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[E381]Exercises For Piriformis Syndrome

by Brad Walker, Bra

Piriformis syndrome is a condition in which the piriformis muscle becomes tight or spasms, and irritates the sciatic nerve. This causes pain in the buttocks region and may even result in referred pain in the lower back and thigh. Patients often complain of pain deep within the hip and buttocks, and for this reason, piriformis syndrome has also been referred to as "Deep Buttock" syndrome.

What is the Piriformis?The piriformis is a small muscle located deep within the hip and buttocks region. It connects the sacrum (lower region of the spine) to the top of the femur (thigh bone) and aids in external rotation (turning out) of the hip joint.

Many muscles and tendons make up the hip and buttocks region. The piriformis is the horizontal muscle in the center, running over the top of the sciatic nerve.

What Causes Piriformis Syndrome?Piriformis syndrome is predominantly caused by a shortening or tightening of the piriformis muscle, and while many things can be attributed to this, they can all be categorized into two main groups: Overload (or training errors); and Biomechanical Inefficiencies.

Overload (or training errors): Piriformis syndrome is commonly associated with sports that require a lot of running, change of direction or weight bearing activity. However, piriformis syndrome is not only found in athletes. In fact, a large proportion of reported cases occur in people who lead a sedentary lifestyle. Other overload causes include:

Exercising on hard surfaces, like concrete;
Exercising on uneven ground;
Beginning an exercise program after a long lay-off period;
Increasing exercise intensity or duration too quickly;
Exercising in worn out or ill fitting shoes; and
Sitting for long periods of time.

Biomechanical Inefficiencies: The major biomechanical inefficiencies contributing to piriformis syndrome are faulty foot and body mechanics, gait disturbances and poor posture or sitting habits. Other causes can include spinal problems like herniated discs and spinal stenosis. Other biomechanical causes include:

Poor running or walking mechanics;
Tight, stiff muscles in the lower back, hips and buttocks;
Running or walking with your toes pointed out.

SymptomsPain (or a dull ache) is the most common and obvious symptom associated with piriformis syndrome. This is most often experienced deep within the hip and buttocks region, but can also be experienced anywhere from the lower back to the lower leg.

Weakness, stiffness and a general restriction of movement are also quite common in sufferers of piriformis syndrome. Even tingling and numbness in the legs can be experienced.

In the second part of this two part series, I’ll discuss treatment methods for piriformis syndrome, as well as go over a few tips for prevention. Often a few moments of carefully thought out warm-ups or stretches will save you a lot of pain in the future.

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What is Piriformis Syndrome?

Piriformis Syndrome is the name of a painful nerve entrapment condition in which the sciatic nerve is placed under abnormal pressure by the piriformis muscle. The piriformis muscle attaches to the sacrum bone of the low back to the top of greater trochanter of the femur (thigh bone) and lies on top of the sciatic nerve. When the piriformis muscle becomes tight and enlarged, pain results from myofascial trigger points (knots) in the muscle, pressure on the sciatic nerve, and sometimes from the S-I Joint in the low back. Pain from Piriformis Syndrome is usually found in the extreme low back, buttocks, hip, and often the back of the thigh. Most of the time the symptoms are on one side, but may affect both sides in some cases. Additionally, people with Piriformis Syndrome often have trouble sitting for long periods and the pain may worsen when walking or squatting.

What is the cause of Piriformis Syndrome?

There are a number of causes for Piriformis Syndrome including direct blunt trauma to the buttocks, prolonged sitting while working or driving, Morton's foot, or S-I Joint instability. Frequent or prolonged running on canted surfaces and participation in sports requiring quick lateral movement such as tennis, skiing, and basketball may also overstress the piriformis muscle and lead to Piriformis Syndrome.

Massage Therapy and Bodywork for Piriformis Syndrome

There are many ways that massage therapy and bodywork can be used to treat Piriformis Syndrome. The massage therapist will employ a number of techniques to relieve the condition. For example the massage therapist may use Neuromuscular Therapy or Trigger Point Therapy to eliminate myofascial trigger points in the piriformis muscle. The massage therapist could also use Myofascial Release techniques or Deep Tissue Massage techniques to release adhesions between the piriformis muscle and surrounding tissues while also using Muscle Energy Techniques to gently lengthen the piriformis muscle. Piriformis Syndrome also responds well to positional release therapies such as Ortho-Bionomy which work with the body's nervous system to release muscles and improve joint movement in the area. In addition to working on the piriformis muscle it may be necessary to provide therapy for other muscles near piriformis and even to muscles opposing piriformis to improve muscular balance. Comprehensive treatment with massage and bodywork, in conjunction with a home program of stretching and exercise, usually helps to completely resolve Piriformis Syndrome.

Other Treatments for Piriformis Syndrome

While massage therapy and bodywork are an excellent treatment for Piriformis Syndrome there are other treatments you should discuss with your physician:

Anti-inflammatory medications
Anesthetic and Steroid Injections
Surgery

Other Names for Piriformis Syndrome

Pseudosciatica
Back Pocket Sciatica
Deep Gluteal Syndrome
Hip Socket Neuropathy

The information on this page has been provided for information purposes only. It is not meant to provide a medical diagnosis, only a licensed physician may diagnose Piriformis Syndrome. If you feel that you have the symptoms of Piriformis Syndrome please see your physician for a proper diagnosis and plan of treatment which may include massage therapy and bodywork. There are a number of more serious conditions that resemble Piriformis Syndrome that could require immediate medical attention.

If, after consulting your physician, you would like to pursue treatment of Piriformis Syndrome with Massage Therapy and Bodywork please contact me at my San Antonio Massage and Bodywork practice or contact a Massage Therapist near you.

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About Author

Both Brad Walker & Ben Crabtree, LMT, CNMT are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

Brad Walker has sinced written about articles on various topics from Fitness, Supplements and Shoes. Article by Brad Walker. Brad is an internationally recognized stretching and sports injury consultant with 20 years of practical experience in the health and fitness industry. Brad is also the author of The Stretching Handbook, The Anatomy of Stretchin. Brad Walker's top article generates over 1900 views. to your Favourites.

Ben Crabtree, LMT, CNMT has sinced written about articles on various topics from Massage, Fitness and Massage. Ben Crabtree is a Licensed Massage Therapist, and Certified Neuromuscular Therapist in San Antonio, Texas. His practice is dedicated to relieving pain through the use of several massage and bodywork. Ben Crabtree, LMT, CNMT's top article generates over 49500 views. to your Favourites.