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Now and Then: 7 Simple Steps for Managing Piriformis Syndrome

Posted Jun 05 2012 9:13am

After 6 days in a row of pretty solid runs, including a 9 miler on Saturday and two post-night-out 5 milers that somehow turned out better than any in which I’d gone to sleep sober, well-nourished or early, I decided to sleep in on Monday.

Could I have run? Certainly. But between a mountain of work and last week’s piriformis scare, I figured that I’d take the drizzly dawn as a sign to stay in. No running, no living room workout, no sweat.

I knew I’d regret this decision midday and, in the words of Homer Simpson, “go something something,” and that’s exactly what happened — my energy levels began to dwindle and my mind began to wander. Exercise keeps me focused and awake; lazy mornings, while kind of nice at the time, render me lethargic and unmotivated. They really don’t benefit anyone.

I did want to take this opportunity, however, to check in on this small bout of piriformis pain I’d been dealing with over the past few days. Last week, I touched upon a minor concern with this recurring running injury—if you can call it that—and, although it was seriously bothering me for all of 72 hours, I really feel as though I’ve learned to manage the condition to the point that, if it does return, with foresight and intelligence, I can kick it within a few days. (Today’s awesome 5.75 mile run along the East River is proof of this, but more on that tomorrow.)

This is a big deal for me. Only a year ago this month, I signed up for my very first half marathon only to discover that I’d have to take a 4-week break from running. Simply
put, I was devastated. How would I train for my first shot at 13.1 miles in only 4 weeks?

While I was fortunately able to accomplish this feat and run my first half in 2:11 (my goal for the Queens Half Marathon was 2:10, so I was pretty happy given the extreme temperatures and yawn-worthy scenery), I vowed that I would never let such a manageable condition spin so far out of control ever again. With the right decisions, piriformis syndrome can so easily be maintained. With the wrong ones, however, you can wind up on the sidelines, blowing the little money you make in the first place on overpriced yoga classes, physical therapists and massage therapists. (Ok, the last one was kind of nice.)

What not to do if you think you think you have piriformis syndrome.

  • Don’t kid yourself. If you feel like your body is trying to tell you something is wrong, then it probably is. Run if it feels comfortable, but if the pain deepens, stop before it gets even worse.
  • Don’t believe for a second that your injury will magically heal after a day of rest or even a week. Sometimes you might need to just wait it out, but think about it this way; had I given myself a 2 week rest, I may have avoided the inevitable full month hiatus.
  • Don’t self-diagnose. I did this, and I happened to be kind of right. But by self-diagnosing, I closed myself off to the myriad other issues that piriformis syndrome might have been caused by (and consequently caused), like tight calves, quads, IT bands, and everything else.

How I’ve learned to manage my piriformis syndrome. **Note, I’m not a doctor. These are home remedies and tricks I learned by working with several professionals. If you’re really dealing with a physical injury, you’ll probably benefit from checking in with an MD, not just some girl who runs for glitter and stuff.

  • Book yourself a massage. I thought this would be too indulgent. Then a doctor — like a real, live MD! — told me to do it, so I felt justified. Just be sure to seek out a bodyworker who specializes in athletic injuries and has ample experience with trigger point therapy and myofascial release, not, you know, any old therapist at a spa.
  • Learn how to stretch. Pigeon pose is one of my favorite stretches to relieve the pain of piriformis syndrome. Other really great positions: seated spinal twist, figure 4 and simply stretching your arms over your head and reaching with clasped fists to the left, center, right, and back to the center.
  • Restorative yoga. I’ve never really looked at yoga as my workout per se, which is why I prefer classes of a restorative nature that enable you to stay in the same, stretchy pose for moments at a time. If you’re from New York, I highly recommend Jivamukti’s Spiritual Warrior. This class is also the reason why I’m able to do a headstand today!
  • Read a book upside down. This isn’t quite what it sounds like, but I’m dead serious about it. When I was first dealing with piriformis syndrome, I stopped by Tara Stiles’ “relax” class at her studio, Strala, in Soho. While there, I asked her what I could do for long-term pain management, and she recommended simply lying with a block under my lower back and “hanging out there” for a while. She even told me to read a book in this bridge-like pose! Hemingway, anyone?
  • Foam roll. Not only does sitting directly on the sore sports feel great, but the foam roller is incredibly important for all of the surrounding muscles, ligaments and tendons. For me, it’s of paramount importance that I foam roll my IT band and my lower back, otherwise, I ultimately feel it in my hips, sides, and everywhere else.
  • Locate your trigger points. Once you do, you can slowly knead into them using a tennis ball or your boyfriend’s (or girlfriend’s) fist, slowly decreasing the sensitivity of the area. A warning: This is one of those “hurts so good” circumstances. Brace yourself.
  • Strength train. According to my physical therapist, I developed piriformis syndrome because I neglected to cross train and, as a result, developed weak glutes. That’s why I’m so careful today to strength train at least once a week, and if I don’t, to do random leg lifts everywhere I go.
  • Listen to your body. I’m not even going to say don’t run, because I’d be a total hypocrite if I did. Last week, I felt the onset of piriformis syndrome and continued with my morning routine anyway. The difference, or at least what I think made the difference, was that I very much listened to my body. I took it slow, I aimed for dirt paths when possible, and I stopped to stretch multiple times throughout the run. It may not have been pretty, but it’s what had to be done.

Have you ever dealt with a recurring injury? What was it, and how did you learn to manage it on your own?

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