Piriformis Syndrome

Piriformis syndrome causes pain in the buttock which radiates down the leg and is due to the sciatic nerve being impinged by the piriformis muscle.

Symptoms

Symptoms include tenderness or pain in the buttock muscle. The pain may radiate down the back of the leg into the hamstring muscles 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, especially into internal hip rotation is often seen.

Explained

SciaticThe piriformis muscle is one of the small muscles deep in the buttocks that rotates the leg outwards. It runs from the sacrum bone at the bottom of the spine and attaches to the thigh bone or femur roughly near the outside crease of the buttocks.

The sciatic nerve runs very close to this muscle and in around 10% of the population it passes straight through the muscles fibers. If the piriformis muscle becomes tight it can compress the sciatic nerve and cause pain which can radiate down the leg, commonly known as sciatic pain.

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 tight adductor muscles on the inside of the thigh. This means the abductors on the outside cannot work properly and so put more strain on the piriformis muscle.

Treatment

What can the athlete do?

Piriformis stretching exercisesApply heat therapy to relax the muscle. This should only be done no acute injury or inflammation. Stretching exercises for the piriformis muscle and other external rotators of the hip should be done as well as adductor muscle stretches and exercises to strengthen the piriformis muscle can be done when pain allows. See a sports injury professional who can advise on treatment, rehabilitation and prevention.

What can a sports injury professional do?

Piriformis massageA sports therapist can use ultrasound to relax the muscle as well as apply specific sports massage techniques. Stretching the piriformis muscle using muscle energy techniques will release tension in the muscle. They will also advise on strengthening and rehabilitation to avoid injury recurrence.