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zeta
Trad climber
Berkeley
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Topic Author's Original Post - Jan 21, 2011 - 02:01am PT
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hey, has anyone ever dealt with piriformis? It's literally a 'pain in the ass'--wish I was kidding about this, but I'm not. It irritates the sciatic nerve, it's difficult to diagnose, etc. It's been hurting ever since my first day of tele in December and doing a lot of stretches doesn't seem to be helping (yet). Am considering acupuncture, physical therapy, massage (etc.) but would love to hear about anyone's experiences with this first
thanks!
Jen
http://en.wikipedia.org/wiki/Piriformis_syndrome
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Mighty Hiker
climber
Vancouver, B.C.
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Jan 21, 2011 - 02:16am PT
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It sounds like a pirouette with piriformis would be out of the question.
Did you get it checked by a physio or such? At least to make sure of diagnosis, if not treatment or therapy.
Anyway, good luck with it!
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Seamstress
Trad climber
Yacolt, WA
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Jan 21, 2011 - 02:24am PT
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My husband is a massage therapist. I highly recommend seeing one who does deep tissue work and is familiar with that issue. Working the piriformis and gluts will help.
I also recommend PNF stretching or allowing gravity to help gently stretch out that area. Lie face up on a high, flat surface. Dangle your legs (or just one at a time if it is too painful) off the surface. Just a minute at a time, alternating left and right if need be. Do a set of three. This may be somewhat uncomfortable, but you will feel relief and your back should feel better, very quickly.
You can add a component to this stretch by employing a partner to provide resistence as you activate the opposing muscle group. With a partner to help you, you can do pull up your legs against a force (their hands) gently applied when you are at the end of the muscle's range. Push against that force for 7 seconds, then release. Your legs should dangle just a little bit lower. Repeat 2 more times.
As a confirmed "tight-ass", this works. Like anything else - try it. If it makes matters worse - stop.
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Clint Cummins
Trad climber
SF Bay area, CA
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Jan 21, 2011 - 04:34am PT
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I know Amber Trotter had it. It pretty much ended her running career.
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can't say
Social climber
Pasadena CA
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Jan 21, 2011 - 09:16am PT
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I would suggest as others have, to get thee to a deep tissue massage therapist. It's what I do for a living and I work on people who have Piriformis Syndrome quite a bit. It's particularly common among very active people.
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Skeptimistic
Mountain climber
La Mancha
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Jan 21, 2011 - 09:27am PT
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Definitely find a PT who is a Certified Manual Therapist. They have extensive training in deep tissue manipulation and supporting treatments. While massage may temporarily fix the problem, there are often other factors at work such as posture or gait changes that are the underlying causes which need to be addressed. Good luck
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Tony Bird
climber
Northridge, CA
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Jan 21, 2011 - 09:44am PT
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everyone's body is different and responds in different ways. i developed some sciatic nerve problems and the cure proved to be some regular trail running. i think there's a lot to be said for cross-training--using different muscle groups, exercising the ones that may be getting ignored.
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Wade Icey
Trad climber
www.alohashirtrescue.com
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Jan 21, 2011 - 10:42am PT
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before sinking a lot of time and money into pt and massage, get an xray to rule out or confirm arthritic conditions. I could have saved a year and several k.
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Branscomb
Trad climber
Lander, WY
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Jan 21, 2011 - 10:47am PT
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My daughter did a couple of months of PT after she had an enclosed abcess in the piriformes region this last summer. Lot of toxic muscle damage/adhesions in there post-infection.
The PT consisted of 3x a week doing heat and electrical stimulation and ultrasound stimulation. She also did a lot of gentle stretching twice a day, nothing agressive, just gradual.
All that stretching and PT really helped, she had a lot of trouble walking before she started it and now she's walking fine. Our insurance covered the whole thing, since the doc ordered it as part of her recovery.
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zeta
Trad climber
Berkeley
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Topic Author's Reply - Jan 21, 2011 - 11:55am PT
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thanks!
seamstress: i didn't even realize what PNF stretching is, but maybe I should add that to the stretches I'm doing now--there's seems to be divided opinion on stretching & piriformis. Some warn not to stretch too much; others say it's the best thing to do so I'm trying to hit it somewhere in the middle...
stzzo: massage rec. in berkeley? yes, PM me in the info, though I hope they're not too expensive or take insurance
regarding deep tissue massage, that's what I normally do but I really wonder if the massage will be able to 'get there'--it's a pretty deep spot!
branscomb: how did your daughter's abcess diagnosed?
thanks for the recs/ideas, keep em coming!
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Seamstress
Trad climber
Yacolt, WA
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Jan 21, 2011 - 12:19pm PT
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It can get in there - my husband is over 200 pounds, also in construction and a climber. I can FEEL when he is applying pressure to those trigger points. I'vw been a runner for 32 years and competed in the local and regional road racing circuit forever. I belong to a very competitive team,and some gals are national class runners. My team mates love him.
All stretching has to be very careful not to go too far or it will trigger an armoring response...or rip. I am a terrible stretcher. It should not be approached as a competitive sport!!
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Branscomb
Trad climber
Lander, WY
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Jan 21, 2011 - 12:24pm PT
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It was a sudden onset. Her hip just started hurting and she could hardly walk. We thought she'd pulled a muscle or something, but then she started to spike a temp and we took her to a doctor who, very fortunately, is a very sharp guy and picked up on this quickly before it became critical.
It was near all these major artery and nerve structures and deep in those big muscles, so they couldn't drain it. Had to fly her to Children's Hosp in Denver where they blasted her with big IV antibiotics for a week.
Prety bad. I think Kristi and I aged about 25 years last summer.
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Branscomb
Trad climber
Lander, WY
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Jan 21, 2011 - 12:39pm PT
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Specifically the diagnostic routine was an X-ray of the hip to R/O an epiphysis (slippage of the growth plate on the femur head), then a CBC which had a low WBC count but a high granulocyte %...weird but suspicious (probably all the granulocytes were concentrated around the abcess while the marrow was pumping out more to compensate for loss), and a CRP, which is a indicator of inflammation, which was slightly elevated.
Pretty slim evidence but he picked up on it and had us go to the hospital where where they did a ultrasound and blood cultures. The next day they did a MRI and that showed the abcess pretty clearly plus the blood cultures were all ready couming up positive for gram pos cocci in clumps (Staph). Fortunately it wasn't MRSA, but a pretty susceptible Staph.
Nobody up here had ever seen this but in Denver they told us it was not uncommon in teenagers, esp girls, to get these closed abcesses like this, usually in a joint. They see about 3-4 a month at Denver Children's.
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scuffy b
climber
Three feet higher
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Jan 21, 2011 - 01:44pm PT
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The piriformis is very susceptible to massage.
It's deep, but not so inaccessible as you might think.
Probably easy to miss if you and your therapist are not
already thinking Deep.
Pigeon pose is a good stretch for me. Be patient for good
results.
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quartziteflight
climber
Who knows?
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Jan 21, 2011 - 03:37pm PT
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Ive had problems with my piroformis for years it sucks try this.
copied and pasted:
This self-performed myofacial release using a tennis or lax ball can be performed everyday by athletes (or the general population) to help drastically decrease low-back pain. Give it a try
http://www.youtube.com/watch?v=HWfnAUsYUTI
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neebee
Social climber
calif/texas
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Jan 21, 2011 - 05:17pm PT
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hey there say, zeta, hope you get well soon...
this happened to me, at the cat shelter...
i had to do a different cat cage series, to clean...
instead of the top cages...
i had to use my one leg to lug the heavy stuff out through the low door, and could not change from leg to the other, or anything, to not overstrain my leg...
well... it got to the point where i could not WALK at all, on that leg...
i learned what it was by all the symptons... and it took about two years to get well... massage therepy make it nearly well, and rest, too, and some stretching...
but the thing that made it take so long was that the sacrilliac bone joint, was pushed up somewhat, due to the muscle under it, bulging somewhat, from the muscle strain...
my friends, some osteopaths from england, manipulted the bones some, and such and it went back in place, after so long...
been about fully better, until i had been moving out of my little place, to the bigger one...
now, i am hurting again, but after rest, i think it will be well again,as the bone is not pressing outward...
really awful stuff, it was... :(
but--all in all, i am thankful that i did not hurt by back, by lugging that cat litter, out, without the aid of my leg, it would have been worse, in the long run, if i had hurt my back...
so, get well soon...
PATIENCE is what you will really need...
and rest, is for it not to get INFLAMED...
in those cases, sometimes it is said that surgery is needed, but that can make it worse in the long run, too... if it scar-tissues up...
best wishes.... i wish mine had never got hurt...
sometimes i feel i will never be the same, and i can't other folks
any more, or clean house well, etc... :(
but i am still happy, as i can WALK, run, and play with the ol pup dog...
lifting stuff, is a no-no though, as it make odd pullling, unless i hold stuff, in the middle chest area, with using both arms...
please let us all know how you fair, in this hard journey...
god blesss...
:)
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zeta
Trad climber
Berkeley
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Topic Author's Reply - Jan 27, 2011 - 07:28pm PT
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so...i've done a bunch of things lately and am figuring some things out that are helping my piriformis
first, deep tissue massage:
i had this sports medicine guy massage my butt for 1 hr which was *awesome* I realized that I had been doing some stretches wrong--which was actually making the piriformis hurt more than less... he gave me some good tips on correct stretching
then, acupuncture:
after she put needles in my toes and hand, she had me do the piriformis stretches on my back (carefully, with the needles in!) When I did that, the piriformis pain didn't hurt and there was all this heat in my leg. Not sure if it helped but for $20, it was worth a try. Think I'll go again
and then today, PT:
i did some finagling to get an appointment w/ a well-known PT which was definitely worth it. She's awesome. My piriformis is not at all radiating (no related sciatic which is great!) but appears to be linked to lower back pain that I've been ignoring for a long time. Taught me different ways to sit, posture stuff, ways to set up my laptop to be better for my back. Have 3 more appointments set up.
I still need to be patient--which means no climbing, running, biking, or skiing any time soon--but I think if I'm religious about these stretches (icing also and rolling on the tennis ball), it'll get better.
hope some of this was useful and definitely planning to be back in Yosemite this spring!
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HHL
Trad climber
Stumpcreek, WV
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Jan 27, 2011 - 07:40pm PT
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I have chronic low back and piriformis pain. Stretching and just being active helps. Try to avoid any prolonged sitting as that seems to cause flareups for me. Good luck.
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zeta
Trad climber
Berkeley
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Topic Author's Reply - Jan 27, 2011 - 07:48pm PT
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avoid prolonged sitting?
i'm writing a dissertation! but otherwise, yeah, well i'll try!~
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Seamstress
Trad climber
Yacolt, WA
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Jan 27, 2011 - 08:24pm PT
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Unfortunately there are times when you have to scale back and take action. That can be very difficult. Be diligent enough to make this a short, healing break. I find it hard to stick to a healing plan until I am crippled. Then I get religion and do all the right things for the days/weeks necessary to get past it. Patience and diligence are your friends.
Your experience about stretching incorrectly is very common. These folks - massage therapists and PTs see a lot of that. Sounds like you are using this time very productively!
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