Hello wonderful people,
Last night I solved an enigma that has plagued me for a long time. For 10 months I have been following a pattern of locked glute-day / unlocked glute-day. They alternate, like clockwork. The locked day is so bad, that not only am I in pain the whole day, but it brings all my rehab to a complete standstill, until the unlocked day comes along. Such a long term pattern has made a considerable dent to morale and progress to what would otherwise be a solid and steady recovery. I have battled and toiled to find an answer every day for months. The timeline of my problem
• May 2023: Start of locked-glute cycle
• June 2023: Piriformis muscle relief exercises / Paul & Avgi
• Aug 2023: Started with physio Phoenix. Trip to Minehead
• Nov 2023: Started core exercises on my back
• Feb 2023: Acquisition of proprioception
• March 2023: Stumbled across diagnosis & prognosis
The solution may be an anti climax to some; piriformis syndrome / root cause = weak core (including obliques). The answer came while browsing a forum for runners on Reddit. There is an added problem of my calf and ankle following the same pattern as the locked glute, which is likely a follow-on from the glute, but some myofascial attention should address that nicely.
Many questions arise, but the fact that serious strokes lead to a severe degradation in core strength, and I have only had awareness (proprioception day was in Feb.) of my weak side for a month, explains all. YouTube did plenty to steer me away from the truth ; a standard exercise to relieve piriformis is given, but this only causes it to hurt a lot. Countless clips mentioning piriformis syndrome fail to mention core strength (or lack of), so that I never reached a remedy, prognosis etc. So, the original post from the Runners thread (runner loses core from office work and cannot run = stroked violinist cannot walk due to offline core), and all the follow on posts resonate so strongly with what I’m going through. I have just recounted everything to my Chinese Doctor, and he finally accepts this explanation… & knows perfectly well how weak my core is. How many discarded theories and explanations have I come up with, week after week? Now, I can work toward core muscles with real motivation (warning: The exercises are very hard core ; bird-dog, knee (to start with) plank, obliques). Because my core is weak, other things have to take up the slack (like my piriformis). The same goes for people who find it hard to engage their core; other components incorrectly substitute for core. The crazy clockwork cycle I was going through was because on the bad day I would do gentle exercises then step up the work on the good day, only for the body to be overwhelmed, and repeat the cycle of bad day / good day.
What is so compelling is that when I engage my core muscles, my glute starts to relax; yes it’s evening when it naturally does wind down, but I can feel core muscles engage encouraging the piriformis to give up its grip. I can’t begin to think how many stroke-survivors (not all need core strengthening) would benefit from this knowledge? If anyone would like to look at the thread that shone light it’s here;
Thanks to all who listened to me moan!!
Have fun ; supper time for me !!!
Ciao, Roland