If you're diagnosed with piriformis syndrome, your running prospects will vary depending on the severity of the issue. "If it's something that has just started, I hate to shut anyone down if they want to run," says Orzechowski. "If they have had it for a year and there is pain going down the leg, I'm going to tell them to stop running."
One of the main issues with piriformis syndrome is that runners will take time off to let the injury heal, but then experience a recurrence as soon as they ramp up mileage again. This is a result of not doing the proper strength work that will prevent the problem in the first place. "If your core is weak, all those muscles around it can't work effectively because that's your base," he adds. "When your core is strong, everything activates properly."
A recent review published in the Journal of Evolution of Medical and Dental Sciences simply suggests a regimen of anti-inflammatories, rest and ice in treating piriformis syndrome. In addition to core strength work, including the hip abductor and adductor muscles, stretching the area may also provide pain relief. This can be done through static stretching or foam rolling, depending on the athlete.
Orzechowski also often prescribes myofascial trigger point release and Graston Technique to treat affected athletes. "We use a variety of myofascial techniques to get in there and decrease pressure on the sciatic nerve and calm down the piriformis," he says. These therapies allow the clinician to be more exact in targeting the area of interest. While foam rolling can further irritate the sciatic nerve if you compress it as you work to stretch and massage the hip and glute region, trigger point therapy and Graston allow for scar tissue and muscle dysfunction to be pinpointed more accurately.
Injectable treatments, including local anesthetic and cortisone, are also sometimes recommended by doctors, although the results are generally variable. In most cases, manual treatments done in physical therapy, as well as a commitment to strengthening and stretching, will have you back on your feet in no time.
To be sure, since this is a complicated injury, if you're having persistent pain in your backside that is preventing you from running, it's time to see a specialist. By coming up with a solid treatment plan, a physical therapist is usually the fastest route to getting back out and running healthy again.
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