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I Spoke Too Soon, My Back Is Acting Up Again

Later in the day on Friday after my long hard ride, my back in the vicinity of my right SI joint got painful. It even bothered me sitting down and laying down so interfered with my sleep Saturday night. It has never happened before that this was precipitated by a bike ride, my back usually doesn’t mind those, especially on my recumbent. I was also getting some sciatica-like pain running down my right leg, which I have not had in a while. This made me think this might be the piriformis muscle, not the SI joint, because if it becomes spasmed it can press on the sciatic nerve crossing under it. Reading up on “piriformis syndrome and si joint”, I found that these two conditions can get mixed up as the piriformis crosses the si joint so symptoms can be similar and in the same area of the body. The piriformis muscle is attached at the hip and the sacrum. When it tightens it helps stabilizes the SI joint.

I have some other clues. When I go on long hard rides, especially if I am pushing a bigger gear doing intervals, I sometimes get butt pain, which I assumed was just the glute muscle complaining because I am working it hard. But the piriformis runs right under the glute, and the pain could have been coming from this. I experienced this pain on Friday’s ride and shrugged it off. Possibly the piriformis muscle became inflamed or even went into spasm. The other clue if that the symptoms were mostly gone by Saturday. It makes sense that a muscle spasm or inflamed muscle would calm down in one day, especially since I took anti-inflammatories Friday. It seems less likely that if I’d done something to inflame the SI joint itself it would have calmed back down so quickly.

So I decided to proceed as follows: as many days of rest until the symptoms are completely gone, then phase exercise back in slowly and easily. The mistake I made on Friday, after some rest and easy days following a setback, was to dive right back into my hardest ride, full length and full intensity. After my symptoms are gone this time, I’ll also slowly phase physical therapy exercises for SI joint strengthening, and also resume doing my strengthening and stretching exercises for the piriformis muscle. I’ll be seeing my orthopedic doctor on July 16, and hopefully either things will be better by then or I’ll be able to pursue it further with him.

An article specifically on the piriformis muscle and bicycling:

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