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piriformis/sciatica pain--exercises to avoid???  

post #1 of 8
Thread Starter 
I've been experiencing some pain in my left leg. From the nature of the pain (buttocks and deep mid
to low thigh) I believe it is piriformis sydrome rather than sciatica. The pain is usually always
above the knee, and tends to be more severe near the end of the day, when getting up from being
seated, or when returning to a low seat from standing. Bending over to put on shoes, etc., will also
sometimes cause some pain, as will sometimes sitting (reclining) on my favorite "cushy" couch at the
end of the day.

The pain has been with me now since early December. There is no "injury event" I can think of that
would have triggered it. I have tried the Sacro-Wedgy product and stretches with little success, and
I'm thinking something in my weekly workouts might be aggravating it. I was hoping there might be
some folks out there with some suggestions on exercises to AVOID while I try to get a handle on
this. Maybe laying off a few specific exercises will reduce the inflammation, if it's truly a
piriformis problem.

Mondays I usually did squats, both traditional with barbell and with a hip-sled. Then I would work
back and biceps, with a mix of traditional barbell/dumbell exercises and some circuit room machines.

Wednesdays was a little deadlifting, chest and triceps, again with a mix of traditional free weight
and machine lifts.

Friday was a depletion workout of the same exercises done Monday and Wed but with lighter weight and
very slow, controlled reps. I will also sometimes do some indoor "gym climbing," which sometimes
involves a controlled fall (usually onto the feet) from 6-8' up onto a thick foam mat. I'm about
6'1" and 200lbs.

For aerobic training I do around 20-30 of interval training on any of the following: stairmaster
(with some deep steps now and then), treadmill (basic running), elliptical trainer, recumbent bike,
normal bike. I used to like the rowing (erg) machine, but that is too painful. And there were a
couple of weekends I'd do some extended backpacking trips and some longer bike rides on a road bike.
But generally when I'm active in these ways there isn't any notable pain.

I'm guessing the squats and deadlift should go, but perhaps not. I'm trying to think through the
condition anatomically, but perhaps a few folks out there have battled this condition and make some
suggestions. I will probably need to bite the bullet and go see a professional at some point (I live
in rural area with limited options, however), but I'd like to try a little "self help" first,
avoiding the offending behavior if that might help.

Any thoughts greatly appreciated!!!
post #2 of 8

Re: piriformis/sciatica pain--exercises to avoid???

In article <3E54395D.AEE5F097@fridayscomputer.com>, Steve Freides <steve@fridayscomputer.com> wrote:

> Puncturevine wrote:
> >
> > I've been experiencing some pain in my left leg. From the nature of the pain (buttocks and deep
> > mid to low thigh) I believe it is piriformis sydrome rather than sciatica. The pain is usually
> > always above the knee, and tends to be more severe near the end of the day, when getting up from
> > being seated, or when returning to a low seat from standing. Bending over to put on shoes, etc.,
> > will also sometimes cause some pain, as will sometimes sitting (reclining) on my favorite
> > "cushy" couch at the end of the day.

> > Any thoughts greatly appreciated!!!
>
> I would continue your search for a good stretch. Plain old splits in their various forms ought to
> help, lunge-type stretches might do something. You can actually work on strength and flexibility
> at the same time if you do some of the old-fashioned presses like the bent press, side press,
> windmill (based on the yoga "triangle"). I might also try to avoid things that tighten the hip
> flexors like the bike and stair stepper.
>
> -S-

I've had problems with that too- pain near the 'sit-bone', and it's REALLY common. The physio showed
me some stretches, like the 'sciatic spiral'. You lie on your back and pull your knee across your
body, up toward the opposite shouldr and HOLD it for at least 20 sec. and repeat 3 times on each
side. And yes, yoga is GREAT For the back. The problem was aggravated in an accident last fall when
I was hit by a car and landed on my back. But all that stuff has helped, that and going to an
osteopath. It still gets stiff from time to time and this &**&^^ cold weather hasn't helped. Sciatic
nerve irritation is really common among cyclists. Find a good set of stretches and do it after every
workout and ride.
post #3 of 8

Re: piriformis/sciatica pain--exercises to avoid???

Marlene Blanshay wrote:

> And yes, yoga is GREAT For the back.

This is a potentially dangerous over-generalization. Some yoga exercises, as taught by many yoga
instructors, would do way more harm than good for many trainees.

-Wayne
post #4 of 8

Re: piriformis/sciatica pain--exercises to avoid???

In article <Xns93285B9879AF98ch@130.133.1.4>, "Wayne S. Hill" <hillw4@asme.org> wrote:

> Marlene Blanshay wrote:
>
> > And yes, yoga is GREAT For the back.
>
> This is a potentially dangerous over-generalization. Some yoga exercises, as taught by many yoga
> instructors, would do way more harm than good for many trainees.
>
> -Wayne

Yeah, I am not sure about some of them either, like the plow or bending over backward, but the whole
point is that you do what you can and done correctly, it's beneficial for flexibility, circulation
and relaxation, great for stiff joints and tense muscles.
post #5 of 8
Thread Starter 

Re: piriformis/sciatica pain--exercises to avoid???

"Jimmie" <jcalhoun3@cox.net> wrote in message news:<FdA5a.73668$zL6.33669@news2.central.cox.net>...
> The symptoms you described do not sound like a piriformis syndrome, in fact more disc related than
> anything else...I would first get evaluated by a physician who will refer you to either a physical
> therapist or chiropractor. Generally, disc disease elicits or increases pain upon sitting, bending
> over and going from sitting to standing; whereas you probably feel better standing and walking.
> Would recommend finding a book callled Treating your own Back by Mckenzie...good luck

I suspect you are right, which is unfortunate since I'm only in my mid-30s. I guess I didn't expect
to have this sort of problem until I was older. I did a little more research/reading on this and did
a real easy workout on Fri, but with the following "additional" exercises:

1. slow, controlled, deep squat with little weight on the Smith machine
2. some back extensions on the Roman chair
3. some "Mackenzie"-like stretching, esp. laying on your front and slowly raising yourself to your
elbows, then outstretched arms, and holding that stretch.

I could feel a difference immediately after the workout, and I feel pretty good today.

But I wish I could figure out the cause. I suspect it has something to do with poor lumbar support
in my office chair and my "cushy couch" at home, both of which I'm sorry to say I spend too much
time in I bought a small lumbar pad today and can tell the difference using it while sitting on
the couch.
post #6 of 8

Re: piriformis/sciatica pain--exercises to avoid???

Marcus E Engdahl wrote:

> Wayne S. Hill <hillw4@asme.org> wrote:
>>Marlene Blanshay wrote:
>
>>> And yes, yoga is GREAT For the back.
>
>>This is a potentially dangerous over-generalization. Some yoga exercises, as taught by many yoga
>>instructors, would do way more harm than good for many trainees.
>
> Avoid crappy teachers at all costs.

How is the average person supposed to know the difference? This is just like the personal
trainer problem (although the average yoga instructor is probably much better than the average
personal trainer).

-Wayne
post #7 of 8

Repost: Thank you, LeRoy Perry. Piriformis-Form & Style (was Aching butt)

In article <GPa5a.31541$863.78858@news-server.bigpond.net.au>, Scott & Ivana
<scott_ivana@hotmail.com> wrote:

> Marlene's stretch is really a glut stretch. I've found that nothing 'stretches' quite like massage
> but who has the $$$ to get that everyday.
>
> Instead I lie on a tennis ball. I start near the top of my butt and roll across each cheek from
> inside to outside & back again. When I find particularly sore spot I just lie on it. There's also
> a spot between the 'tip' of the shoulder blade and the spine which I find needs a real digging
> with the tennis ball as well. I also roll along my ilio-tibial band - pain! You can also get a bit
> of relief doing this to your calves as well.
>
> The other really important stretch is the hamstrings. Keep hip straight and feet shoulder width
> apart. Put you foot on a chair and relax the whole leg (esp. your foot/ankle). Keep you leg
> slightly bent and 'drag' you leg backwards. This stretch isolates the hammie in a way that a
> straight leg stretch won't.
>
> Once you've done this for about a week - visit an osteo or chiro. Adjustments will last longer and
> be easier to achieve if you already a bit loose.
>
> Scott

Some thoughts from a previous post of mine reponding to a query:

In health and on the run, Ozzie Gontang Maintainer - rec.running FAQ Director, San Diego Marathon
Clinic, est. 1975

Mindful Running: http://www.mindfulness.com/mr.asp http://www.faqs.org/faqs/running-faq/

In article <36CA401D.E7D2FD81@flash.net>, Phil Margolies <pmarg@flash.net> wrote:

> Mariko wrote:
>
> > My butt has been hurting since October, and I'm hoping someone might have some suggestions.
> > Details: I have suffered from iliotibial band syndrome many times, and this may have
> > something to do with the butt problem. The point of pain is where my bottom attaches to my
> > leg, and the pain is pretty deep. I can't really sit for an extended period of time because
> > it starts to hurt.
>
> I agree with csrunner1-sounds like piriformis syndrome.
>
> Take a look at: http://danke.com/Orthodoc/pirif.html http://www.rice.edu/~jenky/sports/piri.html
> http://www.rice.edu/~jenky/sports/piri.2.html
>
> -Phil

Ozzie writes:

Some observations:

Piriformis

What it does: Piriformis rotates your thigh laterally (turns it outward). Piriformis abducts
(ab(Latin) from/away from; duco lead, direct [ad=to or toward]) or turns the thigh away from the
body when your leg is flexed.

Piriformis is attached onto the front of the sacrum (origin) and inserts into the top of the
femur (insertion) - sort of at the top and inward on the greater trochanter.

Piriformis does most of the work when you turn your leg outwards.

You now can see how the hyper-tense (overly tight) gluts which has as its job of laterally (outside)
rotating the thigh. That rotation or turning the thigh outward

So if the piriformis does most of the work when you turn your leg out along with the gluteus max
which laterally rotates the thigh, when these muscles become hypertonic (overly tight) they assist
in rotating the entire thigh...and the lower leg and foot also go along for the ride.

So more than likely, you'll often see that when you stand or walk or run through some water and look
at your running foot prints they look like:

/ and not |

\ |

/ |

\ |

and when you stand up brushing your teeth in the morning or standing around not thinking about how
you're standing and you look down at your feet, you will see

\/ and not ||.

Now to correct this you you'll bring the front of your feet \/ together ||.

But the problem is that, if you go back to what you've just learned from the info about the
piriformis and the glut max, you'll say to yourself: "Hmmmmmmmm, if I turn the front of the foot
inward, I won't have done (never good at English when I speak to myself) anything to the
piriformis or the glut max. How can I best effect those muscles which may be a big part of my
splay foot stance?"

Ah now I see what Ozzie's talking about. And you'll say to yourself, "Oh, that's why Ozzie
thanks Leroy Perry to this day for showing him some of his chiropractic intuition and folklore
at a workshop which helped Ozzie understand how to effect the foot at the origin of the splay
footed problem"

When you are standing \ / and want to get your feet to align | |

1. View your feet. Note if the feet are \ / evenly or more \ | or
| / or some ankle between _ _ and | |.

2. If your feet are \ /, turn your heels outward so that if you were looking straight on into a
mirror you would not be able to see the inside of your heel like you can when you look at your
feet and you're standing \ /.

3. Now that you can't see your heels because you're standing | |, lift one leg and bring it to a
position so that it is directly aligned underneath your hip. Think of the legs as two columns
upon which your pelvic is supported.

4. By turning out the heels first, you're countered the lateral rotational tendency of the
piriformis and the glut max. (Now isn't that sweet.)

Two more observations:

5. If you stand in front of a mirror and tighten your butt muscles you'll see the thighs rotate to
the outside. You don't even know you're using the piriformis since it's so deep inside...just
like you know know you're using the psoas to kick a foot ball or kick your dog.

6. In "Preparation" in Tai Chi, you'll notice that you start \/ and then to get into your
"Beginning" stance you rotate the heels out to get into | |. When that happens your knees when
they bend, bend straight ahead. Ahhhhhh.

Well maybe you don't say "Ahhhhhh" to yourself because you don't know what the hell I getting at.

Okay, Okay.

If you chronically have a tendency to have hypertonic piriformi and glutei Maximi (Latin -
nominative plural) you can now relate to why people call you "tight assed."

Now trying to run like that \ /, and now ever thinking that your legs and feet are suppose to track
| |, gives you some sense of the system upon which you stand, walk and run, and realize that those
unnecessary torques and twists do have their effects over the seconds, minutes, hours, days, months
and years because you're doing it all the time....unconsciously.

You're practicing to stand in improper form and style and you're not even thinking about it, let
alone doing something about except when you consciously stretch and workout...and when you compare
that to all the unconscious exercise you do by the way you walk, stand, sit and move....you realize
that 7 or 10 or 20 hours a week of exercise is nothing. Because if you worked out 20 hours a week,
slept 56 hours a week, you still have over 90 hours a week that you're awake.

Albeit unconscious, when you are sitting, standing, walking and moving without awareness: It's not
what you do that gets you in trouble. It's what you do wrong and don't know that you do wrong or
incorrectly...all of those unconscious seconds...that gets you in trouble. Every injury, every
overuse syndrome, every ache and pain you have related to physical movement started with a
millisecond of unconscious improper movement...that you did but didn't know that you did, because
you never thought about it because you were unconscious thinking or worrying or daydreamsing about
something else.

It's not what you know that gets you into trouble. It's what you know that just ain't so.

Sometimes it feels good to be a pain in the cerebral glutei and piriformi of people who suffer from
psychosclerosis (English: hard headedness). I know I suffer from it, doesn't everybody? Never mind.
post #8 of 8

Re: piriformis/sciatica pain--exercises to avoid???

Quote:
Originally posted by Puncturevine
I've been experiencing some pain in my left leg. From the nature of the pain (buttocks and deep mid
to low thigh) I believe it is piriformis sydrome rather than sciatica. The pain is usually always
above the knee, and tends to be more severe near the end of the day, when getting up from being
seated, or when returning to a low seat from standing. Bending over to put on shoes, etc., will also
sometimes cause some pain, as will sometimes sitting (reclining) on my favorite "cushy" couch at the
end of the day.

The pain has been with me now since early December. There is no "injury event" I can think of that
would have triggered it. I have tried the Sacro-Wedgy product and stretches with little success, and
I'm thinking something in my weekly workouts might be aggravating it. I was hoping there might be
some folks out there with some suggestions on exercises to AVOID while I try to get a handle on
this. Maybe laying off a few specific exercises will reduce the inflammation, if it's truly a
piriformis problem.

Mondays I usually did squats, both traditional with barbell and with a hip-sled. Then I would work
back and biceps, with a mix of traditional barbell/dumbell exercises and some circuit room machines.

Wednesdays was a little deadlifting, chest and triceps, again with a mix of traditional free weight
and machine lifts.

Friday was a depletion workout of the same exercises done Monday and Wed but with lighter weight and
very slow, controlled reps. I will also sometimes do some indoor "gym climbing," which sometimes
involves a controlled fall (usually onto the feet) from 6-8' up onto a thick foam mat. I'm about
6'1" and 200lbs.

For aerobic training I do around 20-30 of interval training on any of the following: stairmaster
(with some deep steps now and then), treadmill (basic running), elliptical trainer, recumbent bike,
normal bike. I used to like the rowing (erg) machine, but that is too painful. And there were a
couple of weekends I'd do some extended backpacking trips and some longer bike rides on a road bike.
But generally when I'm active in these ways there isn't any notable pain.

I'm guessing the squats and deadlift should go, but perhaps not. I'm trying to think through the
condition anatomically, but perhaps a few folks out there have battled this condition and make some
suggestions. I will probably need to bite the bullet and go see a professional at some point (I live
in rural area with limited options, however), but I'd like to try a little "self help" first,
avoiding the offending behavior if that might help.

Any thoughts greatly appreciated!!!

Hi, I have good news for you..... I've had the same thing for over a year! And I have tried various things - gone to my doctor, a specialist, a pysiotherapist, etc and none of them helped. However, I recently had an amazing breakthrough - and though the problem can often be excruciating and frustrating as you know - the solution is simple and something you can do on your own. Here's what I've found out about myself. I have what are called trigger points in my piriformis and other hip and butt muscles -- for me, as for you it sounds, these trigger points caused my muscles to shorten and swell and put pressure on the sciatic nerve - and for me, the pudendal nerve (lots of fun!!!). I had heard of trigger points before but didn't fully understand them or how to 'inactivate' them. I also knew of the tennis ball massage technique, but didn't fully get how to make it work. One thing I found was that stretching was the wrong thing for me - stretching a muscle with trigger points makes it worse! I have stopped stretching and now focus all my effort on massaging the trigger points..... My suggestion to you is to get a hold of "The Trigger Point Therapy Workbook: Your self treatment guide to pain relief" by Clair Davies. There is a chapter on piriformis syndrome -- for me this was a revelation, and I'm sure it will be for you as well. The early parts of the book tell you what you need to know about trigger points and how to treat them. This does work and you will see results very quickly..... For me, my hip and nerve pain basically went away after a few days.

So, the good news for you is you can do this on your own and it will work. I recommend the book because you do need to have a good understanding of what trigger points are, how to treat them and how to avoid them or deal with them before they become a problem. Just picking up tips and tricks on the internet won't be enough.

Anyone with any kind of chronic pain should look into trigger point therapy.
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