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

[donaldc]

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.