June/July 2009

Metamorphic Massage Newletter

Tennis and Piriformis Syndrome

Nikki Nichols LMP, RN,BSN

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Piriformis Syndrome and Tennis

Tennis and Piriformis Syndrome

World famous tennis players are competing right now at Wimbledon in England, the oldest tennis tournament in the world. Imagine you are one of the players and you've just won your first set at Wimbledon. How exciting! You run after the ball rotating your leg externally and suddenly extreme pain occurs in your buttocks. You hobble off the court feeling angry and sad. The team doctor tells you have Piriformis Syndrome. Frustrated and greatly disappointed you start to nurse your sciatica back to health hoping to play again soon. Though you can't play today, there's a consolation , you can partake of the Wimbledon tradition of eating strawberries and cream. Yum!

Tennis players, long-distance bikers golfers, skiers and runners who do intense downhill running are all at risk for Piriformis Syndrome. Non-athletes who are prone to Piriformis Syndrome are truck drivers and people with weak muscles, poor posture or are overweight.

What is Piriformis Syndrome?
Piriformis Syndrome is a pain syndrome caused by irritation or compression of the nerves, that pass through the Piriformis muscle, which externally rotates the hip and abducts the thigh. Piriformis Syndrome is often called Sciatica, because the primary nerve that gets compressed is the Sciatic nerve.

The sciatic nerves, which derive from nerve roots at L4-S3, pass through the sciatic notch, lie deep to the Piriformis, and extend down the posterior thigh then branches into the tibial and peroneal nerves . The sciatic nerves are the largest nerves in the body, growing to more than a three-fourths inch in diameter.
Piriformis Syndrome may be caused by a herniated disc or a tight Piriformis muscle, which can cause spinal stenosis, a narrowing of the nerve's passageway and compression of the nerves. To know exactly what is causing the pain it is important to get it diagnosed by a medical professional
The female-to-male incidence ratio of piriformis syndrome is 6:1.

Symptoms:
Piriformis Syndrome pain can be a mild tingly pain, a burning or even an excruciating, debilitating pain. It can cause numbness or muscle weakness. It occurs in the gluteal region, the groin, the hip or coccyx, and may radiate down the posterior lower leg. The pain may increase when the thigh is moved outward, like when sitting cross-legged.

Treatment:
The best treatment for Piriformis Syndrome is massage therapy, also known as soft tissue manipulation. Massage therapists use a variety of techniques including Trigger Point therapy to reduce the hypertonicity ( tightness) in the muscles.
In addition to massage, it's good to use ice packs for 20-30 minutes every 3-4 hours for first 2-3 days may also help reduce the pain.
Since inactivity often exacerbates the problem, it is important to strengthen and stretch the back and abdominal muscles as well as the muscles that rotate the thigh inward and outward. The following are appropriate stretches.:Piriformis stretch, standing hamstring stretch, pelvic tilt, partial curl, prone hip extension. Nikki can show you these exercises at your next massage appointment.

For further info:

http://emedicine.medscape.com/article/87545-overview for many more details on Piriformis Syndrome

http://ezinearticles.com/?Sciatica-Exercises-Alleviate-Discomfort-For-Golfers&id=50932&opt=print
The Sports Medicine Patient Advisory, Pierre Rouzier
Orthopedic Assessment in Massage Therapy, Whitney Lowe

Metamorphic Massage
"where injuries are transformed into wellness"
Specializing in athletes with injuries

Nikki LMP -- provider of massage at 3 Olympic Games
WA Sports Massage Team - active member for 12 years

Call or e mail to schedule a massage.
Nikki Nichols LMP, RN, BSN
Metamorphic Massage
206-499-4281
Nikki@metamorphicmassage.biz