Piriformis: Pain in the You-Know-Where
September 2nd, 2009
I spend several hours a week working at my friend’s farm in North Yarmouth. It’s a pleasure to be out there – and every week I get to come home with a bounty of fresh, organic local vegetables.
Lately, the harvest has been full of bush beans and cherry tomatoes. While these veggies are delicious, they also require extended periods of bending over while twisting and reaching. This is murder on the low back!
To relieve the pain, I went to see a massage therapist friend. I told her I thought there was something out of whack with my sacroiliac joint. She poked around briefly and then mumbled “Nope. Piriformis.”
So what is this muscle? Piriformis originates from your sacrum (base of your spine) and attaches to the top of your thigh bone. It rotates your leg outward. When you lift your leg straight out in front of you, piriformis also brings the leg away from the center of the body, to the side. (Imagine a martial artist doing a roundhouse kick.)
When piriformis has a trigger point, you may feel pain down the back of your leg or into your sacroiliac joint (center of your low back). When piriformis becomes enlarged from repetitive use or strain, it can entrap the sciatic nerve, causing pain and numbness all the way down the leg!
This mimics the condition known as sciatica. It’s called “piriformis syndrome,” and it’s common in runners, golfers, and other athletes, as well as computer workers. It’s also common in people who carry wallets in their back pockets and sit on them all day.
Treating trigger points in the piriformis is just like treating any other muscle. My job involves bringing oxygen to the area, along with simple stretches to increase range of motion. Sometimes treatment may be slightly painful in the moment, but as long as it’s therapeutic pain (“hurts so good”), it may actually be beneficial. As always, remember to communicate with me about pain levels during treatment!
In between appointments, it’s a good idea to stretch your piriformis. I found a really nice video online explaining a good piriformis stretch. I’ve shown this stretch to many of you – it’s always good to see it again. Click here to have a look.
Keep in mind: proper form for this seated stretch is crucial! If you have difficulty maintaining proper form, you can also try this while laying on your back, which stabilizes your spine.