|
If you’ve ever felt pain
in the hip, pain in the center of the butt or pain down the back
of the leg, you are likely suffering, at least partially, with
piriformis syndrome. The piriformis is a muscle which runs from
your sacrum (mid-line base of spine) to the outer hip bone (trochanter).
This muscle truly works overtime on anyone who runs at all.
The muscles in and around the
gluteal region help with three areas
1.rotation of the hip and leg;
2.balance while one foot is off the ground; and
3.stability for the pelvic region.
Needless to say, all of these
characteristics are highly needed by runners.
Conclusion--the piriformis muscle is pretty important
for all of us.
Injuries to the Piriformis
This muscle is a prime candidate
for repetitive motion injury (RMI). RMI occurs when a muscle
is asked to perform beyond it’s level of capability, not
given enough time to recover, and asked to perform again. The
typical response from a muscle in this situation is to tighten,
which is a defensive response of the muscle. This tightness,
however, manifests itself in several ways to a runner.
The first symptom suggesting
piriformis syndrome would be pain in and around the outer hip
bone. The tightness of the muscle produces increased tension
between the tendon and the bone which produces either direct
discomfort and pain or an increased tension in the joint producing
a bursitis. Again, a bursitis is an inflammation of the fluid
filled sac in a joint caused by an elevation of stress and tension
within that joint.
The second symptom suggesting
piriformis syndrome would be pain directly in the center of the
buttocks. Although this is not as common as the other two symtpoms,
this pain can be elicited with direct compression over the belly
of the buttocks area. A tight muscle is a sore muscle upon compression
due to a reduced blood flow to that muscle.
The third symptom suggesting
piriformis syndrome would be a sciatic neuralgia, or pain from
the buttocks down the back of the leg and sometimes into different
portions of the lower leg. The sciatic nerve runs right through
the belly of the piriformis muscle and if the piriformis muscle
contracts from being overused, the sciatic nerve now becomes
strangled, producing pain, tingling and numbness.
Simple Physiology
Any muscle repetitively used
needs to have an opportunity to recover. This recovery can either
be on Nature’s clock, or can be facilitated and sped up
with proper knowledge and treatment. Since the muscle is tightening
due to overuse, continued use will only make it worse. This injured
muscle needs to relax and have increased blood flow encouraged
to it for more rapid healing. This tightness that exists also
reduces the normal blood flow going to the muscle reducing the
speed with which the muscle can recover. To encourage fresh,
oxygen-rich blood to the muscle is the most powerful means of
getting the muscle to begin to relax and function normally. Multiple
massages per day to this area is greatly encouraged.
The next step in this "recovery"
process is to use a tennis ball under the butt and hip area.
While sitting down on the floor, roll away from the side of involvement
and place a tennis ball just inside the outer hip bone under
the butt area. As you begin to allow your weight onto the tennis
ball, note areas of increased pain and soreness. Trigger points
will tend to accumulate in a repetitively used muscle, and until
these toxins are manually broken up and eliminated, the muscle
will have an artificial ceiling with regard to flexibility potential
and recovery potential. So, if it’s sore and hurts while
your sitting on it, you’re doing a good job. Let the ball
work under each spot for 15-20 seconds before moving it to another
area. Once you’ve been on the ball for 4-5 minutes, now
put the ankle of the involved leg over the knee of the non-involved
leg (crossing your legs). Now place the tennis ball just inside
the outer hip bone again and work the tendon of the piriformis
muscle. While this pain is typically excruciating and takes some
time to effectively reduce, the benefits here are huge. Be patient,
be consistent and good things will happen.
Additional Treatments
Due to the fact that the sciatic
neuralgia and the hip bursitis or tendonitis are both inflammatory
in nature, ice, or cryotherapy, over the involved area 15-20
minutes at a time will be beneficial. This should be done multiple
times per day.
Stretching of the hip muscles
should not be done until the acute pain is gone. At that point
in time, begin with gentle stretching, such as the cross-legged
stretch while pulling up on the knee. The muscle should have
increased flexibility before an active return to running.
Finally, I’m always discouraging
the use of pharmaceutical anti-inflammatories. Not only do they
greatly aggravate the intestines, but they also suggest an artificial
wellness that can lead to bigger problems. Proteolytic enzymes,
such as bromelain, are both natural and extremely beneficial
with no side effects. For more information, visit your health
food store or check out Rehab Plus on our website.
Until next time, remember,
they can’t throw dirt on you if you’re moving, so keep
on running.
Material ©
The Running Doctor |
 |
Used by Permission |
|
