Photo by Eric Schmuttenmaer
Imagine running in a race and just as you think you see the finish line you realize after getting a little closer that it’s just another mile marker along the way to a race without an end. Psych! That’s how I’ve been feeling lately.
For 9 long weeks now, doctors, therapists and I have all been searching and poking and prodding and x-raying and trying to figure out why my right butt-hip-hammy-lower-back is so tight and causing me sciatica. In my last diary entry, I outlined all the diagnoses I’ve had up to that point: piriformis strain, lower-crossed syndrome, bulging disk.
For the last couple of weeks I’ve been operating under the assumption that my back is the culprit, even though I really never had any back pain. I regularly swing two rather heavy youngins around and don’t have any problems. I have to say after hearing it was likely my spine causing my problems my back started hurting and I was petrified of straining it further.
On Friday I went for my first physical therapy session. The therapist had me do a bunch of different range of motion tests and none of them indicated I had any problems in my spine. I was doing almost full-on back bends and experienced no pain or limited range of motion.
Next, she poked around the muscles and discovered that my piriformis is still very tight. She worked out some knots and definitely felt loosened up. Based on that she said she was fairly certain my sciatic pain was caused from my tight piriformis and not my spine. Allelujia! Suddenly my back stopped hurting and has felt fine since!
The physical therapist’s opinions were corroborated by my amazing massage therapist who spent the entire 75 minutes investigating my right side. She agreed it is highly unlikely the problem is a bulging disk or anything else in my spine. She found more knots in my piriformis, my psoas and another muscle that has never ever been attended to, the iliacus muscle. The iliacus in particular was a horrid awful knot. I didn’t realize that the sharp pain I had been feeling in my pelvis shortly before I became injured was from that muscle. Summarizing, the muscles in my upper right leg were still a bit of a mess, two looooong months after the initial injury.
Here’s something kind of funny and why my ART doc became concerned I had a disk issue. About 4 weeks post-injury ART doc was certain that my problems were caused by my psoas which caused a chain reaction that led to my pain in my butt. This is the whole lower-crossed syndome thingee. Anyway, to fix the lower-crossed syndrome I needed to work on strengthening my glutes. ART doc recommended I do some single-legged squats among other exercises and to lay off of running for a week. Since I wasn’t running I did a TON of single-legged squats in the hopes I’d REALLY get those glutes nice and strong and I’d be up and running quickly.
Onto week 5 post-injury. After the week of no running and ton o’ single-legged squats was over I started running and sadly felt like my whole right leg was one big knot. It was frustrating and when I told ART doc about it he became worried about my sad lack of progress. That’s when he suggested a bulging disk might be the culprit.
Ok. Back to Saturday’s massage at 8 weeks post injury. As my massage therapist worked her way down my leg she noted that almost all the muscles on the outside of the leg were really tight. She asked if I had been doing a lot of balancing on one leg. DOH! It all started to make sense.
At week 5 when ART doc and I both thought I wasn’t making any progress even after the treatment for lower-crossed syndrome, I probably actually was making a lot of progress but silly old me WAY over did it on the squats and probably was wrongly doing them too (using bad form).
So here’s what I currently think is going on:
1. I have a piriformis that is really angry at me after months and months of running on it while it was sore.
2. The sciatica is caused by the angry and inflamed piriformis.
3. The piriformis problem did not happen in a vaccuum and is likely caused by the psoas and the iliacus muscles which caused a chain reaction leading to the pain in my butt (my tight calves may have been the marble that toppled the domino rally, but we can never really know that for sure).
4. I can’t do single-legged squats without someone lording over me making sure I do them with correct form and I probably should never do upwards of 100 a day. DOH! and DUH!
Now what? I have my follow-up orthopedist appointment today and I am going to see what he says about things. I have another physical therapy appointment on Friday and the therapist can check to see whether my muscles have tightened back up and to check my progress with my therapy. After that I have a follow-up with my massage therapist later the following week to go over all the muscles and see which ones are being stubborn about staying unknotted.
I am debating going in to see the ART doc to treat the iliac muscle early next week. I feel like I really need to be running at least a little bit soon so I can start feeling what’s going on. I will behave until I speak with the experts.
It’s now 9 weeks post injuryand I am definitely skeptical after several disappointments along the journey so far, but maybe I just might see the finish line way out on the horizon.
Posted by Salty. Check out more at Salty Running.