PIRIFORMIS, SCIATICA AND TREATMENT

Over the past 5 or 6 years, the piriformis is a subject that has come up on a regular basis as the culprit for problems such as sciatica.  So what is it, where is it, why is it a problem and how is it best treated?

Piriformis Muscle

It is a small, deep muscle originating at the base of the spine (sacrum) and attaching to the outside of the thigh bone round about level with the crease of your buttock.  It is involved in the external rotation (turning out) of the thigh.  Problems can arise if this muscle is too tight and presses against the sciatic nerve.  So what leads to a tight piriformis?

• Muscle imbalances caused by: Sitting for long periods of time, exercising on hard surfaces, overuse, increasing exercise levels too quickly, exercising too soon after a period of rest, exercising in ill-fitting shoes and not warming up/stretching out thoroughly.
• Biomechanical issues: Poor posture, tight stiff muscles of the hips and thighs, herniated discs.

Symptoms

• Pain deep into the buttock
• Pain all the way down the leg
• Reduced range of motion of the hip
• Tingling and numbness down the leg
• Weakness in the leg

Treatment

• RICE (rest, ice, compression, elevation) and a period of rest for the first couple of days in acute cases.
• Deep heat and massage: always see your physio to get a correct diagnosis aid recovery
• Stretching (http://www.youtube.com/watch?v=-lp9PPqzrWI)
• Strengthening (Pilates Oyster or any of the side leg series with toes turned out)

Prevention

• Always warm up thoroughly before exercise
• Always stretch out after your workout
• Following a Pilates or yoga programme will both strengthen and stretch the muscles of the hips and thighs and reduce muscle imbalances.

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