Piriformis Problems – A pain in the butt.

Piriformis Muscle. Where is it, and what it does?

This muscle lies beneath the gluteus maximus muscle. Piriformis problems can be both painful and debilitating. Its origin is on the lateral surface of the sacrum and it inserts on the superior portion of the greater trochanter.  It is a relatively small muscle that helps with the external rotation of the hip joint. Stand on the heel of your foot and turn your foot outwards, away from you. Your piriformis just got busy. Turn your toes inward and you start to stretch the muscle.

What can go wrong in the area?

Your sciatic nerve runs under the muscle. So, if you peeled a human being back in this area, you would get the glute muscle, then the piriformis muscle, then the sciatic nerve and then the hip bone. The sciatic nerve is the largest nerve in the body, and is used to send information back and forth between the brain and legs. The nerve is as thick as your thumb in this area.  Piriformis syndrome happens when the muscle goes into a spasm and begins to place pressure on the sciatic nerve.

The pain caused by this constriction can radiate into the buttock, down the thigh and up into the spine. Piriformis syndrome can also include tingling, or numbness normally in the buttocks. Running and sitting in a car can aggravate the condition.

Caution needed here.

The problem with Piriformis syndrome is that it’s symptoms are very similar to spinal issues such as a herniated disc.

Order of treatment.

1)       Get assessed and if necessary get onto a program that a. Helps get the muscle released. I have found that getting a dry needle into a specific spot can make a huge difference. b. You need to get the area more strong and stable. Part of the goal is to look for areas of weakness and address that with a progressive strength protocol. You will probably need the muscle released a few times as you progressively get the surrounding areas strong and stable. I have left the Whatsapp number below if you feel that I can help here.

2.     If pain continues or gets worse it is time to get an x ray as a start to begin to understand if something is happening in the lower back. You GP will be able to advise the route forward that might include a MRI and a trip to an orthopod.

A few other options:

–          Anti-inflammatory meds after chatting to your pharmacist.

–         Stretching can help but can also make matters worse if there is a tendon issue.

–          Make sure that you are in the correct pair of running shoes. Excessive pronation will cause the leg to rotate inwards and over work the muscle. The internal rotation of tibia and femur places strain on the muscle as it tries to counteract the movement. All treatments will be negated if you continue in the wrong shoes. I have seen a number of people helped by simply getting into the right shoes.

Runners should look at our Runner’s Leg Assessment.

Hopefully this article helps. Reach out via Whatsapp on 066 236 9187 if you feel I can help.

Regards,

Mike Roscoe.
Kinesiologist.