How piriformis syndrome can affect the runner

A guide to piriformis syndrome in runners

Piriformis syndrome is a condition that can cause pain in the runner's buttocks and down the legs. Often caused by overuse or poor running gait, it can impact greatly on your running. Here's the guide to piriformis syndrome and how you can hopefully prevent it.

What is piriformis syndrome?

The piriformis is one of the small muscles deep in the buttocks that rotates the leg outwards. Running from the base of the spine, it attaches to the thigh bone (femur) roughly where the crease in your backside ends.

The sciatic nerve runs very close to this muscle and sometimes (in about 15 per cent of people) it runs through the muscle. If the muscle becomes tight, this can put pressure on the sciatic nerve and cause pain in the buttock, which can also run down the leg.

What can cause piriformis syndrome?

Overuse, an uneven running gait, or even lower spine issues can cause a problem to arise. Commonly the cause is a tight adductor muscle with an abductor muscle (on the outside of the hip) not working in tandem with one another. The consequence of this is that the piriformis ends up acting as an abductor (lifting the leg to the side). This forces the piriformis to work harder than it would normally have to, so it becomes strained and tightens up.

What can you do to prevent piriformis syndrome?

Stretching the piriformis muscle as part of a general strengthening program can help alleviate the problem. It is important to not just pay attention to the piriformis muscle, but also to the other muscles around the pelvis — the adductors, hip flexors and gluteus muscles — which should also be stretched.

As a general rule, stretches should be held for 30 to 40 seconds, and should be repeated three times. For maximum benefit, try to do this up to five times a day. A good strengthening exercise is the 'dog leg' exercise where you go down on hands and knees and lift the leg up to the side like a dog. Repeat these 20 or so times and have a good stretch afterwards.

Heat applied to the muscle, or even taking a hot bath, can also help relax the area. However, do not apply heat if you suspect a tear or strain in the the muscle.

What can a sports injury professional do about piriformis syndrome?

A session of ultrasound and deep massage techniques, combined with stretching can improve a piriformis condition by helping relax and stretch the piriformis. It might be necessary to have at least a couple of treatments. It is also worth being checked over for lower spine problems and also having an assessment of your running gait to ensure that the problem doesn't recur.

Remember that whatever techniques you are shown to improve the condition of the piriformis muscle, you should continue to use these long after you feel you have recovered from the injury to prevent the problem coming back again.

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