Piriformis Syndrome: A Literal Pain in the Butt

First of all, thank you for the kind, supportive comments on my last post. Dropping from a race is never fun and certainly not something any of us set out to do. But, shit happens. I am 100% positive it was the right move and once I accepted that, I got over feeling sorry for myself pretty quickly.

On the car ride home from the race I was already furiously Googling to find out what my issue might be. After typing in my symptoms it didn't take long for me to land on Piriformis Syndrome, which the doctor confirmed for me this morning. The Piriformis muscle runs horizontally across the butt and the sciatic nerve can pass in front of it, behind it, or even through the muscle in about 10% of people.

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When the Piriformis muscle gets inflamed it can press on the sciatic nerve, which can cause pain to shoot down the back of the leg. All of this would explain the knot I felt in my butt during the race and the spiraling tightness moving from just below my butt down my hamstring. Piriformis Syndrome also explains why I was in so much pain just from driving in the car. While it can definitely be a running injury, Piriformis Syndrome can also be brought about by extended bouts of sitting (aka what I do every day at work and most of the weekends when I'm not running).

I still have no idea why the muscle got inflamed when it did. I didn't have a traumatic injury prior to Labor Day weekend when it started hurting nor did I tweak anything while running. The good thing is that I started stretching it as soon as I got home on Sunday, following some of the treatment exercises recommended online. Self-diagnosis is definitely something to be careful with, but in this case I just kept doing what felt good:

• Pigeon Pose has been great at relieving some of the tightness
• A great video about neural flossing for Piriformis Syndrome can be found here: http://www.youtube.com/watch?v=tFtUgS69rPk&feature=fvw
• In addition, I bought this from Trigger Point. I have their foam roller and love it. Like the foam roller, this massage ball is no joke. I have been rolling it between the wall and my butt and it has relieved a lot of the tension.
• I've also been doing many of these exercises (below)

  

  The Figure-4 Gluteal Stretch  and Standing Hamstring Stretch have been especially effective
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After two full days off, I ran four very slow miles on the treadmill on Wednesday. They felt good and I did ample stretching before and after. On Monday I will start PT again for what seems like the millionth time. But, I'm more than happy to go back if they can teach me a few new things and help make sure that I really kick this thing to the curb for good.

The most annoying thing about Piriformis Syndrome has just been that sitting makes me feel very nervous. This is sort of a problem since my job requires me to sit at a desk all day. I've tried to make sure I'm sitting straight with my feet flat on the floor, but all I really want to do is this:

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Injuries totally suck, but thankfully I caught this one early. Also, if I'm going to have an injury, at least a butt injury is pretty funny. :)

D to the N to the F

I'm not even sure how to start this post. It's one I hoped I'd never have to write. Sadly I had to drop out of the Lehigh Valley Marathon yesterday around mile 13.5. My first DNF.

Looking back at this summer's training cycle, it hasn't necessarily been bad. The only bad thing about running this summer was that I felt incredibly slow and sluggish on nearly every run. I don't really attribute that to anything but the weather though. Summer heat and humidty + running just don't mix for me.

So, other than feeling like a sloth, running went pretty well over the past 12 weeks. I got through my long runs feeling fine. I haven't had any ITBS problems that plagued me over the winter and early spring. In fact I made it all the way into my taper until I started feeling some discomfort in my right hamstring. It started acting up badly on Labor Day weekend, a week out from the race. I first noticed the cramping after sitting on the couch all weekend and then again at my desk the next week. By Tuesday evening I was in pain just walking around and bending over to touch my toes. I began to get worried, but it wasn't really affecting my running, so I was still on board to run the race.

Wednesday night before the race I got a really awesome sports massage. The masseuse sat down with me for a full 10 minutes asking lots of questions about what was hurting. He spent a majority of the time on my right leg and by the next afternoon it felt like a lot of the kinks had been worked out. On Saturday morning I did a short shake out run for the race on Sunday. I noticed a little cramping after the 3 miles and once again began to worry if I would be able to run the race. After my shake out run, I drove two hours round trip to the expo to pick up my packet. Keeping my right foot on the peddle for that long was causing intense cramping in my hamstring and butt. I had to take 5 minutes to stretch out before I got back in the car after getting my packet. I spent the rest of Saturday relaxing and stretching the crap out of my legs.



Pre-marathon dinner: Red Snapper, brown rice noodles, and baby Brussels Sprouts that I got way too excited about when I found them

When I woke up at 4:30 am on Sunday things felt pretty good, but I couldn't help feeling like I was not going to cross that finish line. We drove out to the start line, about an hour a way, and I was already in a pissy mood. It was 90% humidity, which is really less than ideal marathoning weather. On top of that, I started regretting signing up for a race that I knew was going to take place mostly on a toe path along the river. Don't get me wrong, I love a good scenic race, but I've been doing almost all of my running lately on the toe path in Philly. The combination of the lack of crowd support and the swampy weather was making me none too happy, but I had already decided earlier that week to just use the race as a training run and not stress myself out about running fast. An opportunity to practice pacing after the disaster in May.

Don't let this smile fool you. Fake energy.

As soon as the race started and I began running I felt off. I wasn't in pain, but I could already tell my legs, breathe, and mind were not in sync. Some days you get going and you just feel awesome. Other days you just know you're not with it.

Sure enough around mile 2 or 3 I began to feel some discomfort in my right hamstring. It wasn't painful discomfort though. I tried to get my mind in the game, but I must have thought about quitting at least five times for every mile. Rarely do I deal with so much personal negative energy when I'm running and here I was wearing my don't-talk-to-me bitch face while everyone was pumped up and smiling around me.

As the miles ticked by I made myself stop thinking about a possible injury DNF. "If I think its getting worse, I will stop," I told myself. Instead of  thinking about my leg, I focused on how bored I was. Bike path, toe path, more bike path, more toe path and over and over and over. I was basically just running angry the whole time.

Around mile 10.5 I noticed my leg acting up a little more. By mile 11 I realized that I was not going to finish the race without really messing my body up. The cramping was into my butt by then and both knees were hurting. I finally made the decision to DNF at the halfway point and amazingly, after spending five days leading up the race wondering if I would make it and spending the previous 11 miles hating everything about the race while also fearing I would have to drop, once I finally made the decision I only felt one thing - relief. All the back and forth in my head stopped and it just got quiet. Dropping from a race was a weird experience. I ran through the halfway point and then just pulled over to the side and stopped running. Just like that it was over. I found race official and eventually got a ride to the finish line to meet Mike.

Even though I was absolutely sure I had made the right decision, I still cried like a baby because I felt like a failure. Part of me wonders if I would have kept running if I wasn't injured. I was already having such a bad time that the thought of running another 13 miles on the toe path seemed even worse than trying to run through an injury. This is my third big race in a row that I've gotten injured during or right afterwards and I'm beginning to feel cursed.

The good news about all of this is that at least I finally have enough self-discipline to know when to stop. There are several other races I am excited about running this fall and finishing a race I wasn't even enjoying would not have been worth it.