Monday, January 24, 2011

addressing the hip issue

Many of my clients including myself suffer from what's commonly called piriformis syndrome. The piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve, causing pain in the buttocks and referring pain along the course of the sciatic nerve. This referred pain, called "sciatica", often goes down the back of the thigh and/or into the lower back. Patients generally complain of pain deep in the buttocks, which is made worse by sitting, climbing stairs, or performing squats. The piriformis muscle assists in abducting and laterally rotating the thigh. In other words, while balancing on the left foot, move the right leg directly sideways away from the body and rotate the right leg so that the toes point towards the ceiling. This is the action of the right piriformis muscle.
I've found that in addition to stretching and myofascial release, strengthening of the adductors, extensors and flexors of the hip have been a great benefit. I do this by simple using ankle cuffs with a rubber band attached. I do the following program every 3rd day and stretch the piriformis, perform myofascial release on the glute medius, piriformis and I.T. band daily.
All the following exercises are done with the ankle cuffs on

1. Side step slowly for 10 steps in each direction, paying special attention to the foot stepping inward (that would be the left foot while moving to the right), this is a good opportunity to allow the abductors of the leg to work eccentrically. Do 3x.

2. Work the extensors of the hip by doing leg lifts (these are for your glutes, so your heel is moving backward toward the ceiling, I recommend leaning on something in front of you to keep your balance. Go slowly, try not to allow too much slack in the band as your heel moves up and down and really try to keep your hips square, this allows your glutes to work more effectively. Do 3x

3. Work the hip flexors by lifting the leg in the opposing direction, your toe is now moving toward the ceiling. All of the same rules apply, especially squaring of the hips, but this time place your back against a wall so you can support yourself in the squaring of the hips without over compensating. Do 3x.

I'm finding this routine very beneficial in terms of pain management and increasing my strength and awareness while running. I have a goal of 25 miles a week this summer (that's outside, so the pounding increases exponentially) and I know the only way I'm going to get there is to keep my hips strong and healthy. I'll keep all updated with progress as life rolls on.

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