Hi Drew. An experienced physio, who specializes in
Sports Medicine or Sports Injuries can easily
diagnosis Piriformis Syndrome(PS) based on a manual
exam. As you probably already know PS is common among
runners.

A proper exam will evaluate the position of your
pelvis & how it moves. The fact that your leg turns
out after sitting, indicates at least one of your
external hip rotator muscles contracts while sitting.
This may or may not indicate Piriformis Syndrome. BUT
it does indicate your pelvis & muscles are not
functionally normally. The tough part is figuring out
what is causing what & how to treat it. Linja is right
about an old injury affecting something else &
haunting you, undiagnosed for years. This is
especially true of falls on the butt.

I am not a doctor or Physio. I speak only as an
experienced patient, who has tried many things for
these kinds of problems. I now see this pain complex
as primarily a muscle imbalance problem. MD's &
their fancy, expensive hardware cannot "see" the
problem & don't understand it.

I have been in far wost shape than you for years.
Despite endless doctors, tests, & drugs, the thing
that has helped me the most are masterful PTs
(physios) who "SEE" with their hands & have yrs of
experience in advanced manual techniques.

A starting point is to find a physio who has at least
10 yrs experience doing Myofascial Release Therapy &
has a good understanding of the biomechanics of the
pelvis.

Massage therapy or Cranial-Sacral therapy are, in my
opinion, very limited in what they can do.

I have been seeing a PT who uses the techniques of
Integrative Manual Therapy & have consistently made
progress. But as my therapist says, the longer you
have had the pain(dysfunction) the longer it will take
to "peel back the layers of dysfunction & muscle
compensation".

Dr. Sharon (Weiselfish) Giammatteo developed the
techniques. I think she taught seminars in Germany.
She might be able to recommend someone in England. I
don't know. You might be able to contact her through
some of the e-mail addresses found on
http://www.centerimt.com/education.asp
If you are interested in these techniques, see
http://www.centerimt.com/WhatisCenterimt.asp
There is a long description there. Scroll down to the
sections on Low Back and Hip Pain.

My therapist has not recommended any of the
nutritional supplements or psychological stuff
mentioned on the website. Which is great because I
think nutritional supplements is just a way for
practitioners to get patients to part with more money.

The "proof " in the pudding is the SKILL of the
therapist & the effectiveness of the techniques.

My general advice is to avoid surgery & try the
advanced manual techniques first. Good Luck. If you
find a good therapist in the U.K., please let us know.
We have another member there. Thanks & good luck to
you. Mary

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