Foot Pain In 12 Yr Old Girl Has An Arch Effectively Treating Piriformis Syndrome (Pain In The Butt)

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Effectively Treating Piriformis Syndrome (Pain In The Butt)

The piriformis muscle (piriformis; “pear-shaped”) is a tiny muscle located deep in the buttocks below the gluteus maximus. This small muscle is the best known of the group of muscles known as the “rotator cuff of the hip” and is often the source of pain in the bottom.

Piriformis syndrome is an unfortunate condition where the piriformis muscle becomes too tight. It can be aggravated by bending over, lifting, sitting, playing sports or even driving (foot on gas pedal). Contrary to what your MD may tell you, there are no drugs or surgeries that are effective in treating Piriformis Syndrome. In over 20 years of practice, I have never seen a person whose Piriformis “Release” surgery actually worked.

PIRIFORMIS SYNDROME AFFECTS WOMEN MORE THAN MEN

Piriformis syndrome is an extremely common condition and is much more common in women than in men (about 12-15 times more common). Although I can only speculate as to the reason for this, I suspect it is a child bearing issue. It is probably also related to the naturally wider shape of the female pelvis. This is probably the reason why I find it much more common in women than in men – even in women who have never had children.

PIRIFORMIS SYNDROME CAUSES Sciatica

Piriformis syndrome is the main cause of sciatica (leg pain, numbness, tingling or weakness), hip and buttock pain. Because sciatica is so commonly involved, it is often misdiagnosed as a slipped disc, herniated disc, or chronic low back or sacroiliac problem.

The sciatic nerve is both the largest and longest nerve in the body, and its largest point is about the thickness of a thumb. The origin of the sciatic nerve is in the lower back (lumbar spine) and is located at an angle towards the middle of the buttock. It then extends down through the leg, passing under the piriformis muscle. Note that in up to half of the population, the sciatic nerve travels through the curl muscle, passes over the piriformis muscle, or splits in two and passes directly around the piriformis muscle.

WHERE IS THE PAIN OF PIRFORMIS SYNDROME DISCOVERED?

The symptoms of piriformis syndrome usually start as a deep pain in what women refer to as their “hip” area. This pain will be traced along an imaginary line that runs from the very tip of the buttock fissure to the greater trochanter of the hip bone (the bony knob on the outer or side of the thigh).

CAUSES OF PIRIFORMIS SYNDROME

People most prone to chronic contractures and microscopic scarring of the piriformis muscle are people who wear shoes that are rough or don’t fit their foot type, have poor spine or lower limb mechanics, are overweight, have poor posture, spend too much time sitting, too much at a time. concrete, not enough activity (or sometimes too much exercise), and of course the big one – just being a woman.

Due to the mechanical stresses that cause chronic tightness/contracture, the piriformis muscle can actually shorten over time. This often results in microscopic scarring of the fascial sheaths that tightly surround the muscle itself. Piriformis syndrome is most often worse at rest (sitting or lying down) and is often (but not always) temporarily relieved by moderate activity (especially walking or stretching).

EFFECTIVE TREATMENT OF PIRIFORMIS SYNDROME

For years, I didn’t really understand why I had such good clinical results with so many cases of gluteal/hip pain and sciatica, while other seemingly identical cases were largely unresponsive to chiropractic adjustments. Often these “problem” cases would get fantastic short-term results from tweaking them, but those results never seemed to last more than a few days (and often no more than a few hours). It wasn’t until I started doing “TISSUE REMODELING” in 2001 that I started to understand what was going on.

Over the past ten years, I’ve come to realize that Piriformis Syndrome is literally an “epidemic” in the female portion of our society (it’s Destroy Chronic Pain.com’s #1 site – see our site’s patient treatment diary); with the medical community largely not understanding what it really is or how to effectively treat it. Again, drugs and surgery are not “effective” treatments for piriformis syndrome. Don’t Think “Piriformis Release Surgery” Will Solve Your Problems!

PIRIFORMIS SYNDROME AND MICROSCOPIC SCAR TISSUE

If you read my first article, “Relationship of Chronic Pain to Microscopic Scars of Elastic, Collagen-Based, Connective Tissue,” you have at least a cursory understanding of scar tissue. Microscopic scar tissue is normal, flexible tissue (think well-combed hair here) that has been disrupted from its organized structure. For a variety of reasons, this connective tissue can break into a tangled bundle of inflexible and highly sensitive microhairs (think of a tangle of hair that can’t be combed out). This type of microscopic scar tissue is usually not in the muscle itself, but in the fascia. Fascia is a thin but very tough, yellowish-white membrane that covers muscles. In my neck of the Ozarks, deer hunters call these membranes “Striffin.”

FASCIAL ADHESIONS

Fascia is arguably the single most pain-sensitive tissue in the body! FASCIAL ADHESIONS will cause pain and dysfunction. Eliminate facial adhesions and eliminate chronic pain!

Because most of this scar tissue is in the fascia and not the muscle itself, it does not show up on MRI. In my opinion, a microscopic piriformis muscle scar is the single most common cause of chronic, long-term, sacroilliac or buttock pain (the sacroilliac joints are the bony ridges just above and to the side of the top of the buttock). . It’s also the most common cause of what I’ve been calling “buttock-based” sciatica for years in the office.

LEG / PIRIFORMIS JOINT

If you have particularly high arches or “fallen” arches, or if you have any type of abnormality in your lower body biomechanics; you may need arch supports (orthoses). We have some nice generic orthotics that will work for a lot of people. However, some of you will need custom orthotics. Let me give you an example:

High arches can be a big contributor to Piriformis Syndrome. The higher the arch, the more you are “pushed” on the outside of the foot. To see how it affects the piriformis muscle; stand up, place your hands on the top of your buttocks in the piriformis area. Now shift your weight to the outside of your feet. Notice how the piriformis muscle immediately becomes tight like a drum? This happens all day long if you have high arches. And there is only one company on the planet that I know of that specializes specifically in shoe inserts (orthoses) for people with high arches. Shawn Eno’s Xtreme Footwerks in Idaho Springs, CO.

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