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By Ethan Farr, Sports Myotherapist & Exercise Scientist Piriformis syndrome is characterised by pain and discomfort in the buttocks, typically caused by irritation or compression of the sciatic nerve near the piriformis muscle. It can also cause referred pain into the leg, including sharp or aching pain, pins & needles, numbness or tingling in the leg or foot. This is a condition we see often in people who cycle due to the position on the bike, but can also be seen in other highly physically active sports, too.  In over 80% of the population, the sciatic nerve runs deep to and exits underneath the piriformis muscle.
Early divisions of the sciatic nerve can predispose patients to piriformis syndrome, with these branches passing through either below or above the piriformis muscle. Runners, cyclists, and rowers are at the highest risk for piriformis syndrome due to their engagement in activities that involve pure forward movement. These activities can weaken the hip adductors and abductors, which are crucial for opening and closing the legs. The piriformis muscle can become tight from prolonged sitting, a common issue among working people, and this is particularly pertinent for long-distance cyclists, who are exposed to two of these predisposing factors. Additionally, the repetitive motion of cycling primarily engages the hip flexors and extensors while neglecting the hip abductors and adductors. This imbalance can further strain the piriformis muscle and contribute to its tightness. Furthermore, the posture adopted during cycling—leaning forward with hips flexed—can exacerbate the compression of the sciatic nerve against the piriformis muscle. This compression can result in pain, numbness, or tingling that radiates down the leg, mimicking symptoms of sciatica. For long-distance cyclists, who spend extended periods in the saddle and engage in pure forward movement, the risk of developing piriformis syndrome is heightened. The combination of prolonged sitting, repetitive motion, and muscle imbalance underscores the importance of preventive measures such as proper bike fit, regular stretching routines targeting hip muscles, and incorporating cross-training activities to maintain overall muscular balance. By understanding these predisposing factors and implementing appropriate preventive strategies, cyclists can mitigate the risk of developing piriformis syndrome and maintain their performance and comfort during cycling activities. How we can help: Myotherapy supports through the focus on addressing muscle imbalances, tightness, and overuse issues that commonly afflict cyclists due to the repetitive nature of their sport. Techniques such as deep tissue massage, trigger point therapy, myofascial dry needling, and myofascial release are effective in releasing tension in these muscles, improving flexibility, and restoring proper alignment. These therapies can enhance blood circulation and lymphatic drainage, which aids in the removal of metabolic waste products and reduces inflammation. This can significantly accelerate the recovery process after intense cycling sessions or competitions. By incorporating regular remedial massage or myotherapy sessions into their training regimen, cyclists can proactively manage muscle tightness and imbalances. This proactive approach not only helps in preventing injuries like piriformis syndrome but also promotes overall muscle health and performance efficiency. So if you would like to not only reduce any pain you experience or reduce your risk of overwork injuries whilst also improve your cycling performance make sure you book in with me for an assessment and to start your treatment plan. I'm available Tuesdays 8am-12pm, Thursdays 12.30pm-7pm, and Sundays 9am-3.30pm at Simple Wellness Myotherapy. We are located at Shop 12B/150 Kelletts Rd, Rowville VIC 3178 or you can call us on (03) 8204 0970 By Duke Autret Many, if not most people will have heard of, or may even have experienced sciatic pain or sciatica, but what is it exactly? Let’s explore. Sciatica is a term that gets thrown around alot but the fact is that it’s quite a vague term which is used simply to describe any condition where the symptoms involve pain running from the lower back down either one or both legs (potentially all the way down to the foot). Pain types can be sharp, shocking, tingly, numb, cause pins and needles, or cause pinching or catching sensations on movements.  So in fact Sciatica describes not one single condition, but rather a set of symptoms, and that these symptoms that we call Sciatica can be the result of a number of different mechanisms or conditions. To be more precise, Sciatic refers to the name of the nerves which branch out from origins in the lower spine/back and then splits into two Sciatic nerves - one for each leg, and thus innervates the muscles and structures of the legs. However this nerve can become vulnerable to irritation by pressure bearing on it from other structures, when this happens the experience is Sciatica! As mentioned before there can be a variety of reasons for this impingement on the Sciatic nerves and some examples can include pressure from a tight Piriformis muscle (which the sciatic nerve passes directly through or beneath), pressure from an Intervertebral Disc bulge/herniation of the lumbar spine (lower back), Stenosis which is the narrowing of the spinal canal, Spondylolisthesis which is the slipping of one vertebrae over the next and that can pinch the sciatic nerve, or Spondylosis, an arthritic joint degeneration at the lumbar vertebrae which may cause inflammation and subsequent pressure and irritation from that. As we can see, there are many ways in which the sciatic nerve can become impacted and the end result is the same experience and symptoms we call ‘Sciatica’. Some of these situations sound scary, but the majority of the time it is easy to get the pain under control while working with an experienced Myotherapist who can help guide you or refer you on if your condition is particularly acute or severe. Since the irritation that occurs to the Sciatic nerve is to do with some or other kind of pressure, then the priority for treatment becomes to create more space for the nerve to be free, as nerves also need to be able to slide and move with the rest of the body. Importantly, the treatment we use will be dependent on which of the various mechanisms are at play, but commonly any technique employed will be with the aim of creating more space for that nerve, and most often will involves treating the muscles of the lower back, pelvis, hips, glutes and back of the thighs and maybe even calves. Some of these techniques can include hands on options like remedial massage and myofascial release, or helpful nerve gliding movements that can help reduce the sensitivity of those nerves. And in situations where the symptoms are very acute, fresh and severe often Myofascial Dry Needling is a go-to in order to take the edge off and tone everything right down without adding any more undue pressure to the nerve/system. Myotherapists can also provide joint mobilisations to aid in better mobility of the lower back and hips. Mobilisations vary from manipulations - we won't be "cracking your bones", but gently encouraging rhythmic movement to return to your joints without any high velocity cracks or crunches. From here we would look at tailored exercises for your situation which could simply be stretches for a few key tight muscles to a full program to help build stability around the spine and support the structure for healthy nerve function. Some common exercises you might try could be deep abdominal work, diaphragm ‘weight-lifting’, the sphinx, Piriformis stretches, and Glute and Adductor strengthening. Our practitioners will demonstrate these types of exercises and how to safely do them while you're experiencing sciatica, and we can assist you in progressing them as preventative care exercises once the intensity of your pain has eased.  If you or anyone you know is currently suffering with Sciatic pain, please come and see us, we are here to help. Just call or leave a message with us at the Simple Wellness Myotherapy clinic here in Rowville, or alternatively you can see our booking schedule and make an appointment yourself for a time that best suits.
You might be familiar with that sharp, shooting pain sensation in your lower back, hip and leg. It can also be felt as numbness, pins and needles, tingling or burning type of sensations. Whatever way the pain or symptoms present, it runs along the Sciatic nerve - which is why this is referred to as Sciatica.
But did you know theres more than one potential cause behind this pain? Often this pain can be linked to muscle tension in the glutes and hips. The Sciatic nerve runs underneath the muscles of your glutes, and when it gets compressed there it can be a real pain in the bum - literally! Because this nerve runs all the way down to your feet, the jolts of nerve pain can sometimes be felt anywhere from just localised in your buttocks and hip, to the back of your thigh, behind the knee, straight down your lower leg and even into the base of your foot. The Sciatic nerve can be impacted at the root of the nerve near the spine, however this doesn't always mean there will be pain. Often this is called a Bulging Disc or Herniated Disc, but you might be surprised to learn that even though "Bulging Disc" sounds pretty awful, studies have shown that more than 50% of people over 40 with no pain symptoms at all can have a disc bulge show on scans. Irritation or compression of the Sciatic nerve can be common after serious trauma to your leg or lower back. Things like car accidents, falls, and horse riding accidents are all common high impact incidents that can aggravate the nerve. If you've had an injury like this, its wise to seek treatment for it. Do you have Sciatic nerve pain or nerve symptoms of numbness, tingling and pins and needles? Book an appointment with us to have an assessment and treatment. If we can resolve the issue, we'll create you a treatment plan that includes manual therapies and a take home exercise program. More serious causes do exist, so if treatment of the muscles and joints is not relieving your pain, we'll refer you to see your GP to rule out any serious structural or pathological conditions. |
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Shop 12B/150 Kelletts Rd, Rowville VIC 3178 |
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