Pira-Whhhat?!

I went to a new doctor on Tuesday to get an ultrasound of my hip and piriformis.  The goal was to confirm piriformis syndrome and make sure I didn't have any tears.  I really liked the doctor.  He didn't want to see any of my films or MRI's, he just wanted to hear me explain what has been going on with me!  Seriously, so refreshing to have a doctor actually just listen to what I think is wrong and not focus solely on the films. I was surprised that he didn't find any tears (which is great news...I thought for sure I tore a muscle in my groin a couple of weeks ago...guess it is just the FAI).  He did confirm that I have what they call secondary piriformis syndrome.  It is directly caused by my hip pathology (I have retroverted hips, FAI, and a labral tear).  The doctor was surprised by how tight my piriformis is.  It is actually so tight that it has tightened into a ball and will not lengthen or relax.  This explains my very limited ROM.  My left leg and foot rotate externally and it feels most comfortable to be in that position.  If I try to rotate my foot/leg in, it is very hard to do and, honestly, I really can't get it to go very far....can't cross my legs or bring my leg inward.  The doctor told me there isn't anything we can do until I get my hip fixed.  Then, we can begin to retrain my muscles and work on lengthening the piriformis.

If you have true piriformis syndrome, your sciatic nerve runs through your piriformis muscle OR splits the muscle.   Luckily, my sciatic nerve does not do this.  It is just misbehaving.  A lot of times your piriformis has to work overtime due to having weak gluteus muscles and you can end up having muscle spasms in the piriformis.  This causes the muscle to press on the sciatic nerve and can cause pain & numbness....which is what initiated the problems with the piriformis.

After my office visit (which my husband could not attend due to being out of town), Chris (my husband;) thought of a ton of questions to ask the doctor about my diagnosis.  Why couldn't we try a steroid or botox injection into the piriformis?  Is it possible that the piriformis is the main contributer to my pain and the numbness?  Why can't the piriformis muscle get retrained now?   Would I need piriformis release??  I think I will follow up with the doctor to go over the questions I have and discuss getting an injection.

I meet with my local OS tomorrow morning and will bring up my new diagnosis and ask about the injection.  Hopefully he will have some good insight into what my next steps should be.  I am also hoping he will help me with my knee and shoulder problems!  My knee is continuing to give me problems...keeping my fingers crossed that nothing is torn!