Piriformis/Hamstring Issues? I could use some help

Dave Campbell

During week 17 of the Nov OS, I thought I strained my right hamstring during a run.  It was a Sunday run with some hard mile repeats in it.  I had no real issues during the run, but had to jump in the car and drive for 8 hours post run.  about an hour into the drive, my right hip/glute began to feel like I was sitting on an ice pick.  This happpened in March.  Since then, I've massaged, stretched, rolled, taken time off, etc.  Every time I run, it will hurt pretty bad for a couple days post run.  At the beginning of any run, for about 1/2 mile, I feel groin pain, like its tight.  It goes away during warm up.  Then I'll have mild but manageable glute/hamstring pain during the run.  Within an hour though, the pain level shoots up and moving around is painful.  This will last for a couple days.  Riding the bike does not cause make it worse, I don't think.  At least it doesn't hurt during the ride or post ride.  Only after a run.  I have searched info on piriformis syndrome and this seems to fit.  Sometimes the pain radiates down the right hamstring to just above my knee.  Its most tender to touch massage at the connection between the hamstring and where it attaches to my sit bone/hip. 

With IMLP on the calendar in 8 weeks, I need to move on with this.  Its affecting my run training.  Does anybody have any advice as to what to do.  Should I consider seeing a PT?  Does cortisone make sense?

 

Thanks

filarl

I think that I have the same thing and have been “dealing with it” for a couple of years now, AND still figuring it out. Hams start to get really painfully tight during the run, almost feels like they’ve been super glued to my butt and can’t open up my stride, wind up “waddling” in pain. I initially saw a sports med ART. He also did something called stim-acupuncture where the acupuncture needles actually provided the electronic stim instead of the more common pads. I was a bit skeptical, but he had me come in first thing after a cold early morning run and showed me the difference in my flexibility – it pretty amazing, but he was really expensive, not covered by insurance, and so stopped going for now since not in my budget. Also – lots and lots and lots of stretching and PT to improve strength of glutes and hip flexors and to get them to “fire” more. I think this may not be that uncommon among runners who sit a lot – like desk jobs at a computer, NY Times even had an article about it, but still frustrating and difficult to manage. I still get pain whenever I have to drive after doing any kind of hard run workout, its excruciating. I also started having more intense problems after the bike post changing my saddle last year, so just had a bike re-fit. Am seeing how that goes. I found that doing all the PT exercises were way too time-consuming for me after awhile but after some research bought powercranks for my trainer dedicated bike. (NOT recommended for outside/racing bike, heavy and possibly dangerous if not used to them.) They’re independent crank arms, so you work the upstroke, like it or not, which forces you to really use your hip flexors and glutes all while during your normal trainer workout. I don’t know if they make you faster and improve pedal stroke like they claim, just for me the only way get in the work on the HF and glutes without taking a lot of time away from my sport specific training. Oh – and lastly – I sit on a tennis ball a lot at work and also have a swiss ball under my desk for changing it up whenever I have to work late a lot during our monthend closes. I’m still figuring it out myself, but do feel some of this is helping manage what seems to be a chronic condition. Any one else have anything that works?????

Dave Campbell

Thanks for the info Linda. It looks like this could last a while then. I do have a desk job. Maybe I can get up and move around more during the day.

Yasko Howell

Hi Dave, I have the similar issues since last Sep. See the responses I received. http://members.endurancenation.us/Training/TrainingForums/tabid/101/aft/4276/Default.aspx

After all the options I have gone through (ART, PT, massage, stretches), I had an MRI done with inconclusive results, and I was ready to have a steroid shot. Then, the pain started to be much less all of a sudden. I don't know what contributed the improvement whether it was my fear of needles or something else... One thing is I added based on the advise was to form roll adductor. I am not 100% pain free, but a lot manageable, and I can run at a fast pace finally. I wish you good luck and hope your recovery path is much shorter than mine.

Dave Campbell

Thanks for all the info Yasko. It seems to be getting a bit more manageable as time goes on. I've been rolling, tennis ball, massage, ice, etc. It doesn't hurt during or after I bike. Wed did a bike/run with some Z5 bike intervals, then a short run. hen I first started the run, the pain almost made me give it up. But as I ran farther it subsided to a manageable level and I was even able to get up to a z3 pace. Then last night 2 hours run with some z3 and z2 intervals. The pain on the front side, upper quad/groin never went away like it has in the past and the piriformis/hamstring just stayed at a dull ache all the way through. I went directly to stretching and ice bath afterwards. I almost expected to need a crutch today, but its not so bad. With LP coming up, maybe I'll try some ART/PT and see what they have to say. Thanks Again.

jkruger13

Hi Dave,
I had piriformis issues about 2 years ago that I tried to "run through", which caused a nasty case of IT band syndrome. PT made a big difference. All the little pelvic stabilizer exercises that don't seem like they really do anything actually helped quite a bit. Plus my PT did some really good deep tissue work and ultrasound treatment of the muscle. Oh, and this is the bummer part - NOT running on it until it's improved. I actually had to take 6 weeks completely off running to get it better. But the good news is, 2 weeks later I was able to run a marathon pain-free. The cycling and swimming kept my fitness up, I guess. Now when the piriformis even hiccups I back off the running for 4-5 days and do the PT exercises - seems to work, knock on wood. No problems for the past 2 years. Good luck!!

Dave Campbell

Went to local PT and after their evaluation, they say its probably not piriformis syndrome, but a tight/strained hamstring. They have me doing a lot of stretching, 5 reps, 5 times/day in 3 directions with some "Nerve Flossing" to go with it. I'm sitting on a heating pad several times/day also. Still dull pain on runs. but manageable. Ice baths post run, then some heat later. Hoping for the best here.

John Withrow

The yoga "pigeon pose" has helped my piroformis issues a bit. I suck at keeping up with my stretching, but this particular one has really seemed to help me...