Saturday, February 14, 2015

Down But Not Out

Limping out of the office, two things were abundantly clear:

• I forgot to put on deodorant that morning. Apparently basic hygiene becomes complicated when I'm not living out of a gym bag.

• I am suffering from classic piriformis syndrome.

Neither "revelation" was particularly great (though one could be solved more easily) but I did feel more hope than I had in the past 48 hours, after my right glute seized on Wednesday's run. Those hours had been filled with pain-filled steps, tears from said steps, frustration, tears of frustration, 3.421 episodes of "Property Brothers" and frantic Internet searches that alternated between piriformis syndrome and sciatica.

Dr. Google diagnosed me with sciatica by Thursday night. It might have been the shooting pain when I went up steps or the fact that an amazing massage by JC on Thursday helped for all of 3 minutes, when my glute seized again on the walk out to the car.

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Silly old me was sure that the session with JC, who looked a bit like Michael Clarke Duncan, would be the miracle I needed. I was sure his stature meant he had the strength to get into the problem and his initials ... hello, JC – just like another miracle worker. He wooed me with tales from studying in China and a grandson named Miles. Fate? I think so. The massage was great but it just wasn't the answer. (If you are local and need a recommendation, let me know.)

The sudden onset, too, had me leaning toward sciatica. I had not experienced any pains in the butt save from hip bone soreness, equal on both sides, prior to the run. Le behb could have easily moved, got on my nerve and caused the problem.

Friday morning, I called the office of my doctor/midwife. I was hoping they would have some good drugs but instead they referred me to a therapy practice in Fort Wayne that focuses on women. The therapists specialize in pelvic floor problems and other issues that arise during and after pregnancy. I was dubious at best, as my previous physical therapy experience didn't have me sold. You spend a whole lot of money to have someone watch you stretch. You are told to do those stretches at home and then go back the next session to have them watch you again.

Note: I know it's more than that. I have not lost it ... not completely.

But I was desperate and needed answers, so I went.

The appointment was fairly standard – including the half-hour wait. The therapist, who was being shadowed by a student, guided me through a series of assessments, which included engaging the transverse abdominis, bending forward, bending backward, lifting knees and reaching side to side. We reviewed my symptoms, where the pain was located and at what level during each test. Afterward, the therapist asked the student what she thought.

"It's just like the pregnant woman we saw before," she said.

"Classic piriformis syndrome," the therapist replied.

So, I'm not the only one, eh?
The piriformis is a small muscle that lies under the gluteal muscles in the buttocks region. When this muscle goes into spasm or becomes hypertonic, it may compress the sciatic nerve, causing low back pain or numbness that radiates down the leg, and is generally felt only on one side. This condition is known as piriformis syndrome. Other symptoms may include a deep pain in the hip or buttock, tight and painful hamstrings and calves, and tense pain and decreased range of motion in the hip. ... 
During pregnancy, the pelvic floor will shift gradually to accommodate the baby as it develops in the womb. While in the early stages of pregnancy, the body releases a chemical called relaxin, which relaxes the pubic symphisis (pubic bone), surrounding ligaments, and joints in the pelvis. The release of the relaxin allows the entire area to widen, allowing an increase of space for the baby. This can increase stress and strain on the sacrum (tail bone), where the piriformis attaches, causing the muscle to tighten over time until it is in a constant state of contraction.

Piriformis syndrome can also develop during pregnancy due to postural deviations caused by the weight bearing changes affecting the woman’s body. Often, because of the added weight of the baby, the mother will develop an anterior pelvic tilt. This occurs when the pelvis begins to shift forward with the weight of the baby in a way to compensate for balance. As the pelvis tilts forward, it causes the piriformis to tighten around the sciatic nerve. {Source}
Oh so many lessons from my personal training exam just come flooding back ...

Given the explanation, I'm not 100 percent surprised. I had been having discomfort in the groin area that I attributed to the relaxin in the area of the pubic bone. The pressure there probably caused the piriformis to contract.

The therapist was confident that within 4 to 6 sessions with her, along with twice daily exercises and stretches, that I will be pain free. I cross referenced her prognosis with running friends who had similar problems and they confirmed the short recovery time. I'm hesitant to be all rah-rah, let me be healed, but I have to trust in the process.

And, I already feel a smidge better with the stretches and short treatment she gave me. It's nothing to write home about (although enough to share with the Internet) but it's noticeable. I limp when I start walking but can eventually transition to a waddle. It even feels manageable after a few laps around the house.

Surprisingly, my greatest concern is not running. I know that I won't be running this weekend and maybe not even next week – and that's OK. But I am trying to figure out how I can still teach my classes at the Y. I am cleared to exercise as long as it doesn't hurt/cause additional pain. I can squat without pain and do upperbody work but added resistance like, say, a barbell could be problematic. If I have to cancel class, though, I will.

We have to put our best butt back after all.

5 comments:

  1. Any injury is frustrating, but I'm glad to hear this one is something you can deal with fairly quickly. Hooray! I know you have a couple pregnant runs in you yet ;-)

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  2. Yikes, I hope you feel better soon!! And if it makes you feel any better I forgot to put deoderant on before work one day last week, but thankfully our hospital has a Walgreens located in it, so I was able to get a back up deoderant for my drawer at work, LOL!

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  3. I forgot to brush teeth this morning, not just mine, but Emilia's too, as we do it together. I didn't realize until I was strapping E into her carseat and I got a whiff of her rank morning breath. breath mint?

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  4. I am happy you got some help and it's starting to work! Hope you didn't have to cancel class!

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  5. Oh man..I hope you and your ass feel better soon!!!! Good luck!!! ;)

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