WHAT IS IT? PIRIFORMIS SYNDROME
The piriformis is a muscle which is situated in the buttock, running from the greater trochanter to the sacrum.
The sciatic nerve passes under, or in some cases, through the piriformis muscle. Therefore, tightness of the piriformis can compress the sciatic nerve and result in buttock or sciatic leg pain.
The piriformis provides a stabilising role, and can be overloaded resulting in tightness if there is a lack of pelvic stability from core muscles. It is also involved in rotation of the hip.
Signs & Symptoms
Deep pain in the buttock
Tenderness and tightness in the mid portion of the buttock
Possible referral along the back of the thigh down the leg
Aggravated by prolonged sitting, squats, stairs
Pain on resisted external hip rotation
Pain on stretching into internal hip rotation
Reduced hip range of movement
What Causes It?
Tightness of the piriformis muscle
Poor core stability
Tightness of adductor muscles
Weak glute medius and piriformis muscles
Path of the Sciatic nerve (resting on or running through the piriformis muscle)
How to Self Manage
Rest from aggravating activities
Stretching of the piriformis muscle
Self massage by sitting on a tennis ball
Chronic conditions will be likely to take longer to resolve. In the case of chronic muscle shortening, those individuals may be more prone to repetitive strain and irritation.
How Physio Helps
Exclude referral from spine
Stretching external rotators
Soft tissue massage
Trigger point release
Review of muscle strength and length to identify imbalance
Strengthening exercises to correct muscle weakness and imbalances