Sciatica/piriformis syndrome

coop6

I have a pretty bad case of sciatica, and possibly piriformis syndrome. I think I irritated the nerve during a long car ride, and have been making it worse with training. It started out with mild, intermittant hamstring pain, and flared up recently into deep pain in my right glute, with numbness down the back of my right leg and into my foot. It's really not all that uncomfortable unless I'm sitting or driving, and I don't do a ton of either, so it didn't really grab my attention until recently. It's now progressed to the point that I'm falling down occasionally while running. My right leg is the one that's affected, so if I lead with my left leg going up a curb, I'll catch it with my right toe and trip because I'm not contracting the hamstring and bending the leg high enough. I trip over tiny sidewalk cracks. I ran a 10 mile trail race last weekend, and fell four times in the last four miles just catching the right leg on stuff. I ran twice this week, and both times my right leg was numb after 6 miles.

I've stopped any serious training, am on a prescription NSAID, and am only swimming. I've resigned myself to the fact that I am not likely going to make the HIM I'm signed up for in 5 weeks. It's been a difficult winter for me so far, so I'm content to let a few months of subpar training go down the drain and just do what I need to do to let this heal.  I've had this in the past, but not in the last 6 years that I've been training and competing in endurance sports. It's always gone away on it's own, so I'm optimistic that it will resolve if I quit aggravating it. I'm hoping for suggestions on stretches, or any other treatments that might help this to resolve faster. I did a google search, and the amount of information on this topic is overwhelming, so if any have had experience with this and could point me to a few good resources, I would appreciate it. I would also welcome any advice or experience on how/when to return to training, and when I should abandon trying to treat this myself and seek formal evaluation.

Thanks

new2703

Sorry to hear about your symptoms. Given your history of numbness and weakness, I think an evaluation is necessary.

Michele Cellai

Sarah- it sounds like you are under a health care providers care and receiving treatment. Unfortunately, there are so many possibilities as to causes (as you may already realize) that it needs to be pinpointed.
Some things that should help regardless:
- floating vertically in the deep end of the pool for traction on the area without stress
-significant gluteal weakness can also be a causing imbalances that you are/were exacerbating with training. A gait analysis and functional movement evaluation might be helpful.
-when in a vehicle- sitting on a pillow or other cushion to bring knees and hips level reduces stress on the area.
Good luck

coop6

Thanks Michele. Right after I posted this, I took my kids for a walk and my leg went numb after a block so I had already decided I would go in to see my doctor. I'm on steroids, which have helped immensely already. After looking around online, I found some streches that should be generally helpful or at least not make things worse until I can get in to see PT, which I hope will happen in the next couple weeks. I've been doing most of those stretches already anyway, but now I have a few more. I have an MRI next week too. I think a gait analysis is definitely in order once I get past the acute inflammation and rule out a spinal problem.

Michele Cellai

Any word?

coop6

Thanks for checking in. My MRI was fine. I'm going to PT twice a week and having ultrasound therapy. My leg is still intermittently numb, but not related to training, more with sitting and driving. It looks like this was not a training type injury, but the only way to get it to heal is to go easy on the biking and running. I'm able to run 30-45 minutes, bike up to 90 minutes, and swim. It's enough to keep me sane, so I'm good with that for now. In 4-6 weeks, I should be able to add some volume.

Michele Cellai

Glad to hear it.
Ask your PT about a gait analysis, functional core strength eval when you are closer to discharge. best of luck.