Piriformis – Part 5 of the grumbly muscle series…literally a pain in the arse!

What’s a piriformis and what does it do?

The piriformis is the more superficial of the deep external rotators of the hip.

  • It keeps the femur turned out when we stand.
  • During flexion (walking), it keeps the femur abducted.
  • Helps tilt the pelvis laterally.
  • Helps tilt the pelvis posteriorly.

Anatomy

It originates from the anterior of the sacrum (S2-S4) inserting into the superior aspect of the greater trochanter (the big knobbly bit on the outside) of the femur.

Why does it hurt?

The sciatic nerve runs VERY close to the piriformis muscle. In some rare cases, the sciatic nerve growth THROUGH the piriformis.

Pressure can be exerted on the sciatic nerve if the piriformis and the other external hip muscles are tight. This can cause pain that radiates down the legs – piriformis syndrome. This rather painful. More women have this than men, and it’s believed to be because women have wider hips – known as a quadriceps angle or Q-Angle.

What can we do about it?

Release – In the clinic, I often get my elbow into the gluteal fold while rotating the femur internally and externally… (it’s nicer than it sounds).

At home, I like to sit on a hockey ball while doing the below stretch.

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