my doc told me about a week ago that its incurable, and only manageable. Is this true coz since i saw him its got worse and its starting to really piss me off.
Are there any cures and if so, what are they and which is most suitable? Please help
piriformis
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Participant
my doc told me about a week ago that its incurable, and only manageable. Is this true coz since i saw him its got worse and its starting to really piss me off.
Are there any cures and if so, what are they and which is most suitable? Please help
dont know how serious ur piriformis injury is, but in the past the only thing i had to do was reduce training volume and cut out all single leg work. also strecth the piriformis lots.
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Participant
How could a muscle be "incurable"? I can see virus's being deemed incureable, HIV, Cancer perhaps to a certain extent.. but a muscle? Please explain the problem so we can try to help.
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Member
If you take the right steps you certainly can cure piriformis syndrome. While there are many different ways you could go about doing so, I've had the most success with a combination of PNF, AIS, and Myofascial Release/Neuromuscular Therapy.
PNF and AIS:
What I tend to do is loosen up surrounding tissues using rope stretching and a few other AIS methods. When it comes to the piriformis, though, I tend to use PNF (although I use AIS as well) with a leg on a counter/bench. I advoate this method primarily because you don't always have a partner to do PNF with, and I also have a better grasp on teaching/using AIS through some time with Mark Verstegen.Myofascial Release/Neuromuscular Therapy:
If you have the means and or access to a soft-tissue therapist, it is the clear cut way to go. If not, you can improvise. Like AIS/PNF; I instruct athletes to release the surrounding tissues (Back–> Hamstrings–> Adductors–> Quads –> Abductors–> Calves–> Glutes–>More specific work on the piriformis itself). We'll usually begin on a foam roll or basketball, then as the superficial layers loosen, we'll move into a more dense object like a lacrosse ball. I will say that although this is very effective, nothing is superior to the hands/elbows of a professional; so if this type of manipulation doesn't do the trick I highly recommend finding a skilled therapist.Hope this answers some of your questions.
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Participant
"So how do you stretch without this occuring? Active Isolated Stretching
(AIS) is effective for flexibility enhancement and optimal
physiological function. With this type of stretching you hold the stretch for no
longer then 2 seconds. This allows the targeted muscle to lengthen
without the activation of the stretch relfex in the muscle. This allows the
muscles to be stretched in a relaxed state for optimal lengethening". -
Participant
first of all, thnx for the replies.
In terms of my condition, its certainly not serious, serious yet(has been gradually getting worse though) but it isn't pleasant.
I havn't really streched lots yet coz the one night I did it was terrible for the following week but I might continue for a longer period of time and see if that helps. The troble is this is all the stuff that 'manages' it, lol and i don't really want to manage it unless thats my final option, i'd massively prefer to get rid of it, and so wsgenerl you think a therapist.
Can you give me like their title name so I can ask mum to ask for a good local one or is it just 'physical therapist'?Once again thx 4 the help
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Member
First of all, I think the description of AIS is lacking a key component. You must contract the antagonist of the muscle you are stretching, then guide the stretch deeper for 1-2 seconds before releasing and repeating.
I am thinking along the lines of a massage therapist trained in trigger point therapy, myofascial release, or neuromuscular therapy. I prefer the third option; but they all bear a strikingly similar concept.
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Participant
sweet thanx for that.
Will that cure the problem entirely? I've read that piriformis syndrome is an inflamed piriformis muscle which pinches the sciatic nerve(10% of people have their sciatic nerve pass through their piriformis muscle) and so the therapists massage or whatever will cause the piriformis to become 'un'inflamed? I'm supposing that not the whole 10% would ever have a problem and so as long as the piriformis muscle isn't inflamed your fine and dandy?
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Participant
It could be inflamed, but then, of course, there???s a reason for it to be inflamed in the first place. You are correct in that some people have the sciatic nerve going through the piriformis which might create problems more easily in that area. Whether you are one of those cases doesn???t really matter; I???m sure you will get rid of the problem when your piriformis gets some looseness and elasticity back (it will lessen the pressure on the nerve)??? ergo you must warm it up, stretch it, and ice it afterwards.
The problem with the piriformis is that it???s difficult to stretch. I know a very good stretch but it???s impossible to describe it (I tried but it didn???t make sense in writing). However, there???s three important guidelines:
#1: when lying on your back and stretching the left gluteus (cross over stretch) you should keep the right side of your butt/lower back elevated (put a folded towel under your right side).
#2: don???t support your left knee by holding it with your hands, but rather have the ankle supported against a wall???s corner or someone else holding the ankle against the wall. The position for your ankle is not towards the ground anyway, but at approximately 50cm over the ground (against something). Your ankle is positioned as high as your knee, or slightly higher. Your knee is positioned right over your hip bones (not to the left or right).
#3: You have to relax and wait for the stretch to kick in (that???s why you shouldn???t support your knee with your hands); sometimes it takes a minute or more before the stretch surpassed the gluteus and really hits the piriformis; 5 minutes should be fine if you keep it easy.
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Member
I'm not sure I like the idea of holding a stretch for very long. The problem occurs when trigger points lie within the muscle–I'm pretty sure there are at this time–and you passively loosen the tissue. Travell and Simmons as well as my anecdotal evidence say that stretching muscles with trigger points statically often just aggrivate the situtation. While it may not aggrivate the situation in some, it is likely that static stretching is going to do very little to "unlock" the inflamed tissue.
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Participant
I'm not sure I like the idea of holding a stretch for very long. The problem occurs when trigger points lie within the muscle–I'm pretty sure there are at this time–and you passively loosen the tissue. Travell and Simmons as well as my anecdotal evidence say that stretching muscles with trigger points statically often just aggrivate the situtation. While it may not aggrivate the situation in some, it is likely that static stretching is going to do very little to "unlock" the inflamed tissue.
Neither do I, except with the piriformis issue. Interestingly enough, long light holds did the trick for me ??? and this in a situation where surgery and practically every other method already had been tried. I found out that it took a surprisingly long time because the gluteus would be ???in the way?????? after a minute or so it gave away and the pressure penetrated to the pirifomis. I???m aware of the literature on long holds, but it was the only thing that worked for me (and a few others who tried it afterwards). One negative issue was, however, that the inside of the leg had to be loosened afterwards (it felt uncomfortable directly afterwards). But it worked.
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Participant
ok, thanx again guys.
To begin with i'll go and see a therapist I think, and if worst comes to the worst, i'll have to personally investigate some stretches to try and loosen it but at the moment whenever I strech it, it infuriates the problem for the next few days.
On a side note, it's still fine to train on it aye? I'm not really in the mood to have another lay-off so do you reckon it will be sweet guys?
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Member
After a session or two, I would highly recommend using stretching as an ADJUNCT to your soft tissue work, not as a seperate treatment.
You can train on it, provided the pain is tolerable. It is quite possible to begin to try and lean away from the pain causing more fascial tension/stress on other areas, which could lead into other problems. I would be certain to adjust the volume of your work and avoid lifts/exercises that cause much discomfort.
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Participant
staying off or reducing curve work tends to help those with piriformis issues.
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Member
um, i'v heard that using tennis ball massage can help piriformis problems, this true….?
That'd be a form of soft-tissue work, so yeah.
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