Piriformis Syndrome

I've been suffering with hamstring pain for the last 6 months and have spent a bomb on 'rehabilitating it' thinking it was a pull, only to find out that it was my sciatic nerve which has been impinged underneath the piriformis (your bum muscle). I've now been told by the osteopath that I need new orthotics (my present ones are 4 years old). Does anyone have this problem and can you say that orthotics has solved it? I'm asking before I shell out on another £250!
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Comments

  • It's possible that they are right, but I have found that strengthening both the hamstrings and gluteal muscles, combined with regular and persistent stretching of the same has had the best results. I too have orthotics, and I got new ones (for other reasons) which didn't really make much difference to the piriformis. Core stability exercises probably help too. The other thing to bear in mind is not to do too high a proportion of fast running.

    In short, it's worth trying the other things first if you haven't already, before spending more on orthotics.
  • EJ - as Running Bear says stretch.. stretch.. stretch. I'm not saying orthotics will not improve things, but stretching certainly will do no harm.

    I also found because the roads I run on were cambered, and I always ran facing the oncoming traffic (not that there is much!) I was putting additional strain on my right side. By alternating the side of the road I ran on, this improved a lot.

    The best stretch I have found is - from a standing position, put your right ankle just above your left knee, then slowly drop down into a sitting position. You will feel the stretch - hold it for 5-10 secs then repeat on the other side. I quite often stop after a couple of miles and do these stretches.

    Hope it helps
    RD
  • Thanks guys, I'll persevere with the stretching and think I'll join that 'HSA' or something else to help with all the osteopathic and podiatry bills. Its costing me a fortune! Have you ever joined an insurance scheme? I've tried the NHS and by the time you get to see them you've got another problem. Besides they don't seem to be as bothered with you when they know it's running related because they've got such high waiting lists full of people who can't walk never mind run!

    Jayne
  • Jayne

    Also "suffer" and manage it as best I can by stretching - orthotics have never been suggested to me and not sure they'd help piriformis as it's often where the muscle and nerve travel through the pelvis or some other bony bit (!) so not a bio mechanical issue rather than simple bad luck with your anatomy!!

    Good luck

    Amanda
  • Dear Amanda,

    Well unfortunately I am an overpronater and it's particularly bad on my left foot which is the same side as my piriformis problem. The osteopath said that because the piriformis acts as an external rotater of the hip it is then fighting against the 'internal rotation' of the ankle/foot and that may be where the recurrent problem lies. Have you ever had your feet checked out for this?
  • Hi Jayne

    I have had a gait anaylsis and this didn't reveal any bio mechanical issues - or at least not enough to warrant orthotics. The physio simply thinks I am in the situation whereby there is not enough room for the muscle and nerve and hence the latter gets pinched. My symptoms are a numb yet tight and sore left leg which I just have to get through as it invariably lasts about a mile or so....it sounds as if you have had sound advice from your osteopath although I have heard too many horror stories about orthotics and know too many runners who threw theirs in the bin to give much of a positive view!!

    Good luck...bloody running and bloody injuries - a right royal pain in the ass - literally in our case ;-)
  • Alas my marathon training was going fabulously until the other day I felt a 'pulling' sensation in my right buttock and leg. I did a bit of research and found that it sounds like piriformis syndrome. ....all those 'piriformites' I am in full empathy. I am sooooo p***ed off like I cannot explain.
    RogerDodge....what you wrote rung a bell in my tortured mind...I also run alot on the roads facing oncoming traffic and have obviously strained my right side.
    I saw a sports injury massage therapist yesterday and had a deep muscle massage. She found the problem and I felt 10 times better post massage. The discomfort has reduced dramatically and I have another session booked for Thursday. I am taking some time off running ( which is torture as I am in the middle of a training schedule ) to try and make it better.
    I am so frustrated as I have never had a prob before and have been running for years !
    Has anybody else tried massage ? I haven't thought about orthotics. I am hoping that this niggling sensation will bugger off for ever !!!!!
  • A massage certainly hits the spot, but also hits the wallet fairly hard too. I try and stretch those muscles at least every other day, even if I'm not running.

    Try this link for some stretches
  • Thanks RD,
    That is an excellent link. I just did some of those stretches and it felt good.
    Did you have to take any time off running and if so for how long ?
  • Brilliant link RD! I showed some of my running mates that standing piriformis stretch and they thought I was giving them a balance test! It's the most convenient one to do though as you don't need a chair or a clean floor and can do it straight after a race. Don't forget the tennis ball/golf ball therapy as well.

    If your back's out that can affect it too you know.

    Oh I feel so frustrated at the moment as I was doing PBs 6wks after having my baby 6 months ago.
  • Not taken any real time off running for the piriformis. Standing piriformis is particularly good part way through a run, as you can grab hold of a nearby tree, gate or whatever and do a few stretches.

    I do suffer from a kind of "knotting" at the top of my shin muscle (anterior tibialis) High (10m+) mileage usually leaves it a bit tender. I was told ultrasound would help disperse it. I think I tore the ligament a bit when "going over" on my foot during the madness at the start of a race.
  • Does anyone have a magic wand as mine doesn't appear to be working ?
    What is the tennis ball / golf ball therapy ?
    ej I am up there in the frustarion mode with you !
  • ooops should read frustration mode
  • Dear runningnut,

    What you so is lie on a ball positioning it where the pain is and then place a big stick between your teeth and bite on it HARD! It does the same thing as what a masseur or any professional will do but cheaper and the pain's always better self inflicted.
  • OK..so if you hear any screams around the globe don't panic...it's just me rolling around on a tennis ball. sounds kinky though ;)
  • Hi I am new to running and to forums, but can anyone help. Two weeks ago started with a strong toothache like pain in groin on right hand side, only noticed after few hours after 7 mile run. Its not a continuous pain can stretch and does not hurt. Went for a run two days later ok to run but after stretching for about 10 minutes went to stand on right leg and real sharp pain in groin and down inside and across thigh. Had physo monday. the pain seems to come on {and not all the time} when i put my weight on my right leg to walk, then once start walking eases a little. Yesterday pain was on and off but went for a 2 mile run last night, once start to run the pain seems to subside, got back did 15 minutes of good stretches and ice but went to walk and the pain came back causing me to limp. Like i said no pain when sitting and its no painfull all the time. the other time i can feel it is when sat down with feet on floor and lift my right leg as though lifting knee to torso the pain is there front and side, if did same movement with leg straight no problems. Going back to physo monday, but anyone had this problem. Thanks. PS.stetching thread on this forum is great.
  • I think I may have piriformis. I ran my first marathon 3 weeks ago and after all the aches went away, and I had had 2 weeks off I went for a run. Since then I have a toothachey pain in the top of my left leg/hip. it is very sore when I first stand up or if I rotate to turn , makes me limp on walking, but gets a bit better as I walk. I went for a run last night to try to loosen it up and I could hardly get out of bed this morning. Does not hurt to climb stairs, but occassionally send shooting pain down the side of my leg to my knee and calf. Does this sound familiar and does a massage really help.

  • Helen, i am not sure if mine is piriformis, but it sounds just the same as your problem, yes can feel when putting weight forward to go upstairs. Only had a little massage and some electric pads, the physio said my hips were pretty loose though the one on righ a little tight and bottom of back little tight. I do yoga and pilates and it does not hurt on the movements, but like yours if turn quick to right and move body forward leanving the foot on ground that is like a nerve pain. I do not think the massage did a great deal but going back again on monday, so let you know. main ache is inside thigh to front of knee.
  • I have piriformis syndrome and have not run for 6 weeks. Seeing an osteopath and it is getting much much better. Problem is in my lower back and I don't believe that any amount of stretching will help a back injury.
  • I found this website link helpful
    piriformissyndrome

    I have just had my second session of massage and it certainly does help. I just got back 30 mins ago and the difference in how my muscles feel is amazing. I don't have that dull ache that I had when I got out of bed thios morning.
    Have also been doing the stretches that RogerDodge has posted on this topic ( see above )and am seeing an improvement...slowly but surely.

    Patricia, yours doesn't sound like pirifomis syndrome but what does your physio think ?
    Helen, try the self diagnosis in the link that I have posted. When I did it, I felt a pain in my buttock etc.

    The main thing though is that if you have any pain DON'T RUN as you will exacerbate the problem. Listen to your body...something is wrong and your body is telling you enough is enough.

    I have found the massage sessions to be very beneficial and have even felt my muscles 'ping' back into place whilst being massaged. I suggest finding a good sports massage therapist...but they don't come cheap.
  • Ooops I mean look at RogerDodge's posted link on the previous page !
  • Thanks for reply, runningnut. My physio did not really pinpoint the problem but did loads of stretches and said i seemed pretty flexi, back monday. Did suffer with sciatica for 2 years down the outside of the right leg. This is pain is not the same, though feels like trapped nerve at the front or inside thigh. Have been doing the stretches that RD posted and not too bad today but have not run. My physio told me to go for a 2 mile run few days after treatment and i did yesterday, felt fine when running and stretching afterwards, but felt the pain afterward and it feels tight round the front leg. sorry dont know all the tech names for muscles, well know the names just not the right places. again thanks.
  • Thanks rodgerdodge and running nut, i have tried the self diagnosis and think that this is what I have but do I have to stop running and for how long,am off to try the stretches, and will concentrate on core muscles with my big rubber ball. I will try to save the price of a massage, will keep you posted
  • I would seriously take a rest from running as you may be doing more damage to the injury.
    It is so frustrating not running I know ( am climbing the walls myself with my blasted injury ) but better to rest and heal the injury than risk permanent damage and the risk of not being able to run at all.
    There is also the possibilty of it being referred pain and the cause is elsewhere.....that is why I would recommend a decent sports injury masseur. They get right in there and can release trapped nerves, contracted muscles etc.
    I discovered that the pain in my buttock and leg is due to a lower back muscle which has tensed and contracted is the root of the problem. Since I have had my massages the pain is infinately better.
  • Helen...if you read any running website the first thing they tell you is that if "you feel pain : stop running"
    The pain in my buttock flared up 7 days ago and I hoped against hope that I would be able to run through it.....but all the advice that I received said to the contrary.
    It's a bummer for sure and I totally understand your frustration as I am there with you....but abstinence from running seems to be the major key to recovery.
    It sucks ):
  • I'm slightly at odds with the "stop running" suggestions. Of course the injury you have may well be different to the one I had, so my comments may not apply to you.

    In my case, it was a tight Piriformis muscle which became painful in the latter stages of a run and afterwards. I would say that the pain was of a "niggle" level and certainly not excrutiating. I found that with gentle running and frequent stops to stretch, this improved a lot and is now completely gone. What I am saying is that gentle running will help work and elongate that muscle. In my case I was new to running and as my distance and time on legs increased so did the niggles. If the pain is as a result of an injury, then rest is always advisable, but I never stay too immobile.

    As runningnut says, it is always worth seeking expert advice, if you can find a GP who runs, that is perfect. Whenever I've been to my GP with a running related issue, he has just said "well stop running". As a computer consultant, I dont think my customers would be too excited with the advice "well just turn the PC off!"

    Good luck with it..
    RD
  • Thanks again for all the advice, I am going to stop completely for a week and do all the stretches. I did a bit last night and definately slept better , the link advice about not sleeping on my front helped and with a pillow under my knees.Will get massagein a week if no improvement, big thanks for all advice and sympathy
  • Have had this injury diagnosed too. The advice was to stretch and stop running for a couple of weeks and see how it goes. Have been cycling instead which gives me some satisfaction. Have any of you found cycling ok with this injury?

    The worst pain for me is when I am driving the car. It can be quite painful after half an hour and I have a 1 hour drive to work every day. If I lean over forwards and to the left in the drivers seat I get quite a sharp pain at the join of my buttock/ hamstring.
  • I had exactly the same symptons too ! I didn't run for 10 days, have been having massages and have just started gentle running again. So far so good and the pain has gone but I just have some stiffness in my buttock and I am stretching galore pre and post runs. The massages have been a huge help : not cheap but as long as it works I don't care.
    I am easing back into my runs very gently as I don't want to get injured again.
    This time last week the pain was so bad I was convinced that I would never run again.
    I read somewhere that cycling can actually make it worse because you are putting pressure on your buttock and aggravating the injury.
    My heart goes out to you as it sucks not being able to run. I am keeping everything crossed that the pain will stay away and never return again !
    Good luck fellow piriformite.
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