Piriformis Syndrome

The piriformis muscle is responsible for rotating and stabilizing the hip joint. The sciatic nerve passes directly beneath or occasionally through the piriformis muscle. Due to this anatomic relationship, the sciatic nerve can be compressed due to tightness in the piriformis muscle or following a piriformis strain. When this occurs, the condition is known as piriformis syndrome.

Causes of Piriformis Syndrome

Piriformis Syndrome typically occurs due to tightness of the piriformis muscle. This may occur following piriformis injury, overuse of the piriformis, injury to the lumbar spine or due to repetitive strain or trauma. Piriformis syndrome is more common in sports or activities requiring repeated use of the piriformis muscle. These activities may include running, sprinting, jumping, squatting or lunging.

Characteristics and Clinical Presentation of Piriformis Syndrome

• pain or ache that is felt deep within the buttock
• Pain may also radiate into the back of the thigh, calf, ankle or foot
• Patients with piriformis syndrome typically experience an increase in pain when placing the piriformis muscle on a stretch.
• Patients may also have reduced hip range of movement and experience tenderness in the piriformis muscle on firm palpation.

Risk factors for developing Piriformis Syndrome

• muscle tightness (particularly the piriformis and adductor muscles)
• joint stiffness (particularly the hip, lower back, sacroiliac joints, or pelvic joints)
• muscle weakness (particularly the piriformis and gluteals)
• lower back injury
• poor posture
• excessive or inappropriate training
• poor biomechanics
• inadequate warm-up
• poor pelvic or core stability
• muscle imbalances

Physiotherapy Management for Piriformis Syndrome

In York-med physiotherapy, our registered physiotherapist provides a type of treatment to speed up the healing process and ensure the optimal outcome and reduce the likelihood of future reoccurrence. The treatment plan may compromise of :

• Traction to the lower limp in hip flexion/abduction
• mobs to SIJ
• massage and trigger point releases
• ultrasound to piriformis
• core muscle strengthening exercise program.