piriformis syndrome-sciatic

[flickwet]

Already searched older posts, anyone have any success with this recently? used to get better when I rode, then got worse as I rode, last 3 weeks no riding, not happy.

[HenryA]

Regular massage and stretching ought to help.

Try this:

http://www.thestretchinghandbook.com/archives/piriformis-syndrome.php

The second pictured stretch in particular. In the example the person is pretty high - you'd aim for getting your chest down lower as you get stretched out.

Have you thought about seeing a PT?

[45K10]

Pilates has worked wonders for me over the past couple of years. I had severe piriformis tightness and my left leg would essentially go numb and shutdown during a hard ride or race especially during back to back days of hard efforts.

My g-friend kept hounding me to do Pilates and of course I resisted because it does not sound manly but I wished I had listened to her sooner.

I have been racing for years and had some good results so I thought I was overall in good shape but my core muscles, abs and hips were extremely weak.

Some of the early Pilates sessions had me in the pain box but after doing Pilates over the last two years my piriformis pain and numbness has completely disappeared.

It helped strengthen my hips and corrected the muscle imbalances that I had developed through years of cycling.

Henry A suggested seeing a PT and I think that is some sound advice. A good PT can help you target the muscles that you need strengthen and increase flexibility in. Good luck I know how bad it sucks....

[11.4]

Short of cutting the piriformis (which some doctors will suggest), core strengthening, especially at the lower lumbar region, is your best solution. It isn't fast and doesn't make the pain go away immediately. Strong NSAIDS (as in Celebrex or the like, not just Advil) help and you might get some short-term relief from a steroid series.

The trick about the piriformis is that it wraps around the sciatic nerve and in some cases, the sciatic nerve can actually go right through the muscle. It's a muscle that used to be important when we were bent over on all fours. Standing upright, it just stretches the wrong way and doesn't do much (which is why some physicians will suggest simply cutting it). However, remember that as cyclists we tend to be in that same bent-over-on-all-fours position and actually depend on the piriformis for some hip stabilization (and yes, I know, we cyclists tend to act like we still walk on all fours anyway). That muscle means more to us than it does to athletes in other sports, so I would definitely advise against your having any cutting done. That really should only be a last-resort solution where you have to avoid total disability, anyway.

Stretching does help some, but it's hard to stretch that muscle all that effectively. Assisted stretching (with someone manipulating you) works better. The key is to get your L5-S1 area stronger because you, like many cyclists, are probably hypermobile in that joint and you rotate your hips so as to cause the piriformis to act up. And the exercises are easily done on a pilates ball and just on a yoga pad. Get a good PT versed in sports therapy to demonstrate them, then be religious about it. In my experience, one in four PTs really understand the piriformis, and one in ten or fewer understands how it works with cycling. So don't just trust your PT. Try out their recommendations and see what it does for you. If you don't see improvement and then complete healing, go to someone else. Do NOT use weights on it ... you really only need to use your own body weight and muscle tension to strengthen the area.

It sucks. But it does get better if you're respectful of it.

[flickwet]

I'm gonna due the pilates thing, there is a good PT center next to my office. hopefully time and core workouts will help