piriformis syndrome

[socalstroke]

I started training three months ago after an 18mth hiatus and have experienced a lot of discomfort with what seems to be the piriformis after rowing or running...cycling however, does not result in the same effects. Symptoms include soreness and/or sharp pain behind the glutes, around the sacrum, and where the IT band meets the gluteus maximus (especially with lateral rotation of the left leg). Stretching, heat, foam rollers, and changes to my routine have had little impact. Any suggestions?

[Steven M-M]

Not sure its piriformis syndrome, but I have similar soreness in my right butt. I would keep doing all you're doing but you might also look to any muscle imbalances. When I do 1-legged squats I'm solid on my left but somewhat wobbly on my right, suggesting that this soreness may have something to do with strength differences between my two sides. For me it is mostly just an annoyance, but when it gets worse I have my masseuse do some active release, ART, on the affected areas (trigger points + range of motion): http://www.activerelease.com

[southernrower]

I have it but have not heard of IT band involvement. Most problems seem to exhibit more like sciatica. If all else fails you can have it injecting with novocaine. I have had that done when it gets bad and with rest it has gotten better.

[boston_1x]

That soreness can also be interaction with disc-related stuff. Any history there?

[socalstroke]

No history of disc issues. I also spent several weeks in the pool/bike to slowly ease back into things. Soreness in the lower back has subsided with time, probably due to strengthened supporting structures. The area behind the left gluteus can be brutal though. I can go as hard as I want on the erg without any real issues but walking full stride 20 minutes later can be uncomfortable. Running causes shooting pain and is an absolute no go without several days of rest.

Random, but sneezing while standing straight is the worst when all the muscles get a sudden jolt. If bent over though to keep the muscles engaged, not so much.

[JD]

I had something that sounded quite similar in a previous comeback. Only thing that licked it was acupuncture - 2 sessions.

[AndyLynch]

You don't have piriformis syndrome. I do this for a living. 99% of people that come in with that diagnosis don't have it. Lots of things cause pain as you've described it, piriformis syndrome only being one of them, and its a terribly over-diagnosed and often incorrectly diagnosed problem. Based on "sneezing while standing straight is the worst when all the muscles get a sudden jolt", you most likely have a disc problem. Go see a specialist in physical medicine and rehabilitation, preferably one who deals with primarily musculoskeletal problems. If you don't have one available near you, you could see an orthopaedist. But what you'll need primarily for treatment is a good physical therapist.

[pjbowbauer]

You don't have piriformis syndrome. I do this for a living. 99% of people that come in with that diagnosis don't have it. Lots of things cause pain as you've described it, piriformis syndrome only being one of them, and its a terribly over-diagnosed and often incorrectly diagnosed problem. Based on "sneezing while standing straight is the worst when all the muscles get a sudden jolt", you most likely have a disc problem. Go see a specialist in physical medicine and rehabilitation, preferably one who deals with primarily musculoskeletal problems. If you don't have one available near you, you could see an orthopaedist. But what you'll need primarily for treatment is a good physical therapist.

Well said... sounds like you have an HNP (disc protrusion) and this can be confirmed with an L-spine MRI . Go see a PMR MD for eval . Most people do improve but it may take some PT and other possible interventions (ESI).