All kinds of injuries are troublesome for runners, but if there’s one that’s quite a literal pain in the butt, it’s the dreaded Piriformis Syndrome. Located deep behind your gluteal muscles, the piriformis muscle helps in the external movements and rotation of the hip joint. It is most active during the “stance” phase of running, where it acts as an external rotator of the leg.
When stretched too tight, it can create stress on the thick underlying sciatic nerve, which is responsible for motor and sensory functions across your lower body. Damage to the piriformis often ends up irritating the sciatic nerve as well, leading to shooting pains across your lower back muscles. Other symptoms include radiating pains from the thighs right up to the buttocks and lower back, apart from a soreness of the glutes and hip joints. Because of this proximity to the sciatic nerve, piriformis syndrome is often mistaken for other ailments like sciatica, back aches and hernia; professional diagnosis is therefore a must in order to avoid mistreatment.
Cause of injury
Like with most sports injuries, improper form and running technique is often the chief reason behind damage to the piriformis. Bumping up one’s mileage too fast too soon, speed workouts without adequate warm-up, imbalance in strides, and direct injury from a fall or pull to the piriformis muscle are some common causes behind this syndrome. Following a slow and steady routine with plenty of warm-ups and core workouts is one of the best ways to prevent untoward injuries to the piriformis.
Runners will feel the injury most when landing and pushing off during their training; the pain might get worse when you run fast, go up and down hills, or go around tight turns. When left undiagnosed, the soreness and stiffness will extend even during non-running activities, particularly while sitting for extended hours, like in a car or office. In severe cases, even sitting for a few minutes at a time can cause extreme discomfort, to say nothing of running and working out. Piriformis syndrome can often debilitate you for weeks, but thankfully, if detected early, the injury can be treated through a focussed strengthening and stretching routine.
Recovering from injury
Most running injuries can be treated once the imbalance in form is detected. Piriformis syndrome in runners can be caused due to improper pelvic alignment, overpronation of the foot, or uneven leg length. Sometimes bad fall directly on the area can over-stress the muscle too. Since piriformis injuries are not only restricted to athletes and runners, there are several treatments recommended by physicians worldwide that depend on other factors and overall health. These range for corticosteroid injections to surgeries for extreme cases.
In general, however, concentrated stretching and strengthening of the area can help in alleviating pain and also relaxing the overstretched muscle. Depending on the intensity of your pain and the advice of a medical expert, start out with slow specific stretches that target the gluteal muscle group.
Ideally, start out with gentle stretching of 5-10 seconds before increasing the holding duration to longer. Like with all injury treatments, do take on a demonstration from an expert or understand your recovery routine in the presence of a trained physiotherapist. You don’t want to aggravate the damage by stretching the muscle for too long, or too fast.
Back to running after Piriformis
If you’re injury is not too severe and you can find yourself doing an easy run without too many repercussions on your lower body, you can continue your training on a very light level. At the same time, if you see your workout affecting the pain negatively and spreading the numbness to other parts of your legs, stop immediately and consult a physician. Most people have different reactions to Piriformis Syndrome depending on how much if affects other nerves, particularly the sciatic nerve. It is best to take a break from running and heal completely, so as to avoid recurrences or other complications.
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