Piriformis Problems – A pain in the butt.

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

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 Glut 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 crumbling vertebrae or a herniated disc.

Order of treatment.

1)      Get to your Doctor. It is pointless treating a tight muscle which represents a relatively minor medical problem when in actual fact you have a spinal issue.

2)      Hopefully your results show that your spine and sacrum are in good health and that the nerve is not getting impinged from there.

If that is the case you have a few options: 

–          Treat at home with a mix of stretches, warm baths, light anti-inflammatory meds and a bit of rest. Only take anti-inflammatory meds after chatting to your pharmacist.

–          Your home treatment will be further aided by going for a massage I can help in this regard. I use an active release technique that really works well and have found dry needling to be very effective.

–          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. We have seen a number of people helped by simply getting into the right shoes.

–          Make sure that there is not a leg length discrepancy. You might need to go to a Podiatrist to correct an imbalance.

Runners should look at our Runner’s Leg Assessment.

This is one of the condition that can derail you. It needs to be acted on.
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Regards,

Mike Roscoe.
Kinesiologist.