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Piriformis causing foot and calf pain?

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Piriformis causing foot and calf pain? Empty Piriformis causing foot and calf pain?

Post  wendy_miller on Wed Sep 14, 2011 10:47 pm

I have been having right-sided hip/glute pain my entire cycle, but have been able to train through it. However, it's now accompanied by some foot/calf pain.

There is nothing wrong with my foot or my calf, but about a mile into my run I get severe tightness/burning in my right calf (mostly on the outer side) and in my foot. Hills exacerbate it. If I stop, it takes a few minutes to subside, and sometimes comes back. After a few miles, it eases. After around six miles, it's almost totally gone. But when it's there...it's very bad.

My doctor suspected a slipped disc which might be compressing a nerve. The MRI was negative. But I'm still having pain, and it's definitely nerve-related (burning, tightness, etc.).

I know I have an issue with my piriformis, and I know that it can cause referred pain down the leg and into the foot, but I mostly read about it hurting people's butts. My butt hurts, but it's nothing like the calf pain. Has anyone else experienced calf/foot pain from a tight/injured piriformis?
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Piriformis causing foot and calf pain? Empty Re: Piriformis causing foot and calf pain?

Post  Michele "1L" Keane on Thu Sep 15, 2011 9:18 am

bom YES!!!!!!!!



When I started reading your post yesterday, piriformis was my first thought - not a slipped disc or anything like that. Beleive it or not, injuring or basically aggravating the piriformis can affect you in so many ways. I suffer from a tight piriformis muscle on the right side and it manifests itself mainly as a "pain in the butt", but I also constantly have very tight calves. So I need to make sure that I stretch everything to keep it all in balance. If I let one thing go, then I can be out for weeks with things like PF and achilles tendonitis - all related to my piriformis and tightness in the glute area.

I think that this syndrome manifests itself in so many different ways that it is difficult to nail down, but I would bet on it as being the cause of your issues.

Schuey also had some piriformis issues earlier this year, and they manifested themselves completely different than my issues.
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Piriformis causing foot and calf pain? Empty Re: Piriformis causing foot and calf pain?

Post  jon c on Thu Sep 15, 2011 9:45 am

I would agree that the pain you are experiencing sounds like it is nerve based. I have had a tight piriformis in the past which would give me sciatica especially after running a marathon that made it difficult to sit or drive a car for a day or so. Thankfully it has not been an issue for me now for several years.



I learned several piriformis stretches which did help at the time. Here is one I came across recently that makes sense especially if a person has a history of back related issues in addition to piriformis tightness. You may be familiar with it already. I hope you can get ahead of this as it is not a fun issue to deal with.





https://www.youtube.com/watch?v=2qZ517Rw7ME
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Post  Liz R on Thu Sep 15, 2011 12:43 pm

Sounds like a nerve pinch, so i guess the question is from where. Piriformis is worth investigating. I wonder about checking out other hip structures as well if that isn't it. I am no MD, but I think finding the right stretch is going to relieve your problem.

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Post  Jerry on Fri Sep 16, 2011 10:51 am

Can't help, but fix it for Chicago, Wendy!
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Post  dot520 on Fri Sep 16, 2011 12:56 pm

@jon c wrote:

[url=https://www.youtube.com/watch?v=2qZ517Rw7ME
https://www.youtube.com/watch?v=2qZ517Rw7ME[/quote[/url]]





I've used this for ITBS for several years now. You can do it sitting as shown, or on the floor laying on your back with foot (normally on floor in seated position) on stability ball. By bringing stability ball closer to body it increases the stretch without having to raise your body. Good stuff.
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Post  Michele "1L" Keane on Fri Sep 16, 2011 1:19 pm

The "sit like a guy" stretch - works for me always. Thanks for posting, Dot.
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Post  Alex Kubacki on Fri Sep 16, 2011 2:54 pm

You don't have a muscle imbalance in strength or flexibility somewhere do you? That can cause issues as the other side starts overcompensating.
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Post  wendy_miller on Fri Sep 16, 2011 8:38 pm

Thanks for all the replies!

I actually had an EMG done because I was having a lot of leg weakness (dragging) while running. I had this before with compartment syndrome, but for a variety of reasons knew it wasn't the same--I just knew that the same nerve had to be being affected.

My EMG was very abnormal...basically showed that the sciatic nerves (yes, both sides! The right is much worse, though) are not conducting as strongly or as quickly as they should. I.e...they are injured. An MRI of my back revealed that there are no discs causing this, so it has to be the piriformis. Nothing else really has the ability to pinch the sciatic nerves, as they exit out the lumbar/sacral spine and pass through or under the piriformis. Put it together with my butt pain, and there's the likely explanation.

I had an injection in each piriformis today (had to be under x-ray because they are soooo deep). Will take a few days to see if it works, and the doc said about 60% of the time it works on the first try. Otherwise, takes a second one.

I get the weirdest injuries. Hoping it's fixed for Chicago. They've told me I can run. I will be stretching my piriformis like crazy.
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Post  fostever on Fri Sep 16, 2011 10:46 pm

Yes Wendy,

This is similar or maybe exactly what my injury was in May. After a month off and six weeks PT things got better. I still get some burning on the front of my left hip which radiates from my lumbar region and down the leg. The May injury symptoms started on my right thigh and culminated in my right calf, producing swelling after my May 1st half marathon. They say its all connected (kinetic chain.) I was compensating for the right leg injury so it swtiched legs. I've been keeping up the core strength workouts they gave me to keep it at bay.
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Post  wendy_miller on Sun Sep 18, 2011 9:47 pm

Just as a follow-up...the piriformis injections worked really well. Ran 22 miles today with just a little tingling in one foot. None of the numbness and pressure I've been feeling. And that's less than 48 hours after injections...they won't take total effect for another few days. So I recommend them if you have piriformis problems.
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Post  Schuey on Sun Sep 18, 2011 9:59 pm

Glad to hear that it is feeling better, now lets keep are fingers crossed that it stays in affect for marathon day.
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Post  wendy_miller on Sun Sep 18, 2011 10:15 pm

It's supposed to last at least a month, and probably up to 3.

I'm just hoping injections + taper=perfect race day legs!
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Post  mul21 on Sun Sep 18, 2011 10:32 pm

@wendy_miller wrote:It's supposed to last at least a month, and probably up to 3.

I'm just hoping injections + taper=perfect race day legs!

I just had a massive flare up. I assume this is a cortisone injection right into the piriformis? How many days were you off?
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Post  wendy_miller on Sun Sep 18, 2011 10:37 pm

I did not actually miss any runs, but have not done anything intense (speed or hills) for two weeks. It didn't get any better, and last Thursday my calves had horrendous pain/numbness during my run, which is why I chose the injections. They let me run the day after my injections--I ran 15 miles the day after, an 22 the next. Felt better on the 22 than the 15.

They worked well for me...but make sure you get them done by someone who uses fluoroscopy or CT to guide the injections (this would have to be an interventional radiologist), as the piriformis is very deep and hard to find. They are much less effective if done blindly, and the sciatic nerve can be injured.
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Post  healdgator on Mon Sep 19, 2011 11:51 am

At least you have to be running out of injuries. Good luck.
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