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  1. #1
    Velcro Bootlegger's Avatar
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    Anyone Heard of Piriformis Syndrome?

    I have been having severe pain in my right butt cheek that has crippled me for the past two weeks. The pain travels down the right leg when I sit down and causes my foot to tingle then, if sitting too long, go numb. I visited the ortho doctor yesterday and was told I have this ailment (piriformis syndrome). I was given a dose pack of methylprednisolone and told to follow up with physical therapy. I was also told this type of injury is very difficult to overcome. It is uncommon and may be caused by overuse of the muscle. The only thing that I can think of is that earlier in the year (July) I crashed my MTB and broke my shoulder blade. I was back riding (hurting) in 16 days which may have caused me to apply uneven force to the pedals straining this muscle.

    Does anyone any information about this ailment that could help? I am completely shut down for now...I plan to follow through with the PT next week. Ouch!

  2. #2
    Bicycle Repair Man !!! Sixty Fiver's Avatar
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    The piraformis muscle is what keeps your hip stable and when it becomes injured or inflamed it can put pressure on the sciatic nerve... this is what causes the tingling, numbness, and often excruciating pain.

    There are some specific exercises you can do to stretch this muscle and be warned... you want to go easy at this.

    It is common with runners and with people who stand or work on hard surfaces and is much less common with cyclists.

    I suffered from this in addition to a back injury... constant work has rehabilitated the piraformis and given me much greater flexibility in my affected hip.

    It was one of the most painful things I ever experienced and for a time i could not sit, bend, or ride a bike.

    http://www.ehow.com/video_4398858_pi...d-posture.html

  3. #3
    Bicycle Repair Man !!! Sixty Fiver's Avatar
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  4. #4
    Bicycle Repair Man !!! Sixty Fiver's Avatar
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    Note... sitting cross legged for a few minutes a day is an excellent way to stretch the piraformis... when you can do this.

  5. #5
    grilled cheesus aham23's Avatar
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    yes and it hurts like all heck. follow the above links to set your pain free. later.

  6. #6
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    I have been through this. My experience was the orthopod was telling me it was periformis to promote his linkage to a PT operation. Without an MRI, your guy is just guessing. See a neurologist and get an MRI. Since symptoms are the same, you may, like I did, have a herniated disc. I learned from this experience that an "orthopedist" knows a lot about broken arms and replacement joints, but nothing about spinal issues. That is a whole other specialty.

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    Bicycle Repair Man !!! Sixty Fiver's Avatar
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    You need to make sure the diagnosis is correct as sciatica can be a symptom of many things... i have a nerve lesion at my L4 but was also suffering from PS... imagine my fun.

    If you attempt the lighter stretching activities and experience a great deal of pain... stop. I could actually switch off my legs when I did this stretch (at first).

    This pain is a pretty good indication that you do have issues with this muscle... it is not aggravating as much by riding but you may require a better saddle with a cutout to take pressure off the perineal area as well.

  8. #8
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    I've been dealing with Piriformis for almost a year. Ditto what DSchlichting said. Also, did you make any geometry or seat changes recently to your bike? I have found a more rearward and higher seat position aggravates my condition more.

  9. #9
    Velcro Bootlegger's Avatar
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    Thanks for the responses. I am having a difficult time doing any of the stretching without inflaming my butt cheek and nerve down the right leg. What is interesting is that I can, once loose, do standing activities without any pain. I have not changed my position on the bike for several years and have had the same seat for 5 years.

    The ortho did say that 30% of the time this pain is caused by a spinal issue. I am going to try the PT route and if not helpful will follow-up with a neuro-specialist.

    This sucks!

  10. #10
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    Oh goodness.

    I had the same pain a few years back. I literally went from feeling a tightness in one butt cheek to within two hours, laying on the floor in severe pain at work. I was in so much pain I could not reach the phone to call for help. I was by myself and the pain was so bad I just slid on the floor from my seat and laid there by myself for about an hour. That's about how long it took for me to get to the floor and call for help. I still didn't know what was going on, so my boss paid for me to go for a massage. I could not get undressed. The massage therapist had to come back in and undress me, then carry me to the table. After the massage, I felt well enough to sit up, but I still had to be carried to the cab. I went home after I found out I had piriformis syndrome. My entire backside from my lower back to my ankles felt like they were on fire, and I could not move out of the bed for almost two weeks. After that, I walked with a cane for another 3 weeks. Altogether, I was down and out for 6 weeks.

    I am now a full fledged aerobics instructor, and I primarily work with teaching pilates classes. Because of all the core work I do to strengthen the core muscles (glutes, abs, inner thighs), it's pretty much cured me. You can't do nothing and expect to walk away like you're 100%- you'll have to work at it.

    It really does suck. A neuro-specialist, though, is way too much. I'm not sure you even need the PT- I think just resting it, then getting into a gentle stretching routine might do it. Then, as you gain more flexibility and don't feel as much pain, you can start working more aggressively. Yoga and pilates will be your friend (and save you scads of money from avoiding the specialists).

    koffee
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    one of my new faves: http://streetknocknetwork.com

  11. #11
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    Go see the PT. Go see the neurologist. If you dont get results, see a different PT and neurologist. Dont listen to anyone on the boards. Noone can make a good assessment withough seeing you, let alone have the eduation to differentiate between piriformis syndrome, an instability, and a disc derangement on a message board. As for MRIs, I wouldnt bother with that either... plenty of false positives with that as well.

    I still dont understand why people come to a bike forum for medical questions. Take what advice you want, but as a medical professional, most of what people say is garbage, irrelevant, or destructive.

  12. #12
    Velcro Bootlegger's Avatar
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    Thanks for all the wise advice everyone. It's been three weeks and today I rode for the first time since my problem stopped me. A really slow 20 miles that hurt some at the beginning, felt decent once warmed up, and really hurt me once I got off the bike. The deep pain in the right buttocks causes my leg to scream. Once I settled it down, I was able to stretch out a bit more. I start PT Monday and I'm hoping for a miracle cure....

    " I still dont understand why people come to a bike forum for medical questions. Take what advice you want, but as a medical professional, most of what people say is garbage, irrelevant, or destructive."
    Hmmmm....Thanks for your insight.......

  13. #13
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    Quote Originally Posted by milnerpt View Post
    Go see the PT. Go see the neurologist. If you dont get results, see a different PT and neurologist. Dont listen to anyone on the boards. Noone can make a good assessment withough seeing you, let alone have the eduation to differentiate between piriformis syndrome, an instability, and a disc derangement on a message board. As for MRIs, I wouldnt bother with that either... plenty of false positives with that as well.

    I still dont understand why people come to a bike forum for medical questions. Take what advice you want, but as a medical professional, most of what people say is garbage, irrelevant, or destructive.
    I don't see anyone making an assessment or a medical diagnosis. If the dood says his doctor said piriformis syndrome, and he's asking others in similar situations what they do, it's definitely not something like what you suggest.

    Now, if he says, I have a deep pain in my glutes. What do you guys think it is, and what should I do? Then I would say he is seriously deranged to seek medical attention on the boards! Get insurance!

    koffee
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    one of my new faves: http://streetknocknetwork.com

  14. #14
    Velcro Bootlegger's Avatar
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    Well said Koffee!!

    I been to two PT treatments so far. They are using utlrasound to stimulate the muscle and put me on a series of stretching exercises. At home, I am sitting on a tennis ball to massage the muscle. I have had some relief and I am able to stretch a bit more. I still cannot sit in a car for more than 15 minutes without my leg flaring up. I will be going to a total of four weeks of PT. My therapist stated I could get back on the bike after a week, doing shorter rides with lots of spinning. She also said to stretch before and after religiously, something I was not doing.

    Here's hoping no one here gets this ailment. What a pain!

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