Q: What is my Piriformis Muscle?

-- By Erica Sastre, LMT

Did your massage therapist hit a particularly tender spot in your glutes? Did you have pain or tingling running down your leg? Why is your chiropractor trying to make you do so many squats? 

This week we are putting the spotlight on the piriformis muscle!

The piriformis muscle is a muscle under the gluteus maximus, it attaches at the anterior surface of the sacrum, and the superior aspect of the greater trochanter (SI joint to the top of the femur). It Latterally rotates the hip (twists your thigh outward) , and abducts the hip when the hip his flexed (pulls your thigh away from the body center-line).

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What could possibly go wrong?

Piriformis can be a literal pain-in-the-butt! A tight or knotted up piriformis muscle can cause pain on its own, or limit strength and flexibility. However, this small muscle can cause much bigger problems.

The Piriformis is often to blame for sciatic pain symptoms. The sciatic nerve runs right past the piriformis muscle, and sometimes even through the piriformis muscle. Due to its placement in the body, tightness in the piriformis and adjacent muscles can pinch the sciatic nerve.  This can send pain, numbness, or tingling down all or parts of the leg! If you have ruled out a spinal issues as your source of sciatic, it's time to address the piriformis muscle. ​

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How does the piriformis affect my posture?

Check out your toes! If your feet tend to turn in when you are standing, walking, running, or squatting you may have a weak piriformis muscle. Likewise, if you see that your feet tend to turn outward when standing, walking, running, or squatting, it may be a sign that your piriformis is overdoing it. Either one of these postures can cause problems in the legs, hips and knees, especially with load-bearing exercise. Squatting and lifting weights with misalignment can spell disaster for the knees! Keep in mind that if it is a hip/piriformis weakness, the positional problem will originate from where the hip and thigh meet. If the positional problem originates in the knee or ankle, we will have other muscles to look at! That's why it's a good idea to see a professional, like your chiropractor, to help evaluate postural problems. 

How do I stretch it?

Pigeon pose is everyone’s favorite piriformis stretch! There are a number of modified pigeon poses you can try if you are less flexible. If floor stretches are uncomfortable, try doing a pigeon pose on a chair, couch, or low table.  The 'figure 4' can be done sitting or supine (on your back), or even standing if you have good balance!

Figure 4 Stretch Supine

Pigeon Pose

How do I strengthen it?

Piriformis is a lateral rotator. Meaning, it twists the thigh 'outward' from your hip. Working the gluteal region will generally build the piriformis, as well as create support for the piriformis with the other gluteal muscles. 

Squats are an easy way to develop the glutes. Add a band for extra resistance! Try a one-legged dead lift and keep in mind that the grounded leg is the piriformis that you are strengthening.  Work one leg at a time,  grab on to the back of a chair, bar, or ledge. Lift the other leg out to the side, you can do this exercise with your feet paralell (both toes facing forward) or 'turned out' (feet make a V shape with your toes pointing outward, like in ballet).  Try this one with a band as well! 'Fire Hydrant' starts on all fours. Keep your knee at 90 degrees then swing your leg out to the side, keeping your frame strong to isolate and work the glutes. 

Fun facts about the piriformis

The piriformis is only one of six muscles in the lateral rotator group. The others are; gemellus superior, obturator internus, gemellus inferior, quadratus femoris and the obturator externus.  

In 17% of the population the piriformis muscle is pierced by all or part of the sciatic nerve.

The word piriformis comes from latin, meaning ‘pear shaped’.

Hopefully you learned something fun about the piriformis today! Stay tuned for our next Q&A, and send your questions to [email protected]! What muscle should we feature next?