Today I want to talk about a pain in the ass (no, I don’t mean Melissa… this time). This pain can hamper your fitness and overall mobility and unfortunately, piriformis syndrome is quite common. The piriformis is a small muscle that is part of the gluteal complex. The problem is that the sciatic nerve runs very close to the piriformis. Issues arise when the piriformis gets shortened or spasms, as it can inflame the sciatic nerve.
Once the sciatic nerve is irritated, it can cause nerve pain from something as minor as walking or even sitting. If you’re not familiar with what nerve pain is like, imagine the feeling when you bang your funny bone, but more intense. Sitting for long periods of time can cause the piriformis to get thrown out of whack, and very few of us aren’t victims of the “slow death” (by chair).
Get comfortable, because I’m going to digress for a little bit of story time. I have the misfortune of suffering from piriformis syndrome on a regular basis. I’m sure my daytime desk job contributes to the problem. For me, the condition most commonly manifests as just a sharp, electrical shock-like feeling when I try to run, but can also be when I step out of the squat rack with weight. The worst case happened back in March when I did heavy split jerks a couple times in the same week when I hadn’t done them in several months. This caused a strain in the hip area and my response was to very aggressively roll the area with a lacrosse ball — huge error on my part. The next day I could barely walk and it took a few months before I was able to even train regularly again.
Through trial-and-error, I have found the following to be especially helpful if you find yourself in a similar situation. As a minor disclaimer, this should not be construed as providing medical advice or as a substitute for a consultation with your medical professional.
First, it may be a good idea to take some ibuprofen to lower the inflammation of the piriformis and take pressure off the sciatic nerve. Normally, I’m not a big fan of taking NSAIDs and recommend using ice or even ice baths. However in this case, you will likely find that the ice cannot penetrate deeply enough due to the surrounding musculature and the ibuprofen will be necessary. I unfortunately suffered for a few days before breaking down and taking some. Don’t repeat my mistake if you can.
Secondly, I found it helpful to mobilize the sciatic nerve in a method known as neural flossing. This is loosely defined as moving a nerve through a small range of motion to alleviate any adhesions. While the mechanic behind it can be debated, I have found it to be an immediate relief when I have an acute flare up. While the guy in this video may be a little quirky, he demonstrates how to do the neural flossing for the sciatic:
Those two preceding bits of advice will help you get past an acute flare up, but for ongoing prevention, there are a few other things you can do.
Strengthen your glutes — sitting all day can cause your hip flexors to become overactive and your glutes to become inactive, which can cause hypertrophy (growth) of the piriformis. To help equalize things out, working on lifts we do regularly — such as deadlifts, squats and lunges — can help reactivate those dormant glutes.
Pick an object on the ground, or place one there. A shoe, a hat, a piece of paper, anything will work.
Now, pick up the object. But wait – don’t squat down to pick it up, and don’t just bend over at the waist. Erase the word “bend” from your vocabulary. You aren’t bending; you’re reaching back with your hips.
Stick your butt backwards, as if you were reaching for a stool to sit down. All the while, maintain a tight lumbar spine. Keep your back straight, in other words. Don’t round your back. Keep your legs nearly straight, too, just enough to unlock your knees.
Stick your hips back until you can grab the object. Grab it, then come back up by reversing the hip motion.
Stretch the area — especially important when spending a lot of time seating, such as on an airplane, Kelly Starrett’s drills can help immensely. Also, the static stretch you may have seen elsewhere can help with this.
As you can see, mobility can not only improve your performance, but can help keep you off the disabled list. Some of you may consider me a little overzealous or whine (*cough* Tamme *cough*) when it comes to our mobility stretches, but I’m just trying to help make sure you don’t repeat my past mistakes.
Make Up Day