Piriformis: The Persistent Pest

As a lifelong competitive runner, I’ve often chalked overuse injuries up to a rookie mistake for newbie runners. That is until Piriformis Syndrome literally bit me in the butt.

Life after collegiate athletics is one of many distractions. Without mandatory training room hours and the eagle eye of the Head Trainer, we let our stretching, strengthening and icing fall to the wayside. Doing the things we love (pounding the pavement day in and day out) is easy; however, taking the time for the things we need (proper warm up and recovery) gets overlooked. An imbalance in training that leads to muscular imbalances and, unfortunately, nagging injuries.

The piriformis, and his arch nemesis, Piriformis Syndrome don’t get the same top billing as some of the more common running injuries, but they are every bit as troublesome. The piriformis originates at the front of the sacrum and is situated partly within the pelvis against its posterior wall and partly at the back of the hip joint. It passes through the sciatic notch and when inflamed or shortened it compresses the sciatic nerve causing pain, tingling and numbness in and around the glute.

Often, the root of the injury is overuse and can be traced back to ramping up forward-moving activities (such as running) too fast, too soon. However, as I unfortunately discovered, it can also be a symptom of muscle balance – for me, the nasty side effect of a desk job and a one-dimensional training program.

Without a lateral stretching and strengthening regimen, we “forward-moving athletes” create relatively weak hip abductors, making us more susceptible to Piriformis Syndrome. Add 8-10 hours at a desk with our hips flexed, and we’ve got the trifecta of trouble: a too weak, too short and too tight hip flexor, which forces the piriformis to work extra hard, ultimately leading to inflammation and pain.

There is good news. Piriformis Syndrome can be managed and cured. The key is a little extra attention.

  • Reduce inflammation: If the muscle remains inflamed it will continue to aggravate the sciatic nerve, creating discomfort. Basic options are rest, ice and anti-inflammatory medications.
  • Stretch: Stretching the piriformis is essential to the healing process and there are specific exercises that target the muscle. Runner’s World helps break down some ideas to ‘get over it.’ The frequency of the stretch is critical, so, despite the grief that may come from coworkers, don’t be embarrassed to sprawl out in your cubicle (or wherever it is you spend your day) and loosen up a bit.
  • Strengthen: Work hip flexor strengthening exercises into your workout routine. Take a look at LIVESTRONG.COM for specific exercises that help you develop strength.

For more anatomy and injury fun, check out Moji’s interactive anatomy and injury locator.

Simply click on the small icons in the small left box to the left of the main image to select a front or back view.

Once you have the view of the figure that you desire,  click on any of the areas highlighted in orange to zoom in for more detail.

From that zoomed-in image, you can click on “INJURIES” or “MUSCLES/BONES.”  Roll your mouse over the small orange circles (INJURIES) or grey crosses (MUSCLES/BONES) on the image to see labels.

To see everything at once, simply click “SHOW ALL INJURIES” or “SHOW ALL MUSCLES/BONES” once you have selected “INJURIES” or “MUSCLES BONES.”

1 Comment

  1. Bobboblaw 7 years ago

    Very well written and informative article. Without the anatomy lesson I received at the beginning of this article, I would have had no idea what the hell the author was talking about. WELL DONE.


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