Running with Piriformis Syndrome

Piriformis syndrome
Gisgie Dávila Gendreau
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Gisgie Dávila Gendreau

Gisgie Dávila Gendreau is an injury-prone runner who manages to find reasons to keep coming back to the road. Most recently, she’s struggled with piriformis syndrome. She’s currently winning. Most days.

Gisgie (geese-gee) started running in 2012 to support her daughter who wanted to try out for her middle school cross country team. She hated it. Then she got injured and realized she was in love. With running.

Now she blogs about it at lachicaruns.com.
Gisgie Dávila Gendreau
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Even a twinge of pain can set this fearless (read: pig-headed) runner off immediately into the first four stages of grief: denial, anger, bargaining and depression.

So a year ago when I had severe pain in my left butt cheek that radiated down my leg, I was in a panic. But instead of doing what I needed to do to heal, I spent about nine months in a loop that kept me from the final stage: acceptance.

Spoiler alert: you don’t have to suffer like I did.

When I started this crazy cycle, I was training for my first half marathon and ramping up my mileage with gusto. The diagnosis from my sports medicine physician’s assistant: piriformis syndrome.

The piriformis is a muscle in your butt near the top of the hip-joint that is key in stabilizing the joint when we walk or run. And because the sciatic nerve runs through – or right next to – this muscle and down the leg, when the muscle spasms, it can compress the nerve. Translation: when the butt muscle is irritated, ouch!

The culprit? Typically, it’s over-use, according to Dr. Mark Russell, an orthopedics and sports medicine specialist with Bronson Healthcare in southwest Michigan. Too much running, for example, and not enough cross training to give those muscles a break and to help build core strength.

So what’s a runner chico or chica who has muscle pain the gluteal area to do?

Sometimes, Dr. Russell said, it can be as simple as getting different running shoes to accommodate the runner’s gait. A gait analysis can help, he added, if you want to make sure you’re picking the right running shoe. He also recommends runners stretch before and after runs, and warm up before running.

Treatment typically starts with physical therapy to stretch the muscle and exercises to strengthen any weakness in the hips or other areas that could be contributing to the problem. Cortisone shots can help with the pain as can anti-inflammatory pain relievers like Naproxen, heating pads and the dreaded “R” word: rest.

Some doctors have had good success with Botox shots, Dr. Russell added, with surgery usually only done as a last resort.

My current doctor, a manipulative medicine expert at Michigan State University whom I adore, also recommended I spend some quality time with my foam roller and a tennis ball on the ground, rolling each on the areas that hurt the most. Yeah, it’s about as fun as it sounds.

If you have been having similar pain, here are some tips to get you from denial to acceptance and back on the road quicker:

  1. Don’t ignore the pain. If caught early, Dr. Russell says, piriformis syndrome can resolve in as little as six weeks.
  2. Don’t self-diagnose. Several other things, including a labral tear, a jacked-up sacrum (doctors call that sacral torsion) or a herniated disk can also cause pain in that general area. Only your health-care professional can rule out other causes.
  3. Don’t ignore your doctor’s advice. Do what he or she tells you, even when he or she says the dreaded words: take a break. Dum-dum over here waited until she could barely walk before doing as she was told and is just now getting better.
  4. Don’t skip a step. If you’re not putting in the time to recover, you’re just not going to get better no matter how many specialists you see.

As for me, I only got better when I accepted that this was something that needed attention. I had a diagnosis from the beginning, but I just wanted to do what I wanted to do. That didn’t work out so well.

Contrast that to the past three months, when I have been doing exactly as I am told. I am doing my stretches; getting re-acquainted with the foam roller; using a heating pad when things flare up a bit; discovered yoga and Jillian Michaels workout DVDs for core strength; and am resting when my body complains. And – wait for it – am feeling well enough that I am running again.

In fact, just a couple of nights ago I had one of the best runs I have had in months. One of those runs where I was thinking about everything but running. Not about hurting. Not about when the run would end. And most definitely not about stopping.

Dare I say that I’m back? The next few weeks will tell. In the meantime, I’m signing up for a half marathon this fall, just in case. But should I notice any pain, I’m taking care of the bottom line first.

8 Comments

  1. Krissy Schintgen

    Story of my life! I had been trying to figure out what was wrong with me for the last 3 months. Dr’s and ER thought I was depressed and it was is my head. Here was a blog post I wrote seeking answers.

    http://notfastjustfabulous.com/2015/01/12/she-stood-in-the-storm-and-when-the-wind-did-not-blow-her-way-she-adjusted-her-sails/

    Eventually I was diagnosed with Fibromyalgia & Piriformis Syndrome in my body. As well as Bilateral Scalene Trigger Points and Sacroiliitis…. all because I ran a full marathon and a week later a half marathon.

    I knew I wasn’t crazy, we’ll, I am, I am a runner, BUT I knew it wasn’t in my head!

    Mrs. Fabulous

    Reply
  2. Sue @ This Mama Runs for Cupcakes

    Great post. I think as runners we lose perspective of the big picture sometimes too and tend to run through things we shouldn’t. Hope you are back on track!

    Reply
  3. ALLIE

    Injury is a part of running for a lifetime and you’re absolutely right about not ignoring pain. Like ever. I had this same issue when I first started running b/c I basically did too much, too soon with very little cross-training. Now? Cross-training is a huge part of my running plan and I see a big difference!!

    Reply
  4. LaChicaRuns

    Thanks for the comments. I have a hard time admitting that I need to take a break. But things just get worse, don’t they? Here’s to more listening to our bodies!

    Reply
  5. Arngelo

    Hi Butch,Thanks for the question. I find that isuses of pronation and supination are caused mostly through wearing structurally supported shoes and heel strike. Since the heel is a hard and round bone, the foot will roll either inwardly or outwardly depending on whether you have muscle imbalance causing inward or outward rotation at the knee.Since the forefoot is flat, there is less roll that takes place through the foot. By adopting a forefoot strike gait pattern, you should have significant change or elimination of pronation and supination. I don’t consider being flat footed to be an issue. I believe it is a man-made-up diagnosis. We come in all shapes and sizes. Some people have low arches, some have high. I believe this is the way we are designed and the design is not flawed. If you have pain with your feet, it has more to do with postural dysfunction and imbalances in your body, especially in the arches of your feet. There is a small percentage of the population that may have true structural isuses with their feet. For these people the use of orthotics is beneficial. But they are a tiny fraction of the populace. The rest of us just need to move differently.Here is an article I wrote awhile back that goes into heel strike compared to forefoot strike in more detail.Jesse James Retherford

    Reply
  6. Martin Kielema

    Hi,

    I was searching for some articles about piriformis syndrome when I came across your page.

    Just wanted to give you a heads up that I created something that would be a great addition to your post resources. It’s an article that describes in detail what causes the piriformis syndrome and how you can treat it yourself with 3 exercises.

    You can find it here: http://www.alwaysfysio.nl/en/piriformis-syndrome-treatment/

    Cheers,
    Martin

    Reply
  7. Deb

    I have 10 days left until MCM and my Piriformis injury has returned 2 weeks ago. I have cut back my running, continued stretching, had 3 dry needle procedures and several massages. I have one more massage scheduled for the thursday prior to MCM, all I can do now is hope that I can get through the 26.2 with minimal discomfort. If any has any ideas that may help let me know….Deb MA

    Reply
  8. Laura

    I’m struggling with this now . How long should I rest? And what is ok to do for exercise to keep up the cardio that doesn’t irritate it? I’ve tried a few things but it feels like I’m aggravating it. I’m stretching and have been seeing a physical therapist for about3 weeks.

    Reply

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