Tag Archive | piriformis syndrome

Sciatica Pain Caused by Piriformis syndrome and Treatment (Carlsbad, Oceanside, Encinitas Pilates)

Piriformis syndrome, Sciatic Pain and treatment

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The piriformis muscle is a small muscle located deep in the buttock under the gluteus maximus. The muscle runs very close to sciatic nerve and some people the nerve even can run through the muscle. Piriformis muscle function is assisting to rotate the hip, turn the leg and foot outward (hip external rotation).

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Piriformis syndrome may caused by muscle spasm or excess tightness in the piriformis muscle, either because of irritation in the piriformis muscle itself, or irritation of a nearby structure such as sacroiliac joint ( SI joint) or hip. Most commonly, clients describe acute tenderness in the buttock and sciatica-like pain down the back of the thigh, calf and foot. Pain Increases after prolonged sitting, walking or running and it also may limit range of motion of the hip joint, especially hip internal rotation. Piriformius syndrome is very common in long-distant runners and those who’s sport requires repetitive external rotation of hip (ice hockey).

Many of my client who got a Piriformis syndrome, have also problem with their SI (sacroiliac) joint and visa versa. By saying that, SI-joint dysfunction may be sometimes root of pain, not piriformis muscles itself. Piriformis syndrome, SI-joint dysfunction and hip pain have very similar symptoms and they are hard to diagnose. Sciatica pain may also be caused by piriformis syndrome as well as SI joint dysfunction.

Almost every treatment approach for piriformis syndrome will include a focus on carefully and progressively stretching the piriformis muscle.
However, stretching only piriformis muscles may not be enough to treat piriformis syndrome. Piriformis syndrome may cause or caused by muscle imbalances in lumbo-pelvic-hip region. Stabilization of the pelvic may be affected by tight and short muscles hip flexors, hamstrings, piriformis and SI- joint dysfunction, resulting in overuse and spasm of the piriformis. So, muscle balance around your hip, pelvic and SI-joint are also important to treat. Faulty movement patterns are common for people who is suffering from piriformis syndrome. Piriformis spasms limit pelvic movement and in turn leads to gait deviations and compensations. If the muscle imbalances and faulty movement patterns left untreated, piriformis syndrome may return.

If you go to Physical therapy and did not get help, try Pilates with experienced Teacher. Pilates one-on-one training treats your whole body, not just a pain. So, you get help also your overall possible muscle imbalances and compensations – That is priceless.

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Sciatica Back Pain – Is Pilates really helping?

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg. Sciatica occurs most frequently in people between 30 and 50 years of age. Often any particular event or injury does not cause sciatica, but rather it tends to develop as a result of general wear and tear on the structures of the lower spine.

Common causes of sciatica are Lumbar Herniated disc, Spinal Stenosis, Degenerative Disc Disease, Spondylolisthesis, Piriformis syndrome and Sacroiliac Joint Dysfunction.

Exercise is usually better for healing sciatic pain than bed rest. Sciatica exercises are also important for the healthof the spinal discs. Movement helps exchange nutrients and fluids within the discs to keep them healthy. Many sciatica exercises focus on strengthening the abdominal and back muscles in order to provide more support for the back, so do Pilates.

Many Pilates studios are marketing their services as a treatment for lower back pain and sciatica, but does Pilates really help? Yes, it really helps if you find a good Pilates instructor who has back pain rehabilitation experience and who is familiar with your diagnosis, diseases and symptoms. Why Pilates instructor knowledge is so important? Because all Pilates exercises do not fit all sciatica clients and some exercises might be even contraindicated.

Here are briefly some underlying exercises that spine specialists recommend for each diagnosis of sciaticaThese exercises help to relieve pain and prevent further back problems:

  1. Spinal stenosis: Focus on flexion exercises (forward bending). Flexing the lower spine relives pain and nerve irritation for people with spinal stenosis. They often feel better bending forward than standing up straight. Still it’s important to strengthen back and abdominal muscles and teach posterior pelvic tilt which allows the client perform more activities and exercises with less pain.
  2. Degenerative Disc Disease: Focus on spinal stabilization exercises, back extension exercises including the McKenzie method. All Pilates exercises are focusing spinal stabilization, so Pilates for DDD is really beneficial. However, back is fragile for DDD clients, so full flexion and intermediate spine articulation exercises are in some cases contraindicated.
  3. Herniated disc. Focus on spinal extension with McKenzie method and Spinal Stabilization training.  Pilates is good, but has to be pain-free range.
  4. Spondylolisthesis: Focus on flexion based exercises and spinal stabilization program. It’s important to teach how the lumbar spine remains stable in a flexed position.
  5. Piriformis syndrome: Focus on stretching piriformis muscle, hamstring muscles and hip extensor muscles. Maybe only stretching exercises is enough to help to decrease this painful symptom. Finding neural pelvic position, spinal stabilization training and hip range of motion are all important for people with piriformis syndrome.
  6. Sacroiliac Joint Dysfunction: Focus on restore range of motion in SI-joint, which can be limited if the joint is inflamed. So, spinal stabilization, pelvic and hip exercises are all good.

All the above diagnoses cause sciatica pain but as you see the recommended exercises are very different. Pilates in general is good but definitely there is no “one size fits all” exercise for sciatica pain clients. Sometimes Pilates instructors are too confidence to taking care of people who suffer back pain, caused by sciatica. Many Pilates programs don’t give enough information about back disorders and many instructors don’t have enough experience either. It’s very important for Pilates instructors to know the client’s history of sciatica pain before they plan any Pilates program for their client. However, carefully planned Pilates program with a good hands-on skilled instructor make the life of sciatica pain client easier by relieving pain, strengthening and stretching muscles and increasing spine and joints range of motion. “Motion is lotion” is true here.

Please visit PilatesWise.com and read more about our SpinePilatres bacxk rehab program which is specifically designed for people with back pain and sciatica. Program is combination of Pilates and Spinal Stabilization, click HERE and learn more. This program is available also via SKYPE, so not need to live in North County, San Diego, California.