Injuries. We all get them, we all hate them, and we all deny that we have them until we’re side-lined from running. We are all unique and no body is the same, but learning about other runner’s experiences with injury can help us overcome our own battles. Hi, I’m Sierra and I have spent the past eight years battling piriformis syndrome.
No numeric value can truly express how many hours I have spent cross-training from this injury. (Actually, one can, you just don’t want to see it.) It was my freshman year of high school, cross country season was in full-swing, and I was looking and feeling strong. I can vividly remember the moment I felt the first shot of pain. It felt like something snapped and each time my left foot hit the ground it would shoot down my leg. I crossed the finish line, limped to my bag to grab water, and the tears came. There was no doubt in my mind that my season was over, and indeed it was.
I spent the next few months jumping from doctor to specialist to physical therapist to orthopedist… and, however many hundred dollars in co-payments later, I finally had a diagnosis. Well, I had several diagnoses. I found out I had scoliosis, seasonal stress fractures on both of my heels, collapsing arches, and – the kicker – legs of concerningly different lengths that were causing piriformis inflammation or some sort of injury to that area. They gave me two options: surgery or custom-made orthotics. I walked away with bank-breaking custom-made orthotics and excitement that I had my cure! Wrong. Although resting and wearing my orthotics 24/7 helped decrease the inflammation, what all of those advisors had failed to realize was that my pain was from piriformis syndrome, not a piriformis injury. But, of course, I didn’t learn this until seven years after my diagnosis. What I learned during that time was that my piriformis had won and that I would never be able to run at the mileage or intensity that I had once trained at. Every time that I tried to run farther or run harder or run faster, the pain would return and I’d spend the week nursing myself back to health. I learned quickly that I had to I spend my time running lightly, but mostly cross-training, finding that running over 25 miles in a week caused the pain to strike. It wasn’t until I started at Running Warehouse that I had the opportunity to learn about piriformis syndrome, and to mix and match products to “cure” myself.
Before I get down to my self-prescribed cure, I should probably define the scum-of-the-earth injury that I’m writing about. Piriformis syndrome is spasming, tightening, swelling, or injury of the piriformis that causes severe butt pain. In my case, what was causing the swelling, tightening, and spasming was the fact that my sciatic nerve grows through my piriformis muscle. When the nerve is irritated, I feel pain centered in my piriformis and then shooting down the back of my leg. So what irritated it? Mileage, rolled ankles, intense workouts, not stretching and rolling for at least thirty minutes a day, turning a corner during a run, twisting my upper body to the side while leaving my lower body facing forward… I guess the better answer is everything. Everything irritated it.
What worked for me
Now for my cure. While these guidelines have worked for me, I am not a doctor, and the best help that anyone can get when it comes to an injury is advice from a doctor. What has worked for me may not work for others (but at least I can tell you that there is hope! I digress…). Taking the time to figure out what works for me has greatly benefited my running… and let’s be honest, anything that benefits your running benefits your EVERYTHING. Hopefully this helps you, and best of luck/happy healing to you all!
1. Drop matters! My biggest discovery was that a shoe’s slope (the drop) matters. Steeper slopes (larger differences between the heel and toe stack heights) mean irritation, lower slopes mean pain free running. My rule is to keep my shoe drops between two and six millimeters, although six can be pushing it. Finding performance shoes and racing flats that fit these needs is a breeze, but finding a standard daily trainer can be tough. The best options I have found for daily trainers are the HOKA ONE ONE Bondi 4 or 5, followed closely by the ASICS 33-FA (although I’ve had some issues with calf pain in these shoes). My favorite performance shoe for my uptempo runs and workouts is the New Balance Vazee 2090. My favorite trail shoe is, hands-down, the Saucony Peregrine 6.
2. Sit on a massage ball for 15 minutes a day. Digging in deep and putting some deep tissue pressure on my piriformis keeps it calm and takes little to no effort. I slip a massage ball under my butt for about 15 minutes every day at work and it gets the job done! I’m a big fan of the Pro-Tec Spiky Massage Ball and the Trigger Point 2.5″ Massage Ball X, but, honestly, any extra firm small ball gets in deep like I need (lacrosse ball, quidditch snitch, etc.). At first this task was rather painful, but I’ve grown use to it and it is now rather relaxing.
3. Performance shoes or racing flats only twice a week. This one is a tough one because I love how much faster and lighter I feel running in performance shoes, but sacrificing that material and weight puts a lot of force on my piriformis, which means pain. Take a deep breath… fewer training runs in performance shoes will not kill you. It’s a trade off that I have to make in order to get in miles (miles that feel good), and I still get the indulgence of those quicker shoes on workout Wednesdays and Saturdays. I look forward to those days… it’s like a reward for taking good care of myself (aka whole grains and veggies all week until my Sunday morning chocolate chip pancake treat).
4. Cushion, cushion, cushion. I LOVE firmer and more responsive shoes because it makes me feel as energetic as a lightning bolt, but I’ve had to adapt my preferences to better suit my piriformis. This means cushion… cushion in excess. I had this misconception that firmer shoes were faster shoes, but I learned that firm or cushioned, you’re still running… and how fast and intense you’re running is going to depend on you, and not the shoes. Cushion-y shoes have actually really grown on me, and I’m a huge fan of, as I mentioned above, the Bondi 4 or 5. I do at least three of my weekly runs in these shoes and love that even with all that cushion, they’re still lightweight! I have even found that the 5 (the newest model) has taken on a firmer feel that fits my original preferences. Give cushion a chance and see how it works for you.
5. If there is pain, STOP and take a day off. Another hard one because no one wants to “accept defeat,” but you’re really just telling your body that you hear it and you’re listening to its needs. So stop, take a day off, ice, roll, sit on a massage ball, and cross-train (as long as it isn’t a high-impact activity). Listen to your body and give it a chance to recover, and I promise that it will reward you.
Sierra balances an overflowing schedule of work, college, and running, and can relate to any 20-something who’s trying to figure out life. Her running is her kind of self-care – and also the small amount of time that she gets to spend with herself every day, coming before all else (except her dog, Butters).