Friday, December 7, 2007

Piriformis Syndrome Prevention

The piriformis muscle lies deep to the gluteus maximus. It is often a neglected stretching area. Piriformis Syndrome is a condition in which this tight muscle irritates the sciatic nerve causing pain (or a dull ache) in the buttocks and referring pain along the sciatic nerve.

This pain goes down the back of the thigh and/or into the lower back. Deep pain is often made worse by sitting, climbing or squatting.

Exhibited below is an inflammed sciatic nerve:

Piriformis Syndrome is often found in athletes who are in sports that require running, change of direction and weight-bearing activities. Exercising on hard or uneven surfaces also cause problems.

Biomechanical problems such as poor running mechanics, tight muscles in the lower back, hips and buttocks and running with the toes pointed out also cause piriformis problems.

Treatment of piriformis syndrome is treated like any other soft tissue injury: 1) begin with the R.I.C.E.R. principle the first 24-72 hours (Rest, Ice, Compression, Elevation, Referral to Doctor), 2) rest and recovery and 3) strengthen and condition the muscles of the hips, buttocks and lower back.

And, of course, a proper warm-up and stretching routine is always critical.

Stretch the piriformis muscle this way:

1. Lie back and cross legs with the involved leg on top.

2. Gently pull opposite knee towards chest until a stretch is felt in the deep buttock area.

3. Hold for 20-30 seconds. Repeat 1-2 times as needed.

4. Keep the lower back straight in a neutral position.

In part 6 of this series, I will cover the cause and treatment of hip pointers.

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Mark Dilworth, BA, PES
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