Piriformis and S.I. joint rehab

Sorry, I’m sure this gets done every few months and I’m sure I’ve started half the threads!

My ambitions and goals on the bike are getting more and more ambitious in completely inverse proportion to my physical robustness! 😂

In recognition of this I’m trying to take time out to really rehab my hips and low back, in particular the hips as my right piriformis and S.I. joint both seem very prone to aggravation, and even seem to get aggravated by the very gentle yoga (anything hip flexion-y) and rehab exercises I’m currently doing.

I expect lots of recommendations to do ‘pigeon stretch’ which I have been specifically advised NOT to do by physio as I’m just stretching muscles and tendons which are already too long and weak, although I’m using the movement as a sort of general warm-up mobilisation move, just not holding it as a stretch.

Also tinkering with saddles, I thought ‘scooped’ saddles like a Specialized Power or Romin might help, and whilst I think they offload tension from the low back, they do so by promoting more rotation of hip which just puts more stretch on the piriformis I think. Am going to try a flat saddle (Selle Flite or Fizik Antares) again to see if this is the case.

Not sure exactly what I’m asking but just wondering if anyone else has successfully overcome similar issues?

Ta

As far as my Physio told me, the “Pigeon stretch” (modified upon a low wall/bench) is specifically for the piriformis.

I’m prone to SI problems – your core, hip position (consciously do tummy tucks/pelvic tilts as you bend over, get dressed etc.) are particularly important, as did switching on glutes and all you hip stabilisers.

I’d suggest seeing a sports specific physio to get going, & then don’t neglect the exercises you’re given.

As far as my Physio told me, the “Pigeon stretch” (modified upon a low wall/bench) is specifically for the piriformis.

Oh yeah, agreed, I was just advised that the last thing mine needs is more stretching, especially evident on the bike where my whole pelvis sits squint and the right piriformis us effectively in constant stretch already.

I’m prone to SI problems – your core, hip position (consciously do tummy tucks/pelvic tilts as you bend over, get dressed etc.) are particularly important, as did switching on glutes and all you hip stabilisers.

That all rings true, tummy tucks especially make the difference when I bend down for anything.

Am working with physio, we’ve not discussed S.I. specifically yet, but doing some v.basic hip and piriformis stuff.

Watching this with interest, been having trouble swinging my leg over a bike for 12 months now with hip and groin pain.

Finally got a referral from my GP to a physio in a fortnight’s time so hoping for some help then.

I started taking Ibuprofen daily for a month which helped, I stopped taking it after my GP appointment and within 4 days lower back, hip and groin pain is back worse than ever.

Tried lots of stretching, yoga and massage and nothing has solved it for now than a couple of days at a time so far.

So bad today I couldn’t get on the motorbike without a step🥺

Also tinkering with saddles, I thought ‘scooped’ saddles like a Specialized Power or Romin might help, and whilst I think they offload tension from the low back, they do so by promoting more rotation of hip which just puts more stretch on the piriformis I think. Am going to try a flat saddle (Selle Flite or Fizik Antares) again to see if this is the case.

Don’t just focus on the saddle itself; many pics of bikes I see on here have saddle heights that, when looking at the saddle angle – often nose tipped downwards –  suggest they’re too high for the rider. Tipping the saddle nose forward can feel like it gives you more “drive”, but it’s often because the seat is too high you have to tip it forward to reduce pressure on the perineum. Though this position seems to let you get on top of the gear a bit more and drive the cranks forward, in reality for a long day out on the trails it’s just bloody tiring, and as you rightly identify, perhaps not biomechanically the best position.

MAAAANY years ago I did a few ABCC coaching sessions that focussed upon saddle height & position. A big problem identified in then early nineties was that the (then) current idea of saddle height seemed to be directed by time trialists & triathletes and clearly their requirements are very different to a mountain bike.

If you’ve got access to discovery plus or Eurosport just watch some for the cobbles riding currently being shown; the old advice or guide used to be knee just slightly bent at your pedals lowest point, whereas the current pro will normally have his or her seat in a lower position that has your “sit bones” properly sat on the correct part of their saddle, meaning it’s far comfier for far longer and doesn’t put undue pressure on you hips, lower back or perineum.

So I’m looking at this almost exclusively from road and gravel riding, but your point still stands re: saddle height, it’s something I’ve never properly experimented with. I think it has drifted downward by about 10mm over the years compared to the last ‘accurate’ bike fit I had. I had noticed that the pros seem to have quite a bit more bend in their knee at the bottom of the stroke than I think I have.

My fear is that dropping saddle more will increase hip flexion at the top of the pedal stroke, if anything recently I’d been considering raising saddle slightly to open hips! I’ve always been averse to trying shorter cranks because if I like them I would have to swap them on the 4 bikes that I regularly use, gets expensive! I guess perhaps I could retire the old CX bike and just use the gravel bike year round, one less set of cranks to replace 🙄

Watching this with interest, been having trouble swinging my leg over a bike for 12 months now with hip and groin pain.

Sorry to hear that Smokey_Jo, sounds worse that what I’m dealing with.

I’m totally unqualified to comment but one thing I’ve had really good results with is proper diaphragmatic breathing (basically in through the nose, fill the belly, out through the mouth). Done properly it can have an amazingly relaxing effect and IF your issue is muscular you might find it helps relax said muscles which are perhaps compressing a nerve or something. I’ve struggled with a lot of mindfulness stuff but one thing that has stuck is the breathing technique as above.

I’m in a similar boat. I have been working on a series of exercises to strengthen my hips and lower back. I’d say that I have seen some improvement. What I have found is that I am more comfortable in the saddle now with less chaffing. And I have better lateral movement when skiing. I still have to make conscious actions to maintain the correct positions on the bike, but it’s getting easier.