Return of the Piriformis: The Best Run Under the Worst Circumstances

On Wednesday night, after a glass of white, a glass of red, and a highly indulgent 10pm dinner at The Smith that left me in severe belly pain (why can’t I seem to ever have leftovers when I eat there?), I got in bed only to realize that something was very, very wrong—and it wasn’t my grumbling insides.

The first time I Googled what’s become a recurring pain in the ass (literally), I had no idea what was going on with my body. Worse yet, I figured I’d only come up with porn while searching for my answer since, what else would Google find for “deep ass pain?”

Surprisingly, the answer was both obvious and appropriate: I was dealing with piriformis syndrome, a sciatica-like condition and a symptom of running on uneven, concrete surfaces (thanks, NYC street pavers).

Piriformis syndrome can feel as though there’s a boulder lodged somewhere within your lower back, hip and ass cheek (cheeks, in my case, since I have it on both sides). The tricky part is that you don’t really feel injured while running, at least not during the early stages of piriformis syndrome — but it’s more than obvious that you have an issue when walking, sitting in a chair, or even simple laying on the couch. I know; it makes no sense.

To alleviate some of the discomfort, it’s natural to want to knead the area with your fist or a household object. After all, it’s more of a soreness than a tear or particular pain that would otherwise set off an alarm that you require medical attention. For immediate relief, you can use a tennis ball or a foam roller; if you have a significant other around, or a very, very kind friend, I suggest you ask them to physically locate the trigger points (translation: those especially tense, tight areas that elicit a reaction when touched) and massage the area manually.

The main problem with piriformis syndrome is that, while the short-term remedy — essentially a massage — doesn’t sound so bad, the moment you stop kneading the area that’s bothering you, it may also begin to worsen, sending the pain shooting from the rear to the hip to the lower back. That’s what I was dealing with last night.

Fortunately, after working with physical therapists, massage therapists, movement educators and other alternative wellness practitioners throughout Manhattan since discovering the condition (the perks of my job, no doubt), I’ve also learned how to manage it like a champion. I promise I’ll write up a post about what I’ve learned one day soon, but today’s not that day. (Though I will scatter this post with a couple of yoga poses that offer a tremendous amount of relief. Like this guy to the right, for example.)

Today, I feel like talking about Thursday morning’s run, which turned out to be the best run I’ve had in a long, long time despite drinking two glasses of wine and dealing with my achey backside.

In most cases, I’d take a day off to rest my muscles when piriformis syndrome becomes an issue, but Thursday’s sunshine was far too tempting. Ultimately, I think this worked to my advantage; looking back, my theory is that I was so scared of hurting myself that I was able to maintain full-on concentration and a steady, easy pace.

After a week of relentless humidity, Thursday’s run was perfect. The sky was clear, the air was crisp. New York City was packed, as usual, but I managed to Frogger my way in and out of aggressive commuters until I found myself at the 72nd Street entrance of Central Park. Even the uphill battle of getting to Central Park couldn’t ruin my run. No, I was feeling indestructible. I wanted to race. I wanted to run forever. I wanted to pick up my speed and cross some imaginary finish line somewhere off in the distance. But instead, I plugged along, conscious of my muscles.

Here’s where prudence comes in handy. In those moments when you’re feeling really good during a run, it’s only instinct to try to avoid anything that could interrupt your pace and flow. Rather than force myself through all 5 miles of Thursday morning’s run without a break, however, I stopped after a couple of miles at the Bethesda Fountain —one of my all time favorite spots in New York City — to stretch out my glutes and to ultimately check in with my body.

Even if I didn’t want to, I know that my pit stop was the intelligent thing to do. (You can tell from my enthusiastic expression, right? Though really, I was incredibly grateful to be in Central Park at that moment, pit stop or not.)

I dropped down into a figure 4 stance, sinking deeper, deeper, deeper into the pose until I could feel that the muscles and nerves were calm and happy. Only 2 minutes later (yes, I timed it), I was back on the road and heading home, enjoying the last couple of miles of one of the most meditative runs I’ve experienced since before my unforeseen half marathon streak began in August 2011.

When I got back to my apartment, I foam rolled right away – one of the most important habits that anyone with piriformis syndrome — or addiction to running, for that matter — should take up.

As I write this now, my hip still hurts, and I know I have to be cautious in the coming days in order to avoid aggravating my muscles further. I’ll also be doing a lot of impromptu yoga poses that specifically target the area and feel incredibly good for the affected muscles. Consider this your warning: If you get embarrassed easily, you may want to avoid me for a couple of days.

On another note, my favoritest supermarket in the entirest world—Agata and Valentina—just opened right below my office, which means I’m pretty much never leaving Union Square again. Look how big and spacious and clean it is!

Random, but I felt the need to throw that in there out of excitement with the week coming to an end, so take it.

Have a great weekend!

  • Have you ever dealt with a recurring injury that you’ve learned how to manage? Do you run through it?
  • Isn’t it weird how the strangest of circumstances can result in the best of runs? (This isn’t yes or no question; I’d like your examples here, such as, “I had my best run after drinking a pitcher of sangria the night before.”)

15 thoughts on “Return of the Piriformis: The Best Run Under the Worst Circumstances

  1. I always got my best, just when I wanted to have a funny and easy run, sometimes I end running half marathon when I was supposed to run 3 miles, I ran uphill and did my most wonderful when I only wanted to have a nice and easy one before going to bed, and a few days ago I did my fastest when I took my running shoes off and ran barefoot for almost a mile, even stopping a couple of times to put my running shoes on and off. So….. free your mind, and enjoy that’s the most important.

    • Well put! It’s true, the best runs are the ones with the least pressure. This morning I was on 5 hours of sleep and a bottle of wine (from the night before). My stomach hurt. I was tired. The run turned out to be spectacular. Go figure! 5 and a half miles down and glad I did it.

  2. A while back if I walked for an hour and a half I’d get a pain that stretched from the inside of my knee, wrapped around the front of the knee and then up the outside of my leg into my hip. I took the leg to my primary doc and he said, “Well, don’t walk for an hour and a half.” Not that happy with that answer, I visited an orthopedist. I told him I was a runner (at that time my typical run was only about 3 miles) and he said, “Well, you’ll have to give that up. You are 100% headed for a knee replacement.” He said I should ride a bike or use an elliptical trainer instead. I really didn’t think my running had caused this injury as he stated but I figured he knew more than I did. So I started using an elliptical but I really wasn’t happy not running. A few years went by and I Googled the path of the pain and hit on something called Iliotbial Band Syndrome. That band goes from inside the knee, around the front and up the leg. What a coincidence. Basically the cure for my pain was a specific set of stretches before a run. I tried them and now I run about 5 miles regularly with no knee pain at all. I can also (much to my doctor’s surprise) walk 2 hours pain free! I like doctors and they mean well, but they’re not always right.

    • Ah, IT band pain. What amazes me is that everything is connected. Much of the time, my piriformis pain comes from the IT band, and vice versa. I roll these religiously. It’s great that you were able to play detective though and to determine the true cause. With piriformis syndrome, I had to take a month off. But it was a month off to keep running for the rest of my life! I think a lot of people knock running, saying that it’ll cause long-term damage without any true evidence. At the end of the day, it’s about listening to our body and knowing what it’s saying and what it needs on a day to day basis that’ll keep us healthy and strong!

      • You are 100% correct. I found over time that running actually put me more in touch with my body and that’s helped a lot in fine tuning my wellness plan.

  3. I have recurring shin splints. I’ve tried everything–stretching, yoga, ice, massage, various pairs of shoes, strength training, neoprene sleeves, arch supports, you name it. My tibias just hate me. I am training for my first half-marathon (a way to get myself back in shape since I just had a baby 7 months ago), and they’re kind of starting to flare up again. I’m hoping if I work on my pace a bit, try to keep it slow and steady, and keep building strength, I’ll be able to get past this once and for all.

    • Ugh, the worst. Shin splints haven’t been a problem for me since I found the sneakers I wear now. Remember to listen to your body; rest when you need to, and crush the longer runs. Good luck with your first half marathon! And treat yourself to lots of massages 🙂 It’s “medical.”

  4. I have been dealing with a back injury since the end of April – beginning of May and has sidelined me lately from exercising. Just had x-rays taken and hoping for a strain or sprain. Have a Great Weekend:)

  5. Fascinating! You described (the Piriformis) something that I’ve been dealing with on and off for the last couple of years and didn’t know it had a name. I thought it was sciatica pain but my doctor nixed that idea and just told me I had a muscle pull in my back. Your description of it not hurting when you run but being uncomfortable when you are still hits the nail on the head. She gave me mild muscle relaxers to take each night as the pain was at its worst in the morning. This cleared it up in about a week. This was a few months ago and the pain hasn’t returned but I am sure it will at some point.

    • It’s really tricky because it comes and goes. I’m convinced it’s something that’ll always be around, but as long as I can manage it, and force myself not to run when it’s really flaring up, then I’m good to go. I think. Glad that you were able to benefit from this! Get yourself a tennis ball 🙂

  6. Trying to deal with what I thought (self-diagnosed) as piriformis syndrome now. But, the fancy running doctor I’ve been visiting for the past two weeks indicated that my issue is not exactly that, but, instead, a lack of symmetry in terms of hip flexor strength. So, he’s prescribed a handful of exercises/stretches that I’m supposed to do every other day. We’ll see if it works. I wish you the best with yours.

  7. I think it’s interesting that you posted this today because I was having a particularly bad day today and it was raining so I decided to put off my run and relax with a few beers (3 to be exact!) and a wave of sadness came over me and instead of falling into it I decided to go running. I am finding lately that I feel free and better able to deal with things after I run. I would say that even though I didn’t do my 30 minutes straight (I took a 5 min walking break in between) I still felt like it was a great run. I was able to really push myself mentally to get through simply by pep talking myself! Now if only I could pep talk myself during my stress eating moments!

    • It’s hard! Especially the fact that, sometimes, the biggest challenge is simply putting down the beers and getting out the door. Something that helps me? Knowing that the beer – or wine or sangria or whatever – will be there when I get back. Movement is movement, sweat is sweat. Once those endorphins get going, whether it’s your worst or best run, you nevertheless feel grateful that you’ve done it…especially when the other option is sitting on your ass. There’s PLENTY of time for that after 🙂 As for stress eating, all I can say is to recognize those moments and try to fill them with something else; take a walk to your favorite store, go shopping, walk to a produce stand and pick up something fresh and delicious. At least then you’ll be filling your body with healthful fruits and veggies!

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