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piriformis syndrome advice

MartinB2444MartinB2444 Posts: 266
Anyone on here suffered with this and got any good tips?

I started riding Sept last year, getting out regularly and working hard. Over the past few weeks I have started to develop a pain in my L buttock which is developing earlier in the ride and now noticeably when I up the power, particularly climbs. It is now persisting after the ride. I've had an L5/S1 disc problem in the past but this is quite different, the pain feels similar but isn't brought on by straight leg raising but is aggravated by external rotation of the hip when flexed.

I'm thinking the most likely diagnosis is piriformis syndrome. I've picked up a couple of excercises to do online searches. Apart from this my bike feels like a good fit but I will be booking in for a pro fitting session.

I really don't want to rest up if I can possibly avoid it. Spinning a low gear helps so I will modify my riding a little (if you pass anyone with legs whirring round but going no where it will probably be me :cry: ) but living in the Peak District there are times when you just have to grind for a bit.

I would really appreciate advice from anyone with experience of this condition (or alternative diagnoses)

Martin

Posts

  • turnerjohnturnerjohn Posts: 1,069
    go see a doc and get it checked out properly...or refered to a physio. without correct diagnosis you cant start treatment !
  • MartinB2444MartinB2444 Posts: 266
    Sorry John, I should have mentioned that I am a doc! I've also got some experience in sports medicine (mainly with footballers). I think my diagnosis is correct but I am planning to see my own doctor and he is likely to refer me to the local musculo skeletal service and I think they will organise an MRI scan. This will all take 2-3 months and I still am unlikely to have access to someone with specilist knowledge of cycling related injuries. I just wondered if anyone had any personal experiences of dealing with the condition, good or bad.

    Martin
  • mustolmustol Posts: 134
    I've had a long-term lower back problem (awaiting results from a MRI scan and some nerve tests), which has lead to some bouts of piriformis syndrome. I have seen considerable improvements over the last few months after treatment from an Osteopath and doing some pilates. You definitely need to get it properly diagnosed, but I have found that doing some light dynamic stretches helps much more than the static stretches that are recommended to help with piriformis problems. When I am cycling I find that long sessions in the saddle, particularly when pushing hard can aggravate the piriformis, so do a lot of climbs out of the saddle (it's good practice anyway) and try to vary between pushing a bigger gear and spinning in a lower gear. Also, try to avoid sitting down for long periods - get up and have a wander on a regular basis - it's sitting down in my office job that seems to aggravate it the most.
  • turnerjohnturnerjohn Posts: 1,069
    Sorry John, I should have mentioned that I am a doc! I've also got some experience in sports medicine (mainly with footballers). I think my diagnosis is correct but I am planning to see my own doctor and he is likely to refer me to the local musculo skeletal service and I think they will organise an MRI scan. This will all take 2-3 months and I still am unlikely to have access to someone with specilist knowledge of cycling related injuries. I just wondered if anyone had any personal experiences of dealing with the condition, good or bad.

    Martin

    Priceless that made my day lol.

    MRI and physio would hopefully confirm what is wrong. Least you can keep riding.
    One thing I did wonder reading that again...as your new to cycling is it your body simply saying hold on...not quite up to this just yet and asking for a more gradual build up program ? ...like I said just a thought you maybe going a little harder then the body can cope with and thats why your having the problems....your far more qualified then me though !

    Happy recovery :D
  • MartinB2444MartinB2444 Posts: 266
    mustol wrote:
    I've had a long-term lower back problem (awaiting results from a MRI scan and some nerve tests), which has lead to some bouts of piriformis syndrome. I have seen considerable improvements over the last few months after treatment from an Osteopath and doing some pilates. You definitely need to get it properly diagnosed, but I have found that doing some light dynamic stretches helps much more than the static stretches that are recommended to help with piriformis problems. When I am cycling I find that long sessions in the saddle, particularly when pushing hard can aggravate the piriformis, so do a lot of climbs out of the saddle (it's good practice anyway) and try to vary between pushing a bigger gear and spinning in a lower gear. Also, try to avoid sitting down for long periods - get up and have a wander on a regular basis - it's sitting down in my office job that seems to aggravate it the most.

    Thanks for this. I know they might not be easy to describe but could you tell me a bit more about the dynamic stretching excercises you are doing. The style of cycling you describe fits with what I am discovering minimises the problem. I too spend a lot of time sitting down!
    turnerjohn wrote:
    One thing I did wonder reading that again...as your new to cycling is it your body simply saying hold on...not quite up to this just yet and asking for a more gradual build up program ? ...like I said just a thought you maybe going a little harder then the body can cope with and thats why your having the problems....your far more qualified then me though !

    Happy recovery :D

    Good point John, I have been going pretty hard and my 53 year old body is liable to complain! However, my usual aches and pains have all resolved since I've started cycling, might be related to stopping playing squash. My arthritic knees feel great.

    Better go an make an appt with the doc, hope they have a better appointment system than ours :roll:
  • EyoreroxEyorerox Posts: 43
    When you start doing the piriformis stretches it always gets worse before it improves
    maybe lower your seat a tad until you get better, you could always try tramadol and NSAID!
  • MartinB2444MartinB2444 Posts: 266
    Thanks Eyorerox. I'll have a play with saddle height and keep doing the stretches.
  • MartinB2444MartinB2444 Posts: 266
    Eyorerox wrote:

    That's the best description of the cause of piriformis syndrome I've read. Most major on sciatic nerve impingement. I'm a bit of a sceptic about massage therapy but I'm going to dig out an old tennis ball and give it a go.
  • nicknicknicknick Posts: 535
    I had Piriformis syndrome a couple of months ago. It is extremely frustrating and was very painful on just low intensity rides. To cut a long story short a bit of sports massage, stretching and a week off the bike helped, but most importantly I paid close attention to my seat height (took a video of myself on the rollers) and found it was actually too high even though it felt fine. Now with a lower/correct seat height I am pain free and even little niggles that have plagued me for years have disappeared. If you ever read any of Steve Hogg's articles about seat height he is pretty much always correct! It is also interesting how much knee bend the pro's have now compared to 10 years ago.
  • MartinB2444MartinB2444 Posts: 266
    Thanks Nick, I'm off to Cadence Cycles for a Bike fit at the start of August so hopefully that should help. I actually tried raising my saddle and that was definitely worse. The worst time for me now is when fully powered up, out of the saddle.
  • JcrosslandJcrossland Posts: 29
    Not sure where you live but it is well worth the money to go and see a bike fit specialist. They will be able to adjust perfectly your bike position to your body and give good advice. Sounds like it may be a seat issue. I had to change mine as i was getting a similar problem.
  • MartinB2444MartinB2444 Posts: 266
    Jcrossland wrote:
    Not sure where you live but it is well worth the money to go and see a bike fit specialist. They will be able to adjust perfectly your bike position to your body and give good advice. Sounds like it may be a seat issue. I had to change mine as i was getting a similar problem.

    Booked in with Adrian Timmins at Cadence Cycles!
  • kingrollokingrollo Posts: 3,148
    I had - still have the problems - loads of scans - all show nothing. Been well over a year now. I went down exactly the same route as yourself - stretches, pilates, bike fit. I am not cured - and can still only ride about 30 miles - the big leap for for me was a Selle SMP TRK saddle - this at least makes cycling bearable - only about £30.

    If sitting in your office chair brings it on - than isn't likley to be a bike fit issue IMO
  • GazzaputtGazzaputt Posts: 3,227
    Jcrossland wrote:
    Not sure where you live but it is well worth the money to go and see a bike fit specialist. They will be able to adjust perfectly your bike position to your body and give good advice. Sounds like it may be a seat issue. I had to change mine as i was getting a similar problem.

    Booked in with Adrian Timmins at Cadence Cycles!

    Reviving an old post here but my Piriformis has flared up again.

    How did you get on at cadence and did their bike fit help?
  • I had always suffered with Piriformis Syndrome and calf muscles micro-pulsing particularly in my left leg. I suffered with this for years, whether as a runner, a waterskier, gym junkie or as now, cyclist. Over the years I have seen Physios, Chiroparctors, Masseuses and the Doctor. Guess which was the biggest waste of time?

    Moving from base to the build period earlier this year, the pain and the pulsing returned. As I had bought a new bike I decided I should get a bike fit. So I went for a Retul fit with Ben Hallam at http://www.bespokecycling.com/ in London. As well reading the endorsements I booked in for a bike fit primarily on this statement on their website:

    Ben has developed his bike fitting philosophy based on the principles that he learnt from his degree [in BSc Sports Rehabilitation and Injury Prevention]. The core principle to Ben's bike fitting is that "the body is adaptable and the bike is adjustable". This means that the body will adapt to a bad position (compromising posture and core stability) and consider this to be "normal"

    This approach and Ben's experience as a World Class Cyclist seemed worth the extra £50 over what other Retul Fitters in the London area seemed to be offering through their websites.

    It did not take Ben long to identify the problem. Cutting to the chase, I was rocking my left hip more than the right; shown to me by videoing my hip movement from the rear. A few more tests later and the cause was inhibited glute muscles predominantly the left glute. Rather than using the largest muscle in the legs I was using my hamstrings. Thus, setting off a chain of muscular and skeletal compensation issues. Manifested as Piriformis Syndrome for me.

    http://www.brianmac.co.uk/glutes.htm Inhibited Glutes is quite common.

    A small change to the bike set up, some glute firing and stabilsing exercises to be emailed to me, and a corrected riding position and pedalling technique to practice I went home wondering whether that was money well spent.

    That was 6 weeks ago and recently I've noticed my pushing / pulling pedalling technique is becoming second nature. My bike posture has improved; the more forward upper body position, riding on the sit bone with relaxed shoulders is more effective. And a side benefit which I hadn't expected but highlights the posture issue, when walking I now tend to roll off of the balls of my feet and I'm not tripping over my own feet so often.

    The rehabilitation process continues, but more significantly I am able to train significantly stronger in the upper training zones for longer, piriformis-pain free (mostly). The only problem now is my glutes ache a lot more.

    Hope this helps.
    Live to ski
    Ski to live
  • GazzaputtGazzaputt Posts: 3,227
    Thanks for that info I'll be booking an appointment with them.
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