don't stretch. For me though the key to getting past it was stretching the psoas and illiacus. The stretch that worked the best was hanging one leg off the table like they show here:

http://experiencelife.com/article/smart-stretching/

trixiee · Postby **trixiee** » Thu Apr 18, 2013 7:24 pm

ceileigh wrote:I had issues with this last year and it still acts up if I don't stretch. For me though the key to getting past it was stretching the psoas and illiacus. The stretch that worked the best was hanging one leg off the table like they show here:

http://experiencelife.com/article/smart-stretching/

Yup, do those stretches, and they do help!

chunkymonkeymelonhed · Postby **chunkymonkeymelonhed** » Tue May 07, 2013 8:51 pm

trixiee wrote:suffering with this now too... after 2 hours on the bike, it becomes almost unbearable. Had RMT on Friday, with no improvement what-so-ever.

Next step - physio or chiro?

Physio did the trick with my piriformis issues. Three treatments and (knock on wood) I have not had any further issue with it.