The piriformis is a sneaky little muscle that packs quite a punch! If you are experiencing pain in the hip that seems unrelated to the piriformis, take a look at our general hip pain blog to determine other possible causes.
It's located in the buttock region and their job is to externally rotate the hip!
Just like any other muscle it can become tensioned (tight) and painful.
Due to it's location and proximity to the sciatic nerve it can also cause some radiating symptoms into the leg. Some individuals have an anatomical variation where their sciatic nerve pierces through the piriformis. This isn't typically a problem until the muscle becomes tight and impinges upon the sciatic nerve.
Some describe it as a very localized, golf ball sized area of pain located in the gluteal region. If there is some sciatic nerve involvement, symptoms may radiate into the leg.
So what next?
Getting in to see your physical therapist is important. They will be able to do an exam to rule out different diagnoses that present with similar pain. For example, radiating pain in the leg could be coming from the spine as opposed to more local impingement at the piriformis. The treatments would be entirely different, which is why a correct diagnosis is important.
The next step is manual therapy! We need to calm down the irritable tissue and restore the normal length tension relationship of the muscle. We do this through massage techniques, dry needling, stretching etc. You might feel fairly tender, but the longer your therapist works on you, the less sore those tissues should feel. The initial few visits will be dedicated to decreasing your sensitivity before we move on to strengthening.
We want to strengthen the entire hip joint complex so that no muscles are compensating or overworking for others. This will help prevent muscles from tightening down as well. They use this as a protective mechanism for stability when they lack strength!
If you have piriformis pain and tightness, physical therapy can help! We will work to increase length and decrease tone in the muscle, as well as strengthen the muscles around that area to prevent reinjury. Reach out to our office today!