Piriformis syndrome is a neuromuscular disorder that can compress the sciatic nerve, and while it can cause a lot of pain for runners, a simple piriformis stretch can often lead to relief.
The piriformis muscle is a small muscle that is situated deep in the buttock. It starts at the lower spine and connects to the upper surface of each thighbone. It helps rotate the hip joint and turn the leg and foot outward. It’s easy to see how runners can experience piriformis syndrome, but it has the potential to impact all of us. In fact, some people have likely had buttock pain without realizing it was piriformis syndrome.
The piriformis muscle enables us all to walk, shift our weight from one foot to another, as well as maintain balance. It is used a lot in sports that require lifting and rotating the thighs. When it goes into spasm, it can compress the nerve (sciatic) that passes alongside it. If you have ever felt a sciatic nerve pinch you know how shocking and painful it can be.
Piriformis syndrome can cause intense pain in runners
Runners use the piriformis muscle a lot. The buttock pain tends to happen when runners speed up their running too quickly or when they fall, thus injuring the muscle. Piriformis syndrome symptoms can keep runners on the sidelines for weeks or even months.
If a runner hurts his or her piriformis, the first sign might be tightness in the middle of the buttock or along the back of the hip joint. This can progress to a stronger feeling, like a Charley horse. When landing and pushing off during a run, the pain is much worse. At some point, the pain and discomfort becomes more pronounced, and the runner will have difficulty even walking and sitting for long periods of time. Some people with piriformis syndrome report having difficulty sleeping and driving a car.
Since the injured piriformis muscle is compressing the sciatic nerve, oftentimes a shooting pain will radiate down the runner’s leg and up to the lower back. The sciatic nerve can be pinched for other reasons, so piriformis muscle problems can be mistaken for other conditions.
Piriformis syndrome causes and symptoms
Our muscular system is a complex network made up of tissue, blood vessels, tendons, and nerves. As interest is sports has grown, so has the study of muscles (myology). Myology experts say exact piriformis syndrome causes are unknown. However, they suspect the following can lead to the condition:
- Tightening of the muscle due to injury
- Swelling of the piriformis muscle due to injury or spasm
- Bleeding in the area of the piriformis muscle
- Muscle spasm in piriformis muscle due to irritation in muscle or in a nearby structure.
While the most common piriformis syndrome symptoms are buttock pain and sciatica pain down the leg, there are other symptoms people with the condition can experience. Here are a few examples:
- Pain when walking upstairs
- Increased pain after sitting for long periods of time
- Reduced range of motion in the hip joint
- Stiffness and/or pain while walking
Piriformis syndrome treatment and prevention
When you have piriformis syndrome caused by activities, it is best to avoid the activities or positions that aggravate your symptoms – at least until the problem subsides. Rest, ice, and – in some cases – heat can minimize some of the discomfort. What may come as a surprise is how much piriformis syndrome stretches can help get you back to optimal condition and to the point where you enjoy your regular activities again. Many are amazed at how much better they feel after doing piriformis syndrome relief exercises such as stretching. Your doctor can suggest a physiotherapist who can guide you through piriformis syndrome exercises that help reduce sciatic nerve compression.
Your doctor may suggest other therapies, such as anti-inflammatories or muscle relaxants. In severe cases, surgery is an option, but it is always a last resort.
With piriformis syndrome treatment, one approach does not fit everyone, so make sure you keep track of all of your symptoms and how and when they occur, so you can discuss it all with your doctor. This will allow him or her to develop the best treatment plan.
Piriformis syndrome prevention is something we can all think about if we are active individuals. For example, runners should avoid hills or uneven surfaces. Warming up properly before physical activity is important, too. When we are involved in any sport, we should increase our intensity gradually. During exercise, walking, or running, using good posture is another way to prevent stress on the piriformis muscle.
Piriformis syndrome pain relief stretches and exercises
A wide variety of stretching exercises not only help decrease the buttock pain linked to piriformis syndrome, but also decrease the painful symptoms along the sciatic nerve and help return the patient’s range of motion.
Here are two simple piriformis syndrome stretches:
- Lie on your back with both feet flat on the floor and both knees bent. Pull your right knee up to your chest, grab your knee with your left hand and pull it towards your left shoulder, and hold the stretch. Repeat it for each side.
- Lie on your back with both feet flat on the floor and both knees bent. Rest your ankle of your right leg over your knee of your left leg. Pull your left thigh towards your chest and hold the stretch. Repeat this for each side.
For those who are prescribed exercise, here are more piriformis syndrome stretches that can be done at home:
- Foam Roll – Sit on top a foam roll with the foam placed on the back of the hip. Cross one leg over the other, with your foot on the opposite knee. Slowly roll the back of the hip, applying pressure on tender spots for 30 seconds.
- Statically Stretch the Piriformis – Lie on your back with one foot placed on top of a stability ball, with the other foot crossed over your knee. Pull the ball toward your body with your heel. Press the crossed knee away from you until a stretch is felt in the back of your hip. Hold for 30 seconds.
- Leg Slides – Lie on your back with your knees bent and your feet flat on the floor. Gently draw your navel towards your spine. Hold the contraction and relax as you slowly extend one leg until it is completely flat against the ground. Slowly return your leg to the starting position and repeat with the opposite leg.
- Floor Bridge – Lie on your back with your knees bent and place your feet flat on the ground, shoulder-width apart. Draw your navel in and contract your gluts. Slowly push through your heels and lift your pelvis off the floor until your knees, hips, and shoulders are in line. Hold the top position for a few seconds and then slowly lower your pelvis back down to the floor.
It is important for all of us to be active. Exercise keeps our heart and muscles strong, but remember: if you do run into a problem, stop whatever activity you are participating in, rest, and assess the pain. If the discomfort and pain do not go away, consider seeing a doctor. When it comes to piriformis syndrome, it is best not to push yourself and risk making the injury worse.
Sciatica nerve pain, or sciatica leg pain, occurs when a person experiences feelings of numbness or tingling, which begins in the lower back region through the buttocks and runs down the leg – the sciatic nerve. Sciatica nerve pain is a symptom related to an underlying condition that affects the sciatica nerve. Conditions that can lead to sciatica nerve pain are a lumbar herniated disc, degenerative disc disease, and spinal stenosis. Continue reading…
It’s a pain that runs from your lower back, through your buttocks and down the back of your leg. It hurts to sit, it’s uncomfortable to lie down, and it seems stretching doesn’t help. That pain you’re experiencing is an effect of your sciatic nerve and it can be severe. Continue reading…