Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).
This condition is common amongst athletes and runners in particular, causing intense pain and it can keep you sidelined for weeks or even months. Piriformis syndrome is often light-heartedly referred to as a real pain in the butt for runners, but it’s no laughing matter. No matter how experienced you are and whether you are a marathon runner or a casual running fan, you don’t want to mess around with this one.
While there are many runners who don’t know what piriformis syndrome is, those who have had the misfortune to experience it will share stories of terrible discomfort that they never want to experience again. As we always try to outline to our patients, knowledge goes a long way in helping you avoid health problems, so you need to understand what piriformis syndrome is, what causes it and what you need to do to if you fall victim to this nasty syndrome.
The piriformis is a very small muscle that lies deep in both your hips’ muscle tissue. It begins at the base of your spine and attaches to your femur or thighbone at about the point where the groove in your buttocks ends. As small as it is, it has an important job because the piriformis muscle integrates with related muscles to perform two functions: When you extend your hip, it plays a role in letting your leg extend outwardly. It also lets your leg rotate inwardly when you flex your hip. For runners, the piriformis plays its biggest role when your foot is planted as you push off and stride.
How can such a small muscle make such a big difference? Positioning is the key here. Your sciatic nerve, or sciatica, runs right next to the piriformis muscle, and some 15 percent of us actually have sciatic nerves that run through it. Here’s where it gets complicated: The sciatica runs from the bottom of your spine, along your glutes and down the back of your legs. It’s the conduit for nerve signals that let muscles in the back, lower part of your body get to work when you need them. Because of their close proximity, when the piriformis gets irritated, your sciatica very often gets irritated too, and that’s called piriformis syndrome.
People with piriformis syndrome will tell you it is a deep, aching pain that causes a real pain in your butt as the pain radiates from the back or your pelvis to the top of your thighbone. The first signs you experience could be soreness in the middle of your butt or right along the back of the joint of your hip. Beyond the deep pain, symptoms often include weakness or even numbness in your lower back that runs down your leg into your calves and affecting your hamstrings, too.
Sitting for any length of time often makes the pain worse. It usually is very uncomfortable to walk, let alone run, or even sleep at night. Runners often report that they realized they had a problem when they felt pain strongly when they planted a foot in the process of pushing off and striding. Terrain such as hills, slopes or stiff turns, and a fast-paced run will really bring out the pain in runners.
So, what causes piriformis syndrome?
The interaction of this key cluster that includes your sciatica and piriformis muscle can be thrown off when a muscle known as an abductor muscle, which is on the outside of your hips, stops interacting properly.
When the abductor muscle isn’t doing its job properly, the piriformis picks up the slack and has to do both their jobs, resulting in an overworked, strained piriformis, which impacts the sciatica and triggers the syndrome. If you have lower back problems, it can cause the malfunction. It can also result from issues ranging from an uneven gait and a problem with your pelvic alignment due to overuse. Research has also shown runners who increase their mileage too quickly, add sprints to their runs or have taken a fall, are prone to piriformis syndrome.
There are so many other health problems with symptoms that are similar to piriformis syndrome that you need to see a medical professional at the first sign of trouble.
Are you experiencing any form of muscular aches and pains?
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Your chosen health professional will perform a variety of tests and may also order scans to determine whether you are suffering from piriformis syndrome or another problem with similar symptoms, such as spinal stenosis (a narrowing of the spinal canal) or a herniated disc in your lower back.
Once diagnosed, your health professional will direct your plan for recovery and it is very likely they will advise you to stop running immediately and take time off to rest. It is also extremely likely you will be referred to a professional myotherapist who will devise a specialised rehabilitation treatment plan based on your specific condition.
It may very likely include icing or heating or a combination of both and a combination of stretching and strengthening exercises to relieve the tightness, reduce your pain and address the underlying cause that resulted in your being afflicted with piriformis syndrome.
Many runners report they have had terrific success with myotherapists who are extremely effective in using soft-tissue therapies in order to treat a large number of problems ranging from headaches, back pain and plantar fasciitis to frozen shoulder, golfer’s elbow and knee problems.
Myotherapists are highly certified to perform treatments that target the injured area with techniques that restore normal texture, tension and motion and the dedicated, expert team at Elite Myotherapy deal with issues such a piriformis syndrom on a regular basis.
We encourage you to stay fit and healthy by whatever physical outlet you choose and if this is running, please take the necessary precautions to avoid injury by stretching. For those of you who take your running and your health seriously, we strongly recommend maintaining your muscles at an expert level with the proven physical prevention and treatment of injury that Myotherapy offers.