Piriformis syndrome anyone?

[eletos]

I’ve been a keen fair weather cyclist and spin addict for a number of years now.

When I have overdone the cycling a bit I have often had a dull ache in the left buttock, usually if I ease off for a few weeks it slowly goes away.

Went out for a ride back on early May, nothing daft, 40 miler at a steady pace, the first real trot out of the season.

The week following saw the return of the buttock pain, but more acute than ever before. Sitting down, lying down and driving was pure agony.

Dr thought it was Trochanteric bursitis as the outer hip was also painful, so off the the physio for some treatment (not on the NHS!).

Now at the end of August I’m still struggling with it and have self diagnosed piriformis syndrome. Been doing a load of strengthening exercises and stretches to mitigate, although a slight improvement, I’m still off the bike.

I must have shelled out over a grand on physio, acupuncture and chiropractors since May. All I get is your hamstrings are tight, your left leg is longer than the right by 8mm and the left glute is not as strong as the right.

Anyone suffered with similar and had any success in reducing the symptoms, either through exercise or other means?

Steve




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[mowflow]

I'm not long over 2 months of agony with this. Fortunately I have a very good physio who I've used for a previous shoulder injury that got me back to health.

Weekly visits for a month with the old electroshock acupuncture stuff with 2 weeks of twice a day unloaded strengthening exercises building up to weighted exercises have done the trick. I can still feel a weakness on the problematic side but I'll get it stronger in time.

After I started feeling better I stayed off the bike for a month along with other activities.

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[Andrzej]

I have had a piriformis problem for over a year and just started having physio and acupuncture to try and sort it; plus stretching hard, and using a massage ball. Again, only left buttock, and for some reason worst pain is when driving, and it does not affect my cycling or running. Friends tell me it is also called weavers bottom, or in Yorkshire fat wallet syndrome.......

[Meesterbond]

Might also be worth getting someone to look at your position on the bike - saddle too high or too low, cleats (if you use clipless) in slightly the wrong place, saddle too far forward or back or even tilted... they could all have an impact, particularly when you consider that you probably perform the exact same motion 5000+ times an hour.

That's not to say that the strengthening exercises aren't also a good idea but worth trying to find out if that's a cause as well as working on the symptoms.

[Vanguard]

Foam roller both back and side of the glute a few times a day for a few mins at a time

I've had this same injury too and it has a lengthy recovery time, obviously also do strengthening exercises that isolate the glute, don't go too heavy though.

[alfat33]

Is there any chance you have a disc problem in your lower back? That’s what my problem was. A couple of sessions of physio, accupuncture and anti-inflammatories relieved the problem long enough for me to have an MRI scan to diagnose the disc problem. Once that got sorted the piriformis problem never came back.

[eletos]

Thanks for the replies, just got back home from an agonising 8 hour flight!

Is there any chance you have a disc problem in your lower back?

Yes, I have lumber disc degeneration, MRI in the past has revealed disc prolapse on the left side. Coincidence? Not sure. Don’t know what treatments there are, consultant never suggested anything and advised to crack on when symptoms subsided. Been nailing ibuprofen for months now, waiting for the ulcers the present themselves!



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[alfat33]

Thanks for the replies, just got back home from an agonising 8 hour flight!



Yes, I have lumber disc degeneration, MRI in the past has revealed disc prolapse on the left side. Coincidence? Not sure. Don’t know what treatments there are, consultant never suggested anything and advised to crack on when symptoms subsided. Been nailing ibuprofen for months now, waiting for the ulcers the present themselves!



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Apparently my disc was pressing against a nerve causing the piriformis muscle to spasm. So even stretching to relax the piriformis only had a very temporary effect. The anti-inflammatory I was prescribed was diclofenac which was a god send.

I’m not certain of the medical details but maybe if your disc has deteriorated it’s triggering something. Hope you can get it sorted.

[Middo]

I have had PS, get a good physio. The treatment certainly smarts but it works.
Stretches at home are also key and continue with them as you begin to exercise again.
Also get a good foam roller.