The Piriformis Muscle
The Piriformis muscle is a deep muscle located beneath the gluteal (Bum Muscles) and can for alot people become tight and compress down onto the Sciatic nerve causing what we call Piriformis Syndrome.
This muscle is important for all of us but especially for athletes who participate in running sports that require sudden changes of direction.
The piriformis works along with other hip rotators to turn the hips and upper leg outward (external rotation of the hip). Strong and flexible hip rotators keep hip and knee joints properly aligned during activity and help prevent sudden twisting of the knee during quick side-to-side movements, quick turns, lunges or squats.
A condition called "piriformis syndrome," which causes pain deep in the hip and buttock, is believed to be caused when the piriformis muscle compresses the sciatic nerve. Stretching and strengthening a tight or weak piriformis muscle has been found to reduce or alleviate this pain in some athletes.
Sciatica and piriformis syndrome can seem quite similar, parularly in terms of symptoms, and this similarity in how they feel has caused considerable confusion for doctors and patients alike. Some individuals have stated that they are actually the same thing, but despite similarities in symptoms, the underlying
causes of the two conditions are different.
Sciatica refers to irritation of the sciatic (often mis-spelled as syatic or psyatic) nerve, that arises from nerve roots in the lumbar spine. The most common cause of sciatic nerve irritation, or "true" sciatica is compression of one or more of its component nerve roots due to disc herniation or spinal degeneration in the lower lumbar region. Sciatica usually begins in the buttock area and, depending on the severity of the underlying nerve comression and inflammation, may extend down the entire leg to the ankle and foot.
Piriformis syndrome is sometimes called false sciatica, because instead of actual nerve irritation, it is caused
by referral pain.) caused by tight knots of contraction in the piriformis muscle, which attaches to the upper femur bone and then runs across the back of the pelvis to the outside edge of the sacrum, the triangular pelvic bone at the base of the spine. The symptoms of piriformis syndrome are very similar and may be indistinguishable from true sciatica.
In some cases, piriformis syndrome may cause true sciatic nerve irritation, as the sciatic nerve may run
underneath or even through the middle of the piriformis, so contraction of the piriformis may produce sufficient compression of the sciatic nerve to produce actual nerve symptoms. This is one of the main sources of confusion when it comes to distinguishing true sciatica from piriformis syndrome.
As mentioned earlier, the symptoms of true sciatica are very similar to piriformis syndrome. Both cause pain, tingling, burning, "electrical shock" sensations, and/or numbness down the leg, often all the way to the foot. In addition, both sciatica and piriformis syndrome tend to be at least partially related to biomechanical functional problems in the joints of the back and pelvis and they may even be present simultaneously in the same person, so it an be difficult to tell them apart.
But since the most effective treatment for the two conditions varies signficantly, it is important to determine the correct diagnosis if at all possible. In most cases there is an easy way to distinguish between sciatica and piriformis syndrome.
In most cases, sciatica can be differentiated from piriformis syndrome with a couple of simple test maneuvers.
To begin, from a seated position, one straightens the knee on the side of sciatic pain, holding the leg out straight and parallel to the floor, and if this position causes an increas in symptoms, it is a good indicator of true sciatica.
The second maneuver is done in two parts. First, from the sitting position one bends the leg and pulls the knee on the painful side towards the same-side shoulder. In all but the most severe cases, there is usually no major increase in pain in this position. The second part of the maneuver is to pull the knee toward the opposite side shoulder. An increase in the sciatica-like symptoms is a strong indication of piriformis
It is important to distinguish between sciatica and piriformis syndrome, because the treatment for the conditions varies, and getting the diagnosis right typically leads to more effective treatment.
At The Therapy Rooms we are very successful at trating both Pirifomus and Sciatic problems with our Myo massage, but first we will need you to come in for a consultation. Please see some of the exercises below that will help most of you until we can see you.
How to Stretch the Piriformis Muscle - Simple Piriformis Muscle Stretch Options
- Sitting Cross-Legged. One of the easiest ways to keep your hips open
and stretch your piriformis muscle is by sitting cross-legged on the floor for
several minutes a day.
- Piriformis Chair Stretch. Another easy way to stretch out the
piriformis, especially if you have a desk job, is to cross one leg over the
other with your ankle resting on the knee of the opposite leg. Gently press down
on the inside of the knee and slowly lean forward until you feel a mild stretch
in the hips.
- Lying Piriformis Stretch. A more intense
stretch can be performed while laying on your back on the floor. Cross the right
leg over the left, with the right ankle resting on the left knee. Slowly lift
the left foot off the floor and toward you while you apply gentle pressure to
the inside of the right knee. Hold 20 to 30 seconds, and repeat on the other
Advanced Piriformis Stretch - Pigeon PoseThis stretch, pictured above,
is a more advanced piriformis and hip stretch, in which you use your whole body
weight to stretch the piriformis, the IT band and other hip rotators. Use caution as
you get in to and out of this pose.
- Start in a push-up position on your hand and toes.
- Slide your right knee forward toward your right hand. Angle your knee, so
the outer ankle is touching the floor (see picture).
- Slide your left leg back as far as comfortable.
- Keep your hips square to the floor.
- You should feel a deep stretch in your right glutes (buttock), hip and the
- You can either stay up on your hands or fold forward and let your forearms
rest on the floor in front of you or fully extend your arm in front of you.
- Breathe slowly and deeply from your belly. Hold the stretch 30 seconds to
60 seconds and release. Repeat on the other leg.