Trigger points in the priformis are often associated with pain in the lower back and deep within the buttocks. In some cases the pain can be severe and may also refer down the back of the leg.
The little piriformis muscle sits behind the hip joint and helps to turn the hip outward. Over time and as a result of a number of common daily activities (including long hours sitting, or overuse) the piriformis can become tight and develop active trigger points.
In some cases, these trigger points may cause the muscle to compress and irritate the sciatic nerve. This brings on lower-back and buttock pain, which can be severe. In fact, severe enough that it hurts just to sit. This so-called Piriformis Syndrome is often confused with sciatica.
The main difference between piriformis syndrome and sciatica is that sciatica is typically caused by a spinal issue, such as a compressed lumbar disc. So, when a client presents with the symptoms of sciatica but without the presence of any spinal issue, the go-to diagnosis will often be piriformis syndrome, almost always associated with trigger points.
Piriformis and Trigger Points
Interestingly, there are two distinctly different groups who tend to be most at risk from developing active trigger points in the piriformis. The first are office workers, drivers, or those who spend extended periods sitting. In some cases this can also be linked to the combination of sitting combined with poor orthotics when walking.
The other group includes people who are extremely active, especially rowers, runners, and cyclists. These people engage in pure forward movement, which can weaken the hip adductor and abductor muscles. When combined with any additional weaknesses in the gluteus muscles, this will often lead to the development of active trigger points in the poor little piriformis.
Piriformis and Runners
Another situation commonly seen in runners is trigger points in the piriformis caused by over-pronation (an excessive inward roll of the foot after landing). This in turn causes the knee to turn on impact. The piriformis muscle then triggers in an attempt to prevent the knee from turning and trigger points develop as a result of this action being repeated over time.
Piriformis and Self Managed Care
If you fall into any of the categories mentioned above, ask your therapist to advise on a good strengthening and stretching routine. This should involve all the main hip and thigh muscles and may help avoid the onset of active trigger points.
If you are suffering from active trigger points in the piriformis, you really need to receive treatment from a suitable qualified and experienced therapist, who will use applied pressure and massage techniques to help dissipate the trigger points. However, the stretch above is an example of something that you can do yourself at home, which at the least may provide some pain relief.
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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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