How to Deal with Piriformis Syndrome

Hidden in the dense tissue of the hip is a little-known muscle called the piriformis. Extending from the sacrum to the top of the femur, the piriformis aids with the rotation and stabilization of the hip when running or walking, so it's pretty important!

When injured, the piriformis can cause severe pain due to its proximity to the sciatic nerve. This nerve runs from the spine past each buttock and down into our legs. The piriformis sits immediately next to the sciatic nerve and, in some cases, the nerve actually runs through the piriformis.

When a runner sustains a piriformis injury, it can manifest as a dull ache, a more stabbing pain, or even a radiating sensation of discomfort that originates deep within the butt, extending down the leg. Runners who are suffering from piriformis syndrome are often unable to sit for extended periods of time as the affected nerve makes it too painful to put weight on the butt. Walking, especially upstairs, can also be painful.

Running is usually not as painful as sitting, though the inflammation can create tightness in the upper leg which can affect one's form, leading to a hitch in one's stride or a sensation of not being able to fully extend out when pushing off the ground.

What can cause piriformis syndrome?

Overuse is the most typical reason the piriformis becomes injured and inflamed in runners. Other causes include excessive sitting, straining the piriformis by overworking it through heavy lifting with poor form, or even excessively running up hill or stairs. Whatever the cause, once this inflammation occurs, it can irritate the sciatic nerve which can cause pain not only in the immediate vicinity of the injury, but throughout the leg.

Though it is typically possible to run through piriformis syndrome, it is advisable to seek a medical professional at the onset of pain. If left untreated, piriformis syndrome can become chronic. Diagnosing piriformis syndrome can be complicated, though, because it shares symptoms with many other injuries such as sciatica and high hamstring tendinopathy. Heading to a trained physical therapist is the best way to receive a proper diagnosis and learn of the most effective treatment methods for your specific injury.

When treating piriformis syndrome, taking an anti-inflammatory medication, such as ibuprofen, is the best way to temporarily alleviate pain. Though it is not always necessary to stop running entirely when piriformis syndrome strikes, it is advisable to avoid exceptionally hard or long runs. Swift increases in effort can cause the injury to worsen.

Stretching the muscles of the upper leg and hips before and after each run will be one of the most effective ways to loosen the piriformis and treat the injury.

Utilizing a foam roller to massage the area around the piriformis is another way to break up inflammation and relax the muscles.

Finally, piriformis syndrome is often related to weak hamstrings, glutes and hips. Completing exercises such as lunges and squats will help strengthen those muscle groups and support the piriformis. (Again, we're fond of incorporating a regular strengthening and mobility routine into our training - something relatively low-effort that won't take a ton of time but will provide a lot of bang for your buck.)

Piriformis syndrome can be painful, but the methods for curing it are straight-forward. If you believe you may be suffering from piriformis syndrome, seeking the advice of a physical therapist is the first step on to getting back to running pain-free.

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