My butt hurts

[darkemeralds]

I went to medical school over the weekend and have diagnosed myself with piriformis syndrome.

The piriformis is a butt muscle, involved in rotating the hip. When it gets balled up and inflamed, it presses on the sciatic nerve, and when the sciatic nerve gets pressed on, your ass hurts. A lot. And your thigh, and maybe your knee and calf too.

The syndrome has been building for a few weeks, and became acute last Sunday as I was shuffling through a crowded IKEA and couldn't readily get off my feet. The pain was...significant.

The treatment I've prescribed for myself is a series of fun little stretches, some of which involve sitting on a tennis ball. I'll probably get acupuncture this week, and I expect I'll wind up at massage therapy too. Maybe some BodyTalk if I can afford it.

The cause of piriformis syndrome in my case is almost certainly bike-riding. And stress. I think I'll try giving up stress first.

Comments

Abduction from the Seraglio

[executrix]

Re bike riding causing piriformis syndrome: OH FRIG! I'm sorry. Are there ergonomic modifications you can make to the bike (e.g., building up one pedal) that'll allow you to move without hurting yourself?

The tennis ball will definitely help though.I have a gadget made out of a racquetball attached to a flexible stem on a wooden handle that can be used to lie on or whack your trapezii with.

Other things that I bet could help:
1. Counter-intuitive, but when you get out of bed, stand on the bad leg first (or the worse leg if they both hurt!), which will make the leg straighten out so you can walk on it. Eventually.
2. Warrior II with the bad leg in front (leaning up against the side of the bed if necessary), spend some time with your front elbow braced against the knee, then into Triangle. Crack!
3. If you're at the gym anyway, do the hip abduction/adduction machine. I forget which one of them says that it stretches the piriformis, but it should be on the label.

Re: Abduction from the Seraglio

[darkemeralds]

Abduction from the Seraglia. *snorfle*

There is a three-pronged approach to the pear-shaped muscle syndrome. The first is to stretch and release the piriformis itself--get it to relax and let go of its grip on the sciatic nerve (and not really build it further). The second is to build the surrounding muscles to help take the strain. The third is to quit doing the causative thing.

I'm not going to quit the causative thing (yet). I notice that this condition has come about since my weight has dropped into the "merely overweight" category, which has both reduced the pillowage between the muscle and my saddle, and given me the stamina to push a lot harder up inclines. The upright, seated position one takes on a Dutch bike means there's quite a bit of hit to the gluteus minimus and piriformis muscles (more than on a butt-in-the-air, stand-on-the-pedals racing bike, which calls the big glutes).

I'm going to get my saddle adjusted, slow down a bit on the inclines, and keep doing the exercises. And yes, resisted hip adduction/abduction is one of the exercises. I think I can do it with an exercise band.

This tennis-ball apparatus sounds interesting! Kind of naughty, to be honest.

Re: Abduction from the Seraglio

[executrix]

As for kind of naughty, yup, I went there too.

Also, I find supine sciatic stretch really helpful. Lying down, with the standing leg either stretched straight out or bent, you bend the knee of the working leg and start with the foot flat on the floor or bed. Bring the working foot out a little and up toward the hip, toes pointing in. Hold the back of the ankle and let your knee drop down. (It's more intense if the standing leg is bent than if it's straight.)

Re: Abduction from the Seraglio

[darkemeralds]

Yes! I have that one in my little sheet. It feels wonderful.

Re: Abduction from the Seraglio

[executrix]

PS--Piri Formis sounds like a Dr. Who Companion. Possibly one who screams a lot.

Re: Abduction from the Seraglio

[darkemeralds]

Hah!

There was a Perry or Peri, as I recall.

[shezan.livejournal.com]

I don't want to be an alarmist, but one of my cousins had something she thought was this. Unfortunately, it turned out to be infinitely nastier. Pretty rare, so chances are it's not what's happening to you - but if it were happening to me, I'd be having tests left, right and centre NOW. Possibly sheer paranoia.

[darkemeralds]

I'm taking the simple approach for now: it looks like a duck, it quacks like a duck, it developed in the presence of classically duck-like causative factors, and it responds to the treatment for ducks, so I'm going with "duck" at the moment.

[shezan.livejournal.com]

Promise that if it seems even a little slow in responding to the duck treatment, you'll have it looked over?

[unseelie]

New seat configuration; maybe some angle up or down, adjust the height a little to change pressure points? You've definitely got my sympathy- Good luck on recovery!

[darkemeralds]

Thanks! I've got a new Brooks saddle, and it's just reached that bowed point where it needs tightening up. I would imagine that alone will help.

[ranunculus]

AArgh!!!

[kis]

Would a different saddle help? One of those gel ones? Or a more chair-like one? I hate to think you might need to give up bike riding.

[darkemeralds]

I definitely think a saddle adjustment is in order. I need to consult with some bike experts or maybe a physical therapist.

Not riding is not an option. I depend on it for too many aspects of my life and well-being.

[tehomet]

it developed in the presence of classically duck-like causative factors

Hee!

I hope you feel better soon.

[darkemeralds]

Thanks. I already do!

[runningwater]

My man just had sciatica for about 5 months (for the 2nd time in 2 years). Poor thing could barely move at times. I imagine the pain you are in is similar (his pain comes from the spine and then works down to his calf)...I hope the changes you are making help!

[darkemeralds]

Thanks. Yep, the exercises are already making a difference. Happily, this condition is a little more tractable than classic sciatica, where the spinal disk presses on the nerve. This is a muscle pressing on it--much more susceptible to direct exercise.