Thursday, October 2, 2014

Piriformis Injury and Physical Therapy

Are you familiar with the piriformas muscle? This short little muscle goes from your butt into your hip and aids in hip flexion.

While injuring this muscle is not super common, it happens enough in runners to be aware of it's existence, and some good ways to stretch it out and keep it limber.

The "injury" part is really just that it becomes tight. It is linked to the sciatic nerve, so it could cause some sciatica-like pain as well. For me, it went south and helped to pull a quad muscle in my leg.

My injury came about through several ways, as most injuries do. First, I needed new shoes. I had trained in my old shoes for the Garry Bjorklund Half Marathon in June, as well as the Ragnar Relay in August. With the Rock'n'Roll Half Marathon coming up in October, I knew I would need new shoes after Ragnar. Unfortunately, my "style" shoe in my favorite brand was changed this year, and I didn't feel comfortable buying the new one online. I could have gone to the running store to get fitted for new shoes, but timing was never on my side.

So, on September 13th I ran the Tunnel 10K in Duluth. I was clipping along at an 8:30 pace, all on the hard concrete of the highway. My piriformis started bothering me then, but I kind of ignored it. (Typical runner!) It was never painful, just annoying. It came and went, and I even did a long run of 11.5 miles relatively pain free the weekend after. Then last Thursday, while running 6 miles, I felt a pulling and aching feeling in my quad. That week I had managed to find my "old" shoes, new and on clearance, online and ordered them rush-delivery to me.

Thankfully with some rest, my muscles feel relatively normal again. I'm still not 100%, but getting there.

I did go see my doctor about it, as I was concerned about the pain with only 3 weeks left until my half marathon. She referred me to Physical Therapy. I had never been to PT, so I was a little nervous at my first appointment yesterday. Overall it went really well! So well, in fact, that I may not have to go back. We're going to touch base over the phone and kind of access as we go.

The therapist gave me some really good stretches, which I think all runners should take advantage of even if this is not an issue for you. It's always good to stay limber!

This is a great stretch, and feels so good! Although you won't be getting down to the ground quite as much as this computer model person. Here's another good view:

You do want to get down on your elbows, and make sure you relax your head, neck and back. Your foot should be pointing straight behind you. Do this for a count of 10, 2-3 times on each side.

The Clamshell. I was already doing this stretch, and PT said to keep doing it. It's a great way to build strength in the piriformis muscle and IT band.
Another stretch that I don't have a picture of is the one-legged squat. Basically, you will bring your right foot over your left knee, and then squat down on the left foot. You should feel the stretch through your butt and quad of your right leg. Hold for a count of 10, repeat 2-3 times. Repeat on the other side. 

Another muscle that is sometimes affected when you're dealing with the piriformis is the psoas muscle. This muscle runs down the front of your hip into your quad. Here's a good stretch for that muscle:

Old skeleton is showing not only how to do the stretch, but how it works the psoas muscle as well. This is a pretty hard stance to hold, so another good way is to put that back foot on something like your bed. Flex your butt muscle and squat down on the opposite leg, while kind of pushing your butt forward. You can hold on to something like a chair or dresser while doing it this way instead.

So there's all the information I know about the piriformis and psoas muscle. Hopefully these tips can help you stay limber and injury free!

Have you had injuries from running or other sports? How did you overcome them?

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