Debilitating Piriformis Syndrome and Cycling

patentcad

I just started riding again @ age 47 after a five year hiatus due to a horrible medical odyssey with low back pain that resulted in pointless surgery and five years of pain killers. It appears that my only problem all along is a badly strained and adhesioned piriformis muscle impinging on my sciatic nerve. This manifested itself for all this time in a sharp burning pain in my left buttock (near the left sacroilliac joint) that radiated partway down my leg. I'm 90% confident that this diagnosis- that I self-diagnosed and had confirmed with the help of a Pilates coach - is spot-on. I went to doctors, physical therapists and specialists for many years and even had major and minor back surgery -all for nothing.

I'm trying to get back to competitive cycling. That's the goal. I'm still in pain but overall feeling much better without pain meds. Anyone else ever hear of this syndrome or experience it? Piriformis Syndrome.

DocK

I have heard of it and treated it (I am a sports chiro), and you may be correct with your diagnosis, but I am suprised you had little success with PT. My suggestion is to one, continue with Pilates and two find a good PT or chiro who does ART (active release) or Trigenics therapy, both have websites and you can locate providers, ART is U.S. based so there are many more. Both are soft-tissue techniques with slightly differing methodologies but highly successful. I personally perform Trigenics on my patients and can say it has a high rate of success. Hope this helps, Good Luck!

patentcad

Dock- thanks for your reply. I went for PT 3x and nobody whispered a friggin WORD about Piriformis Syndrome. Yeah, I'm pretty pissed off about that. But that's in the past The great news is that after a month of cycling and Pilates I'm feeling 60%+ better - and the harder I ride (and stretch) the better it feels. I was on a doctor's website (who specializes in microsurgery for P.S.) and the median time in pain for his patients is 4.2 years. They ALL have had at least one pointless surgery. Get the picture? The medical community is busy DEBATING whether Piriformis Syndrome is a 'real condition'. Don't get me going. I've had enough of idiotic doctors for a lifetime. And man are they ever out there. Makes me appreciate the good ones all the more.

Pilates is nothing short of miraculous for me. I could barely ride 8 miles on a flat bike path a month ago. I rode 180 miles last week - around the very hilly and windy roads in my area. I'm amazed at how fast the fitness is returning - and I'm still 20lbs overweight. Most importantly I'm off those cursed pain meds (oxycontin) after 3 years and my pain is under control. I haven't felt this good in 6 years. Thank God.

I rode for fitness before I started racing. My goal is to race again (I'm 47, I'll take on the older guys in the 45+) but even if I don't get there cycling will remain a big part of my life. It's what keeps me sane. I actually felt flashes of my old self on the group rides I did this weekend - jamming up hills, jamming down hills - I was actually able to do some hammering - and ride in a 23-24 mph paceline. Couldn't do that 10 days ago. I can't wait to get healthy enough to start doing some strength work. I'm seriously hoping to be back on the fast training rides I used to do regularly by August.

Latdog

I am wondering what sort of back surgeries you have had. I had similar problems, and recently had a microdiscetomy. Most of the pain is go. Many doctors have different beliefs about piriformis syndrome, some don't believe in it. My doctor told me that if I would have waited much longer, I may have had permanent damage to the nerver.

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g-L

patentcad

Doctors can debate all they want about Piriformis Syndrome - after 5 weeks of cycling daily (I'm up to 175+ miles weekly) and how well it responds to piriformis stretches and Pilates, I'm a believer. This after getting jerked around my doctors who were clueless for years. I had a pointless (utterly) fusion @ L5-S1. You on the other hand - your symptoms were mostly relieved by back surgery. Why you are even considering a pirifomis issue is puzzling to me.

skittlebike

Don't know if anyone can help, but I need it. I've done all the "web searching" I can to try and diagnosis what I have and seen a PT, and family practitioner, and had X-rays, but nothing:


It began almost a year ago with a little "pop" in the gron area while I was running. Then, pain, even to walk. For the next 6 months ago, I was certain this was caused by running, since it happened while running. But kept cycling hard and racing and trying to deal with my running life as a thing of the past. I should mention I have been running for almost 25 years and only seriously cycling for about 3 years. Well, winter rolled around and I began riding only intermitently, and running a little, and then a little more, and then WOW, I thought I was cured, no pains. Then the weather turned nice and I started getting out on the bike more and there was the pain again. Not when I rode, only walking or running.

I've done some groin stretching and every other stretch the PT recommended (I'm actually pretty consistent with stretching)

Since I'm in the Army, my options are Orthopedic Doc, or a DO. I'd really prefer a DC, but it would be on "my dime" ANY thoughts on stretches...anything! Thanks

WarrenG

In addition to the chiro and PT I'd suggest going to see a good sportsmedicine doctor. My coach, who is a sportsmedicine doc listened to me describe the symptoms of my training buddy for just a few minutes and then he replied that he suspected it was piriformis syndrome-something that is not that unusual in cyclists-especially ones who have been riding/racing for a long time. An MRI can help indentify it too. After 4 months of treatment my buddy is doing much better. So, good help is available.

I assume that twice daily stretching is also part of your rehab?

patentcad

No, MRI's Can NOT identify this syndrome. Not at all. Part of the problem. That's why it's called a SYNDROME - it's a bunch of symptoms patients complain about for which there IS no smoking gun diagnostic test whatsoever. So half the doctors don't even acknowledge its existence. I saw at least 10 specialists over 5 years, none of whom even MENTIONED this condition. Amazing, isn't it?

It has been 9 months since my initial post. The few responses in that time should be an indication of how rare this condition is. I'm still riding now, more than ever. And that's the only thing that really seems to help with the pain that comes and goes - but is fairly consistent overall. Stretching 2-3x daily as well.

REHAB? That would indicate that something is cured and getting better. This is a chronic condition. I doubt it will EVER get better. I live with it. I'd rather be riding my bike 10K miles per year than sucking down 300mb of oxycontin daily. Which is what Western Medicine had to offer me after failed back surgery. Friggin idiots. Amazing.

WarrenG

Your experience is unfortunate but like I said, there are doc's out there, like the one I mentioned who know quite a bit about this issue, and yes, it is not as rare in the general population as it is for athletes in some sports. If you live anywhere near NorCal I can connect you with a doc who has lots of experience helping cyclists with this issue.

patentcad

I appreciate it. Unfortunately I'm in NY, and CA isn't an option. I've essentially given up on doctors for this - other than some maintenance with the odd chiropractor. Forget it. I've gone to these idiots since 1999. I am friggin DONE. I'll just ride my bike, stretch like hell, go to the chiropractor and take Advil (which occasionally works, but usually does squat, so I don't take it much).

Finding a guy who knows about piriformis syndrome is next to impossible. Try it on the Internet some time. Good luck. You MIGHT find a doctor on the OTHER SIDE OF THE COUNTRY. Perhaps. Like your guy in CA. I do thank you for the thought. I need somebody local. REAL local. Like within an hour of here - and even that's a stretch for my patience level at this point. I've simply been jerked around too hard, too long by too many assholes. Even doctors who SAY they know about this - they really don't have much of a clue. Trust me on this. That's one of the reasons nobody specializes in this. Too undiagnosable - and even more incurable.

BillBB

Have you tried the tennis ball ? I began to experience similar symptoms some time ago after having a bike related accident with an SUV. I can't assure that what I have been experiencing is the same as what you have, and I"m sure it's not as bad though, but it sure sounds very similar. Somewhere I read that if you use a tennis ball (Please continue reading, this is serious,...) to apply pressure to some "trigger points", that this should help your condition.
Well, what I've done is basically lie on my back and roll (while applying my weight to the ball) the tennis ball where it hurts, and it HURTS ! But keep at it slowly. I guess its like a seep tissue massage. I just started to do this on Sat. and was able to compete in a TT on Sun. It feels much better today so I'm going to continue doing it, along with the stretching. Maybe some of the brainier guys in this forum can explain it better.
Just my .02 cents. I hope this helps.

patentcad

Thanks. Good idea - I've been thinking about it. Will give it a try. What I really have to focus on is MAKING the time to stretch 2-3x daily. That's tougher in the winter when I'm riding mid-day. By the time I get back to my home office after a 2 hr. bike ride I'm running out of time to devote to personal fitness. In the warmer months (coming soon) that's MUCH easier. I'm on my bike @ 6:30AM then. That makes devoting 20 mins to post-ride stretching a whole lot more possible from a work standpoint.

BillBB

The results I'm getting with the tennis ball massage are remarkable. I have also done stretching, core exercises and icing the area at least three time a week, but the real turnaround has happenned since I started using the ball on Saurday.
Since your condition is worse and chronic I would recommend you start slowly to see how it goes. Hope you get better soon.

patentcad

Many thanks Bill. I'll try it. Any websites on this???