I’d like to talk about the often overlooked and overworked piriformis muscle. Piriformis literally means “pear-shaped” and is flat and band-like located deep in the buttock underneath gluteus maximus. It may be small but has a big job. It runs diagonally from the spine to the femur. It’s a major player of the hip rotator muscles with the sciatic nerve running underneath or through it. It stabilizes the hip joint and lifts and rotates the thigh from away from the body. This means in almost every motion of the hips and legs we are using the piriformis.
Some people suffer from piriformis syndrome which is a neuromuscular disorder that happens when the piriformis compresses the sciatic nerve. It shares the same symptoms of other dysfunctions like sciatica, trochanteric bursitis, primary sacral dysfunction, and sacroiliitis.
There are more than 200,000 new cases a year in the US and an estimated 6% of patients diagnosed with lower back pain actually have piriformis syndrome. If you think you’re suffering from this it’s best to see a doctor for a diagnosis and ruling out other things such as a herniated disc.
If the muscle is irritating the sciatic nerve there may be pain and numbness radiating from the buttock to the thigh and calf and even extending to the foot.
If a massage client has a tight, contracted, or painful piriformis I like to try gentle stretching and seeing if their range of motion is limited. It’s important not to go too deep too fast in case there is an injury or sensitivity. Keeping the massage strokes broad, firm, and even. Forearms and knuckles are great for this and if it’s appropriate, elbows for releasing a spasm or trigger point. The piriformis can be a real pain in the glutes so try to take care of your body and give it time to rest between injury and workouts.