The hip region of the body plays a vital role in our body’s strength, impact control and core stability. In particular, the piriformis muscle! Even though the gluteals (buttocks) are a major muscle group in this area, the piriformis still serves as a substantial component to hip movement and control. On the contrary it can have the potential to cause some significant pain.
Originating from the middle border of the sacrum just above the coccyx (tail bone) it connects into the head of the femur. Acting as an external rotator it moves the hip outwards opening the upper thigh away from the centre of your midline. Seems like a completely one dimensional muscle with a minimal role compared to other muscles or muscle groups in the body. Well it’s much more than what we give it credit for. When heel strike happens during the action of running, walking or standing; Shock from the impact transfers from the foot, through the ankle and knee joint into the hips. The piriformis in this case assists in the stabilisation of the hip joint. Given that we walk, run and stand quite a bit you can imagine how much work this support muscle actually does. Not to mention the assistance it provides the major gluteal muscles and your pelvic floor.
Leading back to the piriformis syndrome, let’s look at the symptoms. Seeking out the help of a health professional i.e. a physiotherapist or massage therapist is always advisable. If this is not an option, you can test at home individually for tightness which will reproduce the symptoms. This can be done seated and by crossing the affected leg/foot over the opposite knee. The outside of your ankle should be placed on top of your knee of the unaffected side. This side should be at 90 degrees when testing. If your knee on the affected side is pointing upwards and is somewhat difficult to push down, then this test is positive for piriformis tightness. This will usually be accompanied by pain felt on the outer part of your gluteals. Keep in mind that this test is also a great way of stretching the piriformis. A shooting pain may also be felt on the posterior (back) portion of the hamstring and also the calf whilst bending at the hip or sitting.
As the piriformis muscle sits directly over the sciatic nerve any tension or over activation can place pressure on the nerve causing referral down the leg. An anomaly occurs in roughly 10% of the population when the sciatic nerve runs through the piriformis and can be excruciatingly painful. Be careful not to self-diagnose this condition as referral can originate from a few regions so again, seek professional help.
Piriformis syndrome is very manageable with manual therapy, stretching and strengthening exercises. To improve any deficiency or decrease pain in the body you’ll need to not only seek treatment but improve weakened areas of the body. A physiotherapist, massage therapist or exercise physiologist can design a strength program tailored to your needs.
To book an appointment call one of our clinics or book online at prohealthcare.com.au
John Smith, Remedial Massage Therapist