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What's a piriformis, and why is it giving me a syndrome?

There's a good chance you've heard of, or been told by someone, that you or that someone has what's called Piriformis Syndrome. You very well likely have pain, going along the back of your leg, maybe even into the calf or foot, it's been bothering you for weeks, and you don't know why. All you have is this strange new phrase called Piriformis Syndrome, and questions about what it is, and how to make it go away.

Let's look at the anatomy first. The piriformis is a pear shaped muscle, located in the back of the hip. All muscles are responsible for some sort of movement, and this one's no exception. It helps turn the leg outward, while it's extending back. It's a very active muscle, and often engaged during physical activities such as running. Given its location, is has a lot of nerves surrounding it, and the largest nerve in the body, the Sciatic Nerve, runs right under it. This is the nerve that is responsible for most of the sensations you have in your legs, calves, and feet, and for controlling most of the muscles there too.

The relationship between the piriformis muscle, and the sciatic nerve are key in Piriformis Syndrome. Nerves, by nature, are very delicate. They don't like to be crushed, stretched, pulled, twisted, or anything crazy. When a nerve is stressed, and exposed to any kind of trauma, physical or otherwise, it tends to cause pain. Given the location of the sciatic nerve, and that it runs under the piriformis, if the piriformis muscle is tight for a long time due to exercise, or being stretching and pushed from sitting, it will begin to stress the sciatic nerve. Under these conditions, the nerve will then send pain signals. Now, because the nerve is responsible for sensation in the legs, you may feel pain in the legs, and even as far down as the feet. However, even though it feels like the pain is coming from below the hip, the cause is really in the back of the hip, from the piriformis.

What can be done about this? The best way to prevent this condition from occurring is by stretching. Piriformis syndrome often occurs with physical activity, so stretching after working out the legs is critical. Stretches such as the pigeon stretch, as shown below, are effective for loosening the piriformis, and decreasing any compressive force it's applying to the sciatic nerve. If stretching is not enough, try looking for physical therapy, and chiropractic care treatment. A protocol involving massaging and stretching the muscle in order to loosen it, followed by inferential electric stimulation and manipulation, or adjustment to decrease pain, yields good results. Finally, strengthening the muscle, to avoid future issues, is not a bad idea either.

While Piriformis syndrome may be caused by other issues, such as blunt trauma to the hip due to a fall, or foot posture, most typically the cause may be directly associated with the piriformis.

It may certainly be an aggravating, and painful condition, but one which is treatable. Prevention, in the form of stretching after exercising, and not sitting for prolonged periods of time without a break, are great ways to avoid having Piriformis syndrome at all. But if it becomes too much, professional care from a physical therapist, or chiropractor, may be advisable. If it leads to that, make sure to find someone you can rely on, and will provide reliable, consistent, and individualized care for you.


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