In our continuing series on stretching to make running and walking easier, we come to a common injury: Piriformis Syndrome.
Runners ask about it all the time, so it seemed like a good topic to write about. Here is some helpful information provided courtesy of Kevin Jermyn, a track coach in North Carolina.
Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve, causing pain in the buttocks and along the path of the sciatic nerve. The nerve pain, called “sciatica”, often goes down the back of the thigh and/or into the lower back. The pain is deep in the buttocks, which is made worse by sitting, climbing stairs or performing squats. The affected leg is often externally rotated (toes point out) when relaxed, such as when lying face down on the bed with your feet over the end of the mattress.
The piriformis muscle assists in abducting and laterally (to the outside) rotating the thigh. It lies deep in the gluteal muscles. The sciatic nerve usually passes underneath the piriformis muscle, but in approximately 10% of the population, travels through the muscle. It is thought that acute or chronic injury causes swelling of the muscle and irritates the sciatic nerve, resulting in sciatica. Patients with an aberrant course of the nerve through the muscle are particularly predisposed to this condition.
Contributing factors to piriformis syndrome can include:
- If the leg is externally rotated for an extended period of time (such as when driving) the piriformis muscle can shorten;
- Faulty foot mechanics;
- Faulty spinal mechanics;
- Gait disturbances;
- Poor posture or sitting habits.
There are several treatment strategies to help heal this common injury, including stretching, strengthening, and massage of the piriformis (click here for form and tips). The key is to find the right combination that works for you, so experiment with each and see what works. Or better yet, seek advice from your orthopedic or physical therapist.
Other ways to help alleviate the pain are:
- Orthotics or new running shoes to help with poor biomechanics;
- Cut back your training volume, and then return to running pre-injury training volume and intensity gradually;
- Cut back your speed work and hill running;
- Ice after training;
- Avoid long car drives, or take short breaks to loosen up;
- Electrical stimulation (microcurrent, HVGS);
- Ultrasound therapy;
- Improve your posture;
- Address faulty pelvic mechanics.
The choices will depend on you. Just remember to seek professional help if needed.
The information contained here is merely that, informational. PRO BIKE+RUN makes no guarantees as to the effectiveness of the treatments stated above. We advise you to seek treatment by a medical professional to truly diagnosis and/or treat any injury or condition.