Forums >Health and Nutrition>Piriformis syndrome and / or sciatica, what to do?
I was kind of hoping after the marathon 2 weeks ago and taking a little bit of time off that the plantar fasciitis and piriformis syndrome and / or sciatica that I have been dealing with would alleviate themselves somehow but the plantar fasciitis stays and the pain in my buttock has only been getting worse. I managed it while training by rolling out the piriformis and glute as needed to keep the pain down while occasionally taking ibuprofen. The plantar fasciitis is neither here nor there and I am willing to keep working on that. Does anyone have any suggestions on how to at least manage piriformis syndrome? Some days I am in near constant pain, especially if I have to sit a lot. I will be ramping up my training again over the next weeks and months and would like next year to be a big one. Any suggestions, routines, etcetera would be helpful.
Sometimes it is related to a tight adductor. Try stretching and rolling that every day (along with everything else of course) and see if after about a week you have relief in your pyriformis. It helped me.
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Unfortunately, the piriformis is one of those tricky areas that has a hard time healing. I personally find that only hard lacrosse type balls can work, along with heavy stretching. I will also say that the one time I had a more serious case of it, a couple of sessions of trigger point therapy immediately cleared it up, as the rolling only really works as a management tool or on light cases. If you haven't done TP injections before, you are missing out.
5K: 16:37 (11/20) | 10K: 34:49 (10/19) | HM: 1:14:57 (5/22) | FM: 2:36:31 (12/19)
Mother of Cats
How do you sleep? If you sleep on your side, especially without a pillow between your legs, that could be worsening it. If you can possibly sleep on your back, with a pillow under your knees, that might help some.
+1 to suggestions about stretching the adductor (and other areas). What I've noticed is that tightness elsewhere in the hips puts a bit extra stress on the piriformis (a stabilizer). Working on general mobility for the adductors, quads, and hip flexors can't hurt, and might help a fair bit.
There is no magic bullet, injection, or pill here. Just playing detective and figuring out what is making that muscle overwork, and how to ease that burden.
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Is the PF on the same side as the pain the butt? I have had times where I have the PITA and the same foot is not happy. Typically I have been able to run through it and keep it under control with lots of core.
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Pigeon pose is my favourite for stretching out tight hips and a cranky piriformis. If I can find some discipline and spend a few minutes in pigeon pose every day, it definitely makes a difference.
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Exactly!
Prince of Fatness
I've had my share of hip / glute issues over the past few years and follow a lot of the suggestions here. For massage I found that nothing gets at the sore spots as well as a lacrosse ball. Pigeon pose is a great stretch for the piriformis. I was also told by a chiro to sleep on my back and have been doing so for a few years.
As far as other exercises go I find that lunges help with the hips. And finally, sitting. I'm a desk jockey so I sit a lot and it definitely bothers my hips. I got myself a sacro wedgy and that really helps. I use it both in the car and at my desk at work. If you sit a lot that may be worth a try. Also try to get up and stretch your legs every hour or so.
Not at it at all.
Pace Prophet
Do you know whether it's pirifomis or sciatica? Because they are very different basic causes. If you have been rolling and stretching and getting massage and your glutes are still unhappy, you may need to get your spine looked at.
The McKenzie exercises (you can google, or buy the book Treat Your Own Back, it's pretty cheap) have helped me a lot. Also try the Myrtl exercises. If your back is the source of your buttache you really need to fix your back.
Some people have reported good results from dry needling but it didn't work for me. I also got the sacrowedgie but I didn't feel that it did much for me.
Finally, I only saw major results when I...stopped sitting. I bought a kneeling chair for my office (flashbacks to the 70s) and it helps SO MUCH you would not believe it. I also use cushions in my car (fortunately I don't have to drive much) and in my armchairs/couches at home, and am cautious about spending much time in chairs. Good luck.
Chief Unicorn Officer
I dealt with this for over a year. I tried all the home remedies, stretches, tools to rub it out. I finally had to give in, go to PT, and take over a month off while treating it.
If nothing helps you need to just address it head on like that. Don’t be stupid and ramp up training when you’re only going to hurt yourself worse and/or prolong any healing.
Mile 5:49 - 5K 19:58 - 10K 43:06 - HM 1:36:54
Joann - I think you answered your own question when you related to sitting "a lot" as aggravating the issue. Ilanarama also mentioned sitting. The single biggest thing I changed a few years ago when I had a nasty piriformis pain problem was, you guessed it, I stopped sitting so much. I have a stand-up desk, and every chance I get, I stand. The second thing I did was pay a lot more attention to strengthening my glutes and hips.
Good luck - piriformis is a pain in the you-know-what!
DP
Marathon Maniac since 3/2016. Marathon PR: 3:29:25 - Richmond 2015. Back to Boston in 2019!!
I've been suffering from deep hip/gluteal pain for years on my right side and have been diligently working on trying to be pain free. I've come to find out after working with several PTs that most likely my case is a problematic quadratus femoris muscle (quadratus femoris tendinopathy). Of course, your case may be different, but it might be worth exploring what else could be causing you pain and what other diagnoses are possible.
I was given isometric and isotonic exercises to help alleviate the pain and strengthen that area. They recommended that I absolutely avoid massaging, poking, rolling, etc. the tendon because that would irritate it more. At least from my own experience with my own injury, rolling it out with a hard ball and deep massage didn't help me.
Return To Racing
I hardly ever sit, but I get a lot of (lower butt/leg) pain when I am sitting, especially in the car or on the couch. No problem walking, running or sleeping. Piriformis Syndrome according to Dr. YouTube and trying some of the stretches (no foam roller). Hope it's fixed before a long drive to Arizona in February.
SMART Approach
Sounds more like your upper hamstring tendon attachment site than piriformis. Very common in runners. Probably not an issue if you don't feel it running.
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Thanks. Big issue when driving though