Piriformis syndrome: A big fat pain in the bum

I’ve had a weird pain in my hips, lower back, extending down my left leg for ages. It’s even affected my gait causing me to overpronate, hurting my medial lateral ligament and causing major tightness in my calf muscle. I knew it wasn’t serious, but it has majorly affected my speed, much to my annoyance! Turns out it’s Piriformis syndrome or ‘fat wallet syndrome’ (why does it not surprise me that the thing I have has a stupid name?). It means, for whatever reason, the piriformis muscle is impinging on my sciatic nerve.

The piriformis muscle is a deep muscle located beneath the glutes. Its role is to laterally rotate and stabilise the hip. This muscle is important for athletes who participate in running sports that require sudden changes of direction. The piriformis works along with other hip rotators to turn the hips and upper leg outward (external rotation of the hip).

In 17% of the population, the sciatic nerve passes through the piriformis muscle, rather than underneath it, so overuse of this muscle or tightness can cause compression/irriation of sciatic nerve. It seems, typically I am one of those 17%. Why couldn’t I be the 1% of the population with some amazing skill?! :-(

The only way I can describe the pain is as though somebody has punched my left butt cheek! :-) Ibuprofen (for which I took copious amounts for the marathon) seems to help to reduce the pain, but what eventually happens is that my left side becomes incredibly stiff and my stride becomes narrow as I’m unable to lift my leg properly. 10ks seem to be fine, but further distances I really struggle at.

So, for now I’m going to have to sit on a tennis ball and try and free up the nerve, take anti-inflammatories and do lots of yoga, pilates (to strengthen the core) and extra stretching. I’m still going to run, but no more long distances, just lots of 5 and 10ks at least over the coming weeks.

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