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Thread: Piriformis syndrome / sciatica

  1. #11
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    It's great to have some massage professionals commenting! We should get their comments on other problems, too, before they get overloaded!

  2. #12
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    Uh, yes. But you're not gonna like the answer.

    I did PT. It helped. But only as long as I went to PT. I stopped running (which probably caused it). Right before my 2nd half marathon is when it flared up (about last April).

    But it's been a year, and I still have it. It's not constant, daily pain (like it was last summer), but it still flares up once a week or so. Like today. Sitting on a tennis ball helps. I've been walking, doing yoga, lifting, swimming, and biking. I think maybe yoga and the foam roller help. Today I had a flare up, and it's the second day in a row that I skipped my 15 mins of yoga in the morning.

    I have also purchased orthotics for my running/walking shoes. I have toyed with running barefoot. I noticed in particular that ANY running (like 1/2 block to chase my kid) will cause a flare up. But in Hawaii on vacay, I chased him a lot in flip flops, and no flare ups. I also have a knee issue though, so I've only tried to run here and there for a few minutes.

    My pain is in my left leg. Apparently, I pronate AND I run with my toes pointing inward and my legs also go inward, particularly the left leg (crosses way over the center). My doc and PT said that my running style causes my piriformis to be too stretched taut, making it constantly try to contract.

    Good luck. It really really sucks.

  3. #13
    Senior Member CathyA's Avatar
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    And I would make sure its not your feet. Feet that aren't properly supported can really affect your entire leg/hip/back.
    My sciatica/piriformis syndrome really flared up when I was using an exercise bike. I think some of us just have our nerves in more vulnerable places.
    I think alot of people have problems with foot pronation. I've had many custom orthotics in my life. Most of them helped alot. But this last time, I spent $450 on them, and they didn't help. What ended up helping the most were Walkfit orthotics I bought at Target for $20.00.

    How are your knees doing?

  4. #14
    Senior Member citrine's Avatar
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    Another MT here....the entire gluteal region, thighs, and feet need to be worked out to ensure that all the muscles are nice and loose. There are a lot of great stretches you can get on the internet for free. Another thing that would help is to place a tennis ball under your glutes and roll around gently over it. If you cannot lie on the floor to do it, you can also do it against a wall. A few sessions with a good MT will definitely help you out

  5. #15
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    Quote Originally Posted by pony mom View Post
    Another massage therapist here. Find an MT that uses a technique known as 'pin and stretch'. Since the piriformis muscle is contracted and fat, it is squeezing the nerve in the small notch they pass through. Pinning the muscle, thus shortening it, while stretching it will help lengthen it. The way I learned it is having the client lay prone, stand on the side you're working on between the thigh and glutes. Place leg towards edge of table and bend leg at the knee and hold the ankle. Push the ankle away from you, towards the other leg (while lower leg is vertical), with other hand press and hold a spot on the piriformis muscle (I can explain where it is but just poke around---it'll be tender). While pressing that spot, pull the ankle towards you, release the spot, then repeat. It's much easier to do than it sounds. It'll be such a 'good' pain. Doing this will stretch the muscle, releasing the contraction and ease up on the nerve.
    Pony mom, can you rewrite your answer from the point of view of the patient? Can I do this by myself? I've tried to figure this out, and I can't get past "while lower leg is vertical". I've been living with piriformis syndrome for two years now, and whatever you're describing sounds good, but I just can't get it. Thanks!

  6. #16
    Senior Member pony mom's Avatar
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    I don't know if it can be done on your own. You're basically lying on your stomach, with leg on affected side placed out to the side a bit (away from other leg) with leg bent, so your lower leg and foot is vertical and pointing to the ceiling. You need another person to press on your piriformis muscle in your glute while your bent leg is moving. It's not anatomically impossible to reach your glute but pressing down firmly enough with your arm at that angle is difficult.

    The movement done by the person performing this was described as 'pulling a pint', since the technique was developed by a British man. Holding your ankle, they hold your bent leg, then press on the muscle, then pull the ankle/lower leg towards them (like pulling a giant lever). Release the muscle, push the leg back to vertical (or slightly more towards other leg), push muscle, pull leg towards them. The knee stays on the table while the lower leg moves back and forth. The lower leg should stay bent at 90 degress during the movement so you don't strain the knee.

    Hope this makes it a bit clearer. When it's done correctly it'll be a delicious pain. The kind that hurts but feels good.

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