New Posts  All Forums:Forum Nav:

Piriformis Syndrome and Skiing?

post #1 of 20
Thread Starter 
I have Piriformis Syndrome which I developed a year ago. I sat out last season. Does anybody have Piriformis Syndrome and how does it affect your skiing?
post #2 of 20
What type of treatment have you done for it?
post #3 of 20
Thread Starter 
Quote:
Originally Posted by ut_hucker View Post
What type of treatment have you done for it?

Right now I'm doing a stretching program twice a day. I have been doing massage therapy but it really has not been helping. Last May I had a cortisone shot done on my sacroilliac joint. This has been a long recover after fracturing my hip socket in August 2007.
post #4 of 20
What is it?
post #5 of 20
Quote:
Originally Posted by Paul Jones View Post
What is it?
http://www.thestretchinghandbook.com...s-syndrome.php

Although this is a decent article on PS, they fail to mention that in a minority of the population, the sciatic nerve runs through the middle of the piriformis, rather than underneath it. Those poor folks, as you can imagine, are much more prone to PS.



Quote:
Originally Posted by Buddah Bar
Right now I'm doing a stretching program twice a day. I have been doing massage therapy but it really has not been helping. Last May I had a cortisone shot done on my sacroilliac joint. This has been a long recover after fracturing my hip socket in August 2007.
PS, like many other musculoskeletal injuries/imbalances, is a little tough for most manual therapists to treat. Unless a massage therapist, PT, or chiropractor has good hands and can analyze it properly, they probably won't do much good and may aggravate it.

A cortisone shot in the SI joint is a dumb treatment for PS. Yes, it may artificially numb the pain (a stupid thing to do for any musculoskeletal condition), but cortisone injections are quite potent and toxic to the healthy tissue in the immediate area as well. You may as well inject Drano in there.

The medical profession is quite inept at treating PS and a host of other musculoskeletal conditions safely and effectively. I would recommend that you avoid chiropractors as a general rule, as most of them create more problems than they help.

If you are considering seeking professional help for this, Buddah, you may want to check out a professional certified in Active Release Techniques. These folks have a decent understanding of musculotendinous physiology, and are oftentimes successful in treating conditions like PS:

http://www.activerelease.com/providersearch.asp


A good chiro or PT who is familiar with ART will not only analyze and correct the piriformis itself, but will also analyze and correct the surrounding muscles, and the sacroiliac and iliofemoral (hip socket) joints as well... all important components of healthy piriformis function. Just rubbing or stretching the piriformis itself is usually ineffective. Malfunctioning, misaligned, or restricted joints will prevent muscles, tendons, and nerves from healing.


[FYI on a sidenote... Piriformis Syndrome is a more common and more likely cause of Sciatica than herniated spinal disks. MD's and chiro's are constantly misdiagnosing sciatica as a "disk problem," when most minorly bulging or degenerated disks are not the problem AT ALL. I have found in my experience that the vast majority (80% +) of all sciatic cases are muscular in nature, not disk related.]


Hope this helps!
post #6 of 20
Thread Starter 
The big question is "Will I be able to ski this season?"
post #7 of 20
Quote:
Originally Posted by Buddah Bar View Post
The big question is "Will I be able to ski this season?"
Well, nobody here can answer that question for you. It depends on a number of circumstances:


Is "piriformis syndrome" the correct diagnosis?

What's the extent of injury/tissue damage? Is there scar tissue buildup or atrophy involved? What other muscles/tissues/joints are involved in the dysfunction besides the piriformis?

Does this condition require professional help/intervention for it to be properly corrected/rehabilitated?

How quickly can your body heal? What factors are preventing it from healing properly?

Are there mitigating factors or stresses (occupational, athletic, sitting, etc.) that are causing repetitive stress or microtrauma to the problem area?

Is your nutritional intake helping or hindering your body's healing systems?

Is your stretching regimen helping or hindering your neuromuscular system?


I wish I could provide you with more accurate information and advice, but that's impossible on an internet message forum.
post #8 of 20
Great answers. If you have been treating the problem with the same approach for a period of time, it is time to look at other possibilities as the stimulating factor for your pain. Baja summed it up really well.
post #9 of 20
Thread Starter 
Quote:
Originally Posted by Baja View Post
Is "piriformis syndrome" the correct diagnosis?
It has not been officially diagnosed but I have many of the symptoms. My piriformis muscle is very tight and sore nearly 98% of the time.

Quote:
Originally Posted by Baja View Post
What's the extent of injury/tissue damage? Is there scar tissue buildup or atrophy involved? What other muscles/tissues/joints are involved in the dysfunction besides the piriformis?
I hit debris on the trail and ditched my bike. I fell hard on my left foot then landed hard on my left side. I fractured my acetabulum.

I have an incision on my left hip from my buttock to my upper thigh from the surgery to reconstruct my hip socket. I was not able to bear weight on my left leg for nearly two months. There is some degree of atrophy. I developed issues with my sacroilliac joint.

Quote:
Originally Posted by Baja View Post
Does this condition require professional help/intervention for it to be properly corrected/rehabilitated?
I was on a physical therapy program until I lost my job last May.

Quote:
Originally Posted by Baja View Post
How quickly can your body heal? What factors are preventing it from healing properly?
I did heal from the fracture and surgery much more rapidly than my orthopedist expected. I really don't know why my issues with my piriforimis persists.

Quote:
Originally Posted by Baja View Post
Are there mitigating factors or stresses (occupational, athletic, sitting, etc.) that are causing repetitive stress or microtrauma to the problem area?
Until last May I was working an extremely stressful job in a tech support call center. I would be sitting for 8-11 hours at a time.


Quote:
Originally Posted by Baja View Post
Is your nutritional intake helping or hindering your body's healing systems?
I could be doing better on the nutritional front.

Quote:
Originally Posted by Baja View Post
Is your stretching regimen helping or hindering your neuromuscular system?


I wish I could provide you with more accurate information and advice, but that's impossible on an internet message forum.

The stretching does help with the soreness and pain but is not curing it.

I really think I should call my orthopod and pain management physician tomorrow to find out what I can do. I really don't want to sit out this season if I can help it.
post #10 of 20

Me too

I've also developed the syndrome over the last 6 months.

I suspect sitting for long periods of time under alot of stress have something to do with it. I was working 7 days a week in front of a monitor for 10-12 hour stretches.

I have tried acupuncture and a chiropractor with various degree of
success. Thanks to Baja for the tip on ART.
post #11 of 20
Quote:
Originally Posted by Buddah Bar View Post
I really think I should call my orthopod and pain management physician tomorrow to find out what I can do. I really don't want to sit out this season if I can help it.
You could do that, but I can tell you that they have practically nothing to offer you except injections and drugs... dumb temporary palliative treatments for structural musculoskeletal imbalances.

For situations like yours, medical people are the wrong professionals for effective treatment. ("pain management" physicians are the worst, since they hardly ever address and actually fix the cause of the pain) They're great at crisis care intervention and emergencies, but are lacking in the health and fitness area.


Buddah, I strongly suggest you bypass the medics and find someone who will actually help your condition. All the information you're giving here indicates that you need a hands-on manual therapist who will find and correct the cause(s) of your problem.

And please, please, please, don't let anyone talk you into "spinal decompression" :

http://forums.epicski.com/showthread.php?t=72352
post #12 of 20
Good advice from Baja. Stay away from the ortho/pain management. Locate a good PT who treats runners/athletes. Unless you get the correct diagnosis and treatment, sitting out a season is not going to help you.
post #13 of 20
Just an update.

I have been using an inversion table religiously for the past month and the pain has gone away. Initially the pain moved from the piriformis towards the lower part of the spine but the pain gradually got better.

It also helps to consciously breath deeply. The breathing motion helps to stretch the spine and relieve overall tension.
post #14 of 20
In all my postings here I've never mentioned that I also suffered from this at one time, because I was effectively cured, by trigger point therapy, provided by an orthopedist.
At one time, my PS was so bad that I stopped while running to dig my fist into my right buttock, as hard as i could. This provided little relief, but some amused stares from other runners. (I do look ridiculous sometimes).
I also considered sitting on a ball or stone, to try and mash the troublesome section of muscle.
Trigger point therapy was expensive; but worth every penny.
post #15 of 20
Thread Starter 
My orthopedist recommended me to start back up on a strength training program. I've only been doing this for a few days but it's helping. I will be starting back up on the trigger point therapy pretty soon.
post #16 of 20
Buddah,

In doing knee rehab before skiing, the PT told me I have this and the rehab is addressing both issues. I have been totally upfront with the orthopedist and the PT about the cardio and strength training (heavy as I can) I've been doing and continue to do, and they have had no problems with it. Also told them both that I was going skiing over Christmas, and neither tried to talk me out of it!

Rehab for me has focused on strengthening the teardrop muscle on the lower, inside part of the thigh, and strengthening and stretching the piriformis and hamstrings. A couple of exercises: (1) sit up with your legs straight in front of you. Push the back of your knees down into the rug, but focus not just on activating your quads but the teardrop muscle; hold 10 seconds; (2) in that position, lean back on your elbows, tighten quads but focus on the teardrop, rotate your leg to the outside (from the hip) and lift your foot 6 or so inches and hold about 5 seconds. Feel like you are using that muscle to lift your leg (this one also seems to hit a point right on the top of quad, hip flexor, and piriformis).

Note that part of my problem (besides the knee pain) was that the muscles on the outside of my leg were stronger and a lot tighter than the muscles on the inside -- the teardrop muscle work is designed to correct that imbalance and help stabilize the knee. I never would have thought that focusing on a particular muscle could work, but it does -- that muscle alone was sore during the first week of rehab, even though my quads would eventually start cramping as I was doing the sets.

PT also has me doing about 10 minutes of stretching, twice daily. Lots of hamstring stretches and a piriformis stretch -- where you lie on your back, cross the bad leg over the good one, and pull the lower knee into your chest until you feel a stretch in the other hip/butt. Hold 30 seconds; repeat 5-10 times. The PT said I could foam roller the IT band and hip/butt, "if you can stand it." Have found it tolerable to roll the piriformis -- the IT band has been much more painful.

http://www.sportsinjuryclinic.net/cy...piriformis.htm
The above site has some exercises/stretches for piriformis (they want you to subscribe, but if you click on stretching or strengthening above the title "Piriformis Syndrome" or buried in the article you should be able to access those pages at least once; then try to print out before you're cut off). The good stretch I described is, I believe, the second one they show. You might want to try to incorporate some of these, especially the stretches, into your workouts, maybe ask your ortho if these will be okay for your hip.

I haven't tried skiing with this, so I'm as much in the dark as you are about how all this will turn out. Hopefully, we'll have good luck!

DEP
post #17 of 20
It's not just one muscle, it's one small section of that muscle, which exerts pressure on a nerve.
In my case, the piriformis / nerve pressure caused severe tightening of the hamstring, which in turn pulled on the muscles that encircle and activate the knee, making the knee painful at all times, and almost impossible to bend. Walking normally was impossible.
Injections into the piriformis eliminated all the problems. No PT was needed, in my case.
I started roller blading that summer (age 49) and returned to skiing the following winter.
post #18 of 20
Piriformis syndrome can be complicated. I've been fighting it for 2.5 years. I developed mine from running.

A lot of other complications can come up along with the piriformis issues. Mine problems included tight psoas muscle, tight hams/calves, knee pain and weakness, plantar fasciitis, and loss of coordination in the leg. I've had to relearn how to get my muscles to fire correctly in my leg. I also found that I wasn't engaging my core muscles when bending over. This put a lot off stress on my back and piriformis.

I have still skied the whole time. It only bothered me when I absorbed the landing in big drops. I was able to ski moguls aggressively, but I couldn't run at all. I couldn't sleep because of the pain and pulling sensation at my sacrum.

For the best information on how to get better I suggest visiting the message board at www.letsrun.com. Search for Piriformis Syndrome and Loss of Coordination.

Strengthening the muscles around the piriformis is probably the way way to get better.

Good Luck.
post #19 of 20
I first heard of trigger points when I bought the book Sports Injuries by Hans Kraus, after a painful day of rock climbing in The Schawangunks.
Years later, when I was effectively crippled, and at the end of all the treatments my insurance would pay for, I found a therapist through the NAMTPT website. She did a lot of good work restoring functioning and motion, and referred me to an orthopedist who was trained by Drs Travel and Simons. You can get books and charts by Travel and Simons that show exactly where trigger points commonly appear, and all the symptoms that follow them.
In my case, I needed to stretch and soften the piriformis, to eliminate the pressure on the nerve, which was causing the seizing up of my leg and pain in my knee.
After treatment by the orthopedist, I was able to hike, climb, skate and ski again, for the first time in years.
post #20 of 20
correction: it's Travell and Simons.
Janet G. Travell; David Simons.
The treatments Dr Travell developed and taught to my own Dr. gave me my life back. Really!
Google her for more info.
New Posts  All Forums:Forum Nav: