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

Marathon Training’s Got Your Knee in a Pinch? Lay off the Foam Roller!

Marathon Training and ITB Pain…

Put down the foam roller! I’m sure there is part of you that is saying “NO PROBLEM, it kills me” and another part of you saying “I’ve been torturing myself with this thing for years and I’m addicted to it!”. Recent studies show little to no scientific efficacy in rolling out the Iliotibial band except for irritating the fascia of the lateral leg. Marathon training leads to serious pounding of miles which means there is tens of thousands of moments where the leg turn over leads to shearing of the attachment of that ITB at the outside knee area. How to make it hurt less? 1. Focus on strengthening upstream…work on strengthening your outer hip / pelvic area by side steps with therabands and clam shells. 2. Trigger Point Dry Needling and cupping to release the muscles of the quadriceps, lateral hamstring and lateral glutes!


KT Tape Might Be an Injured Walker’s Secret Weapon

KT Tape Might Be an Injured Walker’s Secret Weapon

My Fitness Pal Blog, August 2019

Lauren Krouse

(excerpt from the article)

Chances are you’ve already seen eye-catching kinesiology tape (aka KT or kinesio tape) on professional athletes. Quarterback Tom Brady used it to help him play without discomfort in the Super Bowl, while professional golfer Jordan Speith was spotted wearing it on his wrist when competing.

But weekend warriors and those who walk for exercise can make use of kinesio tape, too, whether battling knee pain or recovering from shin splints.

Here, what you need to know about kinesio tape and how you can use it to support your walking routine:


“Kinesiology tape is a therapeutic tape used to treat musculoskeletal injuries,” says Daniel Giordano, doctor of physical therapy and certified strength and conditioning specialist at Bespoke Treatments. “Originally created by Japanese chiropractor Kenzo Kase in the 1970s, the majority of KT tapes are made from cotton and an acrylic adhesive. They’re latex-free, hypoallergenic and water-resistant (meaning you can shower with it).”

Designed to imitate the elasticity of human skin, kinesio tape is not to be confused with typical athletic tape: “White tape is extremely rigid and doesn’t do much more than temporarily cast an area,” explains Giordano.


While kinesio tape is widely used, more research is needed to show exactly how it does (or doesn’t) work. For example, a systematic review in the European Journal of Physical and Rehabilitation Medicine finds kinesio tape appears to quickly reduce pain, but there is no support for any long-term effect in regard to improvements in pain reduction, muscle strength or range of motion.

“Although the current research on kinesiology tape has not been conclusive to confirm the effectiveness of the tape, clinicians around the world have continued to see an improvement in their patients’ symptoms when kinesiology tape is applied,” says Giordano.


“KT tape is versatile,” says Bianca Beldini, a doctor of physical therapy and USA Triathlon certified coach. “It can be used to support overworked and tired muscles, provide support to fascia (connective tissue between your skin and muscles), and improve the pliability of strained tissues.” Here, a few ways you can use kinesio tape to keep up with your walking workouts:

  • Ease Walking Pain
    Kinsesio tape can help zap walking pain fast. Theoretically, it “unloads” your muscle by supporting your fascia when applied to your skin, explains Beldini. “It may also work by impacting pain receptors on your skin and altering pain signals to the brain,” adds Giordano. As a result, you feel better almost immediately. Case in point: Adults with osteoarthritis who wore the tape during walks reduced their pain and improved their range of motion and proprioception, per a study in the American Journal of Physical Medicine and Rehabilitation.
  • Support Recovery From Injuries
    “Kinesiology tape may be used to help with the treatment of walking injuries, as application of the tape improves blood flow and facilitates the healing process,” says Giordano. It can also help reduce swelling: “When a tissue is injured, the immune system sends more lymph fluid to the area to help ‘clean up’ the injured tissue. If it accumulates, it can cause swelling,” explains Beldini. KT tape can form a boundary around the irritated tissue, effectively keeping lymph fluid from spreading, she says.
  • Stabilize Muscles
    “By giving targeted areas much-needed support and stability, KT tape can help you start walking with confidence again after common walking injuries like runner’s knee, plantar fasciitis, Achilles tendonitis and shin splints,” says Beldini. Furthermore, it may help delay fatigue in the newly healed area as you gradually return to your walking routine, adds Giordano.
  • Improve Posture
    Good posture is key for quality walking form, but if yours is off, KT tape can help. “Kinesiology tape may be used to give you tactile cueing to help with walking posture,” says Giordano. For example, if you visit a physical therapist, they can use expertly placed KT tape to help combat and prevent poor alignment (such as a rounded upper back), he explains.

To read the full article, click the title or click here.