Piriformis Syndrome and Injury

Rehab of piriformis injury takes time.

In November, I had the pleasure of experiencing one of the most painful events I've had related to exercise and training.  I was training for the RAW United Record Breakers Meet and moving up a weight class to the 165s.  I was feeling good, making gains, and taking aim at some records set by younger athletes.  I wanted to celebrate my 45th birthday with a few trophies under my arm if nothing more than to give my ego a boost.  Everything was going so well that I even jumped at the chance to go indoor rock climbing with my wife at the end of a fairly intense week of training.  A day later, I awoke to the realization that I could barely walk much less train.

I rolled out of bed to the electric shock of INTENSE Sciatic nerve pain.  I'd never experienced anything like it and I was confounded that I couldn't find a position that didn't hurt.  It was like the pain would randomly send radiating shocks down the back of my glutes and legs regardless of how I was positioned.  The intensity of the shocks was amazing to me and I could only compare it to a few other experiences, none of which were training related.  

http://injuryfix.com/archives/piriformis-syndrome.php

A visit to my doctor resulted in the usual muscle relaxer / pain reliever script and the initial diagnosis of a ruptured disc.  I took the pills and hobbled around work for weeks in constant pain.  I figured I'd try to make it to the new year to get the most out of my ridiculous medical deductible and I asked my doc to set my appointments as early in the new year as possible.  During my wait, I tried to read up and investigate what happened so I could come up with some way to decrease my pain.  With another prescription from my doc and a plant shut down approaching, I knew I'd have enough time to figure something out.

One of the first things I found after a quick Internet check of everything that could explain my pain based on the prior lifting and climbing was something called Piriformis Syndrome.
To quote the work of the Summit Medical Group, "Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve deep in the buttock. This causes pain or tingling in the back of the hip that can often travel down into the leg" and the clincher (pun intended) was that it was usually caused by specific patterns of exercise.  Runners seemed to bear the brunt of this wicked affliction, but the muscle is responsible for ones ability to rotate the thigh outward.  I immediately started thinking of moving out of a "drop knee" in climbing and the stabilization required for the intense hip drive in a near max dead lift.  The high volume of my training combined with attempting to climb after being away from that sport for almost a year may have been the simple recipe for my demise.  Still, I was excited that I might have found an answer to my question.  I also found out that in some people the Sciatic nerve runs through the Piriformis.  So logically, if your Piriformis was torn or strained, the resulting scar tissue and adhesion issues would negatively impact your Sciatic nerve.  Now all I had to do was figure out how to rehab a strained / torn Piriformis.  I spent hours finding info and watching videos.  There is a lot of good stuff out there and I began a very conservative stretching and rehab program with hopes that my doctor was wrong about the ruptured disc diagnosis.  

Over the following weeks I slowly got better.  Soon I was able to walk without the limp that had become habit.  Then I could make it up stairs without wincing or crying like a baby.  After a month I could do hamstring stretches which, up until then, were too painful to attempt and seemed to do more damage than good.  During many of my stretches I could feel and hear little pops after which I would feel much better.  After about three months I was able to do basic body weight movements like push ups and toe touches, but I had to move slowly.  I used rubber bands to do specific exercises to heal myself up to this point.  After a few more weeks I started adding weight to my movements.  First it was just bands, then the bar, then dimes, and so on.

It was difficult moving at a deliberately slow pace once I started feeling better, but I knew if I moved to quickly the odds of re-injury were high.  Things have progressed and I am at about 85% of where I was just before my injury.  The goals I had set will still be achieved, but the goal date changed to the end of 2014.  Perhaps I'll still get a meet in before my 45th birthday, but in the end I'm just happy to still be able to move without pain.  While I don't recommend diagnosing yourself, I do recommend getting a 2nd opinion when it comes to athletic related injuries and questioning your doctor's diagnosis.  

Finally, I almost hate to say it, but I didn't take my own advice.  Many of the young people I've trained know I always say, " It's better to improve at a slower pace but consistently avoid injury than to make bigger gains moving toward an inevitable injury."  You simply lose too much time in rehab and it all averages out to less than if you went slow and steady.  Naturally, we all want to cut it as close to the limit as possible and time keeps moving that line.  Pay attention.
Stay strong.