Chronic tight Piriformis
I was wondering how I can help my client. She has a very tight piriformis. We do self myofacial release before and after workouts. She has went in for a massage but nothing is helping. Prior to the tight piriformis she started feeling planters facities on the same side. Do you think this is the cause for her tightness? Is she over compensating?
Does any one have suggestions?
Are these conditions doctor diagnosed? Has she gone to a physical therapist for this? Has she seen a podiatrist?
The body always compensates for something or another. I would have her make sure to stretch the entire body and let her body rest. Stretches are done to comfort level to help balance the body.
Staying hydrated is important as well as eating a healthy diet.
This is obviously not a time to shoot for goals or overdo it.
The MELT method is very well worth looking into, as Karin Singleton suggests.
Good luck to the client; this can be very frustrating.
NAPS 2 B Fit
Judging by the sequence of event, it is likely that the source of the problem originated in the feet/ankle and then moved upward. However, it is also very possible that the source is much higher up than the piriformis itself (for example, in the shoulder or neck), and that caused compensations going downward in the body until the weakest point of the body started exhibiting pain (in this case the feet themselves). Once the pain occurs, the next set of structure upward compensates even further until another set of weak structure is in pain (in this case, the piriformis). A series of dynamic postural assessment will help narrow down the areas that are likely to be a cause.
There are different school of thoughts for corrective exercise and they don't necessarily follow the same methods. Some methods may work really well for your clients; while some clients will not respond to these methods at all (i.e. they don't fit the "textbook definition"). That's alright though. Seems like your client might be this example. I'd suggest seeking out methods used by the BioMechanics Method (which is similar to the NASM CES methods, but also very different in their own way). I'd also suggest methods used by Function First. They've got a really different approach to correcting movement imbalances. Of course, MELT has been mentioned here and worth a look as well.
Anthony Caryey of Function First said at a workshop something of this nature: "If your client has been doing the same corrective exercises for 6 months and nothing has changed, then it's not your client that's the problem. It's the exercise." In fact, I usually tell my client that they should see a significant improvement in their movement in as little as 2 weeks and as long as a month. If there isn't any change in a month's time (despite your client doing the exercises correctly), then you need to change it or else the exercises are just a waste of time.
in my experience, plantar fasciitis and and piriformis problems are the result of faulty movements. There is compensation someplace in the body, and it is often difficult to determine even with the best of assessments.
As a MELT instructor, I would put her on a program using the MELT method which uses self-assessment and self-treatment techniques for connective tissue. There are a few MELT instructors in Denver who may be able to assist you and her to learn the technique. You can find them following this link http://www.meltmethod.com/finder.
Some of my clients who have struggled with plantar fasciitis and/or piriformis problems have gotten relief through a soft tissue treatment known as ART (Active Release Techniques). The treatments are usually quite short and have been especially effective when scheduled as bi-weekly or monthly "tune-ups" for the body. Here's a link to find an ART provider in Denver:
On a semi-side note, have you considered pursuing the CES certification through NASM? I've found its content to be incredibly valuable to use when working with clients who experience chronic pain due to muscle imbalances.
Best of luck to you and your client!
I would have her see her doc and get a detailed diagnosis.
Your client's plantar facsiitis and piriformis issues could possibly be part of the same problem. If I had a client with the issues that your client has experienced, I would follow these four steps from the NASM Corrective Exercise Specialist program
Step One. Self-myofascial release using a foam roller the plantar fascia, gastrocnemius, and peroneals. Find the most painful spot and hold there for 30 seconds.
Step Two. Stretch the gastrocnemius and soleus for 30 seconds.
Step Three. Strengthen the under active and weak muscles by doing resisted ankle dorsiflexion and single-leg calf raises.
Step Four. Have your client perform single-leg balance reach movement patterns.
These steps help to prevent or relieve plantar fasciitis. It would be best to perform a movement assessment to determine what other muscle imbalances your client has and then design a complete corrective exercise program. My guess is that with a tight piriformis if you watched the client do squats you would see her knees move outward. For now, the above steps should help provide some relieve for your client's plantar fasciitis.