My Plight with Piriformis Issues

For the past couple of weeks, I’ve been feeling some tightness in my hip and butt area after runs, but nothing out of the ordinary at first. I’m always tight in the hips, so I started trying to make sure I added more hip openers in my yoga practice, as well as trying to remember to use “The Stick” after my runs.

But after my speed work run last Tuesday morning, I really started to feel some pain in my left hip. By Wednesday morning, I was limping around, due to a rather uncomfortable “pain in my butt.” In addition, I’ve been having recurring pain on the inside of my calf on that same leg. It’s the leg I always have issues with, and it could be due the mild case of scoliosis that I have.

My first emotions were frustration and anger, because I’ve got my half-marathon this Saturday. It’s my third half-marathon, and I have only one goal: to be able to run the whole thing. In my first two half-marathons, I was working through a pretty bad IT Band injury, so I was forced to walk almost 4 miles in my first, and about 2 miles in my second. I’ve worked long and hard to get through all that, and now here I am injured again! WTF?!

I spoke with my running coach, who suggested I see my chiropractor immediately. He was able to see me first thing Friday morning, and he was able to determine that my issue is my piriformis muscle, in terms of the pain in my butt.

The piriformis is a small muscle located deep in the hip, directly underneath the gluteus maximus. It also happens to sit right on top of the sciatic nerve. It’s responsible for aiding in external rotation (turning out) of the hip joint. When issues arise with the piriformis muscle, it’s important to determine the cause. If you simply treat the symptoms without knowing the cause, you’ll simply keep having issues over and over again.

My chiropractor was able to help me determine what it was I was doing to cause the issue, and he showed me some good stretches I can do at home to work out the tightness. Unfortunately, because the piriformis sits so deep within the hip, it is a very tough muscle to get to in terms of stretching. So I will need to be diligent in making sure I stretch this area after every run, and I need to make sure I hold the stretches for this muscle for a minimum of 45 seconds…holding for any amount of time less than that would really not do much good.

There are a variety of good stretches you can find out there on the Internet to stretch the piriformis. However, if you’ve got active piriformis issues going on with your body right now (Piriformis Syndrome), then there are some important things you need to keep in mind. My chiropractor let me know that several of the exercises I’d been doing to stretch my hip/butt area were actually causing me more harm than good, and I was completely in shock! It just goes to show you that just because I’m a yoga teacher, I still have much to learn about various conditions. Because I was so unaware of the harm I was causing myself, I wanted to pass on what I learned so that if you’re suffering from the same thing, you can be aware of what NOT to do.

  • I frequently do Butterfly Pose in my stretching routine and yoga practice. I usually do the variation where I fold forward. However, when you’re working through an active case of Piriformis Syndrome, the folding forward is not recommended. That’s because it stretches the sciatic nerve, which already has a lot of pressure on it due to the inflamed piriformis muscle. So the better option would be to avoid folding forward and instead, add resistance to the inner thighs with the elbows. Or, the supine (lying down) version is also a great option.
  • Sitting at a desk or in a car with the legs apart and externally rotated are also situations that can cause contraction in the piriformis for extended periods of time, which irritates the sciatic nerve. I realized that I do this both at my desk at work, and while I’m driving. So that’s a bad habit I need to break pronto!

If you’re looking for some good stretches to add to your routine that target the piriformis, here are some great ones to try:

  • Pigeon Pose. Avoid folding forward if you’ve got an active case of Piriformis Syndrome going on.
  • Cow Face Pose (you can do it without the arm option). Don’t fold forward if you’ve got an active case of Piriformis Syndrome going on.
  • Wall Hip Stretch. The instructions in this link say to hold for 30 seconds, but I recommend at least 45 seconds.
  • Figure 4. Again, the instructions in this link say to hold for 30 seconds, but my chiropractor recommended at least 45 seconds for this one.

Some great articles I found about Piriformis Syndrome can be found at the following URLs:

Let me just say that if you have Piriformis Syndrome, or think you do, it’s very important to check in with a professional before you arbitrarily start trying to treat it by yourself. You need to figure out what it is that is causing the issue to begin with, so that you can fix it. It is not a condition found only in athletes, as many may assume. I chose to go to a sports chiropractor, as he’s helped me without fail so far with every issue I’ve had over the past year. If you don’t know who to go to, ask your primary care doctor for a referral. He may send you to a sports chiropractor or a physical therapist, or perhaps even an orthopaedic physician.

Now that I know what caused my issues, I need to work really hard to stop sitting in ways that contract my piriformis for long periods of time. And I need to make sure that until I’m through these issues, I do the RIGHT stretches. It will take some time, as I am pretty darn tight there, so I need to be patient and work through it. And I need to make sure I listen to my body and rest when it needs to rest. The biggest thing I need to do is to listen to the advice I give to my yoga students. I actually need to start practicing what I preach. Imagine that!

Perhaps this is a lesson to me. I could choose to look at all these injuries I’ve suffered over the past couple of years and ask, “Why me??” But instead, I choose to think God is putting these obstacles in my path in order to make me a better student, which in turn, makes me a better teacher. With every issue thrown my way, I research it to death, until I feel like I’ve got all the information I need so that I can keep it from happening again. Inevitably, I end up passing on that info to my students, to my running buddies who are going through the same types of things, and to anyone else who cares to know. Hey, if I can help just one person avoid having to go through an injury by sharing what I’ve learned, then every bit of pain I’ve gone through myself is worth it.

Categories Yoga

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