I still clearly remember the first time I discovered my piriformis – I was running a lot at the time. I had just completed my first marathon and was set to run my second one less than six months later. I would be out for a run and have to stop for traffic, but as soon as I stopped my piriformis cried out and the only thing that seemed to give me relief was to actually press on it (in other words look like I was completely holding my own butt cheek) until I started running again. And although it would twinge a little while running, I never found it bothersome until I stopped or would just start moving again after a period of sitting.
The problem with Piriformis Syndrome, is that it can be very hard to diagnose and even harder to treat! It often presents in a similar manner to other conditions such as sciatica, gluteus medius dysfunction, herniated discs and other musculoskeletal disorders. As fitness pros we must remember that it is never our job to diagnose and that exercises to give some relief to the discomfort cannot be a substitute to a referral to a doctor or physiotherapist. Those clients that are looking to improve their core strength and turning to fitness to help, may be plagued by back pain if the piriformis is already aggravated or tight. That being said, I believe it’s definitely one of those muscles that we can all learn to lengthen, especially if repetitive activities such as running or prolonged sitting take up much of our day!
In order to understand how it can be such a pain, let’s take a closer look at where it is and how it functions. It originates at the anterior surface of the sacrum and inserts into the super aspect of the greater trochanter. It has an intimate relationship with the sciatic nerve as it runs anteriorly, posteriorly and through the piriformis muscle. The function of the piriformis is to laterally rotate the hip, abduct the hip when the hip is flexed and extend the hip. If the piriformis is continually in a shortened position (sitting for long periods of time) or if it is strained from overuse (running, hiking) it can cause it to compress on the sciatic nerve causing pain!
Because of the deep placement of the muscle, it is very difficult to treat. Rest is always the best option when overuse is the problem but may easily become a problem again when resuming normal activity. If the aggravation is due to running, making sure that the surface is level (not cambered to one side) and that you are not spending too much time downhill may help. Incorporating both exercises to length and strengthen the piriformis can also help to reduce the pain!
I’m sharing with you my top 4 exercises and stretches to incorporate into your fitilates classes or fitness programs. Click the box below to watch this free video now!