How to Treat Piriformis Syndrome

Learn about piriformis syndrome and how to prevent and treat it from STACK Expert Andrew Meyers.

If you have ever had tightness or soreness in your glutes, which may or may not have radiated into your hamstrings, you might have suffered from piriformis syndrome. This injury is closely related to hamstring strains and can sometimes be mistaken for them. Because of this misdiagnosis, the injury isn't always treated properly, leading to a longer recovery time and keeping you off the field even longer. Here are some tips on how to diagnose, treat and prevent this injury so you can start running pain-free.

What Is Piriformis Syndrome?

The piriformis muscle laterally rotates your hip. It originates on the sacrum and passes through the greater sciatic notch to the posterior superior greater trochanter of the femur. The sciatic nerve passes underneath the piriformis, making it susceptible to irritation. Overuse and repetitive activities such as running can lead to trigger points, tightness and spasms in the buttocks. This can cause sciatic nerve pain, resulting in referring pain and tingling down the back of the thigh, as well as limited range of motion and tenderness.

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How to Prevent and Treat Piriformis Syndrome

1. Proper Warm-Up/Dynamic Stretching

Like any other muscle, the piriformis is more likely to become irritated and injured if it is not properly warmed up before activity. Before their workout, athletes should go for a half-mile to a one-mile warm-up jog, followed by 5 to 10 minutes of dynamic stretching to loosen up and prepare their piriformis for activity. Sample stretches include Soldier Walks, Lunges, Open and Close the Gate and Carioca.

2. Piriformis Strengthening Exercises

A weak piriformis muscle is more susceptible to injury from poor running form while fatigued. A strong piriformis muscle allows for a more efficient stride and prevents complementary muscles from having to perform activities during running for which the piriformis is normally responsible. Sample exercises include Glute Bridges, Squats, Theraband Lateral Walks and Theraband Clam Shells.

3. Myofascial Release/Foam Rolling

Self-massage through the use of myofascial release or foam rolling can greatly reduce tightness and soreness due to piriformis syndrome. By rolling out the piriformis and surrounding muscles, you decrease tightness and spasms that can irritate the sciatic nerve.

  • Grab a foam roller and place it under your buttocks.
  • Cross one leg over the other in a figure-4 stretch.
  • Roll your glute on the side of the bent knee back and forth slowly.
  • To get deeper into the muscle, roll your piriformis with a tennis ball or lacrosse ball.
  • Once you come across a tender spot, hold that point and put all your weight on it for 30-60 seconds.

4. Proper Cool-Down/Static Stretching

A proper warm-up is only half the battle. Athletes also need a proper cool-down. After your workout, go for another half-mile to one-mile cool-down jog followed by static stretching. This is a key to increasing and retaining flexibility in your piriformis muscle so it is not tight and stiff. Sample stretches include Knee to Chest, Cross-Body Glute Stretch, Straight Leg Hamstring Stretch, and Figure-4 Stretch.

5. Compression Shorts

Compression is everywhere in the field of athletics because of its proven effectiveness in keeping muscles warm and relieving tightness and soreness. It is one of the four components of R.I.C.E. (Rest, Ice, Compression, Elevation), which is implemented when preventing and treating injuries. Compression shorts or pants assist in keeping the piriformis muscle warm and elastic, decreasing the chance of irritating the sciatic nerve.

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