Piriformis Syndrome

Piriformis syndrome is a condition in which the piriformis muscle becomes tight, or spasms, and irritates the sciatic nerve. This causes pain in the buttocks region, and may even result in referred pain in the lower back and thigh. Patients often complain of deep pain within the hip and buttocks.

The piriformis is a small muscle located deep within the hip and buttocks region. It connects the sacrum ( lower region of the spine ) to the top of the femur ( thigh bone ), and aids in external rotation of the hip joint.

The causes of piriformis syndrome can be categorized into two main groups : Overload ( or training errors ), and Biomechanical inefficiencies.

OVERLOAD : Piriformis syndrome is commonly associated with sports that require a lot of running, change of direction or weight bearing activity. A large proportion of cases occur in people who lead a sedentary lifestyle. Other overload causes are :

  • Exercising on hard surfaces
  • Exercising on uneven ground
  • Beginning an exercise program after a long lay-off
  • Increasing exercise intensity or duration too quickly
  • Exercising in worn out or ill – fitting shoes
  • Sitting for long periods of time


  • Faulty foot and body mechanics
  • Gait disturbances
  • Poor posture or sitting habits
  • Spinal problems – herniated discs and spinal stenosis
  • Poor running or walking mechanics
  • Tight, stiff muscles in the lower back, hips and buttocks
  • Running or walking with your toes pointing out


Pain, or a dull ache is the most common, often felt deep within the hip and buttocks region, but can also be experienced anywhere from the lower back to the lower leg.

Weakness, stiffness, and a general restriction of movement.
Numbness and tingling in the legs.


Immediately apply R.I.C.E.R. for 48 – 72 hours, which is :

Rest, Ice, Compression, Elevation, and Referral to an appropriate professional for an accurate diagnosis.

Next, apply heat and massage to remove scar tissue, and speed up healing of muscles and tendons.

Once most of the pain has subsided, it is time to rebuild strength, power, endurance and flexibility of the muscles and tendons that have been injured.


Firstly, warm-up thoroughly and correctly. You want plenty of blood flow to the hip area to loosen it up.

Secondly, adequate rest and recovery between workouts.

Thirdly, strengthening and conditioning the muscles of the hips, buttocks and lower back.

Fourthly, and arguably most importantly, practice flexibility exercises. When the muscles are supple, they are much less prone to over-stretching




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