Piriformis syndrome and saddles

BlueScot

I've been riding regularly for 18 months, but in the last 4 months I've started suffering from nerve pain in my butt and down my leg when sitting, although generally not when riding. My doctor, who happens to be a keen cyclist, has diagnosed this as piriformis syndrome leading to pain in the sciatic nerve. He has suggested that I re-examine my saddle and riding position as the saddle may be putting pressure on the wrong place of my backside. (I'm also doing all the appropriate stretches.)

I've actually had a professional fit in the last 8 months, but I may need to re-examine my set up. Trouble is, I'm not sure whether, in general, it is better to bring the saddle forward to ease the pressure on the piriformis, or should it go back? My Fizik Arione saddle has been on the bike around 7 months - does anyone know whether its shape could be an issue? Maybe certain saddle shapes are better for this type of problem?
Any advice or suggestions (medical or cycling) would be much appreciated! Cheers.

Burkafett

I also experience sciatic nerve pain but in my case, in the upper and outer left thigh. I find the symptoms can be relieved with stretching and have adapted my (completely unhealthy) lifestyle to accommodate a broader range of seating positions, so I sit cross legged more often (essentially).

From reading the following from this link at Sports Injury Clinic, the description fits what you're saying very well and it is my gut feeling that perhaps your could better alleviate this problem by adjusting the seat height? Though if you find you are not seated in a balanced position with your left side not putting in the same power as your right (again perhaps due to issues of length of leg reach to pedal), then that might be an issue also. I wouldn't rely solely on just one fitting no matter how expert it was if you are experiencing this level of discomfort.

Yes, the best thing to do is try adjusting your cycle posture and by all means try another seat if you feel this will help. It's important to try something at least and maybe follow the recommended stretches etc to help alleviate the pain in the meantime, or even ask your doctor for a referral to physiotherapy? I'm only a novice so expect better advice will follow shortly. Good luck with it btw.

Xzvf

Just found this thread, which seems to describe the problem I'm having precisely. OP, have you overcome the injury? How did it go?

If anyone else has experience with this, I'd appreciate any information you can share.

kingrollo

Be careful here there are many things that can cause pain in that area - it can be referred pain from a bulging disc in your spine, inflamed sitbones, hamstring tendonathpy, pudendal nerve entrapment.
getting a firm diagnosis can be very difficult - my injury in this area has effectivley ended my cycling as it once was - for over 3 years, i have seen physio's consultants, surgeons, scans, xrays, injections - I given up ever get back to the level I was at, I can now do up to 25 miles in some mild discomfort, or ride my recumbent bike !

Concentrate on your trunk area - and get as much flexibilty in this area as you can - a pilates or yoga class can really help with this - hamstring curls on my stomach with weights, and bridges are the basis of my programme- and I just started very carefully doing squats......The best diagnosis I got was high hamstring tendonathapy - basically the top of my hamstrings have frayed where they attach to my pelvis - this is a slow area to heal - and any surgery is unable to get it back to what it was.

Be wary of bike fits - my bike fit put me in a more upright position - at the time I thought this made sense - but actually made things worse - loading all the pressure onto the sit bones

Lowering my saddle, and buying a saddle with cut out helped, as does chamy cream - but not a total cure.....if you want more info please PM me - whilst I am not a medical person - I do feel I have a lot of knowledge in this area !!