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Piriformis syndrome…please tell me your magic fix!

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  • January 13, 2015 at 12:50 pm #23000
    slowclimb

    So heres me, early 40s trundling away, putting in bigger mileages than ever, getting pbs here there and everywhere. Big MTB rides/races, CX rides, best ever 50, 100 mile times on the road etc etc
    I’ll treat myself to a new bike I decide, maybe not a bad decision but certainly a painful one as it turns out…
    I transferred the measurements as best as I could from my old Giant to my new bike – An Ultegra spec Merida Scultura.
    First ride…hmmmm this isnt as comfy as I hoped, fast as f*ck, but not comfy. I’ll try a new saddle I reckoned – Fizizk Arione, lovely saddle by the way.
    Persevered but by persevere I mean keep banging the miles in while trying to ignore the pain. Tight inner right thigh, elastic band wound up tight tight…kept going, hmmm sore lower back after about an hour-ish, sore hip now too….kept going…
    So after a few months of not very enjoyable rides and pain I went to see a local physio, who is great to be fair, piriformis syndrome… Which if you dont know what it is, it hurts…a lot at times. And supposedly very common among roadies and distance runners.
    I’ve a load of stretches etc to do, changes to lifestyle – dont sit about too much, split long drives up, but its looking like a few months off the bike, I can still MTB as it doesnt hurt anything like so much on that as you move around so much more. The annoying thing is that I now get pain on the old Giant and the CX too which I never did before
    What I’m looking for ideally is some magic way of fixing this and tales from you of how you did this and you were sorted after 10 minutes..no stories of woe please, I’m bad enough as it is…
    Once I am sorted ( I will get sorted, please don’t sow any seeds of doubt :* ) I think I need to look at fit on the Scultura, which is an amazing bike. I know I tried to transfer the settings across but I now realise that the odd mm here and there makes a huge difference to angles etc. To be honest I did realise this then too, i just wanted to play on my new bike!
    I know Retul and the like are supposed to be great but I just dont have £200 to throw at something like that and I’m not covinced its not something you cant do yourself with a bit of time and thought.
    I think a lifetime of just jumping on new bikes with no issues and paying lipservice to stretching has finally caught up with me.
    Joking aside though this is really doing my nut in, it will pretty much write off any hopes of racing I had for 2015. I’m a pretty grumpy chap at the best of times and this isn’t helping so any advice or even just happy tales would be much appreciated.

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  • February 17, 2015 at 2:44 pm #826107
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    Jimmy Ray Will

    Me again… have you
    Me again… have you identified why the groin muscle/tendon is so tight?

    I am sure it will be the key to your back problems, but what is causing the tight groin?

    Will stretching the problem really solve the problem without understanding what is causing the problem?

    You will have an alignment issue somewhere, maybe muscular, maybe skeletal, but at a given point you will need to think about stepping up the level of treatment.

    You have been seeing your physio for a while now, and it does not sound as though he/she has really cracked it… for me, I’d suggest it was time to start looking down a different route of treatment.

    As an aside… I have stopped all stretching, instead focus on range of movement and core strength exercises. Muscles don’t tend to tighten up if they are not looking after an existing problem IME.

    February 17, 2015 at 1:18 pm #826105
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    aslongasicycle

    I have a shed load of back
    I have a shed load of back problems and my piriformis tightening is a sign of worse to come, so I back off.
    I stretch. I do core work. I do weights. Use a roller and ball. I swim. I have a non-aggressive position. I have Fizik Aliantes on all my bikes.
    And life is better than it was. And I ride more.
    Don’t take it lightly!

    February 17, 2015 at 12:27 pm #826103
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    slowclimb

    An update for you all…
    Seem
    An update for you all…
    Seem to be getting the piriformis pain sorted, its sore the last few days but thats because I had to drive 800 miles in a couple of days last week I think. I know what causes it and what to expect at least now, and how to manage it.

    However….. we (me and the physio) now think it has all been caused by an unbelievably tight right groin muscle/tendon, it really is like an elastic band waiting to pop. Before the pain from the piriformis was pretty much all consuming but I think this is the root cause. A mate had similar issues and he said the phyio used her thumbs to help release it which was excruciating! I am now trying to spend as little time at the physio as I can too as it really, really adds up!
    I know that this is pretty difficult to stretch properly as its so narrow its easy to cause more damage by stretching too.
    I’ve tried foam rollering it but its actually pretty tricky there.
    Do any of you have any experience of an injury there, and what did you do to remedy it? :/

    January 15, 2015 at 8:15 pm #826101
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    slowclimb

    Yeah the saddle one is funny
    Yeah the saddle one is funny one, my concern is I was getting pain on the saddle that came with the bike – a Prologo Kappa Evo so I think although the Arione maybe isnt the right saddle the issue might be tad more deep more seated (no pun intended 🙂 )
    I think once I get the pain itself sorted I reckon a bike fit is in order.
    I’m at the physio again tomorrow, I’ll keep you posted!
    Thanks again too you all for the input, it really has been a help.

    January 15, 2015 at 2:24 pm #826099
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    Jimmy Ray Will

    Last shout for the ALiante…
    Last shout for the ALiante… the Charge Spoon is built on the same chassis shape as the Aliante, just using plastic resin rather than any fancy carbon stuff.

    Good luck with getting it sorted.

    January 15, 2015 at 1:02 pm #826097
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    Daveyraveygravey

    slowclimb wrote:Thanks again,

    slowclimb wrote:
    Thanks again, with the saddle the real nippiness started as soon as I moved to the new bike so I reckon a bike fit may well be the way. I do reckon the arione maybe isn’t the right choice anyway.
    As I said too – I’ve spent much more than even a top end bike fit getting physio, add in the mental torture of a few months off the bike and it’s not good!
    Davey – ironically I’ve used charge spoons on the mtb for a few years and always got on great……they’re just not bling enough to put on my shiny new carbon bike 🙂
    It is interesting like a couple of you have said to look back through to what I think caused it. Thinking about it it all really started when I started to fiddle with my seat height for tt-ing about 3 years ago! I should just have left alone :(

    Not bling enough?! I know what you mean though. The two demo Fizik saddles were fluoro pink so you wouldn’t just not take them back to the shop, so the Spoon looked “normal” and right as soon as I put it on. My next bike will be bling too, but I’m torn between something Arione-like in looks but it has to be more comfy…

    January 15, 2015 at 9:24 am #826095
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    notfastenough

    I feel more comfortable in
    I feel more comfortable in jeans on an Aliante than in good quality bibshorts on an Arione. The latter is horrific for me.

    Re the Charge Spoon, you can customise to get the right look:
    http://custom.chargebikes.com
    That said, a saddle that is great on the MTB may not be so on a road bike, as you lean forward more and (ideally) rotate the pelvis more.

    I paid £110 for my bike fitting from a guy at manchester velodrome if that’s accessible to you.

    January 15, 2015 at 8:59 am #826093
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    slowclimb

    Thanks again, with the saddle
    Thanks again, with the saddle the real nippiness started as soon as I moved to the new bike so I reckon a bike fit may well be the way. I do reckon the arione maybe isn’t the right choice anyway.
    As I said too – I’ve spent much more than even a top end bike fit getting physio, add in the mental torture of a few months off the bike and it’s not good!
    Davey – ironically I’ve used charge spoons on the mtb for a few years and always got on great……they’re just not bling enough to put on my shiny new carbon bike 🙂
    It is interesting like a couple of you have said to look back through to what I think caused it. Thinking about it it all really started when I started to fiddle with my seat height for tt-ing about 3 years ago! I should just have left alone 🙁

    January 14, 2015 at 10:00 pm #826091
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    Daveyraveygravey

    Would also recommend a bike
    Would also recommend a bike fit, had the Spexialisedyone at £120 (plus 110 on shoes and 70 on bars etc..) It isn’t cheap but all the things that used to make me want to,stop riding are gone. As someone else said it is a lot of money in one go but over a lifetime on the bike it’s peanuts.
    Also tried both those Fizik saddles as part of the fit, the Arione was agony but I stuck with it for 10 days and about 200 miles because the expert recommended it. The Aliante was much better but had a Charge Spoon at home and that for me is better than either Fizik. If I could I would try some more, saddles are very very personal and what you and I might find torture others might find perfect.

    January 14, 2015 at 9:59 pm #826089
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    Daveyraveygravey

    Would also recommend a bike
    Would also recommend a bike fit, had the Spexialisedyone at £120 (plus 110 on shoes and 70 on bars etc..) It isn’t cheap but all the things that used to make me want to,stop riding are gone. As someone else said it is a lot of money in one go but over a lifetime on the bike it’s peanuts.
    Also tried both those Fizik saddles as part of the fit, the Arione was agony but I stuck with it for 10 days and about 200 miles because the expert recommended it. The Aliante was much better but had a Charge Spoon at home and that for me is better than either Fizik. If I could I would try some more, saddles are very very personal and what you and I might find torture others might find perfect.

    January 14, 2015 at 9:27 pm #826087
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    Swami Dave

    Get fitted – I’m in the
    Get fitted – I’m in the process of recovering from my second discectomy due to poor fit and riding through it. It’s not been fun.

    A point on the Fizik saddles: the widths are all much the same (143 or 146 from memory) it’s just the shapes that are different. Spesh and Selle Italia offer measuring services which will give you a correct width and are worth looking at.

    January 14, 2015 at 12:30 pm #826085
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    slowclimb

    Thanks chaps, I think you
    Thanks chaps, I think you have all made some very valid points. I think the thing about being a chain of events really, like a lot of us I’m sure have always been pretty poor at stretching and ignoring niggles. I think its all just caught up with me. I’ve had ridiculously tight IT bands for going on for 10 years, inner thighs probably started to tighten up around a year ago and I think the new bike has just created the perfect storm 🙁
    As far as the saddle goes I did the Specialized sit bone mat thing a few years ago and got the 143mm Toupe which I always got on great with, I did even move that onto the new bike after a few rides but I think the damage was done by then. the Antares seems to be the Fizik around that width – 142mm.
    Looks like a bargain Arione going on eBay soon…
    You don’t realise how much time you spend either thinking about bikes, how/when to get out, what kit to buy etc etc until you cant!
    I will get this thing sorted though!
    The moral of this story though is – don’t ignore niggles and if you’re under 40 start stretching….now! 😀

    Now….. does anybody have bombproof formula for seat height that takes into account femur and tibia/fibula length and crank size?…

    Jimmy – you’re right about private physio, the guy I see is great and has an amazing CV but the cost does add up. Ironically I have already spent way more than the cost of even a retul bike fit on physio!
    And I have just done an IT band foam roller thing on a borrowed roller from the physio…. :”(

    Poptart242 – I looked up and tried that floss the nerve stretch, that really does seem to be an effective and pretty easy to do stretch, think I’ll keep at that, ta for that.

    January 14, 2015 at 10:59 am #826083
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    mariekb1980

    I can 100% sympathise with
    I can 100% sympathise with you, ive been suffering with it since august, its stopped me riding, running, circuit training and generally keeping on top of myself.

    I think im getting somewhere then im back to square one, im seeing a physio on the nhs now after I ran out of cash going private and shes great and has given me stuff to relieve the symptoms, but also by addressing the problem.

    Mine is down to weak hip flexors, so ive got a rigourous routine of foam rolling my IT band, (when that’s tight, it pulls on everything in my butt) trigger point therapy with a hard rubber dog on my butt and a whole heap of strengthening and stretching excercises for my core and hip and hamstrings. Looking back a year from now, I stopped doing hip adductor and abductor excercises in my core routine then started to suffer with my hamstring, and then it spiralled form there.

    Its making a difference, just this week I can sit at my desk without that dull toothache in my butt, can walk without limping and ride.

    Foam roller on your IT band, do it now!

    January 14, 2015 at 9:54 am #826081
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    Jimmy Ray Will

    slowclimb wrote:Jimmy Ray

    slowclimb wrote:
    Jimmy Ray Will wrote:

    I speak from direct experience… the old tight inner thigh, sore buttocks, hip… I remember it well… I also remember the almighty ‘let go’ of the back that followed from ignoring the symptoms.

    Hahaha, Jimmy – you are me! 😀

    With the saddle I thought I didnt get on with the one that came with the Scultura which was gutting as it colour matched the frame 😀 Obviously now I realise it maybe wasn’t the saddle! So I did the Fizik flexibility thing and came out being most suited to the Arione. Is the Aliante still a current model? Not many places seem to have it.

    The Aliante is definitely a current model. However, they have recently updated the design (its nearly 20 years old now), and so many retailers will be running stock down in anticipation of the new design coming through.

    As mentioned, there are loads of good saddles out there, but in my experience, this design provided the stable sit bone position I needed to start getting over my particular challenges.

    Again, from my experience, you’ll know if you are getting the right treatment when you start backtracking through all your aches and pains.

    Thats what I had. If you imagine your problem being a chain of different issues working together, as you start unraveling that chain, its like going back in time. I’d find myself thinking… ‘oh, I remember this niggle’. Quite a curious process.

    January 13, 2015 at 5:59 pm #826079
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    Eebijeebi

    As a long term sufferer,
    As a long term sufferer, thigh muscle, hip and lower back doesn’t seem right for Piriformis Syndrome to me (not problem on a bike btw). I’d look more towards the bike fit etc which would be good news.
    have you actually been measured for saddle with the cushion thingy?

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