I am dealing with the same issue. Two months ago I started seeing a Structural Integration Therapist (includes Rolfing). This helped tremendously and actually healed a very strained set of muscles in my abs and back. However, my PS symptoms have come back and I need to see this person again. My understanding is that sitting really makes it worse, and unfortunately my work requires that. So I'm working on the stretching, but here's the low down the way I understand it: 1) Sitting and running really make this problem worse but it is basically caused by inflammation and scar tissue in the fascia around your Piriformis muscle. 2) Cycling (in my case) doesn't heal it alone but can be used as part of therapy once you've included some other modality 3) The only truly helpful solution is through PT, or Active Release from a Chiropractor, or a Structural Integration therapist and/or Pilates. The optimal solution is using Pilates and one of the other techniques in combination. 4) In my experience, it is quite possible to heal the fascia through the aforementioned areas of therapy but SURGERY SHOULD BE AVOIDED UNDER ALL CIRCUMSTANCES. Your problem is created by scar tissue in the fascia. Surgery only creates more scar tissue, which is why it does not resolve the problem.
