I've been running for a while and recently I've started to suffer from sciatica and my piriformis is strained.
I could do with some advice.
A little bit about me, I run in sandals and minimalist shoes, I've been trained in POSE technique and no longer have knee or foot pain. I do MOVNAT strength training and I also do Yoga.
I've never had piriformis trouble before, but it keeps flaring up. I started yoga six months ago, and the pain started 3 months ago... could it be this?
I also sit all day at work, I go for a long walk at lunch and try to stay mobile.
Essentially I feel really fit and healthy I eat a LCHF diet.
On paper I'm doing everything right....
Anythoughts? It's got to be a muscle imbalance somewhere...
I have also injured my periformis. The cause of mine I believe was orthotics I was prescribed after injuring my knee. I'm now having treatment from a chiropractioner but though the pain has gone my Glute muscles around my hip are very tight and are interfering with my running technique and I still occassionally get some pain down my shin. Sitting and driving makes everything worse. Try standing up every 20 mins at work. I think the Yoga like my orthotics may have caused your problem by placing your hips/back in a abnormal position for you. Oh I'm not using the orthotics any more.
It is very difficult to find information that helps. Glut stretches and nerve flossing give some relief but it seems to return . The chiropractioner is helping but it is very expensive and no cure yet!
Let me know how you get on.
You have pretty much described my issues exactly. Driving kills me! However, I've spent 15 years driving and never had a problem...
The solution appears on the horizon as I paid for a FMS (functional movement systems) movement screen (by a good physio in london). They marked my movement competence, which turns out is pretty low, even though I do natural movement activities and run well. I've other bad movement behavoiur!
Essentially, I've pretty restricted movment in my hips, combined with tight hamstrings and poor basic movment patterns. I basically have functional disfunction. Because I have issues with mobility my body is creating muscle imbalances that serve to stabilse my body, however when under pressure (such as a long run) these movement patterns revert to disfunction patterns which ultimately cause pain or an injury.
I've been reading relax into stretching by Pavel. Which is a pretty revolutionary read, us runners need to learn from those strength guys. There's not a enough cross fertilisation.
So I've been building up my movement competence building from scratch how I squat etc. Essentially, I don't want to borrow movement from my back because I don't have unrestricted hip mobility, for example.
So I've been reading atheletic body in balance by Gray Cook and most of the books by Pavel.
I have also had trouble with my piriformis and IT band for years. I began Eric's balance exercises at the end of the summer and noticed that after 3 or 4 weeks my piriformis pain subsided. Maybe this was just a coincidence, but I am willing to bet all the strength and stability I have built up has made a difference!
How we train our leg strength and stability, depends on HOW we train the feet. So what you experienced Karen is dead on.
@Paul - if you are not doing the foot/leg stability exercises Karen mentioned, I would highly recommend them for your flutes AND include the one leg pistol squads to help activate and fire the glute medius. Stretching MIGHT be aggravating the sciatic and making is worse, especially if your sciatic runs thru your performs, which can be common in some folks.
Stretching rarely is the solution, as tightness comes from muscle imbalances that need to be addressed to lessen the tug and pull of complimentary muscle groups.
I've actually started doing a program to build to a one leg pistol squat using Pavel's Naked Warrior principles. Essentially, using nerve force (training the brain to fire the muscle fibres effeciently) and building up very very slowly. His book talk you through how to stage it. It certainly worked for my one arm press ups.
I bought your book and have started doing the one leg exercising ala movnat - on a piece of two by four!
Beth- get Eric's book The Cool Impossible. The exercises are in the book. It's a great read and you'll be inspired!
Wow. It's nice to find some information about this. I have been running for not quite 3 years now. At age 38, I have never sustained any serious injuries before. I have had the expected aches and pains of running here and there due to soreness and a little overtraining but nothing serious.
Last winter is when my piriformis issues began. At first, I thought it was tightness and soreness from riding in the car but later figured out that I must have injured it after it continued getting worse and I did some research. It is rather bizarre, because I rarely experience discomfort while running, even after 2 hours of running, but when I stand in place for 15 minutes or longer, my right hip and glutes begin to throb like crazy, sending radiating pain down my sciatic nerve, IT band area, and along th outer edge of my foot.
I was hoping that rest would solve the problem. I took 6 weeks off after my last race of the season and recently resumed my training. I have just been doing 30-minute easy runs every other day for a couple of weeks to build base fitness, and the pain is back already. I just started doing the strength exercises this week. After reading this page, I have some hope that this will help alleviate the symptoms and perhaps even solve the issue. I am guessing that I have had some muscle imbalances for a while.
Thanks for the hope!
Eric, I am also doing some weight training 4 days a week. I work my lower body (squats, deadlifts, hamstring curls, calf raises, and split squats) twice a week as part of my routine. Is this likely to help or hurt my pirformis issue in your opinion?
Thanks in advance.
You know what, Eric's suggestion to do pistol squats nailed it. Within three days the pain disappeared and within a month I was running without pain (on short runs of 5 miles). I've not looked back and make it part of my daily routine.
It just seemed to get the muscles firing correctly.
Thanks, Paul. That is very encouraging. Did you discontinue the yoga/stretching, or did you just start to do the pistol squats?
Hey everyone - great discussion here. It is very important to understand that how we train and use our feet, dictate how well we use other muscles up the legs to the glutes/hips.
Thanks, Eric. This makes a lot of sense. BTW, the slant board and balance disk exercises seem to helping with my piriformis issue.