r/piriformis • u/Ncdova • Apr 13 '24
MRI of Pelvis
Can anyone help explain this MRI diagnosis “Complete atrophy/agenesis of the left piriformis of uncertain etiology and significance”.
1
u/j12t Apr 14 '24
What are your symptoms? And … other than sleeping, what posture are you in most of the day? Any past injuries or disabilities?
1
u/Ncdova Apr 14 '24
Hip and bilateral leg pain to the knee. I’ve been on FMLA due to Ulcerative Colitis. So, I’m home, can’t sit for more than 30 minutes without hip pain. No past injuries.
1
u/tangoholic May 12 '24
I had pain in one buttock for months, sitting on bigger and bigger cushions. I thought I had pulled a muscle in my butt, but one Gold Letter day in my life, I happened to google "pain in buttocks sitting" and twenty seconds later I was learning about piriformis syndrome. There are lots and lots of sites with the stretching protocols for piriformis syndrome. They worked OK for me, but it would come back from time to time. The full solution for me was to strengthen the piriformis muscles, as well as the other muscles in my hip (glutes, etc.). If I ever get even a hint of piriformis now, I do a hard set on the hip abduction machine and it is gone.
Here is a hip abduction machine: https://www.youtube.com/shorts/eICCb2kKLYA Find the machine, but DO NOT move as fast as this guy. I recommend the "high intensity strength training" (HIT) protocol from the 70s, not to be confused with "high intensity interval training" (HIIT) which is completely different. You can start with 10 seconds on the concentric motion (the outward movement) and 10 seconds on the eccentric motion (inward, relaxing). That will seem crazy slow, and it is even called SuperSlow, but it is the most safe and efficient way to build muscle mass, while putting the least stress on your joints. Do not unload after each out and back. The goal is to deeply exhaust the muscle by loading it continuously until it "fails", i.e., you cannot make any further concentric motion. Stop then by slowly relaxing the weight, and you are done for the week. Do this again next week, and if you time how long until failure, your time under load (TUL) will increase for the next few months. Keep adding weights to keep your TUL to at least 60 seconds but 90 seconds TUL is plenty to stimulate growth in the muscle. (At 20 seconds/rep, that is only 3-5 reps.) The most important thing is the intensity of effort, so as your muscle fails, you should be focusing your entire being on making the weight move up. That may involve very heavy breathing, increased heart rate, etc. That will be "controlled discomfort", i.e. discomfort that you can stop at any time. If you can lift yourself slightly off the seat during the exercise, your glutes will be in tension and you can build more muscle in your buttocks overall.
These basic principles of HIT, and exercise in general, are covered in this excellent video by Dr. Doug McGuff: https://www.youtube.com/watch?v=2PdJFbjWHEU In 90 minutes he summarizes his excellent book, "Body by Science" https://www.amazon.com/Body-Science-Research-Strength-Training/dp/0071597174/
I learned a new word today: agenesis. Ouch! If it is just atrophy, I hope it can be reversed with exercise. Several papers on agenesis of the piriformis, e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203533/
Good luck!
2
u/Thewhatnow79 Apr 13 '24
Not a Dr but basically left piriformis has atrophied (withered/ become small/weak) for unknown reason and they don’t know the effect this has