Piriformis Syndrome? MAYBE NOT!

Pain in the butt? Do you think you have “Piriformis syndrome” but no matter what you do to your piriformis (stretch, roll, ball, etc) the pain doesn’t go away? Maybe you are addressing the wrong muscle? I’m here to shine some light one of the other lateral rotators of the hip…the Quadratus Femoris. This sneaky little muscle can have symptoms similar to that of the Piriformis. You can see from the picture that the sciatic nerve sits on top of the QF whereas it runs underneath the Piriformis. The QF has a pain pattern that mimics the Piriformis (I.e. ‘sciatic’ like pain), it can also mimic insertional hamstring tendinosis. It can also appear like acetabular and / or femoral impingement symptoms. It is most active in the gait cycle when weight is taken on the same side of the muscle and increases activation with running. It is best stretched when the leg is abducted (taken away from the body) and internally rotated (toes in position). When Trigger Points are treated in this muscle, the symptoms of pain can be abolished and range of motion, hip flexibility and gluteal strength / balance can return.

The Unexpected, Sneaky Cause of Muscle Pain

The Unexpected, Sneaky Cause of Muscle Pain

Real Simple, October 2019

Jane Bianchi

Tiny knots known as “trigger points” can radiate discomfort throughout your body. Here’s how to get rid of them.

When it comes to muscle pain, sometimes the spot where you feel the pain isn’t the spot that’s causing the pain; instead, the discomfort could be the result of a “trigger point,” or a hyperirritable band of muscle that can register as soreness in another area of your body.

What’s an Example of a Trigger Point?

A trigger point in your calf could limit the range of motion in your ankle, a trigger point in your quad could manifest in your knee, a trigger point in your glutes could feel like a pain in your lower back, and so on. Sometimes trigger points in the neck can cause headaches, ringing in the ears, or jaw aches. If the pain itself doesn’t drive you mad, locating the source of it just might.

What Causes Trigger Points?

Typically, trigger points are the result of an acute trauma, like a car accident, or a repetitive micro-trauma, like running long distances for months or years with improper form; poor posture; or a stress-induced clenching of muscles.

If you have trigger points, it means your fascial system, or connective tissue system, has been compromised, a musculoskeletal condition called myofascial pain syndrome. “Fascia is like saran wrap that covers muscle tissue and envelopes it, almost like a bag,” Bianca Beldini, a doctor of physical therapy and licensed acupuncturist at Sundala Center for Wellness in New York City, explains. When a muscle becomes overworked, it starts to swell in that fascial bag and can result in hypoxia, a decrease in oxygenation of the muscle tissue. “So the muscle is basically suffocating,” Beldini says, and that only makes the swelling worse. “A trigger point is a fascial knot and you can actually feel it—it’s palpable. When muscles swell, we need to release that fascial tension.”

How Are Trigger Points Treated?

If the pain is mild and you know the location of the trigger point, you can try an at-home approach: warm the muscle with a heating pad or an Epsom salt bath, massage the trigger point with a foam roller or a lacrosse or golf ball, and stretch. You can also take a pain reliever like Advil to help relieve those muscle aches.

If that’s not helping, your primary care physician will likely refer you to a physical therapist, or you can consider an acupuncturist, chiropractor, or massage therapist. Professional methods to treat trigger points include active release technique or mayofascial release therapy, a type of soft-tissue treatment that combines movement and manipulation; dry needling, where a physical therapist inserts a needle directly into the trigger point, increasing blood flow to the area, decreasing tightness, and alleviating pain; and ultrasound, which uses sound waves to increase circulation and warmth to the affected muscle.

Longer-term, you should discuss with your medical team ways to improve your posture or address any stress-related issues that might be causing you to tense up. If you regularly work out, play sports, or participate in physical activities like dancing or bowling, be sure to practice proper form and incorporate stretching into your post-play routine. Doing so could spare you hours of agony.

To read the article on Real Simple click here

BADASS World Champion


Couldn’t be more proud of this AMAZING athlete and patient of Dr. B’s at Sundala Wellness. She puts the POWER in CYCLING and the SPIRIT in COMPETITION. Super upset that she took a tumble at the World Championship race this week but so proud that she walked home with a gold and silver medal. Her story of strength, perseverance and badassery is one that makes her a champion multiple times over. #DryNeedling

This was her post from Facebook today 10/20/19:

🥇2 x World Champion
Team Sprint Match Sprint
🥈Time Trial
🥉Scratch Race
I had a bit of misfortune on the final sprint and also won a stay at the luxurious Manchester Royal Infirmary. A few broken ribs, punctured lung, and bruised heart are going to extend my stay in the UK for a bit.
Thank you immensely to Brian Abers and Meg Mautner for staying with me until the wee hours. Thank you to my support team @blueribboncycling, @psimetracing, Bob Biese, Bianca Beldini. Immense gratitude to the group of folks who stayed to cheer on Saturday-you friggin rock!, all the folks who came to check on me, offered well wishes or additional help for my extended stay. Thank you @nationalcyclingcentre volunteers and officials.
It’s been quite a week! Definitely one for the books.

#mastersworlds #gold #stripes #stripesforlife #allin #cantstopwontstop #beastmode #ismybikeok #doesthistubemakemelookfat #manchester #winning