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dg8trs
Sep 7, 11 14:47
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Name This Pain...
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A new painful injury has hit me and I'm trying to figure out what it is and what I can do about it without shelling out a bunch of cash to phys. therapy.
- hurts a little after biking
- made much worse by running, especially hard running
- starts deep in the L buttock, almost under to the groin muscle
- hurts through the top third of the L hamstring
- results in an uneven running stride, even a slight limp
I am 5'9", about 170 lbs, and my L leg is slightly functionally longer than the right one.
I used to wear custom orthotics, but quit them about three years ago without injury.
Any ideas?
Jodi
Sep 7, 11 14:53
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Re: Name This Pain... [dg8trs]
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Piriformis syndrome?
http://tribellas.com/
rroof
Sep 7, 11 14:53
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Re: Name This Pain... [dg8trs]
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piriformis syndrome
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
damnilocano
Sep 7, 11 14:54
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Re: Name This Pain... [dg8trs]
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What they said... and maybe a tight psoas.
If my body isn't strong enough... I hope my wallet will be.
GhiaGirl
Sep 7, 11 14:56
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Re: Name This Pain... [dg8trs]
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get a tennis ball or baseball and roll your glute on it. You'll find the spot that hurts like hell and feel some relief all the way down your hamstring. Work on releasing the piriformis and the hamstring sensation will go away. Doing the pigeon stretch (google it) helps some, but working on the muscle seemed to help mine a lot more.
dg8trs
Sep 7, 11 15:41
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Re: Name This Pain... [GhiaGirl]
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thanks - sounds like fun
I'll try the ball and the stretch and see what I can do
winnidude
Oct 17, 11 10:56
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Re: Name This Pain... [dg8trs]
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First off, I’m no doctor but after having to deal with this pain for over 3 years, I’ve done my share of treatments ask my coach. His typical emails include "how's the butt doing?"
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Do you have sciatic pain when driving? Flying in a plane or sitting for a while? A deep pain in the butt. Sometimes it almost feels like a deep itchiness type of pain
Ever have have pain in the butt/hip when biking, especially us triathletes in aero position? Or after running?
Do you find relief by rolling on a ball, roller or doing certain stretches only to have the pain come back later on?
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I couldn’t ride my bike longer than 35 minutes this spring without having pain in the butt and sciatica.
Driving to work was a destiny for pain. I even learned to drive with my left foot and I sat on a book to harden the seat hoping it would help.
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This spring I had enough and asked my PCP for a referral. It started with a diagnosis of a tight piriformis squeezing the sciatic nerve. I got a cortisone shot in the ass before my race in Puerto Rico this March to try and relieve it. Only to have the same pain after 30 minutes on the bike during the race. This is the same pain that plagued me at Ironman last year where the last 40 miles on the bike I had pains up and down my leg. The pain never seemed to muscle related as my strength was there but at a certain point I cracked and gave in to the pain.
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After the cortisone didn’t work, I went for MRIs. Now I don’t like needles and I had to have this die put into me, yes, I almost fainted, I freakin’ hate needles. This MRI was supposed to look at all the glut muscles, right where my pain was. However that MRI showed nothing so the Doc ordered another one for my lower back, I pleaded for no needles. But that stupid MRI came back negative. The doc prescribed me a slew of exercises and stretches, nothing worked. Finally on our last visit, she said “Well, I’ve done all I can, I wish you luck with it!” WTF
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I’ve done my fair share of research on this, just google “piriformis syndrome” and see how many hits you get. I wasn’t alone but no one seemed to have the concrete answer. There was surgery where they cut the piriformis muscle to relieve pressure, but most of the time the pain would came back. There was the “All in my head” theory, some doctor Sarno thinks all pain is in our head and that we need to think happy thoughts to get rid of it. Hey, I was sold and even tried it. But it’s impossible to think happy thoughts for 24x7 sooner or later you have to think about crap and somehow the pain came back. Or did it never go away.
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My research was leading me to every imaginable stretch to loosen up my piriformis. It would, most of the time, give me instant but only temporary relief. I would also roll on a trigger point ball right on the pain and dang that relief felt good but the side effect was constant glut pain because I was bruising the gluts trying to reach the piriformis which is under the big butt muscles.
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Then I came across one video on youtube. Now for the record, I could be way off here. But I found a solution to my problem after 3 years of dealing with pain so forgive me if you doctors think I’m wacked. This video suggested that nerves travel in tubes or sheaths. These nerves can get stuck in these sheaths if we sit for long period of time(driving, work, aero, biking) and they travel from our heals to the lower back (they travel everywhere just sticking to legs for this story), right through the gluts/piriformis. It was starting to make sense, in my case with all my stretching and I had to have had the most flexible piriformis on the planet, I would still get pain, did I have stuck nerves. Our piriformis and gluts swell when worked hard and I also believe that if you think about pain somewhere in your body, your body starts to pump blood there, thus causing inflammation. If these nerves are stuck in their sheaths and not allowed move freely due to swelling, then I believed I would get my pain. This video I found has a stretch where you sit in a chair, stick your leg out straight and try to point your toe towards your head. I could feel a little stretch in the glut but it wasn’t completely satisfying. Then I thought of a yoga move I did with P90X, where you roll on your back, legs straight over your head, as if your trying to touch the ground over your head with your toes. This seemed like a good way to stretch the same way but not requiring any muscles to be flexed. See here, it’s called the plow
http://www.spinecenteronline.com/educational_resources/exercise_library/advanced_exercises.html
But simply letting the legs hang over my head wasn’t doing much until…
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… I tried to pull my toes towards my head. (Important the legs have to absolutely straight.) What I got was a sensational pull from my heal all the way to my lower back, especially right through the glut and piriformis. The same relief, the good pain that I got when rolling on a ball, yet I wasn’t bruising the gluts to reach it the piriformis. I often use one leg to hold the other one absolutely straight while I try to reach my head with my toes. I don’t go as far over as the picture above, my feet are probably still about 1 foot off the ground. I simply let gravity and my normal flexibility get me to where I need to be, legs straight and pull toes towards head. I'll do both legs and hold the toes pointing towards head for a 10-15 seconds, release and do it again, maybe one leg at a time.
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I have been doing this for a month or 2 now and about 2 - 3 times a day and
I can ride a bike for multiple hours
I have no more issues driving in a car or flying in a plane
When I do feel tightness after a run, I do this stretch and all goes away
I'm also seeing a big reduction in lower back pain as well. I think this stretch is doing wonders on my lower back.
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Again I'm no doctor but I have talked to my share of friends and teammates who have similiar pain and if this simple stretch can help me maybe it can help you.
dg8trs
Oct 17, 11 13:14
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Re: Name This Pain... [winnidude]
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I feel it when I drive long distances or on a plane.
My desk job certainly does not help overall, either.
I'll definitely give it a shot.
Some of the other exercises have had minimal impact (i.e. - the piriformis stretch).
I have a trigger point ball now and have started to use it - it's more targeted than the softball I had been using.
tri dpt
Oct 17, 11 13:57
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Re: Name This Pain... [dg8trs]
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winnidude: sounds like "nerve flossing" to me. It can help if the nerve isn't gliding correctly around the muscles and bones.
http://www.ironmanglib.com
winnidude
Oct 17, 11 13:59
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Re: Name This Pain... [dg8trs]
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Yep, I have that ball as well and tried every stretch out there. I still have it sometimes to just put in my back pocket to give support to the glut, but not to roll on it anymore. I don't even do the piriformis stretches anymore, that one stretch has solved all my issues.
winnidude
Oct 17, 11 14:12
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Re: Name This Pain... [winnidude]
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tri dpt
: Look at that there is actually a term for it. Thanks, now I can describe it better to people.
rloshaw
Oct 17, 11 14:16
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Re: Name This Pain... [winnidude]
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I hate to be a debbie downer but those symptoms are almost identical to how my femoral neck stress fracture felt.... get an MRI
Sure it could be pirformis or psoas/iliopsoas problems but I would rule out a stress fracture first.....
SPROSCIA
Oct 17, 11 20:10
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rloshaw wrote:
I hate to be a debbie downer but those symptoms are almost identical to how my femoral neck stress fracture felt.... get an MRI
Sure it could be pirformis or psoas/iliopsoas problems but I would rule out a stress fracture first.....
Makes me think of avascular necrosis, labrum or similar too. The differntial Dx with out any special tests on this one is surely a long list. Piriformis was not the first to come to my mind based on your symptoms. Curious to know the diagnosis
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jojodfd
Oct 17, 11 21:14
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Re: Name This Pain... [dg8trs]
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Also see if you can find a PT or chiropractor who does ART ( active release technique). I had some of the same symptoms and pirifomis issues
(This post was
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by jojodfd on Oct 17, 11 21:15)
Swampy
Oct 18, 11 9:13
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Re: Name This Pain... [jojodfd]
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I have very similar symptoms to the OP when my psoas gets banjo string tight. This mostly happens when I'm lazy and don't stretch properly, spend all day sitting at my desk, sat in the car 90 minutes a day then hunch over a bike... you get the idea. Stretching the psoas, with what could be best described as a kneeling forward lunge and rolling out the hamstrings/glutes with a foam roller works well. Ironically, the place that I learned this was a massage/bodywork shop in SF called Psoas.
I guess since it's my first post I better say "hi" :)
dg8trs
May 14, 12 9:31
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Re: Name This Pain... [dg8trs]
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After a few months without it, the same pain is back and better than ever.
The only obvious thing that has changed is that I am riding my bike more on the road than I did during the winter, where I spent more time on the trainer.
Could it be possible that the slight change in position could have been all it took to fire up the piriformis again?
I re-read this thread and will try the stretches again to see if it helps.
Unfortunately, I am right on the cusp of starting the first real build phase this year and am wondering if I have to delay it for a week or two.
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