Squat therapy for piriformis muscle pain?

[Benny]

Piriformis pain, lacrosse injury. Haven't been able to lift for 6 weeks, as it takes 2-3 days to recover this injury from lacrosse to the point where I can even walk normally, and I have practices Wednesday nights and games Saturdays. The injury is becoming really painful, especially while sitting at my desk or driving. Narrowed it down to piriformis rather than lower back/disc sciatic impingement largely due to mechanism of injury - I distinctly remember when my right butt cheek went zing on a cold night of practice in mid April.

Searched around in here first... found good advice on stretching & foam/lacrosse ball rolling for sore piriformis muscle which, when inflamed, puts pressure on sciatic nerve.

But I've also read Rip's essay on Muscle Belly Injury Rehabilitation, doing 25 x 3 with light weights (but increasing) every day for a couple of weeks. That advice makes a lot of sense. I started that program 5 days ago with 25 x 3 @ 45#. First squat of each set feels terrible, but reps 2-25 are fine. According to the rehab recommendations, that means I'm in the right place to do it. No practice tonight or game this weekend (bye week) so its the right time to give the rehab a shot. I've been squatting around 4pm every day. But the pain is definitely still increasing, especially as the work day goes on up until the time I get to the squats.

Am I missing anything? Was that rehab advice only for glutes, hams, or quads? I don't really know if the piriformis is large enough to be considered "muscle belly".

I do roll it on a lacrosse ball and take fish oil, have been doing both of those (to little effect) since the original injury. Any other advice, especially from someone who's brought a piriformis back to pain-free? Thanks

[jwhal]

Re: sitting, check your posture. And perhaps get a good, deep massage?

Jon

[Benny]

Thanks, Jon, haven't done a massage. Good idea!

As for posture, I change positions & even chairs a lot - I work from home about half the time and go between a stool, sofa, dining room chair, and bench (low chairs feel bad immediately) and then also have 3-4 hours at a work chair and a couple hours a day in the car. Normal driving isn't too bad, but slow traffic when I have to flex back & forth from gas to brake a lot (its my right leg that is affected) gets excruciating within just a few minutes.

[IlPrincipeBrutto]

Hi,

a few years ago I noticed that, when walking, my right foot would land differently from my left. Also, the whole right leg seemed to be turned 'out', rotated clockwise when looked from above. I tried to work around it, but it was clear that I was not in line.
I went to see a physio, who told me that my piriformis was 'locked' tight. It was like the muscle had contracted, and then it had never relaxed. This meant my whole pelvis was pulled from one side, which explained all the symptoms.

The physio manipulated my glutes and my legs, and fixed the problem in one session.

Now, your case might be different, and it might actually be a muscle tear rather than a muscle 'lock'. But I would second jwhal's suggestion, and get an appointment with a good physio.

Hope this helps,

IPB

[yorick]

I'm pretty sure I have a Piriformis issue too. It hurts in that area, and I'm having sciatic problems from it. I could have some lower back issues too - I'm not sure.

I've found some relief from stretches. This article covers the main ones that have helped me: http://articles.elitefts.com/article...with-sciatica/

[jwhal]

I as well had pelvis issues. A tight piriformis was part of it. I have to stretch my left one daily. One thing you gotta note though, is that most furniture nowadays do not promote good posture. Especially sofa's. Even dining room chairs - working from home this past spring proved to me that my hips became quite unhappy with me after about 90 min's or so. It seems that a lot of what aggravates your pain is all the same stuff that aggravated mine. Do you sit with your wallet in your back pocket? It doesn't help the situation any. Not to say that there isn't another cause for your injury either. This is just minor stuff that one may not think about. I'd consider starting with the massage (physio) because a good therapist will hurt you in a (good) way that you wouldn't try to do to yourself while rolling that area with a ball. Do some stretches for the hips. It may even warrant a few days' rest. I did something to my gluteal area squatting last week, it hurt quite a bit, and not the normal pain. I just laid off for a couple of days and the pain is gone now. It wasn't something I could work through comfortably.

Jon

[Benny]

Thanks, y'all! Haha @ Jon, first thing I did was move my wallet to the other side. Its a thin thing anyway, but getting it off the bad side definitely helped, especially in the car.

Its been 2 more days of squat therapy since I first posted this (today was 25 x 3 @ 75#) and its actually feeling a lot better. Still can't stand up out of a chair fast, but the rest of the time its good, while for the last 6 weeks of rest, it wasn't getting any better.

Going to look into a massage this weekend, but also getting pretty comfortable with recommending the light weight daily squat therapy for the piriformis. Perfect form is the key, like Rip wrote, and my DOMS everywhere except the piriformis tells me I'm doing it right, and also today's DOMS was less than yesterday's, which itself was less than the day before that.

I'm just so stoked to have a bar on my back again. Its like everything's coming back in order. I'm no superstar, I was on 5-3-1 and my 1's were 3's or 4's in the low 300's, 1RM was 345 in Feb. But goddamn I missed it!

[Mcpie]

Are you feeling pain in the Sacral region? For me, whenever my Piriformis is really bothering me, that's where I feel it the most, and the lacrosse ball did wonders for it. There are lots of trigger points in the lower back region. One of the ones that acts up for me and isn't an intuitive place to work is the Quadratus lumborum. Two spots in particular there, and they can refer pain to your ass, making you think it's the Piriformis.

[jwhal]

Are you feeling pain in the Sacral region? For me, whenever my Piriformis is really bothering me, that's where I feel it the most, and the lacrosse ball did wonders for it. There are lots of trigger points in the lower back region. One of the ones that acts up for me and isn't an intuitive place to work is the Quadratus lumborum. Two spots in particular there, and they can refer pain to your ass, making you think it's the Piriformis.

Same here. Started in the QL, then glutes and piriformis, and that caused the hip hike for me, then the IT band got tight, VL and Rec Fem littered with trigger points and VMO shrunk to almost nothing, giving me shitty knee pain.

Jon