Piriformis Syndrome

The piriformis muscle is a pear-shaped muscle in the gluteal region. It has several implications in injuries of the body. 

I will usually include the piriformis muscle when strengthening and stretching the gluteal muscles because of the location.

The piriformis muscle starts at the sacrum and ends on the femur. It assists with external rotation or turning the hip outwards when standing or laying down. 

In most of the population the sciatic nerve runs underneath the piriformis muscle, however there are some people who have the sciatic nerve above or in between the piriformis muscle.

Issues caused by the piriformis muscle:

Piriformis syndrome (PS) is when the piriformis muscle is tight and presses on the sciatic nerve causing pain. With piriformis syndrome, the main pain is in the buttock region and some radiation down the back of the leg.

Compared to sciatica, PS is rare, only about 6%, but can be discovered by testing properly. If the tests are performed and cause pain in the glute region, you most likely have piriformis syndrome. 

One test is with a person on their stomach, the PT will rotate their leg inward and outward, if pain is reproduced then that is a positive test.

Another thing that tells me a patient has PS, is if they have more pain when sitting compared to standing. The increased pressure increases the pain.

Check out this article for more information on the piriformis and sciatic nerve variants.

How to Help Piriformis Syndrome

An active, healthy lifestyle is the best way to stave off any injury, but injuries do happen. Proper stretching and strengthening of the gluteal region are also necessary.

Piriformis stretch:

Clamshells

Hip abductions

Glute bridges with ER

My blog post about glute strengthening here, has others to work the entire area. Also, my post on nerve stretching here has a good stretch to improve sciatic mobility. 

The piriformis muscle is a pear-shaped muscle in the gluteal region that can cause some serious pain when not attended to.