Hip problems - Piriformis

[Riccal]

A quick appeal to Ppruners - has anybody suffered from this, what caused it, did you recover and how do you ensure the problem doesnt arise again.

There seem to be lamentably few stretching exercises as a prophylatcic.

Im quite heavy (100 kilos plus) and play racketball (European version). Used to be a good squash player - premier county team player - but jacked it in about 7 years ago and took up racketball 8 months ago to celebrate giving up smoking at the age of 52 (yeah, Im surprised to still be alive as well).

Anyway, this problem with the Piriformis muscle which attaches the hip to the base of the spine is threatening my ability to keep playing. The muscle impedes the sciatic nerve so resulting pain is not only hips but through the legs as well.

So, anybody had it and go over it. Tell me how please!!

Rick

[Charlie Foxtrot India]

Have you seen a specialised sports doctor if it is sport related?

I have had hip problems for years since a bad leg injury and was told by various docs and physios and podiatrists I had trochanteric bursitis, a tight ITB and that other one that sounds like a type of coffee...tensor fascia latae or summat, labral tears, having orthotics in my shoes etc etc...they were probably all partly right as I do have significant leg length discrepancy but there was no improvement with all their treatments. Even cortisone jabs made little difference.

It took a specialised sports doctor to diagnose, by MRI, that I actually have osteoarthritis.

Spose what I am saying is hips are pretty complicated and it took the sports doc and his understanding of my particular sport (karate) to get the diagnosis right and ensure I could keep on doing it with minimum pain, although a total hip replacement is inevitable eventually.

[Riccal]

Im actually in the process of a specialist consultation now.

I actually thought that it was my hips going and that I just had to resign myself to replacement surgery in the near future. However, the general prognosis is good in that it isnt my hips but a muscle (piriformis) that attaches to the hips that is causing the trouble. Problem is that the sciatic nerve runs behind it and tends to get trapped which is what has happened with me. It is one of those areas that is not easy to stretch but deep massage will break the scar tissue down and release the sciatic over time.

Sounds like you had a hell of a lot going on. Hope you have a bit more mileage in you yet before you need to do anything radical.

Rick

[RPness]

Hi,

@CharlieFoxtrottIndia

If a doctor tells you about anything that leads inevitably to a surgery of any kind, in your interest, double check it with someone else, favorably someone who doesn't know the first diagnosis and his author.

Speaking as a long term physiotherapist (along other qualifications) I can tell you that there could be _much_ less surgeries in this field when there would be a real diagnosis that searches for the problem's origins and that doesn't feel satisfied once there is a "we have tried something, now there's only one thing left"-mentality.

I don't want to criticize your doctor, I just want to remark, that there's often more than one thing to think about in these things, and just that cortisol didn't make a difference and just that you're active in sports doesn't mean, you're ruining your hip...

Kind regards,
Peter

PS: Riccal, you've got a pm

[David Horn]

Idle question... you're not carrying your wallet in your back pocket, are you? Even if it's thin it can provoke piriformis-like symptoms if you sit on it all day.

[Riccal]

Thats not that idle a question actually. It was asked by the physio that I am speaking to at the moment and as a result I take my wallet out now when I sit down.

I am oddly quite happy about the whole thing in a perverse kind of way really.
When I played squash I played in a county premier league in a 5 man team and I would play middle order. Not a bad standard but obviously not a patch on national or international players. That was at 40 years old and about 200 lbs in weight.
I sorta gave up cos I reckoned that my playing ability had deteriorated so much that I couldnt see the point of playing anymore. Stoopid huh?
I have taken up racketball 8 months ago at the age of 52 and having just given up smoking. I also weight about 25 lbs more than when I gave up the sport. Racketball is less high impact and more aerobic than squash cos the ball is a lot bouncier and doesnt die so easily. One of the guys I play is 10 years younger than me, about 50 lbs lighter and was knocked out of the quarter finals of the British Open over 40s racketball competition. This guy beats me but only just.

On this basis Piriformis is kind of a medal (my wife finds this as stupid as you lot undoubtedly will as well.

Riccal

[Charlie Foxtrot India]

@RPness, thanks for the advice, The sports doctor was the last resort after I'd tried physio, podiatrists, cortisone etc and it was the physio who referred me to him. The MRI showed chondral wear and subchondral cysts with surrounding oedema. Tendons, ITB, TFL and bursae were in fact normal, and no labral tears. The physio was telling me I had to stop martial arts, the doc said do it as long as you want to, stop if it hurts; it won't make it any worse. No-one is pushing me into surgery, the doc just recommended glucosamine and panadol, but that the long term prognosis will be a THR if/when the pain becomes debilitating.


I've started daily glucosamine (was sceptical, but have seen it do wonders for my elderly dog) and omega 3 from flaxseed, (fish products make me ill). Have stopped physio and put the orthotics away. Since then have done two gradings and won a medal, and hip snaps have gone from several a day to one a week or so (the snap is a stabbing pain that leaves me breathless and nauseous for a few seconds, horrible) So maybe I'll keep going for a few more years on just a few things I can get from the health food shop and loads of non aggravating excercise. :)