Piriformis Syndrome



The Piriformis is one of the small muscles deep in the buttocks that rotates the leg outwards. It runs from the base of the spine and attaches to the thigh bone (femur) roughly where the outside crease in your bum is. The sciatic nerve runs very close to this muscle and sometimes even through it! If the muscle becomes tight it can put pressure on the sciatic nerve and cause pain which can radiate down the leg

A common cause of Piriformis syndrome is having tight adductor muscles (inside your thigh). This means the abductors on the outside cannot work properly and so put more strain on the Piriformis.


Inactive gluteal muscles also facilitate development of the syndrome. These are important in both hip extension and in aiding the piriformis in external rotation of the femur. A major cause for inactive gluteals is unwanted reciprocal inhibition from overactive hip flexors (psoas major, iliacus, and rectus femoris). This imbalance usually occurs where the hip flexors have been trained to be too short and tight, such as when someone sits with hips flexed, as in sitting all day at work. This deprives the gluteals of activation, and the synergists to the gluteals (hamstrings, adductor magnus, and piriformis) then have to perform extra roles they were not designed to do. Resulting hypertrophy of the piriformis then produces the typical symptoms.

Another purported cause for piriformis syndrome is stiffness, or hypomobility, of the sacroiliac joints.The resulting compensatory changes in gait would then result in shearing of one of the origins of the piriformis, and possibly some of the gluteal muscles as well, resulting not only in piriformis malfunction but in other low back pain syndromes as well.

Piriformis syndorme can also be caused by an overpronation of the foot. When a foot overpronates it causes the knee to turn medially causing the piriformis to activiate in prevention of over rotating the knee. This causes the piriformis to become overused and therefore tight eventually leading to piriformis syndrome.

It is most frequently associated with fall injury

Symptoms of Piriformis syndrome:

  • Tenderness in the area of the muscle.
  • Pain in the buttocks.
  •   Reduced range of motion of the hip joint

What can the athlete do to help combat Piriformis syndrome?

  • Apply heat

Visit physioline for  treatment, rehabilitation  and prevention

Physioline treatment

  • Apply specific sports massage techniques.
  • Stretch  the Piriformis muscle using Muscle Energy Techniques.
  • electrotherapy
  • Advise on strengthening and rehabilitation to avoid injury recurrence.