strained piriformis

Posted by: skcreidc

strained piriformis - 10/12/15 10:31 PM

Long time no post here. Glad to see most of the regulars are still active, especially OM.

Not about me, but my 59yo climbing mentor and half time partner apparently strained his piriformis muscle about 9 months ago. Its still a major issue as made obvious to me this past weekend when we hiked up to Yosemite Falls and climbed the 2 pitch Lost Arrow Spire route and did the Tyrolean. That's about 8 miles of hiking over 2 days along with the climbing. By the time we got back home he could barely walk up the stairs to his apartment. Anybody have any experience with this kind of injury? The man has larger Yosemite plans, and at a minimum I need to make a decision as to if I stay on this train if he can't get this problem under control. He has gone to various professionals about the injury.
Posted by: Pika

Re: strained piriformis - 10/13/15 08:56 AM

Hi Chris. Can't help you with your friend's problem but it is great to hear from you again.
Posted by: Rick_D

Re: strained piriformis - 10/13/15 12:35 PM

Made me look, as I'd never heard of it. Wiki presents this, which perhaps is what your friend is experiencing if among the 17% with the anomaly.

Quote:
Piriformis syndrome occurs when the piriformis irritates the sciatic nerve, which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve.[2] This referred pain is known as sciatica. Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle. This subgroup of the population is predisposed to developing sciatica. Sciatica can be described by pain, tingling, or numbness deep in the buttocks and along the sciatic nerve. Sitting down, stretching, climbing stairs, and performing squats usually increases pain. Diagnosing the syndrome is usually based on symptoms and on the physical exam. More testing, including MRIs, X-rays, and nerve conduction tests can be administered to exclude other possible diseases.[2] If diagnosed with piriformis syndrome, the first treatment involves progressive stretching exercises and physical treatment. Corticosteroids can be injected into the piriformis muscle if pain continues. Findings suggest the possibility that Botulinum toxin type B may be of potential benefit in the treatment of pain attributed to piriformis syndrome.[3] A more invasive, but sometimes necessary treatment involves surgical exploration as a last resort.[2]


Can he swim or cycle as a way to work that region without pain?
Posted by: skcreidc

Re: strained piriformis - 10/13/15 03:29 PM

Thanks Charles. I followed your last JMT experience...can't remember if I posted on it or not...but if I didn't; Great Job! I often think about the wonderfull cast of characters on this site. Unfortunately, an endless amount of time is something none of us are given.
Posted by: skcreidc

Re: strained piriformis - 10/13/15 03:43 PM

Hi Rick. That is an excellent find. I keep forgetting that Wiki is a legitimate source of information. I hadn't heard of this muscle either till about 6 months ago when they pinned down his problem; all new news to me. And apparently, my partner might be one of the 17% as him and I have discussed most of what you posted before (including the dr. mentioning he might one of the few with sciatica/piriformis syndrome. The thing I hadn't fully understood, but it makes sense, is this "Sitting down, stretching, climbing stairs, and performing squats usually increases pain". He's gearing up to do the nose on El Cap, 32 pitches I believe, and aid climbing is a bit like climbing a ladder slowly. Oh man.

Thanks Rick
Posted by: billstephenson

Re: strained piriformis - 10/15/15 02:35 AM

Nice to see you checking in Chris.

Sounds like the same thing I dealt with years ago. I'll tell you what I learned.

I think he might want to visit a chiropractor. That's how I got back on track. He adjusted my hips, and that brought some instant relief but I was still in pain. He also told me I had to start doing some stretches everyday and that was the only thing that would ever get me right again.

The main stretch I did was lying on my back and pulling my knee up to my chest, one leg at a time. He told me to do both legs several times, several times a day.

When I asked how long it would be before the pain was gone he asked me how long I'd been hurting. It had been about a year. He said if I did the stretches everyday like he told me it would be about a year before I was pain free. He was right.

I made a point to do them but it wasn't easy because I was in severe pain. But I always felt a little better each time I did them. After almost a year the pain was gone and it's never come back that bad again because when I feel it I do the stretches.

The other thing he told me was to buck up and buy good shoes. He insisted on that, and doing the stretches. I've done both since.

That was 27 years ago and I am still thankful for help I got from that guy. I will never forget him, but I'll add that he made a point of telling me that it was up to me. I had to get the shoes and I had to do the stretches everyday and if I didn't do that I would get worse.

I checked and there are some youtube videos that show some stretches for this. They're not exactly the same as what I was taught but they're very close and may even work better.

Posted by: tramp

Re: strained piriformis - 10/15/15 10:36 AM

Good shoes. That's one thing my father insisted on for us kids. And I continue on with that. Whether it helps or not I know it doesn't hurt.
Posted by: billstephenson

Re: strained piriformis - 10/15/15 01:56 PM

Originally Posted By tramp
Good shoes. That's one thing my father insisted on for us kids. And I continue on with that. Whether it helps or not I know it doesn't hurt.


The Chiro told me that bad shoes make your body subconsciously compensate by changing your posture and the way you walk. One of the first things he did was ask me to walk a few steps towards him and then stand. He looked at my feet and my left foot was pointing outward at an angle when I stood there. That, he told me, was the result of crap shoes and a surefire indicator I was compensating for them and that my sciatic nerve was being aggravated.

I ignored him for about a month and he scolded me about that so I went and got some good shoes. I could feel the difference as soon as I stood up in them. I took a few steps, stopped and looked at my feet, and they were both pointing straight.
Posted by: skcreidc

Re: strained piriformis - 10/15/15 05:07 PM

Hi Bill! Good to hear from you. I passed your info on to my friend, so thanks.

The shoes....you know both of you make an excellent point. If your feet are happy, a lot of the time the rest of you is happy too. And I think his shoe choice is atrocious as his only concern is that they are light. He seems to hobble around in them worse than ever if you as me.
Posted by: skcreidc

Re: strained piriformis - 12/22/15 04:27 PM

So interestingly, the strained piriformis turned out to be needing a hip replacement for my friend. In his case the pain appeared to be very similar to a strained piriformis, but apparently his new specialist suspected different and via a MRI confirmed it.

Chris
Posted by: billstephenson

Re: strained piriformis - 01/11/16 06:45 AM

They're getting pretty darn good at those. A buddy of mine had one last year and rehab went good and he's walking around great now. I know a few others that have had them too, and all are doing good.