If there is one muscle that seems to cause a lot of people pain and misery, it is the Piriformis muscle.  This small hip rotator spans from the base of the Sacrum to the top of the Femur and can become tight and painful from excessive sitting OR excessive activity like running.  The reason this muscle seems to be the bane of so many is due to its anatomical position.  You see, just deep to the Piriformis muscle is the Sciatic Nerve.  Theoretically, if the Piriformis gets tight enough, it can cause pain all by itself or put pressure on the Sciatic Nerve below it.  In any circumstance, it is not fun and it prevents a lot of people (maybe you) from enjoying their favorite activities.

How Do I Diagnose It?

If you are suspicious of having this condition there are a few things you can look for.  

  • Pain that radiates down the leg
  • Presence of a tight, painful band of tissue in the middle of the hip (a tight Piriformis)
  • Pain with prolonged flexion of the hip such as with sitting or running.

There are other tests that are performed by healthcare professionals such as the FABER Test or the FAIR Test.  These tests are fairly easy to perform and may help in your quest to diagnose yourself.  

What Can I Do About It?

There are loads of ways you can treat the Piriformis.  One way is to stretch it.  You can sit on a chair and cross the painful side’s ankle over the pain-free side’s knee.  Then gently lean forwards and hold this stretch for 60 seconds.  Repeat up to 5 times.  This is a stretch that can be repeated as often as necessary to decrease the pain and tightness felt in that hip.  

Another great way to self treat the piriformis is with soft tissue mobilization.  You can get a tennis ball and place it on the ground.  Then slowly and gradually, put the weight of your body over that tight Piriformis muscle.  The key here is to go slow and spend as much time as possible (I usually suggest between 10-15 minutes or as tolerated) treating that hip.  Check out my video here https://business.facebook.com/thatstheknot/videos/1899125610304139/

If those strategies still don’t work for you, you may need the help of a healthcare professional.  I personally prefer treating this condition with dry needling (Yes, I am very biased.)  This is a great way to directly treat the muscle, get it to relax and take pressure off the Sciatic Nerve FAST.

Conclusion

Having Piriformis Syndrome is painful and can prevent you from enjoying activities that require both sitting and standing.  This can make treatment of the condition challenging at times.  If you have questions about this condition, please feel free to reach out to me via email at doc@thatstheknot.com or call me directly at 479-402-9400.  

Dr. Christian Robertozzi

Author Dr. Christian Robertozzi

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