Question
QUESTION: Hi,

I'd like to thank you in advance for any advice you may have to offer me.

On Halloween night 2012 I  suddenly had a sharp pain in my right piriformis (I have piriformis syndrome). It progressively became worse. The pain moved to my thigh. I could actually feel my sciatic nerve jumping inside my thigh. The pain was excruciating. This lasted for around 1 1/2 months. Eventually, the acute intense pain turned into a chronic dull pain with numbness in my lower leg.

I tried stretches, icy hot, capsaicin, self-massage, heat and cold therapy, etc. Nothing worked.

I started noticing that certain stretches would aggravate both my right and left sciatic nerves, but my left side would feel better after a few days.

Last Friday I decided to see my doctor who agreed that I was possibly suffering from a pinched nerve causing my piriformis syndrome. He put me on Baclofen, diclofenac, and oral medrol. I started taking these meds on Saturday, but haven't really felt any relief. Perhaps it's too soon? He also gave me a referral to see a neurologist as well as a physical therapist.

Now here's my question: there's this one stretch I do three times a day 35 reps each. It's called glute squeezes. Anyway, I started to think about this exercise/stretch today and wondered if it could be making my piriformis worse? So I looked it up online and to my horror discovered that I'd been doing it wrong. Here's how i've been doing it: I stand tall with both my legs together so close my knees touch. Then I rapidly began to squeeze and release 35 times sometimes more. So, do you think I've made my problem worse or at the very least prolonged the healing process?

Thank you for any advice you can give!

L

ANSWER: Hello L,

Sorry to hear about all your piriformis problems.  I appreciate the detailed question and your description of the exercise you are uncertain about.  It makes it easier to help you.

The good news is that I do think there is a lot you can do to help yourself get out of pain.  The first thing to do is to stop doing your glut squeezes.  I had a dancer come to me a couple of years ago with virtually the same story as yours.  Once I got her to stop squeezing her glutes all day long she got better very quickly (she didn't tell me she was doing that for the first couple of sessions, haha).

Here's why those glute exercises are a major factor in your lack of recovery - exercise shortens and tightens tissue.  Exercise strengthens tissue, but it also shortens and tightens it especially with repetitive type exercises like the one you are doing.

Take a minute and think of all the muscles in your body like the rigging (ropes) on a big old-fashioned sailboat.  All the ropes (muscles) have to have the proper tensional settings or the entire structure will be thrown off.  If some muscles (just like the rigging) are too tight, especially the big strong muscles in your hips, they can lock down and torque your tailbone, and yank on the sacral nerves that come out of your tailbone and innervate your lower body. And that's what I believe is occurring in your body.

I talk about all of this in greater detail on my completely free website,
Do-It-Yourself-Joint-Pain-Relief,
http://www.do-it-yourself-joint-pain-relief.com/
but suffice it to say that I have no doubt the inappropriate tension caused by your glut squeezes is part of the problem, not part of the solution.

So I'm going to recommend you visit my main Sciatica Pain Relief page,
http://www.do-it-yourself-joint-pain-relief.com/sciatica-pain-relief.html
and follow along with the free videos.  I think that should cover most of what you need.

You can also go to my Pelvic Girdle Pain Relief page,
http://www.do-it-yourself-joint-pain-relief.com/pelvic-girdle-pain-relief.html   There is a lot of overlap of techniques on these two pages, so it's not as much work as you may think.  But video 2 and 3 have some valuable techniques that may help you as well.

I do think you can probably fix yourself, and potentially do so quite rapidly.

I do hope this was helpful.

Best,

Gary Crowley


---------- FOLLOW-UP ----------

QUESTION: Hi Again!

I studied your videos and realized that i'd watch them a few months back on YouTube.  Now I wish I would have paid more attention to them because they are excellent! I started doing some of the stretches last night. They helped eased a little of the pain I was having, so I'll continue to do them!

I don't want to take advantage of your generosity, but can you answer one more question? If so, here it is:

Along with the glute squeezes I was also doing side and front leg swings. The thing is I discovered that I was doing these wrong also (I know I made a fool of myself experimenting on my own). I would stand tall, turn my entire upper and lower leg as well as my foot  inward and swiftly swing my in and out for around 10 reps. Then I would swiftly swing my leg forward for ten reps. Then I'd swiftly swing my leg forward and back for ten reps. I did this on both sides. At first it felt like it was helping me, but I believe it has caused my right knee, which is my bad side to stiffen. My upper right thigh gets stiff sometimes also. So I have decided to stop doing the leg swing also. I realize now looking at images online does not always show the correct way to do an exercise and the accompanying instructions are not always clear. Videos like yours are much better!

Thanks again!

L

Answer
Hello Mysterious "L",

I'm not exactly sure what your question is from what you said above, but I do have a reply.  I would strongly recommend that you stop doing any type of "strengthening" exercises until you free your body enough to be completely out of pain.  Everything you have described to me seems to play into tightening the tissue in your pelvis, and other areas.  And since it seems that you've been doing these type of exercises a while, it might be a nice break for your body for you to spend all your time freeing it for a while instead of tightening it.

People who tell you that you need to "strengthen" muscles to fix your problem don't understand the difference between muscles that are functionally weak (because they are too tight, or being affected by other muscles that are too tight) and muscles that are physically too week.  Most of the time people have "functionally weak" muscles that once released can perform their designated function.  Muscles that are physcially too weak to perform their function do occur (example, if you've been in a cast for 8 weeks), but most of the time it is not the case.

The good news is that from what you've described if you just stop doing some of the things you've been doing, that alone will help your body a lot.  And don't feel like a "fool", as you describe yourself above.  This is how we learn.  When it comes to mistakes, I've made them all, so I sure know a lot about what not to do.  And that puts you way ahead of most people ; )

Hope this proves helpful.

Best,

Gary