MUSCLE OF THE MONTH: PIRIFORMIS
This month we are looking in more detail at the piriformis muscle, which is found behind the gluteus maximus in the buttock (see our blog on Muscle of the Month: The gluteal muscle group).
A deep-set muscle in the lateral rotator group, it will be familiar to personal trainers and fitness instructors who have worked with clients who have suffered from Piriformis Syndrome.
THE ORIGIN AND INSERTION OF THE PIRIFORMIS
The muscle originates at the lower spine, on the anterior pelvic surface of the sacrum and the gluteal surface of the ilium. It then attaches to the superior margin of the femur (thigh bone).
The piriformis runs diagonally, covering the top of the sciatic nerve at the pelvis.
THE ACTION AND BASIC FUNCTIONAL MOVEMENT OF THE PIRIFORMIS
The key actions of the piriformis are:
- To aid the external rotation and abduction
- To aid the rotation of the hip
- To stabilise the sacroiliac joint
- To abduct the femur when the hip is flexed
- It also helps in turning the foot outward.
COMMON EXERCISES FOR THE PIRIFORMIS
Exercising the piriformis is important as although it’s a well-hidden muscle, it’s widely used in everyday functional movement. Over-using a weak piriformis muscle can lead to Piriformis Syndrome (see below).
Exercises to work the piriformis include:
- Squats, dumbbell squats, barbell squats, squat jumps
- Lunges, dumbbell lunges, side lunges, reverse lunges with knee lifts
- Side leg raises, inner thigh leg raises
- Glute raises, bridges
WHAT IS PIRIFORMIS SYNDROME?
Piriformis Syndrome is a neurological condition, when the piriformis muscle spasms, tightens or swells, usually due to injury or sudden over-use. This causes pain or a dull ache in the buttock, particularly after being seated for a long period or while walking up a slope or stairs. In some cases the piriformis compresses the sciatic nerve, causing pain and numbness in the thigh, calf and foot. Although similar to sciatica, Piriformis Syndrome is a distinct condition that requires specific treatment.
It is usually diagnosed through medical examination and can take weeks or even months to resolve.
Options for treatment include:
- Specific stretching exercises, recommended by a doctor or qualified fitness professional
- Physical therapy
- Deep massage by a qualified physical therapist or sports massage therapist
- Ice or heat treatment
- Injection of a local anaesthetic and corticosteroid
- Electrical stimulation eg with a TENS machine
Although not a particularly well-recognised muscle, the piriformis has a key role in lower body movement and should not be neglected if you want to avoid Piriformis Syndrome.
If you think you may have over-used the piriformis and are experiencing pain or discomfort in the buttocks or legs, your first course of action should be to seek advice from a qualified medical professional.