Hi
Re piriformis bruising and need for surgery later. I have been undertaking this type of treatment for 16 years, and none of my patients has required surgery for release of haematoma scarring. Obviously, any patient on blood thinners, or high dose medications such as steroid or non steroidal anti inflammatories, requires great thought before treatment.
Alophysio: could the patient you know of already have some serious haematoma type tethering prior to their treatment: or could they have had an underlying venous malformation predisposing serious bruising. Did this patient have a piriformis problem due to an accident involving deep gluteal muscle or impact eg from a fall prior to their treatment?
All the above needs to be checked during assessment before treatment is implemented. Risk versus benefit analysis must always be considered. No treatment is always effective - not even doing nothing!
Regards
MrPhysio