Golfing with Piriformis Syndrome

Now that the weather is getting warmer (finally) in most of the country, it's time for many of you to dust off those golf clubs and get back out on the green!

But some of you may be cringing at the thought of the pain in the butt that is sure to ensue.

Piriformis syndrome is a common condition for golfers, and it is one that keeps even the best of us off of the course. But it doesn't have to. Over time, stretching can really help alleviate the pain from piriformis syndrome. It can prevent that radiating pain that starts in the buttocks or lower back and rolls all the way down the leg.

When should you stretch?

Stretching should be done regularly, so plan to stretch a few times a week. Most people like to schedule stretching sessions in the morning or night, so it doesn't get in the way of other daily activities. Ideally, you should be stretching throughout the year, whether you're hitting the golf course or not. Still, it's more important to get your stretching in during golf season, so if you've been slacking throughout the year, now is the time to get back into that routine.

Why should you stretch?

Over time, stretching can help repair the muscle that is causing so much pain in your life. When the muscle is relaxed and healthy, it isn't likely to put pressure on the sciatic nerve, which is what happens when you're experiencing pain, numbness or discomfort. Studies have shown that non-invasive treatments such as stretching and physical therapy are more effective than things like surgery or injections.

One study, as noted by Parziale et al, found that surgery should be considered only as a last resort as treatment for Piriformis Syndrome and more conservative treatments are often effective at treating symptoms. So, if you're a golfer dealing with pain in the right or left buttock, pain that radiates to the anterior thigh, groin and lower limbs, pain while sitting, increased pain from running, or difficulty performing daily activities, you may benefit from stretching.

And relief from piriformis syndrome means that you can pick up those clubs and get back to the sport you love. Who needs more of a reason to stretch?

How should you stretch?

The key to effective stretching for piriformis syndrome is to target that elusive piriformis muscle. It is located adjacent to the hip at the top of the buttocks. There are many stretches you can do to target the correct area. If you're concerned or want to be sure you're making the most out of your stretching sessions, you may be interested in checking out the Piri-Stretcher®. The Piri-Stretcher® is a stretching tool which is registered with the FDA as a Class 1 Medical Device for exercise and fitness. It can help relieve pain associated with sciatica or piriformis syndrome by providing assistance to complete a targeted stretch of the piriformis muscle – which is particularly helpful for those of us with limited flexibility. Which after a round of golf, it sure is nice to have a little help with a stretch.

Sports and Piriformis Syndrome

It's no secret that you don't have to be an athlete to develop piriformis syndrome, but it is a condition that does afflict many competitors. There's more than one reason for this, but fortunately, piriformis syndrome can usually be treated without invasive surgery or dangerous medications. Which types of athletes seems to be more prone to piriformis problems than others? Let's explore...

Piriformis Syndrome and Running

While out on your morning run, you feel a sharp and persisting pain in your buttocks. You're an athlete, so you power through, but now your hamstrings are starting to feel tight and sore, so you slow down a bit. With a reduced pace and a little pain, you finish the run. Afterward, the tingling sets in. It starts I the back of your upper thigh and continues down your calf. Runner, meet your piriformis muscle. It's not the best of introductions, but it's how most runners first learn of this important muscle.

Swimming and Piriformis Syndrome

Because water reduces impact on the body, swimming is usually a very safe sport for your muscles and joints. But sometimes, swimmers will develop piriformis syndrome. It often occurs when the swimmer is also engaging in other exercises in addition to swimming, such as running and cycling, and this is very common when training for a triathlon.

Piriformis Syndrome and Horseback Riding

It's impossible to ride without putting pressure on the piriformis muscle. Fortunately, the pressure doesn't always lead to piriformis syndrome, but that's little relief for sufferers. Bouncing on a hard saddle is all but out of the question for most people who suffer from this syndrome, a diagnosis of piriformis syndrome hits equestrians especially hard. If this sounds like you, don't despair. There's a very good chance that you'll be back on that literal horse soon.

Although these sports may lead to piriformis syndrome, don't think you're safe because your most strenuous activity involves lifting and lowering the remote. Prolonged sitting can put unnecessary pressure on this muscle and lead to piriformis syndrome over time. And there are some people who are anatomically more likely to develop this syndrome because their sciatic nerve flows directly through the piriformis muscle, instead of around it. So, there is no definitive way to prevent this condition, but there are ways of treating a problematic piriformis. The key to preventing piriformis syndrome lies in stretching and engaging in moderate activity.

Stretching is a very effective method for treating piriformis syndrome, and it has helped alleviate pain in the buttocks, lower back, and legs for many people. The key is to target your stretch to the piriformis muscle. If you're having trouble or don't know where to start, consider using the Piri-Stretcher®, an FDA registered medical device that is designed to target your stretch to the piriformis muscle.

With the right treatment, you can get back on that horse…or in that bathing suit…or in those running shoes…or on that couch (!) in no time.

Easy Help for Piriformis Muscle Pain

“Ouch, my piriformis is killing me today!” Those are words you never hear, yet piriformis muscle pain is a very real problem for many people.

More likely, you might hear someone with piriformis syndrome say that they have a literal pain in the rear end, or their lower limbs are numb or hurting. That's because it's exactly what they are feeling, and to be honest, most people don't know what or where the piriformis muscle is.

Understanding the Piriformis Muscle

Not surprisingly, the reason for that pain in the rear is a muscle that is located, well, in the rear. The piriformis muscle is right next to your hip joint at the top of your hip. Although you may never hear about it until there's a problem, the piriformis muscle is actually a very important one. It plays an important role in stabilizing your hip and rotating the thigh away from the body.

You use this muscle almost constantly. It's used for walking, shifting weight and for balance, which means you can stand straight without your piriformis muscle. Virtually any time you move your legs, you're using your piriformis muscle.

The Reason for Piriformis Muscle Pain

If you're experiencing pain in your piriformis, it may be for a number of reasons. Some people are born with a sciatic nerve that passes through the muscle instead of behind. These people are more likely to experience piriformis pain than others, but they aren't the only ones who have trouble with this important muscle. A piriformis muscle strain or injury can put pressure on the nearby sciatic nerve and cause piriformis muscle pain, which can also come along with numbness and tingling that radiates down the leg.

An All-Too Common Problem

Low back pain affects about 80 percent of the population, so if you're dealing with piriformis musle-related issues, you may take comfort in the fact that you're not alone. Piriformis syndrome is a common cause of low back pain, and is an issue becoming more common. Fortunately, there are non-invasive treatment options that have proven to be successful for most sufferers.

Help for Piriformis Muscle Pain

Stretching has proven to be one of the most effective and least invasive methods of treating piriformis syndrome and alleviating the associated pain. Often, stretching is prescribed alongside other treatment methods, such as physical therapy or acupuncture. And studies have shown that it's a good regimen. It has been proven that prolonged stretching, hip flexion, hip adduction and internal rotation are all effective treatments for low back, buttocks and radiating leg pain that can come from piriformis syndrome. So…stretching versus surgery, why not give it a try! 

Common Piriformis Injury Causes

Sometimes, when you pull a muscle, you can tell exactly where it is by where you're feeling pain. But when you're dealing with piriformis injury symptoms, it's not always obvious. That's why it's important to know the symptoms, but it's also important to understand how the piriformis injury causes. First, because you may be able to avoid injury in the first place. Second, if you're feeling symptoms, you might be able to trace it back to the point of injury, which will help determine what type of injury you have.

How Can You Injure the Piriformis Muscle?

It is shockingly easy to injure the piriformis muscle. As you fully extend your leg, whether it is during a walk, cycle or swim, it is the gluteus maximus that is primarily responsible for this movement, but there are external rotators that help. Those rotators are also hard at work whenever the leg is rotated. If, for any reason, the rotators are used for an extended period of time, they are likely to experience injury. This may happen as a result of a muscle imbalance or muscle weakness (where the rotators pick up the slack for weaker muscles).

Let's take a look at some common examples:

1. Hyper- or Hypopronation of the Ankle. Whenever there are issues with the ankle, it is common to see the entire leg rotate to overcompensate. So, instead of engaging the leg, the action is shifted up to the hip extensors, which includes the hamstrings, glutes and external rotators.

2. Weak Abductor Muscles. Abductor muscles help to stabilize the pelvis while you walk, so it stays level as you switch from foot to foot. Just more proof that our bodies work a whole lot harder than we realize. But these muscles often become overused and weak, which causes the adductor muscles to become tight and potentially contracted. Since adductors help with hip extension and rotation, this domino effect extends to impact hip extension, putting pressure on the external rotators, which then puts them at risk for injury. Essentially, when one muscle doesn't work properly, others have to pitch in to get the job done, stretching them too thin.

Is a Piriformis Injury the Same as Piriformis Syndrome?

Not necessarily. Piriformis syndrome is caused by a piriformis injury, but a piriformis injury does not necessarily cause piriformis syndrome. Confused yet? Think of the injury as a simple muscle strain. If that strain becomes inflamed or begins to spasm, it may put pressure on the sciatic nerve. If this happens, the injury becomes piriformis syndrome.

Either way, it is important to treat the piriformis injury so it doesn't get worse. Fortunately, stretching has been proven to help in both situations. The main issue is that it's difficult to know when you are properly stretching that muscle, which is why we produced the Piri-Stretcher®.The Piri-Stretcher® is registered with the FDA as a class 1 medical device, and it is used to treat piriformis syndrome and sciatica.

Piriformis Syndrome and Acupuncture

Have you ever heard anyone say that Piriformis Syndrome is rare? Well, it's probably not as rare as those may think. Many cases of this syndrome are categorized under the blanket of “low back pain”, and so, they may not be treated properly. 

Low back pain can be treated a number of ways, depending on its root cause; and it definitely helps to know whether it is a disc or a muscle that is causing your pain. Since piriformis syndrome, at its root, is a muscle issue, we've decided to explore acupuncture as a treatment in this week's post.

Acupuncture as Treatment for Piriformis Syndrome

Much like with any other treatment, acupuncture for PS starts with a thorough examination. The practitioner will attempt to locate the area where the nerves are pinched. For example, if the patient is experiencing pain in the buttock area, the nerves are likely being compressed in the inferior gluteal region.

Many practitioners claim they can spot piriformis syndrome on sight because the patient tends to lean toward the unaffected side while sitting or standing in order to reduce sciatic nerve compression. Patients with these symptoms also rely on heavy doses of ibuprofen or naproxen to dull the pain. Of course, this isn't enough of an exam to diagnose piriformis syndrome, though. It is recommended that patients see the general practitioner, and then, likely, a specialist for their diagnosis before they seek a treatment such as acupuncture.

Typically, an acupuncturist will use gauge #36 Chinese acupuncture needles of 1.5 to 2-inches in length. Treatment is done with a micro-current device and is focused on two to four trigger areas on the piriformis muscle itself.

Most acupuncturists suggest that patients seek treatment one to three times per week. The frequency will depend on the level of pain they are experiencing. Many patients experience some level of relief by their eighth treatment. This may include improved range of motion and reduced pain and tingling.

Piriformis Syndrome and Stretching

Although piriformis syndrome may improve with acupuncture treatment, acupuncturists also recommend stretching the muscle to aid in treatment. Check out this excerpt from a 2002 Acupuncture Today article:

“A course of daily stretching exercises is recommended (part of the protocol) to patients to assist in recovery of the muscles and tendons.”

The article goes on to recommend posture training as part of treatment, which makes perfect sense because posture is such an important part of maintaining back health.

We've found that many patients have trouble targeting the piriformis muscle with their at-home stretches, which is why we developed the Piri-Stretcher®.

The Piri-Stretcher® is an FDA registered medical device that is specifically designed to help the user target their stretch to the piriformis muscle in order to strengthen the muscle and speed up recovery time.

The bottom line about acupuncture for piriformis syndrome is that it may be effective, but it works best when combined with a daily or weekly stretching regimen. 

Alternative Methods for Pain Management

When you're first prescribed pain medication, it may seem like a happy day. Not that you're a fan of drugs or anything, but the medication seems give hope for an an end to your pain. It even works for a short time – until you have to start taking more, and then more still. And then you realize that you're more reliant on these pills than you would like to be. And where you could see an end to your pain before, now you just see a road that leads to addiction.

With 31 million Americans suffering from low back pain alone, this is an issue that affects a great number of people in our country. So, how can we manage pain without relying on medications with serious side effects and risks of addiction? There are quite a few natural pain relievers out there. The key is finding the right one, or combination of ones, that works for you.

Stretching

A staggering 70 to 80 percent of low back pain is muscle related; this is due to conditions such as sciatica, Myofascial pain and piriformis syndrome. Stretching can help loosen tight muscles and begin relieving pain that may be caused as a result of muscle tension. As an example, piriformis syndrome is caused when the piriformis muscle, one of the lateral rotators buried deep to the gluteal muscles, is stressed or tight and puts pressure on the ever-important sciatic nerve. This pressure causes an array of pain in the lower back, buttocks, and legs; and often leads to Sciatica. By using a therapeutic tool, such as the Piri-Stretcher®, to target stretches to the correct muscle, patients increase strength and mobility and can begin to heal the muscle that is at the root of so much pain.

Lifestyle changes

No one wants to hear this, but if you're carrying around some extra weight, this may be causing or contributing to your pain – especially if that pain is in your back. Diet and exercise can help you shed the problematic weight, which can help relieve your pain. This method alone may not eliminate the pain entirely, but depending on how much weight you lose, it can make a major impact.

Chiropractic care

If your pain is in the back, a good chiropractor may be able to help relieve it for you. Chiropractors are trained in healing the back and keeping it healthy, and they employ various methods to help get your back into proper alignment and keep your muscles from tensing up. The right chiropractor will find the root cause of your issue and begin a treatment plan to help you get better over the long term. This method is aimed at actually healing what ails you, and not just covering up the problem with medication.

Low back pain sufferers incur a wide array of costs from pain relief methods including surgery, physician visits, X-rays, MRI scans, medications and injections in order to try to make pain go away. Some of these costs are necessary in order to identify and start treating the problem. Others are likely to mask the symptoms, which may do more harm than good in the long run. Instead of covering up the problem, maybe it's time to start making real progress with a pain-relief program targeted at solving the underlying issue.

Stretches for Piriformis Syndrome: Do They Work?

In the interest of full disclosure, we sell a product that helps with piriformis stretches. But we're not promoting stretching because of the product, we've actually produced the product because we know that stretching helps, and we wanted to make it easier for people to target the piriformis muscle in their stretches. 

Okay, so now down to the nitty gritty. We don't expect you to take us on our word that stretching works. Let's look at the results of a few studies and articles published in peer-reviewed medical journals.

1. Piriformis syndrome: a rational approach to management. This article was published in the December 1991 issue of the journal Pain, and as promised in the title, it outlines a rational approach to managing piriformis treatment. The approach is as follows:

     1. Correct any underlying issues that may be causing piriformis syndrome

     2. Prescribe an at-home program of muscle stretching, which may be augmented with physical therapy.

     3. A trial of steroid injections may be attempted (although more recent studies have found that this may not be the best course of action any longer).

     4. If all else fails, consider a surgical intervention.

2. The Effectiveness of Electrotherapy with Manual Therapy in the Treatment of Piriformis Syndrome. In this 2012 International Journal of Rehabilitation Sciences study, researchers divided 50 patients with piriformis syndrome into two groups. The control group underwent electrotherapy and the experimental group underwent manual therapy (including soft tissue and joint mobilization techniques with stretching exercises. Both groups had regular physical therapy sessions for three weeks and were taught a self-care plan to use at home. Researchers found that the experimental group of stretchers scored lower on total disability tests at the end of the study than those in the control group, leading researchers to conclude that stretching with soft tissue and joint mobilization is a more effective treatment for piriformis syndrome than electrotherapy.

3. The Piriformis Syndrome. In clinical study, as noted in the American Journal of Orthopedics, researchers concluded that a surgical intervention is rarely necessary to treat piriformis syndrome, and conservative treatments are sufficient in most cases to treat symptoms, such as buttock pain, radiating anterior thigh, groin or lower limb pain, pain while sitting, and low back pain associated with piriformis syndrome. Patients in this study used stretching and other conservative treatments such as ultrasound, local massage and eliminating negative habits.

Now that you have the data, talk to your doctor about piriformis treatment methods. If you're interested in learning more about our medical device to help with stretching, visit our website at www.MiracleStretch.com. Here, you'll find more information on piriformis syndrome and recommended stretching exercises.