Piriformis syndrome
Rehab training for the injury

Rehab 1

Focus on training the rest of the body, so you do not lose your current mobility, stability, and strength. Find out what you can do from workout programs and exercise according to the level you have. Training the rest of the body accelerates healing of your injury for several reasons, two of which are increased nerve activity and circulation.

Description of piriformis syndrome

Piriformis syndrome is caused by a state of muscular tightness (hypertonia), which is increased when the muscle contracts, thusly compressing the sciatic nerve. The condition is therefore also called a neuromuscular disorder. The symptoms of sciatica and a piriformis syndrome are completely identical, but the reason behind the symptoms is completely different.

The piriformis muscle is a small flat pear-shaped muscle (hence the name) located deep inside the seat region. This muscle is important for the movement of the lower body because it stabilizes the sacrum and lifts and rotates the thigh away from the body. It allows us to walk, move our weight from one foot to the other and maintain balance. It is therefore vital for all sports that rely on movement of the hips or legs. It has the same function as m. Gluteus maximus (the largest muscle of the buttocks), but since piriformis is shorter it is activated before the large seat muscle, though it is much less strong. For this reason, it’s very easily goes into a state of hypertonia (constant over-tension), which initiates all the classical symptoms. A piriformis syndrome may also be the result of malalignment of the pelvis, known as a sacroiliac (SI) joint dysfunction, which you can read more about on its page.

Anatomically, the piriformis muscle stretches from the sacrum to the femur (thigh bone), and along the way, two holes are created above and below the muscle, where nerves and blood vessels pass through to intervene the hip, abdomen, and legs. Many structures pass through especially the bottom hole, including the sciatic nerve, which is a nerve the width of a pinky finger. As the muscle contracts and becomes thicker it presses on the nerve creating the classical symptoms of piriformis syndrome. When a muscle pushes on a nerve, the sheath around the nerves becomes compressed and the pressure on the nerve increases. This leads to hyper-activity of the nerve, meaning increased sensitivity and often constant sensations as long as the pressure on the nerve persists. One may compare this to the example of a garden hose; when the hose is compressed, the pressure inside increases and on release the water is pushed out more forcefully. Had the pressure been caused by bones compressing the nerve, the nerve would be completely clamped and therefore not be able to work, resulting in numbness along the nerve and weakened functioning including muscle weakness etc.

Symptoms

Piriformis syndrome is characterized by seat or low back pain and / or radiating sensations down the back of the leg. The radiation never goes further than to the back of the knee. Since the syndrome is of muscular origin treatment focuses on reducing muscle tension. In some cases, the nerve intervenes the muscle. Such cases call for operation, and further investigation should be conducted in case of therapy resistance to common piriformis syndrome.

  • Pain in the lumbar part or in the buttocks.
  • Radiating pain.
  • The pain increases with the load.
  • Pain or radiation when walking / running.
  • Restlessness in the leg when resting.
  • Irritation when driving a car where you can’t really find a good sitting position without it causing irritation in the buttock or leg.
Examination

A physician, physiotherapist, sports injury therapist, chiropractor, osteopath should conduct an examination to detect the syndrome while excluding other factors.

The therapist typically makes a:

  • Analysis / inspection / palpation / movement the test.
  • Straight leg lift test.
  • Piriformis stress test. This is done by lying on your back relaxed while a helper holds your leg in an outward extension and an outward rotation lightly lifted off of the ground. If there is pain / symptoms, it is most the result of piriformis syndrome.
Treatment
  • Rehab exercises.
  • Massage / trigger point massage.
  • Spascupreel (2 tabl. 3 g. daily for 9 days).
  • Thermal treatment (heat).
  • Ultrasound (continuous / pulsating), 1 Mhz, 2 W cm2.
  • Kinesiology tape.
Rehab training for the injury

Rehab 1