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Old 07-03-13, 04:51 PM  
Join Date: Jan 2008
Location: S Coast of England, not far from Brighton.
Piriformis syndrome, SIJ problems & sore achilles

I've been seeing a PT for Piriformis Syndrome, including some sciatic pain and lower back pain. I also have SIJ problems that flare up and a sore achilles tendon, all on the right hand side. I've had 5 sessions with the PT for the PS problem and she massages the area, stretches it and has me do piriformis and hamstring stretches on the right side.

Has anyone had anything similar? I'm getting very frustrated at not seeing much improvement. Is there anything else I should (or shouldn't) do? Any strengthening things that might help. It seems strange that it's all on the right side, although the PT doesn't seem to think the achilles soreness is linked. My cardio is limited at the moment because my lower back feels almost "jarred" and because of my achilles, and I'm so frustrated.

I feel as if something is just "out" in my back, so I'm wondering if I'd be better off seeing a chiro or osteopath?

Help! Thanks,

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Old 07-03-13, 05:16 PM  
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Join Date: Nov 2001
Location: In the woods near a river
I'm sorry you're suffering with this. My problem is very similar to yours except for the achilles problem. I went to PT and in 3 sessions I was in more pain than I started with. I went to a chiropractor and in 3 treatments was almost as good as I'll ever get. I have arthritis in my back and hips so I usually have pain no matter what I do but the chiropractor does magic on the low back, sciatica and SIJ.

One thing I've noticed over the years of chiropractic is that my right side pain is almost fixed with adjustments to the left. I stretch both sides because I never know which side or which stretch might make me feel better.

We don't have an osteopath in the area or I'd be going to him/her.

Don't give up!
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Old 07-03-13, 05:22 PM  
Join Date: Aug 2005
I found deep tissue massage, and doing no-impact workouts, to be the most helpful for the piriformis. Chiro always felt good, but was not a permanent fix. I truly believe the massage (very painful but worth it it) basically cured me. I have very little piriformis pain now. I can even do high impact workouts now after several years of strictly low impact.
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Old 07-03-13, 05:34 PM  
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Join Date: Jan 2002
Location: Northern Calif
A friend of mine who is a longtime runner is being treated for similar issues. They told her a lot of her problem is due to lack of core strength, so in addition to seeing the PT, they have her doing one-on-one sessions with a Pilates instructor and recommended she work with a trainer at least in the short term to make sure she's not getting lazy with her form in strength work. It has helped her not be in constant pain, but it's slow going and she's very frustrated that she can't run as much as she's used to, since it's a psychological thing for her as well as a workout.

Good luck!

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Old 07-04-13, 01:42 AM  
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Join Date: Jun 2012
Location: Netherlands
I have too much mobility in my SIJ and the sacro wedgy helps me get things in line. I see a massage therapist every week, but the sacro wedgy aligns me in a way that humans cannot. Plus after the initial investment, it's free and I use it almost daily. The recommendation is 20 minutes per session, but I feel things slide into place after about 5.

I also have a tight piriformis that causes problems for my lower back. Self-myofascial release with a ball releases it. My massage therapist does trigger point therapy on me and he showed me the point to release. I have heard that people use lacrosse balls, but no one here plays lacrosse so I use a field hockey ball. It's quite hard and the release is a bit painful, but it's over quickly and the relief is immediate.

Your achilles tendon pain may stem from any of the other problems or it may be related to a tight IT band. Katy Bowman also has some interesting stretches and now has alignment "snacks" for $5 on her website ( The only one that might be relevant is about standing muscles, but you feel it most when standing so stretching and strengthening that kinetic chain should help.

This is the kind of pain that interferes with every day life. It's hard to be happy when everything hurts. I hope that you find a solution.
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Old 07-04-13, 09:20 AM  
Join Date: Jul 2009
Location: St. Louis MO
Piriformis, IT Band

I have had problems with this too. So far what I have been doing is:

1) sitting stretch -- sit on edge of chair, back straight, L ankle on top of R knee. hold 30 seconds. repeat 3-5 times. do other leg.

2) use a massage tool to massage that area. it will hurt. also massage up and down outer thigh for IT band. then use either ice or heat, whichever gives most relief.

3) stretch that seems to help both hip flexors and IT band: put towel around R foot, hold onto both ends of towel, slowly bring R leg up w/ bottom of foot toward ceiling, then slowly stretch out L leg, heel leading, until both legs are straight, hold. repeat 3 times, then do other leg.
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Old 07-04-13, 12:48 PM  
Join Date: Jan 2008
Location: S Coast of England, not far from Brighton.
Thanks for all your great suggestions. I keep debating about getting a sacro wedgy. I can't seem to find one in the UK though, so I'm trying to find an equivalent over here. All the IT band suggestions are great too. Thinking about it my IT band does feel much tighter on the right hand side and I hadn't thought about a connection with my achilles. I'm going to add in more IT band stretching and see if it helps.

Thanks everyone

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Old 07-04-13, 01:19 PM  
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Join Date: Apr 2013
Location: Western WA
I too have SI issues but mine are because the right SI joint locks and doesn't move. I have to have it manually adjusted by a chiro or PT. My x-ray showed some arthritis in the area and that's probably why. Curious if the wedgy helps to unlock SI joints? Of course I had pain initially because I had done some higher impact stuff (went snowshoeing) on a locked SI joint and therefore all the area got sprained. The pain was one thing but the lack of mobility was really the worst. All lateral movement was painful and difficult and my right leg just didn't move like it was supposed to. My PT nixed all impact for a couple of months and then eased it in slowly.

It is frustrating and I really feel your pain. I can't imagine even the more pain you have on that one side. My condolences.
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Old 07-04-13, 10:51 PM  
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Join Date: Jan 2003
Location: Western North Carolina
I have piriformis syndrome. I definitely feel your pain. It has been really bad this go round. I had it last year and it went away for about a month, then came back with a vengeance and that is where I am now.

The first PT had me doing strength work and some stretching (strength in abductors, hips, core). This helped immediately. Then this time the strength work seems less helpful probably because I'm not weak in those areas anymore after all the work I've been doing. Now her colleague has me backing off the strength work and stretching and this week using a TENS unit to help the muscle relax. That is somewhat helpful. I also have a fabulous masseuse and will increase the frequency of my appointments. I also am using a foam roller twice a day on glutes, hips, IT band. We'll see were we go from here. I am really slowing down. I haven't stopped workouts entirely as I actually feel worse in the piriformis when I am sedentary but I am really taking it easy and am pretty limited.

Could someone tell me about the sacro wedge? I am interested in it. Is it really helpful?

I don't have any experience with chiro or osteopath. Sorry, I can't help with that. It never hurts to get a second opinion about what to do, so you could try another PT. I think there are some bad PTs out there. When I went for my knees years ago, I saw 3 PTs I thought were bad before I found one who knew what he was doing.
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Old 07-04-13, 11:15 PM  
Join Date: Jul 2009
Location: St. Louis MO
Hi ncl,
would you mind sharing with me what the strength exercises were that your PT had you doing for piriformis?
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piriformis syndrome

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