Piriformis syndrome, rest and recovery periods

diego_b

Hi there, I'm currently receiving treatment (dry needling) to try sort out a piriformis syndrome issue that I've been having since August. The root cause of this problem appears to be sacroiliac joint dysfunction. For the joint issues I've been receiving chiropractic adjustment and also have been prescribed stretches to complete twice daily.

I wondering if anyone here has had similar issues either and the rest/recovery period they had to go through before the issue (if it did) go away. I've been running throughout this time (50-60 a month) and now considering taking a break for what's hopefully a reasonably short period (weeks to a month) to try help the process. The suggestion of a break was my own idea.

I've made small progress in the last month or so with it in that the worst pain I get from it during driving appears to have eased a bit.

I'm reasonably happy with the treatment I've received to date however progress has been slower than I would like and if anyone could suggest someone in the Kildare/Dublin area they've attending previously for these kinds of issues can you please suggest that.

RubyK

Hi there, I had piriformis issues during marathon training in 2010. I had physio about 3-4 times before marathon, and it flared up again on the day in DCM. I was advised by physio to take 6 weeks break after mara, which I did. When I started back, on physio instructions, I started off running 1 mile on grass, and stuck to grass or hard sand, for 3-4 weeks, building up to an hour. Stretching after every run (which I hadn't done previously) and by early Jan I was back on the road for Dungarvan 10 mile.

Thank God I haven't had issues with it since (touch wood). Stretching after every run is a must now for me. Hope you get sorted asap.

diego_b

Thanks for that, that's exactly the kind of thing I'm looking to hear really.
I took December off last year to let a calf issue I had been carrying for a few months clear up and it did the trick.
I only took up running in May 2013 so it's still all new to me really and working through niggles is a real learning experience, generally trying to avoid taking breaks as I like to try keep making progress. I'm hoping to try take on the DCM in 2015 so want to do it right as well with getting myself healthy and a proper training plan.

RubyK

No probs at all. If you get it sorted now, you'll be back upping the miles in the new year, plenty of time to get a good base before DCM training.

It's a nice time of year to have to take a break, so don't feel bad!

cianc

Had a nasty bought of this a few months ago. Tried to run through it and gradually made it much worse. Ended up having to take a couple of months off, but what really made the difference was seeing ecoli for deep tissue massage to loosen up the piriformis, regular stretching of the area*, and introducing running back slowly. The last was intentionally done before all the pain/stiffness was gone, and really felt like it helped

I now do lots of hip mobility and back/glute strengthening exercises and no reoccurrences, though it does feel a little tight sometimes.

* I also did some foam rolling, but there are lots of warnings online about this making things worse for the sciatic pain if you're not careful. Ditto for stretching too much.

ger664

I note you are happy with your treatment. I had this on and off for 18 months, saw several physios/doctors/Chiros who all thought it was sacroiliac joint dysfunction of some sort. Eventually got MRI's done on the lower back and hip area. It turned out to be a groin bursa inflammation was causing my issue. It might be no harm to rule out tight adducters/groin with your physio/chiropractic.

As I had ignored this/getting treatment in wrong area for over a year at the time I ended up having to get 2 steroid injections 4 weeks apart to bring down the bursa inflammation followed by 6-8 weeks off running completely.

Taking 6-8 weeks would be no harm regardless.

diego_b

cianc wrote: »

Had a nasty bought of this a few months ago. Tried to run through it and gradually made it much worse. Ended up having to take a couple of months off, but what really made the difference was seeing ecoli for deep tissue massage to loosen up the piriformis, regular stretching of the area*, and introducing running back slowly. The last was intentionally done before all the pain/stiffness was gone, and really felt like it helped

I now do lots of hip mobility and back/glute strengthening exercises and no reoccurrences, though it does feel a little tight sometimes.

* I also did some foam rolling, but there are lots of warnings online about this making things worse for the sciatic pain if you're not careful. Ditto for stretching too much.

Okay so is ecoli a physio? I am curious to see if I could get a better direction on my treatment for this.
Initially the pain was though to be possibly a herniated disc and had an MRI
which came clear.
It's a chiropractor I'm attending at the moment with this and getting dry needling at the same time, concerned that I might be offsetting some of the work he's doing by continuing to run.

Currently not doing foam rolling for this (I do have a foam roller though and a sliotar), the main stretch I do is a figure of four stretch and I really do find that a lot more difficult on my right side (where I had the issue) than my left side.

cianc

diego_b wrote: »

Okay so is ecoli a physio? I am curious to see if I could get a better direction on my treatment for this.

http://www.boards.ie/vbulletin/member.php?u=737591, give him a shout.

diego_b

ger664 wrote: »

I note you are happy with your treatment. I had this on and off for 18 months, saw several physios/doctors/Chiros who all thought it was sacroiliac joint dysfunction of some sort. Eventually got MRI's done on the lower back and hip area. It turned out to be a groin bursa inflammation was causing my issue. It might be no harm to rule out tight adducters/groin with your physio/chiropractic.

As I had ignored this/getting treatment in wrong area for over a year at the time I ended up having to get 2 steroid injections 4 weeks apart to bring down the bursa inflammation followed by 6-8 weeks off running completely.

Taking 6-8 weeks would be no harm regardless.

To be honest when I say happy enough, I happy to the extent that I can now drive my car for longer than 30-45 mins which I really could not do until after a few sessions of dry needling but I started treatment on this issue back in September (originally back in August I had self diagnosed a hamstring issue as that's what I thought but it felt different) both with a physio first and then a chiropractor a few weeks later (I had years ago gotten very good results with a neck issue using a Chiropractor so thought to try again).
Initially both thought it was possibly a trapped nerve both that does not appear to be the case as the issue only affects me in certain instances (driving primarily and sometimes sitting). The Chiropractor then suggested the joint dysfunction which based on my inability to do the figure of 4 stretch equally comfortable on both sides made some sense.....a few weeks of treatment on that seemed to have him stumped and as the Chiropractor had carried out an X-ray (which came back clear) he suggested getting a MRI done on my lower back. I had that done via a referral from my GP and all looks good.

Can I ask where did you get your treatment/diagnosis from eventually....what I have seems to be unusual and a bit of trial and error to try narrow down what exactly it is.

PVincent

I picked this up whilst training for Berlin this year . Initially I just thought it was tight hamstrings , but gradually got worse until the Frank Duffy 10miler when it was obvious a marathon was not achievable . So a very slow process of recovery with lots of core work on the glutes , lots of stretching my ar..e , very little running , (altho plenty of other non weight bearing cardio like cycling , rowing machines, ) ...I was using the foam roller a lot but found very very little improvement until I got a tip from a physio I know . She got me using a hockey ball and the difference rolling on that has been nothing short of spectacular . It takes a huge amount of patience dealing with this , because as someone said earlier , you think you might be feeling ok and then you sit in the car to drive and suddenly the sciatic pain suddenly appears again and it is very demoralsising . Driving was a big problem for me and I could find no way of getting comfortable in my own car . Ironically I had to sit in the back seat whilst a passenger for more comfort ( angle of seats must be slightly different ) . Anyhow as I say the hockey ball has made all the difference to me and I am nearly there now . The last couple of weeks has seen me return almost to full speed sessions and last Sunday managed a 12mile training run, the longest since the Frank Duffy , and have had no reaction other than normal stiffness after a long run when the legs were a little put off by the length of the run . The hockey ball gets in a lot deeper than the foam roller and I will continue to use it . BTW - Any smart comments on the use of the hockey ball have been used up by The Boy Blunder on Sundays run

diego_b

That's interesting with the hockey ball, I suspect that is similar to a deep tissue massage. Good to hear of the differing solutions that people have used and eventually found effectiveness from. I have seen slow progress but that's it really and curbing my enthusiasm for running is difficult. I want running to continue to be something I can do long term so willing to try things and with patience correct the problem.

ChickenBalls

I'm 39 now and I've had this problem on and off for years - I've put it down to a combination of ****e seat in my car as PVincent pointed out above(moving onto a jeep - I think that's why most premiership players have Range Rovers; I know giggs had to change because of his reoccurring hamstring problems during his career), poor posture (as in leaning on one side more than the other, standing at concerts at the like), office job sitting at desk all day, leg length slightly different (due to break playing footy 10 years ago) which only got spotted recently at a bike fitting, my knee to foot length was the difference and lastly one flat foot compared to an arched foot (wear Orthotics and high arch runners to balance).

I've been to numerous Chiropractors & Physio's over the years and they give me the hamstring/glut/piriformis excercises to do which they say do twice daily which I would generally do once a day at least. Foam roller for the IT band and hockey ball for the Gluts (PVincent, if your comfortable with the hockey ball move onto a golf ball, you'll scream with pleasure )

But the big thing that's helped me over come all of this is Yoga! Been doing it over 2 years once/twice a week and I was surprised to find that most if not all the exercises physio's gave me exist in Yoga positions! I'm not sure many men know this already (as most of my classes are full of women) but you'd be better putting your money into Yoga classes instead especially when you move onto advanced Yoga you really work up a sweat.

Anytime I run I aim for grass as much as possible and after a mile warmup I do my yoga stretches for 5 minutes then onto my session as normal - puts a spring in my step doing this. For DCM 2013 I trained 80% grass which worked a treat.

The break will do you good, if you want to keep exercising do a bit of swimming/cycling or weights in the gym it'll help keep the xmas pounds off

PVincent

Thanks for the golf ball tip....mmmmm!
Interesting about the length of leg...my own situation is usually an injury on my right side because I have one leg slightly shorter and less flexible than the other. In 1981 ironically when training for the dub marathon I stupidly played a rugby match 3 weeks before it , and totally destroyed by right knee and quads in a tackle . So they had to sew up all of my quads which in those days was serious surgery. My right leg has a huge degree less flexibility because of that as the muscle is now obviously shorter. So I do kinda know where all my issues stem from , but this was the first time I had piriformis issues. I think mine was a result of lunges and maybe a bit too much hill work ..

ger664

diego_b wrote: »

Can I ask where did you get your treatment/diagnosis from eventually....what I have seems to be unusual and a bit of trial and error to try narrow down what exactly it is.

Ended up going to a very good physio who after 2 treatments said he felt there was more going on and that I should get my GP to refer me for MRI's, he didnt pick up anything on the MRI So my GP sent my MRI to a rheumatologist, who wanted one of the hip as well. That must have showed up something because he only took 5 minutes to press somewhere in the groin and boy did it hurt. 2 injections and rest for nearly 3 months sorted it.

diego_b

@Chicken Balls

Thank you for your experiences also, certainly the sitting down all day at work I think is a factor. Currently in the process of trying to arrange to work from home a few days a week and planning to have a desk where I can stand for a few hours here and there when working. At the moment all of my running is on the footpaths (tarmacadam as opposed to concrete where possible), I have limited options for running on grass barring laps of my local football pitch but needs must I guess. I need to start doing speed work sometime (obviously when I hopefully have this issue resolved) and was planning on doing that on a football pitch...someone posted a simple speed plan here recently where you run the diagonals for speed and then across pitch to recover.
Yoga has been recommended by a few, currently do pilates once a week and just finished a boot camp group of classes so might trade my time for that for Yoga and/or swimming.

@ger664

Can you provide me with the name of the physio and rheumatologist you attended. I'm firstly going to meet ecoli if I can arrange that with him and take it from there if I need to try something further I could try those.

diego_b

I've been told that both legs are the same length so that's one thing, my hope is that it's just a muscular issue as to date any of those I've had been solved with time/exercises.
I'm coming from a place of little activity up to the age of 31 and then significant weight loss (7.5 stone) whilst taking up running at the same time so whilst losing weight was one challenge....training my muscles for running amongst other body weight exercises has been tough.

rom

Regarding people having issues with their car. There is no need to get a jeep. My seat was very low and I had issues until I got given one of these. Its unreal. Have to flip it over monthly but it ensures that I am seated in a much better position. I have a Toyota Corolla.

http://www.backcentre.co.uk/4211-seat-wedges.htm I have something like BRU 9° Wedge

I also wonder how many people with this issue have a sitting job for a living. Logic would point to that as more of a trigger than running but its running is where you will feel it. Many of us spend up to 40 hrs a week sitting at work. 10hrs commuting and prob another 20 hrs at home watch the TV and those are the active people. Saying that you are getting a issue cause you run 3 hours a week while sit 70 hrs doesn't make sense to me.

diego_b

I sometimes wonder is it that we may have adapted or muscles at least to a life spent sitting so when you try exercise that should be well within normal capability it just falls apart. It's true that I spend at least 7 hours sitting at work a day, add in another 1 or so for my train commute plus a few hours eventually in the evening.
Definitely noting that cheap adaptation for car! Not a fan of the range rovers myself and would likely need a well positioned extra digit in my monthly wages to change cars! Physio, chiro and race entries have been pricey in the last year or so!

rom wrote: »

Regarding people having issues with their car. There is no need to get a jeep. My seat was very low and I had issues until I got given one of these. Its unreal. Have to flip it over monthly but it ensures that I am seated in a much better position. I have a Toyota Corolla.

http://www.backcentre.co.uk/4211-seat-wedges.htm I have something like BRU 9° Wedge

I also wonder how many people with this issue have a sitting job for a living. Logic would point to that as more of a trigger than running but its running is where you will feel it. Many of us spend up to 40 hrs a week sitting at work. 10hrs commuting and prob another 20 hrs at home watch the TV and those are the active people. Saying that you are getting a issue cause you run 3 hours a week while sit 70 hrs doesn't make sense to me.

ChickenBalls

The wedge's are a bit expensive - friend of mine told me about this and a cheaper alternative is a pillow which does make a big difference, it helped me. Try that out first before you think the wedge would be worthwhile getting.