Identify Piriformis Syndrome

Piriformis syndrome is truly a pain in the butt, but it’s a condition that runners can easily keep in check in a variety of ways. Piriformis pain most commonly presents in runners as a dull and deep pain that is located pretty much right in the centre of the buttocks. The pain is often felt after long periods of sitting and during periods of general inactivity. In some cases, the pain may radiate down the back of the leg, down through the lower leg and even cause numbness in the feet when the sciatic nerve is affected. Piriformis syndrome has actually been identified as one of the possible causes of sciatica since the sciatic nerve either runs adjacent or in some cases even through the piriformis muscle. It can be rather difficult and frustrating to pinpoint the source of pain with your finger as this muscle is buried deep in your butt. Contrary to popular belief however, you don't necessarily have sciatica if you have pirformis syndrome but you do have an issue with that state of your piriformis muscle.

Causes

Your piriformis muscles are small triangular muscles that are embedded deep within your glutes (butt muscles). They are responsible for the abduction of your legs (turning outwards) and for runners, they are a key component in leg stabilization during forward movement. In fact, while running the piriformis has such an active role relative to its small size and construction, that there is a popular argument in the physiology community that it may be a weak link in our muscular evolution.

So it’s little wonder that it can get overworked and go into spasm for so many runners. If this spasm is relieved in time and left to persist, it can evolve into an all-out muscle knot.

There seems to be a common denominator with piriformis sufferers of the pain being exacerbated by prolonged sitting either at a desk or while driving. Possibly a combination of the pressure of glutes on the piriformis and the work demand put on the piriformis while running begs the question: Is running the cause or rather just a further irritant to a muscle that is already in spasm from sitting?

Piriformis syndrome is less of a running injury and more of a chronic ailment that many runners suffer from. At any rate, running for months and years with chronic piriformis pain can affect your biomechanics and therefore cause a plethora of other problems.

Manage Piriformis Syndrome

One of the main goals when treating piriformis syndrome, is to try and get the piriformis muscle to release and relax. Treatments vary depend on the exact condition of your piriformis. For example, if general tightness of your piriformis is your problem, consistent and gentle stretching might be an effective approach to relieving some of your pain. You must take great care not to overstretch the area however as this might cause your piriformis to respond by doing the opposite of what you want and going into spasm. From experience, it’s easy to overdo it since the stretch almost immediately relieves the pain!



Due to its precarious location deep behind your glutes, if it is in spasm and there is a muscle knot it’s likely that you’ll require some extra help to get it to relax. For this reason, it’s a good idea to seek medical attention in the way of an acupuncturist, athletic or physiotherapist. Personally, I had my running partner who was thankfully a physiotherapist put his elbow with his full body weight on the knot in order for it to release. This crude method along with acupuncture and regular stretching did the trick. Since most of us don’t have the luxury of having somebody put their elbow and full weight on your glutes to relieve your pain, you can try sitting and rolling your glutes over something hard yet pliable like a stiff tennis ball. In any case, consistency with your treatment will be the key to getting through this syndrome.

Some piriformis sufferers with sciatic nerve pain have some pain relief through neuromuscular retraining of the sciatic nerve. Essentially, sit in a chair with good posture and your legs at 90 degrees. Extend one of your legs straight out with your toes pointed up and crane your neck towards your foot. Repeat this 10 to 15 times. The action apparently stretches out the sciatic nerve and helps to relieve any kinks and squeezes so is definitely worth a try!

So for most of us piriformis syndrome is not usually a show stopper but rather a very bothersome chronic injury. In fact, time off from running especially if you end up sitting for longer periods will not usually do any good so you might as well continue to run and train while you work at relieving and getting rid of the pain.

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