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  1. #1
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    Piriformis Syndrome

    Anyone got it too? Tips?
    All problems in mountain biking can be solved by going faster, except the ones that are caused by going too fast.

  2. #2
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    Mine are aching!

    After 14 hrs of snow shoveling, mine are killing me.

    Try a massage therapist. A friend of mine had two back surgeries and his piriformis get really knotted and tight. A good deep tissue massage seems to help him a lot. His wife calls it the "butt massage".

  3. #3
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    I guess I should ask my wife to do it first. After that it should be easy to persuade her I should pay someone else to do it.
    All problems in mountain biking can be solved by going faster, except the ones that are caused by going too fast.

  4. #4
    gmoney was gmoneybike
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    New question here. What is ???

    I'll bite..What is Piriformis Syndrome???
    Were looking at balz

  5. #5
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    I have recently recovered from a herniated disc in my lower back (similiar symptoms to Piriformis Syndrome). The pain sensation down through the leg can be very uncomfortable at times. If you don't want an epidural then there are not many options for treatment. Massage can be effective, although the benefits did not last very long in my case. A regular programme of stretching, 3-4 times a day worked best for me. This site has some very good stretches and tips on general back health: http://www.spine-health.com/topics/c.../sciaex06.html
    The general consensus seems to be that you should stay active. Cycling is a good option as it does not overly stress the back. Good luck and get well soon.

    Brad

  6. #6
    discombobulated SuperModerator
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    Quote Originally Posted by ghashmi
    I'll bite..What is Piriformis Syndrome???
    Sigh, CLICK
    Searching with Google will save alot of people time. Heck you can answer your own question iin as much time as it took to post the query !

  7. #7
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    Quote Originally Posted by pinkheadedbug
    I guess I should ask my wife to do it first. After that it should be easy to persuade her I should pay someone else to do it.
    My buddy's wife was OK with the professional butt massage. They're both in health care so I guess they look at things differently. His masseuse was a total knockout though.

  8. #8
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    See a physical therapist...painful stretching exercises, cortisone (ionophoresis), hot/cold compresses, anti-inflammitories... Lots of stretching breaks during riding helps.

  9. #9
    gmoney was gmoneybike
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    An Explanation...However Weak it Is

    Quote Originally Posted by CdaleTony
    Sigh, CLICK
    Searching with Google will save alot of people time. Heck you can answer your own question iin as much time as it took to post the query !
    CdaleToney:

    I thought it was a reasonable question. No explanation of the conditon was given in the previous posts (thats not a slam btw on any of the people posting).

    For whatever reason the topic/conditon title caught my atttention. I thought it would be uselful to those, myself included, who are clueless to the conditon. Not anymore, I did Google it after your suggestion and now as I have a better understanding. Its cool to see that others on this topic are willing to share their knowledge and experience.

    That said I do see how the language in my post may have been off-putting. My apologies for any offense to those dealing with the conditon. Best of luck!
    Were looking at balz

  10. #10
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    If it's truly Piriformis Syndrome, then doing some soft tissue work on the prirformis itself should give you some relief from the symptoms. IFC and moist heat can help as well.

  11. #11
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    Things that have helped: hamstring & piriformis stretches, self-massage, heat, not sitting down, NSAIDs, keeping moving.

    That said, it sucks.
    All problems in mountain biking can be solved by going faster, except the ones that are caused by going too fast.

  12. #12
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    I've had 2 pretty bad bouts of piriformis syndrome. Both times it was brought on by running. I think it affects runners a lot more frequently. Do a quick search on the letsrun.com message boards and you'll find quite a few threads discussing symptoms and remedies. Each time I went through a laundry list of remedies...

    1) time off
    2) massage
    3) cross-training
    4) time off
    5) time off
    6) more time off

    At one point I took 2 months off and the symptoms were back within a week.

    I hate to admit it, but each time my solution was a cortisone (or something similar) injection right on the trigger point. The injection is uncomfortable since it's deep and the surrounding muscles are sore for a few days. But within 3-4 days I was working out with noticeably less pain and within 10 days all symptoms were gone. I've been fortunate as the injection seems to provide a long-term solution. My injections were separated by 4+ years. A lot of people don't recommend injections because often they're only a short term solution (i.e. within 4-6 months you're looking for another shot). Too many shots within a relatively short time period (10-16 months) can have negative impacts as they trick your body into thinking it has healthy natural cortisone levels, thereby shutting down it's natural production. In and of itself, I don't think that's a problem, but there are also a lot of important secondary hormones produced simultaneously with cortisone and those aren't supplemented by a shot.

    Good luck. Hopefully time off is all you need.

  13. #13
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    A little update as I know this is something that affects a few people.

    I have been monitoring myself a bit and the biggest problem in recovering seems to be that the muscle cramps continually... which makes it sore... which makes it cramp.

    Stretching relieves it to a certain extent, as does heat (but not ice, in my case).

    Advil makes the pain bearable, but only just.

    Here is my secret weapon, that had almost magical results for me:

    A tennis ball.

    Lie down, put it under your butt, locate the cramping muscle, and sink down on it. It hurts, but in a good way. After about four or five minutes of this I had cleared a really nasty acute attack and was able to go out for a pain-free bike ride afterwards (nothing too radical, but even getting ON a bike was a big piece of progress).

    I also strongly suspect that saddle fit and geometry may have a lot to do with this problem, but haven't really isolated the factors yet.

    I also take the tennis ball in the car with me so I can put it under my butt if I get a cramp while driving. At a pinch an Evian bottle (full, capped) will do the trick too.
    All problems in mountain biking can be solved by going faster, except the ones that are caused by going too fast.

  14. #14
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    Further update, hopefully helpful to anyone who searches since this can be an intractable problem.

    After four weeks this is finally starting to subside.

    The keys so far have been (and they're ALL important, in my case, and perhaps only in my case)...

    -- Stretching religiously and painfully. There are three widely used piriformis stretches and they all seem to target different parts of the muscle. Use them all several times a day. Also do hamstring stretches. Especially when the pain kicks in... instant relief to a certain extent.

    -- Advil. More for anti-inflamation than pain relief, since the inflammation seems to irritate the sciatic nerve and send pain and cramping down the whole leg

    -- don't sit. work standing up if you can. Everything heals MUCH faster if you're not constantly sending the muscle into spasm

    -- if you have to drive, use a heating pad under your butt to keep the muscle relaxed

    -- use heat pads, hot tubs, etc, morning, noon and night

    -- use that tennis ball. It really works.

    -- lie on your back on a hard surface when the pain is really bad. The cramps pass much faster this way.

    -- if you wake up sore and stiff, try a pillow between your knees as you sleep

    I've been trying to keep the advil to a bare minimum as I found it was easy to strain the muscle without realizing if I was using too much. I was also nervous about over-stretching when I couldn't feel the burn.
    All problems in mountain biking can be solved by going faster, except the ones that are caused by going too fast.

  15. #15
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    Yet another update -- a surprising one.

    After 4 weeks the pain started to get worse, with my glute going into spasm as well as my piriformis. I went to a sports doc, who took X-rays. He noticed a degenerated disc but there were no neurological signs of nerve impingement. He seemed somewhat mystified as he couldn't find any muscle knots.

    He referred me to a PT who did a really thorough work up and at the end pronounced it was a bulging/herniated disc. That was Wednesday. He did some mild traction and showed me the McKenzie exercises. He also put tape on my back to keep my posture erect. After the first session my pain was reduced to less than half.

    I got the McKenzie book, and did the first three exercises throughout Thursday, and by Thursday evening I was pain free and able to sit and have a drink with a friend, the first time I've been able to sit for an extended period in weeks.

    This morning I woke up and although I had a few twinges I felt no need for the painkillers and right now I'm almost pain free. I get a spasm if I bend forward but the tape is keeping my posture erect. I'm doing the McKenzie exercises, which are ridiculously easy, and they make a massive difference.

    The apparent piriformis problem is COMPLETELY gone.

    I was kind of scared when he told me it was a disc problem but after two and a half days of McKenzie I'm already at least 50% better and I feel like I'm on the road to recovery.

    I wonder how many other people's piriformis problems are undiagnosed herniated/bulging discs? It's certainly worth getting the McKenzie book ('7 Steps to a Pain Free Life') and trying the exercises... you will probably find in a couple of days if not the very first session whether it's for you.

    You can find the exercises online here, but the book is better:

    http://www.communigate.co.uk/ne/eppsg/page8.phtml
    All problems in mountain biking can be solved by going faster, except the ones that are caused by going too fast.

  16. #16
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    Thanks for link

    Thanks for the exercise link. My symptoms have been fairly sporatic lately,and as an FYI, I found that for car rides of more than 45 min., that removing my wallet from my back pocket seemed to help relieve the long term pressure in that area. I used to have a fairly long commute to work, and the protracted inflammation and swelling of the piriform muscle was laying across the sciatic nerve running down my leg. The sharp pain would manifest itself in different locations down one leg, as far down as my ankles, and by the time I arrived at a destination by car, I could barely walk, until the pain subsided from standing & moving.
    As I indicated in previous post, PT involved intramuscular cortisone, deep-tissue massage, and stretching, tennis ball, large rubber strap, hydroculator, etc. at home. Good Luck!

  17. #17
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    I'm reviving this thread as I've been in significant pain for the past two weeks. Two weeks off the bike. Both attempts on the bike have resulted in MORE pain

    Seen the chiro, several times. Seen a sport masseuse. Seen my GP as of today. Working, nothing yet.

    What I have used/taken:
    - icing
    - heat
    - Aleve
    - Advil
    - industrial strength Tylonel
    - Topicals like aspercreme, icy hot, and arnica
    - Stretching

    NOTHING but extreme pain. I'm sooo miserable. I now have read this thread, and I've got a tennis ball after reading about that here and elsewhere. I also have a prescription strength NSAID (diclofenac sodium) and medrol (prednisone).

    I'm picking up the McKenzie book today, and using the tennis ball. PT starts tomorrow. I plan on walking the track as much as possible. The worst thing is, I start a new job next week, and it looks like I'll be standing up while working for a while. I also have a kneeling chair to keep the pressure off, but I'm thinking I might need the steriod shot next.

    Ow.
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