Sports Massage

The following sports massage guide is intended for information purposes only. We recommend seeking professional advice before attempting any self help treatment.

IMPORTANT: Before starting any massage treatment the therapist will check for contraindications (if any apply to you, then massage is not allowed) Click for details.

Massage can be used in the treatment of Sacroiliac joint pain, to ease muscle spasm and help correct muscle imbalances through improving flexibility. With this in mind, sports massage may be applied to:

The lower back muscles
The buttock muscles such as gluteus medius and piriformis
Any other associated tight muscle groups, such as the hamstrings or hip flexors.

Here, we have focused on massage techniques for piriformis and the glutes. Other techniques can be found in our sports massage section .

What equipment is required?

A lubricant is needed to allow the hands to glide smoothly. A number of massage oils are available to buy.
A cheap but effective alternative is simple baby oil.
Do not use too much oil. Enough to allow for smooth, controlled movement is required but too much will mean a lack of control.
A firm, flat surface to lie on in order to apply pressure.

The Piriformis muscle

The piriformis is located on the underside of the sacrum and travels underneath the gluteal muscles and attaches to the top of the femur. It is responsible for outward rotation of the thigh.
The piriformis can often become shortened as a result of many biomechanical problems.
Often, if the piriformis muscle is tight on one side, the whole leg will appear to be rotated outwards. You can see this clearly at the knee or foot in either standing or lying.
Often this is due to adaptive shortening of the piriformis from long periods of driving. Your foot is externally rotated to be placed on the accelerator, especially on long journeys on a motorway.
A shortened piriformis can have a sideways pull on the sacrum and affect its function.
It can also be the cause of Sciatic nerve impingement as it is located adjacent to this nerve where it exits from the ilia.
The piriformis is also a common site for trigger points which are very tender to the patient if you palpate them.

Quick diagnostic test for piriformis shortening

Lay on your front with both knees bent at 90 degrees.
Allow both ankles to move away from each other to their maximum range and compare.
They should be equal and the less distance apart they travel indicates the tightness of the piriformis muscles.

Treatment with sports massage

First, the muscles of the buttock should be warmed up using gentle techniques which become gradually deeper. Stripping the piriformis muscle can be quite uncomfortable for the patient so make sure you check regularly if the pressure is ok.

Effleurage

With the hands stroke lightly but firmly upwards from the back of the knee, up the thigh and over the buttocks.
Once at the top of the buttocks, slowly return the hands to the starting position, applying no pressure.
Try to cover as much of the surface as possible with the hands.
Apply this technique 5 to 10 times before moving on to concentrate on the buttocks only.

Petrissage

Use firmer kneading movements in a circular manner on the buttock.
Aim to move and manipulate the muscles with the hands > Play video
Gradually increase the pressure you use.
Apply this technique for around 5 minutes to ensure the tissues are thoroughly warmed up before progressing to the really deep techniques.

Stripping the Piriformis

Apply firm, sustained pressure along the length of the muscle with the heel of the hand.
Start at the centre of the buttock and apply pressure outwards, towards the top of the thigh > Play video
This can also be done with the elbow to get even deeper into the muscle. However it is difficult to really feel the muscle with the elbow.

Please note:

It is common for the area to bruise following treatment so patients should be forewarned that this is likely. This can avoid complaints of overuse of pressure at a later date.
This is not a green light to put the patient through torture and you should try and work to acceptable levels of pain tolerance by constantly asking for patient feedback.

Finishing off