Friday, July 12, 2013

Piriformis of despair

$10 says this is the most visited post I'll have all year.  Not because it's the most interesting, but because the topic hits so many people.  So, let's jump in the wayback machine and travel begrudgingly to late January, when it was still cold (which almost sounds nice).

I hadn't been cycling much at that point, nor doing anything really.  I decided it was time to get back in some sort of shape other than round, and was doing well at that point.  The weight was coming off nicely and I was feeling good about things.  Somewhere towards the tail end of January, I felt like I had a tight left hamstring.  Not like a stage 3 separation, just tight enough I didn't want to try and run on it.  Since hamstrings are notoriously slow to heal, I gave it 6 weeks of gentle stretching, and by the end, it wasn't any better.  In fact, it was really rough at times.  Particularly when I was getting into my car the side bolster would stretch my hammy as I sat on it and then slid into position.  Sometimes that got REALLY painful.  Generally the pain was manageable, but would occasionally flare up.  I got frustrated and decided to go see my chiro.

He's a great chiro, and will adjust me as few times as possible and get me back into the swing of life.  He said my pelvis was rotated and shifted, causing a lot of tightness, with a bunch of other things going on.  I saw him for 4 visits over the course of about 3 weeks, and it wasn't getting any better.  Just a little different, but still in pain.  Further frustration led me to Brian Holdemann, who is chiro but does more soft tissue work.  He's an excellent doc who's treated quite a few Wizards/SKC players as well as working with the U. of Oklahoma.

The first visit seemed to confirm to him that I have piriformis syndrome.  I won't go into great detail, but the piriformis is a pear-shaped muscle underneath your glutes, and it helps with rotation of the leg.  It connects the femur to the tailbone.  When it gets tight/inflammed, it can push on your sciatic nerve, which can cause a myriad of issues.  It was causing my hamstring to tighten, as well as my calf, and if I sat for awhile, my butt cheek, er, glute, would squeeze tight when I stood up.  Not much fun.

Dr Holdemann worked with me for nearly two hours, and I was drenched in sweat.  Not because it was hot, but as Paul Sherwen would say "he's putting him in great difficulty now".  That was some serious pain.  He stretched my muscles in ways that you can't do by yourself.  Nor would you want to.  The majority of stretches were accomplished with him digging his thumb through my hip, holding the muscle still, and then stretching it my moving my leg in various directions.  We also did some TENS therapy, and that probably helped a bit too.

So that has been going on for awhile, and the pain is changing (which he says is good as various muscles release), but it's still there.  It's the worst in the morning right when I wake up, and it's usually pretty good during the day.  Sometimes it gets sore, but it's mostly ok pain wise.  However I still can't do athletic movements very well, as either the muscle is just completely gone or it's learned to be slow to avoid injury.  I'm really surprised it isn't all better yet.  I think I've been good about doing my stretches on my own, but it's just not there.

We did ride our bikes for a short jaunt up to First Watch, and that really compresses on the piriformis, but that didn't seem to hurt it too bad.  It was sore for about 10 minutes at the restaurant, but ok after the ride home.  That was probably the first time I had ridden a bike in 7-8 months.  Kinda sad really.

So here are some of the stretches I've been doing...

I've also been using one of these:

That gets pretty intense, mainly because it is so easy to find the piriformis and just knead the crap out of it.  That makes for a fun Friday night!

As my treatment plan progresses, I'll post updates.  No really, I will.