Piriformis Syndrome: A pain in the butt!

Piriformis Muscle

Piriformis Syndrome

The Piriformis syndrome can be addressed and you do not need to go straight to a hip replacement. Take a second to think about your favorite activity. You’ve done it for years, either recreationally or professionally. Lately, the unrelenting pain in your hip has made it difficult to go on. So you end up switching things up-singles tennis to doubles, or from full-court basketball to half court.

Pretty soon, the pain grows so bad that you end up giving up your favorite activity altogether. You dread seeing a specialist because you’re concerned that they will say you need a hip replacement. And that will take you out of activity completely, right?

Well, there are other options than a complete hip replacement.

The Piriformis Muscle

The Piriformis muscle, although small in size can have a huge impact on how smooth the body’s movements are. It essentially makes walking and balance possible. Addressing an overactive piriformis can be part of the solution!

The piriformis is a small muscle that sits on the front surface of the sacrum and attaches to the trochanter of the top of the big leg bone near the hip.

It plays a huge role in stabilizing the hip and pelvis when the foot is on the ground and allows the thigh to rotate on the body when the foot is off the ground.

An important thing to note is that in most people, the sciatic nerve rests underneath this muscle, but in about 15% of the population, the sciatic nerve passes through the muscle.

Piriformis syndrome has traditionally been described as a pain caused by a spasm of the piriformis muscle. Pain with sitting is common, as well as pain with hip flexion, adduction, and internal rotation.

Although the symptoms of Piriformis Syndrome are quite easy to identify, the reason why the piriformis is in spasm is often described as “undefined and confusing”.

Read this blog to learn how to stay active even if you have pain in your hips and knees.

Who’s Most Likely To Suffer From Piriformis Syndrome?

Now going back to whether or not the sciatic nerve goes underneath or through the muscle, those people with an atypical sciatic route through the muscle are more inclined to suffer from piriformis syndrome.

People who sit on hard seats often or for long periods of time, commuters who get pain when sitting and reaching for the pedals, and people with chronic low back pain.

Luckily, there are techniques that we have in place to decrease and reduce the pain caused by piriformis syndrome.

watch this video for exercises to help you stretch your hip flexors

Piriformis Stretch

Taking the time to actually stretch the piriformis muscle itself could help immensely. To do so, start by lying flat, either on the floor or on a bed, with both knees straight. Pull the right knee up to the chest, grasp the knee with the left hand and pull it towards the left shoulder.

Now hold for thirty seconds. Repeat three times on each side. This stretch aims to decrease the painful symptoms along the sciatic nerve and help you return to your desired range of motion.

Gluteus Medius and Piriformis Lacrosse Ball

A tennis ball, baseball, or lacrosse ball can be used to roll out the glute muscles. Both aim to release the tension in the targeted area. While laying on a flat surface sit on the lacrosse ball with your right cheek but not directly but off to the side.

Take your right leg and cross it over your left knee and begin to make small circular motions. Start by going counterclockwise and then clockwise. This can be performed for two minutes on each side.

Both of these exercises are great for those experiencing hip, glute, and leg pain.

In the end, taking two minutes out of your day to stretch the Piriformis muscle could serve to decrease the pain and get you back to living life.

To see how both of these techniques are performed, watch the video below.



Nick Hunter, PT, DPT
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