Anatomy spotlight: Piriformis

Piriformis_musclePiriformis… some people know this muscle from having hip or sacrum pain, but many people know this simply as “a pain in the butt”. The piriformis is a small muscle located horizontally in the center of the glute tissue that connects the hip joint with the sacrum. It is one of the primary hip rotators which, just like it sounds, rotates the hip and leg outward or externally. We have 6 hip rotators located deep beneath the glutes with the piriformis being the one superior to the others, or closest to the crest of the pelvis. These 6 rotators all attach to the hip joint and connect to the sacrum and coccyx area via the sacrotuberous ligament. The sacrotuberous ligament is a part of a larger myofascial chain that includes the erector spinae (spinal muscles), and hamstrings – more on that in another post!)

When the piriformis muscle becomes tight, it can activate a trigger point in the direct center of the muscle belly that can refer a deep, aching pain in the hip and back of the hamstring. When this happens, people believe the pain they have is  “sciatica”, when in reality it is usually a trigger point referral condition called Piriformis Syndrome. The sciatic nerve runs either over, under or through the piriformis muscle depending on how you were built, but in most cases this pain is not a true nerve compression in the lumbar spine, or nerve impingement in the glute and piriformis muscle tissue.

The best way to stretch the piriformis is the do the “Figure 4” stretch. While a lot of people recommend doing this stretch while lying on the back, I find doing this while seated in a chair allows more control over the stretch and the ability to stretch deeper. The
“pigeon” pose in yoga is also a great one to isolate the rotators. And lastly, my favorite – the tennis ball! Place a tennis ball against the wall, position your glutes over the ball and roll your piriformis out on it. This is not for the faint of heart…it hurts, but SO necessary to keep this little, but important, muscle happy.


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