Piriformis Syndrome

What is Piriformis Syndrome?

The Piriformis muscle is one of the small muscles deep in the buttocks that rotates the leg outwards. It runs from the base of the spine (the sacrum) and attaches to the thigh bone (femur) roughly where the outside crease in your bum is.

The sciatic nerve runs very close to this muscle and in some people (around 10% of the population) it passes straight through the muscles' fibres! If the piriformis muscle becomes tight it can put pressure on the sciatic nerve and cause pain which can radiate down the leg, commonly known as sciatic pain (see sciatica). It has been suggested that this condition would be better referred to as piriformis impingement due to the impingement of the sciatic nerve.

A common cause of Piriformis syndrome is having tight adductor muscles (inside your thigh). This means the abductors on the outside cannot work properly and so put more strain on the Piriformis.

Symptoms of piriformis syndrome:

Tenderness in the area of the muscle.
Pain in the buttocks.
Pain which radiates down the back of the leg, usually into the hamstrings and sometimes even the calf muscles.
It is common for pain to initially be confused with a hamstring strain or hamstring origin tendinopathy. However there will be no area in the hamstrings which is tender to touch.
Reduced range of motion of the hip joint (video), especially into internal hip rotation.

What can the athlete do?

Apply heat to relax the muscle. This should only be done if you are sure there is no acute injury.
Stretch the Piriformis muscle and other external rotators of the hip joint.
Stretch the groin (adductor) muscles.
Strengthen the Piriformis muscle and hip abductors.
See a sports injury professional who can advise on treatment, rehabilitation and prevention