Piriformis: A Key muscle

The piriformis is a small, triangular-shaped muscle in the hip. It is primarily responsible for controlling the rotation of the hip while we walk or pedal. Because of its location, pain in the piriformis can feel like it is coming from the low back, the sacrum, or even the hip joint itself. Piriformis issues are easily mistaken for other, more common back injuries.

It is estimated that almost 1 in 10 cases of back pain actually come from the piriformis.  Often, patients suffering from piriformis syndrome have been through multiple treatment approaches and sometimes have even had procedures performed on them without relief.

Cyclists and runners are especially prone to piriformis syndrome. Because the piriformis controls the rotation of the hip, it is called upon to work hard with each stride and each pedal stroke. Shoes with poor support and especially core weakness can overtax the piriformis, causing it to become painful and eventually dysfunctional.

Certain bikes, with their aggressive seat angles and aero handlebar positions, are notorious for placing stress on the piriformis. Seats that are ill-fitting or just worn out from miles on the road can also be a factor. A good early stop for cyclists and triathletes with hip or back pain is to take their bike to a bike fitter.

Because of its negative impact on core strength, pregnancy is a big setup for piriformis syndrome. Most athletes don’t feel the effects until months or even years later. When their training intensity increases, typically so do their symptoms.

Foam rolling, using a physio roll to massage the piriformis, and strengthening the core are all great ways to get a jump on treating moderate piriformis syndrome at home.

At Grande Chiropractic, I treat this condition successfully with Active Release Therapy (ART) to break up adhesions formed by repetitive stresses put on this muscle. Often the symptom relief is immediate but the patient is aslo instructed on home stretches.