Piriformis Syndrome

What is it?

Sometimes referred to as sciatica. Occurs when the sciatic nerve gets pinched by the piriformis muscle in the buttock region. Usually the sciatic nerve passes below the piriformis muscle. In 15 percent of the population, the nerve passes through the muscle.

Symptoms?

Pain that starts in the buttock area and continues down the back of the leg.

Treatment options?

Rest and minimize walking and running. Sit on a cushion to reduce pressure on the sciatic nerve. Simple stretching. Anti-inflammatory medication. Cortisone injection. Correcting the biomechanical factors that contributed to the problem in the first place with orthotics. Physical therapy. Surgery is an option for persistent problems.

Prognosis?

Good. While surgery is rarely necessary, even people who have it are often able to return to running or walking.

--J. Paul Lyet, MD

   Lancaster Orthopedic Group

Plantar Fasciitis

What is it?

The plantar fascia in the bottom of your foot is like the bow string in a bow. When it becomes inflamed and starts to separate from the heel, plantar fasciitis develops. A heel spur can accompany this.

Symptoms?

Heel pain that accompanies your first steps in the morning. It may subside after a couple steps but returns after walking or standing for a period of time.

Treatment options?

Heel pads and orthotics lessen tension on the plantar fascia. Anti-inflammatories and stretching help. Night splints keep the area stretched. Physical therapy and cortisone injections also help. Surgery is rarely necessary. A newer treatment uses shock waves to stimulate healing. Although effective and approved by the FDA, it is not yet

covered by all insurances.

Prognosis?

Good. Conservative, non-surgical treatments usually work.

--Gerald W. Rothacker, Jr., MD Orthopedic Associates of Lancaster

Runner’s Knee

What is it?

Common term used to describe knee pain. Often results from a softening of

cartilage around the knee cap (patellofemoral region).

Symptoms?

Swelling, pain, locking of the knee. Pain increases after running downhill or sitting with bent knees.

Treatment options?

Rest is critical. Take some time off from training. Stretch and strengthen your quadriceps and hamstrings. If the pain persists, your doctor may recommend physical therapy and orthotics. In rare cases, arthroscopic surgery is necessary to repair damage.

Prognosis?

If you listen to your doctor and only run or walk when he or she says it’s okay, you should be able to return to action in a few weeks. Be careful not to overdo it during your return or you may end up with a repeat of the same problem.

--Carl E. Becker, II, MD

The Westphal Group

Iliopsoas Tendonitis

What is it?

Sometimes called “snapping hip syndrome.” Inflammation of the tendon on the inner part of the thigh. More common in women than in men because of the shape of women’s pelvis and hip bone.

Symptoms?

Pain when running or walking in the inner part of the groin. A snapping sensation or sound may accompany the pain.

Treatment options?

Rest. Gently stretch the muscles in the groin region and in the abdominal area (the abs help the hip flexors work better). Anti-inflammatory medication can sometimes help decrease the pain and swelling associated with the injury. Surgery is not generally required to treat this condition.

Prognosis?

Good. Most people are able to gradually return to their normal activity level. Initially it is a good idea to limit hill running and speed work.

--Thomas J. Renz, DO

Orthopedic Consultants