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RunnersConnectInjuryPreventionPiriformisSyndrome:Howtodetectitandstrengtheningandstretchingprogramstohelpyouheal

WrittenbyJohnDavis
58COMMENTS

PIRIFORMISSYNDROME:HOWTODETECTITANDSTRENGTHENINGAND
STRETCHINGPROGRAMSTOHELPYOUHEAL

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Itisthatspasmthatshootsdownthebackofyourlegfromyourhip.
Itisthepainthatradiatesdownyourhamstring.
Itisthenumbnessthatremindsyousomethingiswrong.
Itisthehippainwhensitting.
Nomatterwhatwayyoulookatit,whenyouhavepiriformispainwhilerunning,itcanbeveryfrustrating.
Youcangettothepointifyouwonderifyouwilleverbeabletorunpainfreeagain?
Ifyouwerefollowingamarathontrainingschedule,thiscanbedevastating.
HowamIgoingtorun26.2milesifIcannotdomymarathontrainingwithoutmypiriformismusclehurtingmewhenIrun?
Wehavebeenthere.
Alltheresearchintheworldaboutpiriformissyndromesymptoms,andthequestforthebestpiriformisstretchtoeaseyourglutepaindoesnotseemtobehelping,butrather
thanlookingatforumswhereotherstalkabouttheirindividualexperiencesforthepainintheirbuttmuscles,howaboutyouletushelpyoubylookingatthesciencebehindit,
soyoucanunderstandwhatisgoingon,startusingtherightpiriformisexercisestogetyouonyourwaytorecovery.
Forgoodthistime.
Wearegoingtoshowyouthesigns,symptoms,tests,andpiriformissyndrometreatmenttomakesureyoucansayyouusedtosufferfrompiriformispain,ratherthanyoudo.
Doyouwanttoknowwhyitissoimportant?
Thepiriformisisasmall,relativelyshort,andlittleknownmuscleburieddeepwithinthemuscletissueinyourhips.
Ineachhip,itrunsfromthebackofyourpelvistothetopofyourfemur.Becauseofitsuniquepositioning,thepiriformismusclehelpsrotateyourlegoutwardwhenyourhip
isextended,butrotatesyourleginwardandintoabductionwhenyourhipisflexed.

Whenrunning,thepiriformisismostactiveduringthestancephase,whereyourfootisplantedontheground.Here,itactsasanexternalrotatoroftheleg,butitisneither
theprimarynorthemostpowerfulmusclewhichactsinthatrole.
Despiteitsseeminglyinsignificantfunctioninthemuscularsupportofyourbodywhilerunning,itplaysacentralroleinacomplicatedandfrustratinginjuryknownas
piriformissyndrome.

WHYISPIRIFORMISSYNDROMEWORSETHANOTHERINJURIES?
Yourpiriformisispositionedimmediatelyadjacenttothesciaticnerve,averythicknervewhichrunsfromthebaseofyourspinealongyourglutemusclesanddowntheback
ofyourlegs,providingthenervesignalsthatallowallofthemusclesonthebacksideofyourlowerbodytofirewhenneeded.
Didyouknowthis?
Whenthepiriformismuscleisirritated,thesciaticnervecangetirritatedtoo.
Inaroundfifteenpercentofpeople,thesciaticnerveactuallypassesthroughthepiriformis,which,accordingtosomeresearchers,leavestheseindividualsmoresusceptibleto
piriformissyndrome.
Classically,piriformissyndromefeelslikeanaching,soreness,ortightnessinyourbutt,betweenthebackofyourpelvis(thesacrum,specifically)andthetopofyourfemur.
Pain,tightness,tingling,weakness,ornumbnesscanalsoradiateintoyourlowerbackanddownthebacksideofyourleg,throughyourhamstringsandcalves.
Buttockpainandtightnesswithprolongedsittingisalsoacommonoccurrencewithpiriformissyndrome.
Whenyourun,youwillprobablyfeelpaininyourbuttthroughoutthestancephaseofyourstridethepainmightgetworsewhenyourunfast,goupanddownhills,orgo
aroundtightturns.
Piriformissyndromeisrelatedtosciatica,apainfulirritationwhichalsoinvolvespain,tightness,weakness,andanumbortinglingsensationthancoursesdownfromyour
lowerbackintoyourbutt,hamstring,andcalvesorevenfeet.
Thisiscrazy:
Howthepiriformismuscleandthesciaticnerverelatetopiriformissyndromeandsciaticalikepainissomethingthatevendoctorsandresearcherscantquiteagreeon.
Theirinteractionsarecomplicated,astherecanbemanycausesofbuttockpainandsciaticnervepain.
Themereexistenceofapiriformissyndromehasevenbeenquestioned,butthemostcurrentresearchandreviewpapersacceptthatpiriformissyndromerepresentsareal
phenomenonthatisresponsibleforbuttockandlowerlegpain.

WHATAREPIRIFORMISSYNDROMESYMPTOMS?
Itisveryimportanttodistinguishpiriformissyndromefromotherproblemsthatcancausesimilarsymptomsinthebuttockandleg.
Aherniateddiscinyourlowerback,forexample,canputpressureonthesciaticnerve,causingthesametypeofpainthatradiatesdownthebacksideofyourleg,ascanspinal
stenosis(anarrowingofthecanalwhereyourspinalcordpassesthrough)andahostofotherpelvicandlowerbackissues.
Heresthedeal:
Thoughtherearenouniversallyagreeduponcriteriaforpiriformissyndrome,acomprehensivereviewpaperpublishedin2010byKevorkHopayianandotherdoctorsatthe
UniversityofEastAngliaintheUKprovidesusefulcriteria.
Intheirstudy,theydefinedpiriformissyndromeassciatica[i.e.musculoskeletalpainintheleg]arisingfrompressureonthesciaticnervetrunkoritsbranchesbythePM
[piriformismuscle]ordisordersinvolvingthemuscle.
Thisdefinitionisusefulasitencompassesbothsciaticalikepainradiatingdownthroughthehamstringsthatislikelytheresultofpressureonthesciaticnerve,aswellas
localizedpainandsorenessinthepiriformismuscleitself.
Hopayianetal.alsooutlinedthefourmostcommonfindingsinpatientswithpiriformissyndromeamongthe55studiestheyexamined:
Paininthebuttock/piriformisregion

Tendernessataspecificspotinthepelvisbetweenthesacrumandthetopofthefemurtheareathepiriformismusclerunsthrough.
Worseningofbuttockandsciaticalikepainwithprolongedsitting
Aggravationoralterationofthepainwhenthehipandlegarepositionedtoputtensiononthepiriformismuscle
Whilethesesymptomsaredefinitelyevidentinpeoplewithpiriformissyndrome,itsunclearhowcommontheyareinpeoplewithnon
piriformisrelatedsciatica,soitsdiagnosticusefulnessissomewhatlimited.
Fortunately:
OtherconditionsthatcancausesimilarsymptomscanbeidentifiedbyobjectivemedicaltestslikeanMRIoraCTscanthesecancheck
forherniateddiscsorotherlowbackandpelvisissues.
Ifthesetestscomebackclean,piriformissyndromecanbeconsideredasacause.

PIRIFORMISSYNDROMETESTS
Therearealsoafewspecifictestsforpiriformissyndromethathavebeenhighlightedinscientificstudies.

THESTRAIGHTLEGRAISETEST
Painwillshootdownthebackofyourlegwhenyourlegisraisedstraight(typicallybyapartner)whileyoulieonyourback.Thisis
indicativeofirritationofthesciaticnerve,thoughitisnotspecifictopiriformissyndrome.

Becauseofitsproximitytothe
sciaticnerve,aninjurytothe
piriformismusclecancause
sciaticalikepainthatradiates

Thestraightlegraisetestcancausesciaticalikepainifyouhavepiriformissyndrome,butmightalsoindicatethepresenceoflowbackproblems

KNEESAGAINSTRESISTANCETEST
Thistestcanbeperformedwhilesitting.
Attempttopushyourkneesoutagainstresistance(providedbyapartnerorrope).Ifthiscausespain,piriformissyndromeislikely.

downtheleg

Painmightalsooccurifyouattempttoabductyourhipsfromasittingpositionagainstresistanceprovidedbyapartnerorarope.

PIRIFORMISSTRETCHTEST
Finally,twomaneuverswhichputastretchonthepiriformismusclecanalsobeusedtotestforpiriformispain.
Havingapartnerrotateyourhipandleginwardswhileyoulieonyourbackwithyourkneesstraightcanproducepain,ascanlyingonyourunaffectedsideandrotatingthe
painfulsideacrossyourbodywithyourkneebent.

Onetestwhichcanproducepiriformisspecificpainisasupineinternallegrotation,assistedbyeitherbyapartnerorarope,asillustratedhere.

Stretchingthepiriformisinthispositioncanelicitpain(redarea)ifyouhavepiriformissyndrome
Thoughthesepiriformisspecifictestscanhelpconfirmthepresenceofpiriformissyndrome,theyarenotaccurateenoughtoruleitout.
Butheresthekicker:
Hopayianetal.sreviewstudyfoundnoonetechniquetobereliableoraccurateenoughtoendorserather,theycitedthemoregeneralsymptomofaggravationormodulation
ofpiriformispainwhenyoustretchortensionthepiriformismuscle.

Youmightalsobeabletofeelathickeninginthepiriformismuscleitself,deepwithinyourglutes,butthisisalsonotenoughbyitselftodefinitivelydiagnosepiriformis
syndrome.

PIRIFORMISSYNDROMETREATMENT
Asyoumighthavebeenabletoguessfromtheambiguityofthesymptomsanddiagnosiscriteria,piriformissyndromeisnotaheavilystudiedinjury,inrunnersoreveninthe
populationatlarge.
Evencasestudiesofpiriformissyndromeinathletesareextremelydifficulttocomeby,soourapproachtotreatmentswillhavetorelymoreheavilyonatheoreticalapproach
versusonebackedbyhighqualityclinicaltrials.
Mosttreatmentsforpiriformissyndromethatarerecommendedinscientificliteraturearefocusedonaddressingthepainfulorirritatedpiriformismusclethats(presumably)
thecauseofthebuttockandlegpain.
Thislargelyconsistsofstretchingandstrengtheningexercises.
Casestudiesandcaseseriesarticlesfromthescientificliteraturerecommendusingseveraldifferentstretchesforthepiriformis.
Basedonwhatweknowabouttheanatomyofthepiriformismuscle,wecancomeupwithwaystostretchitif,whenthehipisinflexion,thepiriformisactsasaninternal
rotatorandabductor,wecanstretchitbyputtingourhipintoexternalrotationandadductingit.

THEBESTPIRIFORMISSTRETCH(THATACTUALLYWORKS!)
ThisisexactlywhatisaccomplishedinthestretchesrecommendedbyDouglasKeskulaandMichaelTamburelloina1992articleontreatmentsforpiriformissyndrome.

Supinepiriformisstretchwithacrossover(movingleftkneetowardsrightshoulder)

Supinepiriformisstretchwithoutacrossover(movingheeltowardsrightshoulder)

Supinepiriformisstretchassistedbyoppositeleg(movingrightkneetowardsrightshoulder)
KeskulaandTamburellorecommendstartingwiththreesetsoffivetotenrepetitionsofeachstretchtwoorthreetimesperday.
ThoughKeskulaandTamburelloonlyvaguelydescribehowlongeachstretchshouldbeheld(progressingastoleratedbytheathlete),anotherpaperbyPamelaBartonatthe
UniversityofWesternOntarioinCanadarecommendsbeginningwithholdingstretchesforfivesecondsandgraduallyprogressingovertimeto60seconds.
Thisisimportant:
Youshouldbegentlewiththestretches,notoverlyaggressivethismayputtoomuchstressonthealreadyirritatedpiriformis.

PIRIFORMISEXERCISES
Strengtheningexercisesarealsorecommendedinseveraldifferentscientificpapers.
Asthepiriformisworksasanabductorandrotatorofthehip,strengtheningboththepiriformisitselfandtheotherhipmusclesthatsurrounditisaprimarygoaloftreatment.

RUNNERSCONNECTINSIDERBONUS
DownloadourfullPiriformisPreventionRoutineinsideyourInsiderMembersarea.
ItsaPDFwithimagesanddescriptionsofthe10mosteffectivepreventionandrehabexercisesforrunnerswithPiriformisissues.
Clickheretoaccess
NotaRunnersConnectInsidermember?ItsFREEtojoin.Clickheretogetyourguideandgetstartedfree
A2010casereportbyJasonTonleyandagroupoffellowphysicaltherapistsdescribesindetailastrengtheningprotocolusedtosuccessfullytreatpiriformissyndromeina
30yearoldrecreationalathletewhodisplayedmanyoftheclassicsignsofpoorhipmusclecoordination:inwardkneerotationduringsinglelegsquatsandpoorhipabduction
andexternalrotationstrength.
Toaddressthis,theauthorsprescribeda14week,threestepprogramforhipmusclerehabilitation.
Thefirstphaseconsistedonlyofglutebridgesandclamshellleglifts,bothusingatherabandforresistance.
Afterfourweeks,thepatientprogressedtoweightbearingexercises:standingminisquats(withatheraband),monsterwalksidesteps(alsowithaband),asittostand
exercise,andsinglelegminisquats.
Followingfourweeksofthesecondphase,thepatientprogressedtolunges,deepsquats,andevenplyometricstylehopsandlandings(withtheintenttopreparehimtoreturn
tobasketballandtennis,hisprinciplesports).
Inallphasesofrehab,thepatientprogressedovertimetothreesetsoffifteenrepeatsofeachexercise.

ThesearethepiriformisstretchesIhavebeenlookingfor!Greatdetail!
Asimilarprogramdesignedforrunnersisillustratedbelow.Startgradually,butbuildupovertimetothreesetsof15repeatsofeachexercise.

PHASEI:FOURWEEKS
a.Clamshellexercise,addingresistancewiththeraband

CLICKTOTWEET

b.Glutebridgewiththeraband(hold,foruptotwominutes)

c.Sideleglift

b.Monsterwalksidesteps(continuouslymovinginonedirection,thenmovingbacktheother),alsowithaband

c.Singlelegsittostandfromchair

PHASEII:
FOURWEEKS
DoallPhaseIexercises,
andaddthefollowing:
a.Standingminisquats
withatheraband

d.Singlelegminisquatsoffastep

PHASEIII:6WEEKS.
DoallphaseIandIIexercises,andaddthe
following:
a.Frontanddiagonallunges
Whiletherehabprogram
inTonleyetal.was
immenselysuccessful
withtheirpatient,acase
reportobviouslyisntas
usefulasarandomized
clinicaltrial.
Itsunclearhowuseful
thisprogramwouldbe
forotherathleteswith
piriformissyndrome,but
giventhelackofhigh
qualitystudies,andthe
dearthofresearchon
treatmentsspecificallyfor
athletes,Tonleyetal.s
programisstillapretty
goodplacetostart.
Considerthis:

Combiningthesestrength
exerciseswiththe
stretchesdescribedabove
shouldaddressbothmuscularweaknessandtightness.

ThesestretchesandexerciseswerejustwhatIneededformypiriformissyndrome!

CLICKTOTWEET

Otherresearchonpiriformissyndromehasfocusedontreatmentsformorestubborncases.
Isthisyou?
Someisolatedstudiesdescribeinjectionsintothepiriformismuscle,eitherofalocalanestheticlikelidocaneorofacorticosteroid.Studiesindicatethatpainrelieffrom
injectionsishighlyvariable,withsomepatientsexperiencinglonglastingrelief,andothersgettingnoneatall.
Youwontbelievethis:
SomenewertrialshaveeveninvestigatedBOTOXinjections(themuscleparalyzingdrugbetterknownforitsuseincosmeticsurgery)fortreatingrecalcitrantpiriformis
syndrome.
Givenhowlittleisknownaboutinjectabletreatmentsforpiriformissyndrome,especiallyconsideringthatnoneofthestudiesonthistopicinvolvedathletes,itshardtodraw
anyconcreterecommendationstheseoptionsaresomethingyoushoulddiscusswithyourdoctor.
Lookingforalastresort?
Surgicalreleaseofthepiriformismusclehasalsobeendescribedinmultiplepapersasalastresorttreatmentforpiriformissyndrome.Aswithinjectabletreatments,studieson
surgicalpatientsinvariablyfocusonsedentarypeople,oftenwithadditionalexistingbackorspineproblems,soitsnearlyimpossibletoextractanyinformationusefultoa
runner.Again,talktoatrusteddoctorifyouareconsideringsurgery.

RUNNERSCONNECTINSIDERBONUS
DownloadourfullPiriformisPreventionRoutineinsideyourInsiderMembersarea.
ItsaPDFwithimagesanddescriptionsofthe10mosteffectivepreventionandrehabexercisesforrunnerswithPiriformisissues.
Clickheretoaccess
NotaRunnersConnectInsidermember?ItsFREEtojoin.Clickheretogetstarted

OTHERPIRIFORMISSYNDROMETREATMENTOPTIONS
Thoughtheresnotmuchintheliteratureabouttreatingpiriformissyndromeinrunners,itoccurscommonlyenoughforseveralfolktreatmentsandworkaroundstohave
emerged.Amongtheseare:
Havingamassageorstretchingoutthepiriformismuscleandreducetightness.Onewaymanyrunnersdosoisbyrollingtheirglutemusclesonatennis
balloralacrosseball(perfectlyshapedtoputcontrolledpressureontheglutearea).
DeeptissuemassagetechniqueslikeActiveReleaseTechnique(ART)andGrastonTechniquearealsopopular,andtheymaywellaccomplishthesame
goalasthemyofascialreleasemassagetechniquesthataredescribedinsomecasestudiesbyphysicaltherapists.
Anotherpopularmethodtoaddresspiriformissyndromeistosimplyavoiddoingthingsthatirritatethepiriformismuscle:prolongedsittinginparticular
canbeveryirritating,somodifyingyourroutinesoyoudontneedtositasoftenorforaslongcanbehelpful.
Standingdesksarebecomingmorepopular,andtakingashortbreakeveryhourorsoallowsyoutogetyourpiriformisstretchesin,too.Ifnothingelse,
experimentingwithdifferentsittingsurfaces(harder,softer,flatter,ormorecontoured)mightalsoreduceirritation.

Ifyouarestillabletodosomerunning,avoidingworkoutsorconditionswhichirritateyourpiriformiswillalsohelpcommonculpritsincludehighspeeds,
uphillsanddownhills,andtightturns.
Ofcourse,itgoeswithoutsayingthatnoneofthisissupportedbyscientificresearch,soyoullhavetoexperimentwithwhatworksforyouandwhatdoesnot.

SUMMARYOFTREATMENTFORPIRIFORMISSYNDROME
CONSERVATIVETREATMENTS:
Thesearemethodsthatarefairlysimple,inexpensive,andcanbedoneonyourownathome.
Beforejumpingrightintotreatment,itisimportanttoemphasizethatthesetreatmentshavebeendevelopedspecificallywithpiriformissyndromeinmind,notbuttockorsciatic
painingeneral.
Remember:
Ifyourenotsurewhetheryouhavepiriformissyndrome,youshouldseeadoctortogetaproperdiagnosis.Otherinjurieswhichcausesimilarsymptomswillrequiredifferent
treatments.

STRETCHINGROUTINEINCORPORATINGTHEFOLLOWINGEXERCISES.
Beginbystretchingverygently,buildingupovertimetothreesetsof510individualstretches,eachheldforfiveseconds.Overtime,youcanbuildupto60secondsforeach
stretch.
Supinepiriformisstretchwithacrossover
Supinepiriformisstretchwithoutacrossover
Supinepiriformisstretchassistedbyoppositeleg

HIPSTRENGTHENINGEXERCISES

BasedonTonleyetal.spaper,withafewminormodificationstomaketheexercisesmorerelevantforrunners.Startgradually,butbuildupovertimetothreesetsof15
repeatsofeachexercise.

PHASEI:FOURWEEKS
Clamshellexercise,addingresistancewiththeraband
Glutebridgewiththeraband(holdforuptotwominutes)
Sideleglift

PHASEII:FOURWEEKS
DoallphaseIexercises,andaddthefollowing:
Standingminisquatswithatheraband
Monsterwalksidesteps,alsowithaband
Singlelegsittostandfromchair
Singlelegminisquatsoffastep
PhaseIII:6weeks.
DoallphaseIandIIexercises,andaddthefollowing:
Frontanddiagonallunges

GENTLEDAILYROLLING
Useafoamroller(makingsureyoudonotmakethese4mistakes),tennisball,orlacrosseballtoloosenupthepiriformismuscleandglutes.

Thisarticlebreakspiriformissyndromeintohelpfulphases,amustread!

CLICKTOTWEET

PIRIFORMISSYNDROMETREATMENTFORTHOSEWHOHAVETRIEDEVERYTHINGELSE
Thesearetreatmentswithmorecostandlesscertaintyaboutoutcomes,butmayproveusefulwhenyouarefedupofyourpain.

WORKINGWITHAPHYSICALTHERAPISTTODEVELOPASPECIALIZEDREHABPROGRAM
Becausetheliteratureissosparseonappropriateexercisesfortreatingpiriformissyndromeinrunners,itmightmakesensetoseeaPTifyourcaseisparticularlytroublesome
orlonglasting.
Thatway,youcanaddressanyaspectsofyourownindividualmusculartightnessorweaknessthatmightcontributetoyourinjury.
Youcanfindoutifyourstateoffersdirectphysicaltherapytreatmenthere.

ACTIVERELEASETECHNIQUEORGRASTONTECHNIQUE
Thesesofttissuemobilizationexercisesdonthaveanysupportinthescientificliterature,buthavebeenpraisedanecdotallybysome,thoughnotall,runnerswithpiriformis
syndrome.

INJECTIONSOFALOCALANESTHETIC,CORTICOSTEROID,ORBOTOX
Ifyouhavearecalcitrantcaseofpiriformissyndromethathasnotrespondedtomanymonthsofconservativerehab,youcantalktoyourdoctoraboutaninjectabletreatment.
Ifallelsefails,surgeryisafinalalternative.Thisisalsosomethingyoushouldconsultwithatrusteddoctorabout.

CANIRUNTHROUGHPIRIFORMISSYNDROME?
Piriformissyndromecanbeachronic,longlastinginjury.
Yourabilitytoreturntotrainingwilllikelynotcomeallatonce.
Rather,asyourhipstrengthgraduallyimprovesandyourpiriformisgetslessirritatedovertime,yourtoleranceforrunningshouldgraduallyincrease.
Itiswisetostrivetokeepyourrunningvolumeandintensitywithinyourtolerancerange,soyoudontreaggravateyourpiriformis.
Ifyoufindyourselfunabletomakeprogress,itlikelymeansthereisanunderlyingproblemthathasnotyetbeenaddressed.
Beyondthis,thelackofscientificresearchonpiriformissyndromemakesitverydifficulttorecommendanyspecificsonareturntorunningprogram.
Workingwithadoctororphysicaltherapisttoreturntoyourusualtrainingroutineisanexcellentideaifyouhaveastubborncaseofpiriformissyndrome.

RUNNERSCONNECTINSIDERBONUS
DownloadourfullPiriformisPreventionRoutineinsideyourInsiderMembersarea.
ItsaPDFwithimagesanddescriptionsofthe10mosteffectivepreventionandrehabexercisesforrunnerswithPiriformisissues.
Clickheretoaccess
NotaRunnersConnectInsidermember?ItsFREEtojoin.Clickheretogetyourguideandgetstartedfree

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REFERENCES
1.Fishman,L.M.Andersen,C.Rosner,B.,BOTOXandPhysicalTherapyintheTreatmentofPiriformisSyndrome.AmericanJournalofPhysicalMedicine&
Rehabilitation2002,81(12),936942.
2.Anderson,K.Strickland,S.M.Warren,R.,Hipandgroininjuriesinathletes.AmericanJournalofSportsMedicine2001,29(4),521533.
3.Papadopoulos,E.C.Khan,S.N.,Piriformissyndromeandlowbackpain:anewclassificationandreviewoftheliterature.OrthopedicClinicsofNorthAmerica2004,35
(1),6571.
4.Hopayian,K.Song,F.Riera,R.Sambandam,S.Thepiriformissyndrome:areportofasystematicreviewofitsclinicalfeaturesandthemethodologydevelopedfora
reviewofcasestudiesUniversityofEastAnglia:2010pp153.
5.Barton,P.M.,Piriformissyndrome:arationalapproachtomanagement.Pain1991,47,345352.

6.Fishman,L.M.Dombi,G.W.Michaelsen,C.Ringel,S.Rozbruch,J.Rosner,B.Weber,C.,Piriformissyndrome:Diagnosis,treatment,andoutcomea10yearstudy.
ArchivesofPhysicalMedicineandRehabilitation2002,83(3),295301.
7.Beatty,R.A.,Thepiriformismusclesyndrome:asimplediagnosticmaneuver.Neurosurgery1994,34(3),512514.
8.Hopayian,K.Song,F.Sambandam,S.,Theclinicalfeaturesofpiriformissyndrome:asystematicreview.EuropeanSpineJournal2010,19(12),20952109.
9.Keskula,D.R.Tamburello,M.,Conservativemanagementofpiriformissyndrome.JournalofAthleticTraining1992,27(2),102110.
10.Tonley,S.C.Yun,S.M.Kochevar,R.J.Dye,J.A.Farrokhi,S.Powers,C.M.,TreatmentofanIndividualWithPiriformisSyndromeFocusingonHipMuscle
StrengtheningandMovementReeducation:ACaseReport.JournalofOrthopaedic&SportsPhysicalTherapy2010,40(2),103111.
11.Benzon,H.T.Katz,J.A.Benzon,H.A.Iqbal,M.S.,PiriformisSyndrome.AnatomicConsiderations,aNewInjectionTechnique,andaReviewoftheLiterature.
Anesthesiology2003,98(6),14421448.12.Childers,M.K.Wilson,D.J.Gnatz,S.M.Conway,R.R.Sherman,A.K.,BotulinumToxinTypeAUseinPiriformis
MuscleSyndromeAPilotStudy.AmericanJournalofPhysicalMedicine&Rehabilitation2002,81(10),751759.

58ResponsesonPiriformisSyndrome:Howtodetectitandstrengtheningandstretchingprogramsto
helpyouheal
1. KyleKranzsaid:
January10,2014at4:02pm

Ihave/hadpiriformistypesymptoms(undiagnosed,butpainintheareamainlyfromsitting&treadmills).
Myexperienceishere:http://kylekranz.com/?p=314
Basically,Iusedneuralflossingtoalmostcompletelyeliminatethepainwithonlytwodaysofflossing,priortotheeventthatwasthemostpaininmy
ass,a7hourcardrive.
Anycomments/thoughts?
Reply

s earc h t his webs it e

2. GeorgeHeywoodsaid:
January13,2014at8:51am

Assomeonewhoisparanoidaboutgettinganinjurythisarticleisgreat!manythanks!
Reply

3. JohnCheethamsaid:
January22,2014at12:16pm

Iusedtosufferfromthatsamekindofpaininmylefthip.Iwasneversureifitwaslinkedtothepiriformismuscleorifitwasduetotheeffectualgait
causedbymydifferentsizedfeet(2shoesizesdifferent).ThepainwasworstwhilesittingforalongperiodoftimeandjustslightlynaggingwhileI
wasrunning.Ilimitedmyrunningandbegantodostrengthtrainingexercisesonmylegslikesquats,machinelegpress,etc.Thepainhasbeengone
for7monthsnowwhichishowlongIhavebeenstrengthtraining.Iamagainrunninglongerdistancesandthepainhasyettocomeback.(Crossmy
fingersthatitdoesnt.)Thanksforpostingthisarticle.
Reply

4. Ninasaid:
January29,2014at1:34pm

Verygoodandunderstandablepictures!Itrytodotheexercises23timesaweek.SinceIdo(started2weeksago)Ifeelmuchbetter.Thankyou!
Reply

5. asiffirozkhanmansurisaid:
May3,2014at7:41am

iam45yearsoldmale,bloodyPiriformissyndromeitwashappenedtomeinmylife45time,veryveryusefularticle,thisarticleisgreat!many
thanks!bygodblessurverywise!!!
Reply

6. Leahsaid:
August29,2014at8:45am

Ihavefounddryneedling,donebymyphysicaltherapisttobeveryandimmediatelyeffective!
Reply

7. GreggSilksaid:
December6,2014at6:00pm

Thepiriformiscanbeirritatedbybadergonomicofficechairsandcarseats.TheActiveLifeSeatCushionisdesignedtoprotectthepiriformisfrom
badseats.
Reply

CoachTinasaid:
December7,2014at6:56am

ThatsgreatGregg,thankyouforprovidinganoptionforourreaders!
Reply

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8. MikeEsaid:
December15,2014at11:54pm

Thisissuchaspotonarticle.AsamalerunnerIdevelopedpiriformissyndrome6yearsagowhen(Ithink)badworkplaceergonomicswas
exacerbatedbyheavyrunning.IttookthreedoctorsandtwoPTstodiagnose.(Happily,nothipcancer!)IbattlePSstill,withayearsymptomfree
andmonthsofrelapse.Iveevenhaditswitchsides,whichissurprisinganddiscouraging.Enoughmorningsoflimpingoutofbedlikea95yearold
manconvincedmeIneedtoconcentrateoncorestrengthforthelongtermItremainsastruggle.
Reply

CoachTinasaid:
December16,2014at6:29am

SorrytohearthatMike,butgladyouhaverealizedtheimportanceofcoreinrunninghealthy.Itreallydoesmakeahugedifference!Otherswill
enjoyreadingyourstory!Thanksforsharing!
Reply

9. WenWensaid:
January14,2015at3:53pm

GreatArticle!ItprovidedawealthofinformationthatIhadnoclueabout.
Imnotarunner,butIexerciseonanEllipticalmachine.AfewmonthagoIhadkneesurgeryonrightlegandwasrecoveringquitewell.Ibentdown
totiemyshoeandfeltthepaininmybuttocksonthesameleg.IthoughtitwasSciatica(whichIveneverhadbefore),butmydoctordiagnoseditasa
muscleinjury.Ivebeendoingphysicaltherapy.Therearedayswhenthepainisntsobad,butIwantittogoawaycompletely.Patienceiscertainlya
virtueformewiththis.:o)

Reply

CoachTinasaid:
January14,2015at8:02pm

Thankssomuchforyourfeedback,gladtohearyouenjoyedthearticle.Youarerighton!Unfortunatelywithmostinjuries,patienceiskey,and
youwillberewardedforyourperseverance.Thephysicaltherapywillhelpalot,andyouwillbestrongerthanever.Makesureyoukeepupthese
exercisesevenafteritishealed
Reply

LeticiaReyessaid:
May12,2015at5:04pm

Iwasalwaysarunneruntilabout2yearsagowhenIdecidedtosavemykneesjustasaprecautionarymeasureandstartedusingthe
Ellipticalmachine.After2monthsofextremepainandagonythatcausedthesciaticatoflareupandrundownmyleg,anEMGandMRI
confirmedPS(thankfullynohipcancer!).BUT,isthereresearchtoconfirmthattheellipticalmachinecancausesuchinjuries?agymfriend
alsohadthesamethoughtsabouthishipandkneeinjuryafteruseoftheEmachine.Anythoughts?Iamcurrentlytakingcorticosteroidmeds
andthediscomforthassomewhatsubsided,butitisstillthere,includingthetinglinginmyfoot.Itisveryfrustratinganddebilitating!Ihave
stayedofftheEMachine!!Thanksforaveryusefularticle.Sometimeswehavetoresearchourowninjuriestoassistdoctors!Thanks
Reply

CoachTinasaid:
May13,2015at11:01am

s earc h t his webs it e

HiLeticia,thanksforreachingout.Wehavenotheardofsuchevidence,butthatdoesnotmeanthereisnotexamplesofit.Iwilladditto
ourpotentialpostsforthefutureboardtoresearchonitfurther.Itcouldberelatedtoweaknessinyourhips,inwhichcasewehave
coveredhowtoimprovethisinthisposthttp://runnersconnect.net/runninginjuryprevention/therelationshipbetweenhipstrengthand
runninginjuriesthelatestresearch/
Bestofluckwithyourrecovery!Letusknowifwecanhelpinanyotherway
Reply

WayneFitzpatricksaid:
October19,2015at5:17am

Iamalmost100%surethatmyinjuryispiriformissyndromebutmyproblemisthatIhavehardlybeenabletogetoutofbedforthelasttwo
weeks.Igetupinthemorningthinking(likethismorning)finallyitisgettingbetterbutnowhilestandingformorethanaminutethepain
returnsandtheonlyreliefIgetfromthepainiseitherlyingdownorsquatingdown.Thelastisonlypossibleforafewminutes.Thisisenough
togetbacktobed.Allofthediscussionsandthingssaidaboutthisnevermentionthisextreme.ThesepastweeksIhavebeenintheER.
Beeninhospitalgettingmainlypainrelief.Ihavehadthreedifferentscans,Onenormalscan.Onewithcontrastfluid,Andonewithcontrast
fluidthatgoesintothebones.Nothingwasfound.AndthedoctorendedupsayingthatthepainIfeltdidnotaddup.Aburningpainthatcame
deepfromthehip.Itstartedwithkidneystonesandendedwithbackpaintests(centraldiscsetc.)Nothingoutoftheordinarywasfound.Ileft
thehospital(whichseemedtobetotheirlikingbecausetheycouldfindnothingwrong)andreceivedandinjectionfromasportdoctorclose
tothelowerconnectionpointofthepiriformismuscle.Thishelpedforawhilebuttodayitcamebackfullblast.Thisisgoingintoitsthirdweek
ofcompleteinabilitytodoanything.Notevendailytasks.Ihavemylaptopinbedwithmenow.Iamanactive63yearoldbutatthemomentI
feel20yearsolder.Whatiswrongandcanitbesimplypiriformissyndromeoristheresomethingelseofanunderlyingproblem?
Reply

CoachTinasaid:
October19,2015at6:29pm

HiWayne,thanksforreachingout.Sorrytohearaboutyourpain.Haveyoutalkedtoyourdoctoraboutthepainsince?Theymayhave
thoughttheydiagnosedwhatwaswrong.Sorrytohearaboutthescansandtestsyouhavedone,itdoesnotsoundlikeyouhavehada
veryenjoyablefewweeks.Isthereaspecialistyoucangotosee?Unfortunatelyweareunabletohelpyoumuchmorethan
recommendingarticlestoreadaswearenotabletodiagnoseyouwithoutseeingyou.Wecanrecommendyoustarttreatingitusingthe
suggestionsfromthispostifyouareconfidentitispiriformissyndrome,andseeifitprovidesyousomerelief.Sorrywecouldnothelp
more,butletusknowifwecandoanythingelse.
Reply

10. Carlasaid:
February13,2015at3:44am

Greatarticle!Imarunnersufferingfromthiscondition,thesteroidinjectionsdidntworkforme,so,toavoidhavingthebotoxone,Imstartingthis
program.
Questions:
1.Dowedotheexercisesonbothsidesoronlytheaffectedone?
2.Howmanytimesaweekminimumtheexercisesshoulddonetoobtaintheresults

s earc h t his webs it e

Thanksforthedetailedarticle.Veryhelpful
Reply

CoachTinasaid:
February13,2015at3:28pm

HiCarla,thanksforreachingout.Gladyouenjoyedthearticles,youshoulddotheexercisesonbothsides,andcontinuedoingthemafterthey
healasaformofprevention.Youwanttostrengthenthemusclestopreventsomethinglikethishappeningagain.Iamsurethelastthingyou
wouldwantistheothersidebeingaffected

Asforhowoften23timesperweekwouldworkwell.DidyoudownloadthePDFintheyellowbox

atthebottom?Thatwilldefinitelyhelpyouout

Hopethishelps!

Reply

11. Danielsaid:
March4,2015at1:59pm

Excellentarticleandthanksverymuchforpublishingthis.Ihavequiterecently(last2months)startedtogetanoticeablepaininthebuttandupper
hamstringwhichwasconfusingme.IrestedfortwoweeksandlittlechangedIcanstillrun58kfinebutIamgenerallyinsomegenuinediscomfort
foracoupleofdaysbeforeIcanrealisticallythinkaboutgoingagain.Iamgoingtogivetheseexercisesagoandwillreportmyfindings!!
Reply

CoachTinasaid:
March4,2015at4:13pm

HiDaniel,thanksforsharing,pleaseletusknowhowyougeton!
Reply

12. Annsaid:
April26,2015at4:59pm

Hiihavebeensufferingwithp.s.for2months.Havestartedtodophysioexercisesfor2daysandnoticeaslightdifferencealready.Sucharelief!
Reply

CoachTinasaid:
April27,2015at1:51pm

GladtohearthatAnn,keepitup,andyouwillbebackinnotime!
Reply

13. albjarisaid:
May7,2015at3:27am

HelloIaminpaininthehipregionextendstotheentirelegdoesthatmeanIaminfectedinthepiriformismusclenotethereisnopainintheback
areaandthankyou
Reply

CoachTinasaid:
May8,2015at6:50am

s earc h t his webs it e

HiAlbjari,Iamsorry,butitwouldbeimpossibleforustotellyouwhatthesourceofyourpainis.Ifyoursymptomsmatchedwhatwediscussedin
thispost,youdolikelyhavepiriformissyndrome,butyouwouldneedtocontactyourlocalphysiciantoknowforsure.Goodluck!
Reply

14. Marysaid:
May8,2015at10:20am

Lovedyourindeptharticle,thankyou!Ihaveapiriformismuscleproblemalso.IdidntrealizeitwassuchaprevalentproblemuntilIstartedreading
aboutitonline.Iwenttoaphysicaltherapistwhodiagnoseditassuch.HegavemealotoftheexercisesthatyouhaveheresoIguessIwilljustcarry
ondoingthem.Isurehopethispaingoesaway.Doyousuggesticingatallandifsowhen?Iliketowalkbutamnotsureiflongwalksareagood
thing.ShouldIuseiceaftertheexercises/walks?Thankyou.
Reply

CoachTinasaid:
May8,2015at2:09pm

HiMary,gladyoufoundthearticlehelpful.Wewouldnotrecommendicingitatthispoint,andweexplainwhyinthisarticlehere:
http://runnersconnect.net/runninginjuryprevention/icerunninginjuries/Yourbestbetisjusttokeepdoingthoseexercises,andgivingthemtime
tobuildthemusclesyouneedtostrengthenthearea.Walksareprobablyokay,aslongasyoudonotfeelpainduringorafter.Hopethishelps!
Reply

15. tahasaid:
May24,2015at3:57pm

hicoachtina
ihavebeensufferingfromPS(undiagnosed)forthepast2months.iknowforafactthatitsPSbecause,icouldactuallyfeelthemuscletightendeep
insidemyhip.Ionlydidthefirstexercisementionedinthearticleandthepainhassubsidedquitealottothelevelofjustbeingmild.Ithinkiamgonna
startonthehipstrengtheningandcoreexnowtocompletelywarditoff.Prayforme,ireallymissmysportandmycardio,whichireallytookforgranted!
Reply

CoachTinasaid:
May25,2015at10:54am

HiTaha,sorrytohearthat.Gladyouhavefoundsomesuccesswiththeexercises,keepitup,andyourhardworkandrehabwillpayoff.andthis
timeyouwillappreciateitmorelikeyousaidsometimesweneedthosemomentswherewecantdoit,totrulyappreciateit!
Reply

16. Martinsaid:
May27,2015at3:10am

Ihavebeensufferingfrombuttpainfor2years,wentfromdoctortodoctorwithoutsuccess.NowIcameacrossthearticleyouarereferrencingto,
Tonleyetal.,andstartedtodothedescribedexcersises.Icandefinetelynoticeachangeandaslightimprovedafter3daysofdoingthese
excersises.HopeIcanmakefurtherprogress.
Allthebesttoyouall.
MartinfromAustria

s earc h t his webs it e

Reply

CoachTinasaid:
May27,2015at8:36am

HiMartin,thanksforreachingout.Thatiswonderfulnews,andthatiswhatRunnersConnectisallabout!Pleasekeepuspostedonyour
progress,andletusknowifyouhaveanyotherquestions!
Reply

17. Andrewsaid:
June1,2015at9:39am

Itsagreatarticlebutididalotofthingstherapy,excerciseandiamaprofessionlsquashplayerbutallthisdidnthelpsoiwenttomedocheistelling
metosolvetheproblemistohaveanlocalinjectionisthatagoodideaordoesnthelpandmyageis24yearsoldranked56ontheworldranking
andimfoingsquashasmycarrier
Thanks
Reply

CoachTinasaid:
June1,2015at2:51pm

HiAndrew,allwecandoisrecommendtheexercisesthatcanhelp,andunfortunatelytheytakealotoftime,somaybeyouhavenotgiventhem
enoughtime.Recoverydoestaketime,andweasrunnersoftenforgetthat,butifyourdoctortalkedtoyouaboutaninjection,itislikelycortisone,
andwetalkedaboutitherehttp://runnersconnect.net/runninginjuryprevention/cortisoneshotsrunninginjuries/
Thisisaconversationforyouandyourdoctor,wetalkedaboutourthoughtsonitinthispost,butifyouhaveitdone,justmakesureyouhave
beenoverthepotentialconsequences.Hopethishelps!Goodluck!

Reply

Andrewsaid:
June1,2015at9:27pm

Thankssomuchforyourhelpandsupporttoallthequestions,onelastquestioniwillbedoingthatinjectionfewdaysfromnowsoshouldi
followthesekindofroutineandexc.orshouldidoanotherthingforrehabasistillhavenowoffseasontellSeptembersoithinkihaveolenty
oftimeforrestthenrehabisthatright?
Thanks
Reply

18. cecsaid:
June20,2015at10:13am

IstartedgettingPSwhenwalkingmylargedoginournewneighborhoodthathashillsthatIamnotusedto.THecomboofthedogpullingtosniffand
medoingthehillierwalkhaskickedthisterriblepaininforme.
IcanfeelthePiniformesmusclewhenIdothestretches.
IamgoingtobuytheactiveseatcushionrecommendedbecauseIsitforlonghoursatwork,dothestretches,findalevelplacetowalkmydog
nearbyfornow.Ialsowanttodoyourexercisesillustratedinthiswonderfulinformativearticle.Thankyousomuch.Hopealltheseremedieswork.
RightnowIcanonlywalkonemilebeforethispainwillkickin.
Reply

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CoachTinasaid:
June22,2015at9:49am

Hi,thanksforsharing.Hopeyoufindsomerelieffromourarticle.Letusknowifwecandoanythingelsetohelp!
Reply

19. Cherisaid:
June29,2015at4:30pm

Istartedwithsymptomsabout4weeksagoafterexperiencingSIjointpain.IputanSIBeltontohelpthepainandafterawhilefeltamajorpinch!!I
amattheplacenowafterreachingouttothreeor4differentpractionorswhereIcanbarelywalkandtheslightstretchingseemsonlytoaggravatethe
nerve.Whatisthebalancebetweenrestanddoingsomethingthatwillfreemeofthisinsidiouspain?Ihavebeenthroughallthetestsandweare
talkingclassicpiriformissyndrome.IamprettydesperateasyoucantellIamunabletoworkordoanynormaldailyactivitieswithoutexcruciating
pain.Thankyouforyourthoughts.
Reply

CoachTinasaid:
June30,2015at7:45am

HiCheri,thanksforreachingout.Sorrytohearaboutyourpain.Haveyouhadanykindofexaminationwheretheycanreallyseewhatisgoing
on.Wecannotmakerecommendationsaswearenotabletoseeyou,thatisdefinitelywhereyourphysicianisgoingtocomein,butifyoufollow
ourrecommendationsonthispage,ifitispiriformissyndrome,thenthesymptomsshouldlessenifyouarecommittedtothem.Hopethishelps!
Sorrywecannothelpmore!
Reply

20. Mandysaid:
July26,2015at7:47am

Thisissuchagreatarticleandplan!Thankssomuchforsharing!
IwasdiagnosedwithSIJointDysfunctionalongwithpiriformissyndromeafterhavingmydaughter.Iranthroughmypregnancyandnearly11months
afterwithnoproblemuntilshestartedtobreastfeedlessandlessandsuddenlyallheckbrokelose!!!Ivesharedmystorywithothernew,running
momsandfinditsverycommonastherelaxinhormoneseemstomaskinjuries!
IwentthroughseveralroundsofPT,hadagaitanalysisandhadbeenrunningbeautifullythelastseveralmonthsandnowseemtobedevelopingthe
issuesalloveragain!Ugh!
ButIlookforwardtotryingoutwhatyouveoutlinedaboveinhopestogetbacktowhereIvecomesofaralong!
Thanksagain!
Reply

CoachTinasaid:
July27,2015at9:17am

HiMandy,thankssomuchforyourfeedback,wearehappytohearthearticlewashelpful.Sorrytohearaboutyourstruggles,andweknowhow
frustratingthosereturninginjuriescanbe.Wehopetheexercisesandsuggestionsinthispostworkforyou.Pleaseletusknowifwecanhelp
withanythingelseoransweranyotherquestionsforyou!Wewantasmanyhealthyrunnersaspossible!
Reply

Bethsaid:

s earc h t his webs it e

September28,2015at12:14pm

Thanksforsharingthis,Mandy.Iama1sttimemomwhoisstartingtobreastfeedlessandless.(sonis14mths)Ihavebeenhavingpain/achein
therightbuttcheek,andachinessdownthehamstring,calf,andankle.Sawtheacupuncturist,hesaidperiformissyndrome.1sttreatment=nada.
Then,myCALFbecameincrediblytight!!Wentbackfor2ndvisit.Calftightnessgone,butnowmycalfiscompletelyuseless

Cantstandupon

tippietoes.Imnotarealrunner,onlydotreadmilltwiceaweekfor3miles.
Reply

21. KevinButtnersaid:
August2,2015at8:47am

Heythere!Thankssomuchforthisinsightfularticle!Ivehadthetightnessandpaininmybuttocksforfourmonthsnow.Ivebeenwonderingabout
severalthings.
1.Howlongdoesthepiriformissyndrometaketohealonaverage?
2.Prolongedsittingincreasesthepain.Imcurioustoknow,doesitalsoexacerbatetheproblemitselftheinjuredmuscle?
3.Howlongwouldyourecommendsitting,atthemaximum?
Thanks!
Kevin
Reply

CoachTinasaid:
August17,2015at3:24pm

HiKevin,thanksforreachingout.Aswestatedwithinthethreephases,itusuallytakesonaverageabout14weekstocompletelyheal.Asfor
sitting,itisnotgoingtosignificantlydelayhealing,butitwouldbebettertolimitsittinginanypositionthatdoesirritateit.Youshouldtrytomoveas
soonasyoubegintofeelthepain.Hopethishelps!

Reply

22. MaryAnnLucianosaid:
August9,2015at8:35am

Justdiagnosedwithaglutenalmuscletearwithscartissuebutalsotoldofpiriformisinvolvementbymyphysicaltherapist,haveexcruciatingsciatic
painfromhiptoankle.Lotsofupanddownstairsandladders(Imovedfromasecondfloorapartmenttonewlyrenovatedhouse2stories,withlotsof
paintingtobedone)precipitatedtheinjury.Ihavehadas.muscleinjectionviaatenstypemachine,nerveblock,andamtakingbaclofenmuscle
relaxanttorelaxthemuscleonthesciaticnerve,andCelebrexforpain.Toldtorestbutcanbeonmyfeetstanding,sittingispainfulbutneedtoget
backatitformyworkmostlyoncomputer.Willhaveanacupuncturetreatmentforthepainbeforeanotherroundwiththephysicaltherapist.Interested
inyourresponsetoabove,howlongforhealing?whatshouldIdo,notdo?Sitting?standing?walking?cannoteventhinkaboutrunninguntilthis
painabates,12ona10scalehavebeenrestinginbedfortwodayssinceIfoundouttheprognosis,havefinallygottensleepasrelaxantmakesme
drowsy,sittingonlyonhighcushionformeals,toiletinghasbeenverypainfulevenwithhightoilet.Iwillsharethiswebsitewithmyphysicaltherapist
asithasthemostuptodateinformationIhavefoundontheweb,THANKYOU
Reply

CoachTinasaid:
August17,2015at5:26pm

HiMaryAnn,thanksforreachingout,andthankyouforsharingitwithyourphysicaltherapist.Itwouldbebesttoaskyourphysicaltherapistthese
questions,astheyareseeingyoueachday.Keeplisteningtoyourbody,andwhensomethingcausesyoupain,trytostayawayfromthatactivity.
Sittingwilllikelyincreaseyourpain,soitwouldbebesttolimitthatasmuchaspossible,butthetherapyshouldspeedyourhealingalittle.

s earc h t his webs it e

Hopefullybynowyouarefeelingalittlebetter,butthebestadvicewecangiveistotrustyourinstincts,andbeconservativewithyourreturnto
running.Bestofluckinyourreturntorunning.andregularactivities!
Reply

katiesaid:
September21,2015at12:10am

DefinitelytryA.R.T.Imwasgoingthroughthesamepainandafteronesession,Iwasinnopain!Imnowdoingthepiriformisstretches.
Reply

23. charlesshoemakersaid:
August10,2015at8:33pm

LastyearIbegantohavespasmsinmyleftbuttockwhileopperatingastandupforkliftthatwoulddropmetomyknees.ThesymptomsIhadwere
tinglingsensationsfrommyleftbuttockdowntomytoes,thetopofmythighwasverysensitivetothetouch,myleftlegfeltveryheavy,sittingwasvery
uncomfortableandgoingupstairswouldintensifytheheavynessoftheleg.ThispastFebruaryIhadl4,L5andl5,s1fusion.SincethesurgeryIhave
acompletlynumbleftbuttock,heavyleg,discomfortsitting,greatlyreducedbowelmovmentsthathurt,sexualdysfuntion,numbbackofthigh,calf
musclenumbandtight,bottomoffootrockhardandverypainfultowalkon.Smalltoesandoutsideoffootarealsonumbandpainful.
Mydoctorsaysitsmynervesfromthel5S1nevverootsandthatitcantakeuptoayearforthenervestohealfromthefusion.Aftersearchingtheweb
imthinkingIhaveseverepiriformissyndrome.7monthsafterthefusionIfeelworsethanbeforebutmybackfeelsgood.Iwouldappreciateyour
thoughts.
Reply

CoachTinasaid:
August18,2015at6:43am

HiCharles,thanksforreachingout.Sorrytohearaboutyourpain.Hopefullyyouhaveincorporatedourrecommendationsintoyourlifestyleand
havefoundsomeimprovementsbythistime.Restwilldefinitelyhelpyourhealing,anditwouldbebesttoseekadvicefromadoctorwhocan
assessyourconditionandmakerecommendationsbasedonthis.Hopeyoucontinuetofeelbetter.Letusknowifwecanhelpwithanythingelse!
Reply

24. Monasaid:
August19,2015at12:54am

Doesthiscauseyourlegstohurt?Fronttopoflegshurt.
Reply

CoachTinasaid:
August25,2015at8:11am

HiMona,notsurewhatyoumeanbythis,doyoumeanyourhipflexors,upbythetopofyourleg,towardsyourhip?
Reply

25. Kelseysaid:
September10,2015at2:16pm

s earc h t his webs it e

IhavePSandwasstretchingafteralightlegliftingsessiononeday.MykneepoppedandhurtsoIwentintothedocandtheysaiditwasatorn
popliteus.Withthatnow,mykneehurtstobendandpushonitsoitislimitingmystretchingformyPS.Anyrecommendationsonhowtoworkaround
akneeinjurytorelievemysymptomsfromPS?Ihavetonotethatthenumbnessisgreatlyincreasedinmykneeandthetinglingisfiercetheworse
myPSgets.
Reply

CoachTinasaid:
September10,2015at4:42pm

HiKelsey,sorrytohearaboutyourstruggleswithinjuriesrecently.Asforstretching,IamafraidIamnotsurewhattosuggestforyourPSwithout
bendingorpushingonyourknee.Otherreadersmaybeabletohelpyoubasedontheirownexperience,butitwouldbebesttojuststretchas
muchasyoucanuntilyoufeelpain,theneaseoffalittle.Iwillaskourothercoachesiftheyhaveideas,butfornowitmaybebesttojustrestit
andconsidergettingamassagetoseeiftheycanworkoutsomeofthetightness.Hopethishelps,sorrywecannothelpmore!
Reply

26. Briansaid:
November24,2015at11:46pm

IbelievethatIamsufferingfromperiformismusclesyndrome..Itbeganfromacaraccident9monthsagoandthepainisexcruciatingIliveata8to9
onthepainscaledaily.ThemultipledoctorsIhaveseenhavediagnoseditassuchIhavetriedphystherapyinjectionsincludingarecentBotox
oneandhaveyettoreceiverelief.
Iamacommercialplumberandwork40+aweekbutwiththepainitsachallengeDoyouhaveanymoretipsonhowtogetrelieffromthis.
Thanks,
Brian

Reply

CoachTinasaid:
November30,2015at6:53am

HiBrian,sorrytohearaboutyourcaraccidentandthepiriformissyndrome.Ourbestadviceistotrywhatwerecommendedinthispost,the
strengtheningandstretchingwillhelpyourbodytobeabletoprepareitselfbetterforthefuture.Wewouldalsorecommendreadingthe
discussionatthebottomtoseeifanyofthealternativemethodswillhelpyou!BestofluckBrian,wetrulyhopeyoufeelbetter!
Reply

27. susansaid:
December7,2015at4:10pm

Iamcompletelyattheendofmytetherwithafullyearofpainandnervepaindownlegs,havingalmostweeklysessionsofPTanddryneedlingin
between,justwhenIthinkIamimprovingIgetworse,reallycantsitanywherewithoutpain.Completelyfedup.Havedoneeverythingmyphysio
suggested,eventriedfewphysiotherapistsfor2ndopinions,allagreeperiformissyndrome,pleasepleasecanyouadviseasihavebeenagreat
studentanddidallexercises
Reply

28. Bharatkumarsaid:
December18,2015at4:26am

Iamsufferingfromperiformismusclesyndromeshouldicontinuewithmyworkoutroutine??

s earc h t his webs it e

Reply

29. Ravensaid:
January7,2016at12:41pm

Ialmostcriedreadingthroughyourverydetailedandthoughtful,helpful,andhopefulinformationhere!ThankYouforyourworkinputtingthis
together!!
Ayearandahalfago,IwasinatraumaticsailingaccidentwhereIwasknockedbymyheadfromsittingtostandinginacircle(twistingofthehip)
veryfastandhavebeenfeelinglikeanoldlady,goingliterallylameattimes.
Iwantsomuchtogetbacktorunningandbeingabletoexerciseandamsoexcitedtostartthisprogramverywellwrittenandcomprehensive.
SomethingnotofferedbyanyofthedozenorsodoctorsIhaveseen.**InDeepGratitude**,Raven<3
Reply

30. pkatesaid:
January9,2016at8:15pm

Ihavebeeninpainforoverayear,PT,spinalinjectionafterhipandbackMRIandstillnorelief.Hasanyonetriedacupuncture?
Reply

31. relationshipssaid:
June21,2016at6:48pm

Ilikeithenpeoplecokmetoetherandshareviews.
reatwebsite,continuethegoodwor!
Reply

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