Deep Buttocks Revisited
So I probably would have returned those shoes if I hadn't already gone and run in the mud with them, especially since they seem to press on the top of my foot in an uncomfortable way, but instead I've just gone back to my old shoes the last couple of days and will experiment with an alternate lacing technique to try and loosen the front of the new shoes a bit. It's definitely something important to figure out though as I hit 60 miles this week and I'm definitely feeling all the familiar old aches and creaks that come with abusing myself thusly.
Speaking of which...it seems a good time to reprise an entry from a couple of years ago regarding a little something familiarly known as "deep buttocks syndrome". This is apparently another name for Piriformis Syndrome though you wouldn't know it from the fact that I spend a good chunk of the fall of 2002 on crutches going from orthopaedist to physical therapist complaining about how it really hurt really badly really deep inside my right butt cheek. Deep? Inside my buttock? Anyone, anyone?
Well, no. I finally just stumbled across the phrase in a letter to the NY Road Runner's doctor in their magazine and had an immediate eureka moment that honestly changed my life, at least in regards to running. This debilitating ache that started somewhere buried in my big rear end muscle would spread up into my lower back and around my hip and down my leg and at its worst, would actually prevent me from putting any weight at all on the affected side. Terrible, terrible stuff.
I recently went to that Bodies exhibit down at South Street Seaport mainly to get a closer look at some of the actual tissues and ligaments whose names have become such a daily part of my vocabulary and the piriformis display had a huge chunk cut out of the gluteal muscle so that you could see the sleek little horizontal band of muscle that causes so much pain and is such a pain to get to. It runs right atop the sciatic nerve, so it's easy to see how it becomes more developed and taut it would press down on things you don't want it pressing on. As for the exibit itself, it certainly was interesting getting a first hand look at the mechanics that I spend so much of my free time trying to improve, but I'm still feeling a little haunted by the worry that all of those muscular, youthful looking specimens are actually Chinese political prisoners and Falun Gang members who were "volunteered" by their government into this new post-life career as physiology instructors.
It's definitely a persnickety muscle that some people are ergonomically destined to struggle with in a chronic way, but I have found a few stretches that definitely get to the heart of the matter and usually give me immediate relief from the pain and tightness. Two fellow running bloggers who have both recently given birth have mentioned injury issues that sound like what I experience when I'm having piriformis problems, so it could be something that women are particularly prone to post- pregnancy.
Anyway, I will try to describe as best as I can the stretches that I've found most effective for dealing with a stressed out piriformis muscle.
 | This one is done lying on your back, not floating upside down as the drawing might imply. I like to do this one first thing in the morning before going running. It works well as a maintenance stretch. The looser the piriformis, the wider you'll be able to swing your knee out. Really concentrate on pressing your lower back into the ground as you do this stretch. Wiggle your weight around to find the best position, but if it doesn't ache at least a little, you're probably not targeting the right spot. |
I've altered this next one a little since I drew the picture, but it certainly still be done lying on your back. I've found though that it's even more effective bending the affected leg across your body while lying on your stomach, so that your body weight aids in the stretch. If you extend your upper body forward while you do it, it targets the piriformis a little better and allows you to control how much strain you put on your hip and lower back.
| I accidentally found this stretch while tying my shoe one morning. Bend down from the waist as if to tie the shoe on your unaffected side while bending the knee on that side slightly. Then tilt your hip on the achy side up as high as you can, imagining that you're sticking the sore butt cheek up in the air. Again, you might need to wiggle your butt around a bit to hit the right spot. I usually do this one right before I head out the door. I think I'd avoid actually doing this one in public! |  |
As for using the foam roller, all that involves is just sitting on the thing. Put all your weight on the sore side and kind of roll forward so the roller hits your butt muscle a bit higher than where you would comfortably sit on it. It's a little tricky because I think the gluteus muscle naturally tenses a bit to protect the sore bits underneath, but you should be able to find the hard lump that is the tensed up piriformis underneath. Rather than roll over it, just shift your weight sideways back and forth or just keep constant weight pressure on any sore feeling lumps until they relax a bit. It's not always easy to find the right spot with this, but then sometimes I'm able to find a good piriformis pressure point just sitting on a hard wood floor. Like I said, it's persnickety.
The good thing, I've found, is that once you find a few stretches that work for you, they seem to fix the problem quickly and after that it's just important to keep up a maintenance schedule of stretches to keep the piriformis loose. I still feel twinges from it every few days, but never to the point where 10 minutes of stretching doesn't make it go away completely. Good luck to anyone who's struggled with this, let me know if any of this helps or if anything needs clarification.