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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

How Physio Helps

  • Exclude referral from spine

  • Stretching external rotators

  • Electrotherapy modalities

  • Soft tissue massage

  • Trigger point release

  • Dry needling

  • Review of muscle strength and length to identify imbalance

  • Biomechanics review

  • Neural mobilisation

  • Strengthening exercises to correct muscle weakness and imbalances

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