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A Pain in the Butt. Piriformis?
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I have had good news on the myofascial release front. The before and after pictures my physical therapist took show that I stand so much straighter now. The muscles on my abdomen don't look so strained. But all the rearranging has had an unfortunate consequence. I get this searing pain in my butt on the right side sometimes when I get up from sitting and especially when I rise from lying flat on my back in bed. My therapist is trying to address it, but it comes back again.

So yesterday I went to the health club. This time in addition to going in the jacuzzi I tried to jog in place in the pool. Bad idea--OUCH. Then I tried to just walk up and down the length of the pool. Still hurt. The jacuzzi helped but did not make the pain go away altogether. So I had to take a taxi home and stay home Saturday night.

Darn. I think it is the piriformis muscle. My therapist says it has something to do with the SI joint.
Posted on 05/13/12, 09:37 am
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Reply #1 - 05/13/12  5:37pm
" I think it's the jogging, stepping movement - it (I think) creates a shearing strain on the muscles of the lower back, particularly the SI joint.

Back in September / October I tried to recover too soon and started doing 'step ups' as an exercise and gave myself a mega set back, a mega flare up and pain off the scale and me only able to walk a few yards. When I saw my cranio therapists and explained she made it clear it was a bad idea as it caused such a strong problem for the muscles. Seeing as she's also a chiropractor I thought she knew what she was talking about! I just had to rest and wait for it to settle and start back really really slowly. "
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Reply #2 - 05/13/12  8:07pm
" I just came back from my massage therapist. I think I know what is the problem. It is the Psoas muscle, not the Piriformis. The Psoas goes from your lower spine to the inside of your hip bone.

"On the lumbar spine, unilateral contraction bends the trunk laterally, while bilateral contraction raises the trunk from its supine position."

So that is why I have pain when I am rising up from lying flat on my back. But now that I know this, what should I do about it. This massage therapist is a wizard at finding and stretching the Psoas muscle when I am flat on my back. It is really hard to massage it yourself, though Clair Davies has instructions for it. So I bought a three-pack of massages by him. But what else should I do? My MFR therapist just deals with the fascia on the surface. I don't think she could do anything for the Psoas. "
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Reply #3 - 05/13/12  8:28pm
" Here's a beeyootiful drawing of the psoas muscle. This explains so much for me. "
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Reply #4 - 05/14/12  10:12am
" My pt has me use a ball on the psoas area. The ball is a yellow one, about 4" in diameter, that I received with a book I bought on self myofascial release exercises from two John Barnes therapists. He taught me to press with the ball, 2" to the side, and 2" down from the belly button. It must be helping because that pain is subsiding. "
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Reply #5 - 05/14/12  11:32am
" chimerical,
Your MFR therapist can definitely get to the deep muscles such as the psoas...and should be able to help with the pain in the short-term.
But in a long term way, to keep the pain from constantly returning, you need to work on strengthening the psoas in a lengthened state by working on bone alignment and pelvic stability and spinal mobility. This can be done in an extremely gentle way with the kind of pilates/movement work I'm now passionate about sharing.
If you're ever interested and are in NYC, I'm happy to get together and show you the kind of thing I mean...obviously I know your MFR therapist well and could consult with her so we're all on the same page.
Sharon "
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Reply #6 - 05/15/12  9:28am
" Yay, a little progress on this front. I went through the whole day yesterday without feeling this sharp pain. I have done 2 things that might have made a difference.

First I am training myself not to sleep curled up in a fetal position on my side every night, but instead push my feet down to the bottom of the bed. I have been doing this with a pillow stuffed between my legs, but that is a little bulky, so I might lose the pillow.

Secondly I have added a new stretch to my morning routine. I kneel on one knee (with a pillow under it) with the other knee forward and gently push my body forward. There is a picture on this site near the bottom:

I have also cut back on my other stretches: no more leg dangling below the bed to stretch the QL, and I do the cat and cow standing up so I just engage the upper body.

I do still have pain in the piriformis when I move side to side lying down. I'm afraid that it might have come from all the poking and prodding of it. "
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Reply #7 - 05/18/12  4:10am
" I have SI joint dysfunction along with the MPS and fibro. The pain activates trigger points in my glutes and feels like piriformis. It radiates to my hip and down my leg. I get chiro adjustments, massage, and sometimes steroid injections. I also use ice, hot baths, and a TENS unit. I hope you find what works for you. "
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Reply #8 - 05/18/12  9:23am
" Thanks, javagoat. Yes, my MFR therapist thinks it is the SI joint. But the GOOD NEWS is that the pain in that side of my butt has ceased! Maybe the SI joint settled into some sort of stability. Now I have pain in the other side of my butt. The whole area where the sacrum is is very tender. I bought some new Flector patches (expensive--my insurance does not cover it as it did before) to put on that area. "
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Reply #9 - 05/19/12  9:28am
" Whoops, I spoke to soon. It came back. On the way to the health club I felt it sitting on the subway, and also in the jacuzzi. A real sharp pain when I do certain movements. The only thing that seemed to stop it was leaning sideways over my right side, which is where the pain is. That is sort of mimicking my old bad posture with my left hip stuck out and hiked up.

Javagoat, can you say more about your diagnosis. Who diagnosed it and how? Did they say exactly what is wrong about how your SI joint works? "

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