What a pain in the butt…literally! Unfortunately, pain is a way of life for many people; particularly for those who suffer from ailments like piriformis syndrome. The small muscle located in the buttocks region, called the piriformis, is also in close proximity to a major nerve called the sciatic nerve; it is this close proximity that can lead to something known as piriformis syndrome. All puns aside, this disorder can be debilitating and painful. By understanding more about the piriformis muscle, the sciatic nerve and things like piriformis syndrome, you are better equipped to take the necessary steps that can help you maintain a healthy and pain-free body. So I spoke with LA Fitness personal trainer, Kelley Henry, Ph.D. to learn more about piriformis syndrome.

Q: Where is the piriformis muscle located and what is its function?

KH: The piriformis muscle originates at the sacrum (tailbone) and it inserts at the femur (the thigh bone where it meets at the hip). The actions of the muscle include lifting the leg out to the side, rotating the foot outward, as well as stabilizing the hip-joint. The sciatic nerve is very thick (about the thickness of your little finger) and it is the nerve supply for the lower body. It runs under the piriformis muscle; for some unfortunate people it splits this muscle.

Q: What is piriformis syndrome?

KH: Piriformis syndrome is the result of the piriformis muscle compressing the sciatic nerve. Other muscles become involved in piriformis syndrome as well. These muscles include the quadratus lumborum (runs from the lower ribs to top of the hip), the tensor fascia latae (TFL; a small muscle right below where the hip sticks out in the front of the body), the gluteus medius and minimus (the top part of the glutes) and the iliopsoas (hip flexors).

In my experience, both personally and professionally, I have noticed that when one muscle is adversely affected that additional muscles in proximity become involved as well. All of the previous stated muscles have attachment points on the hips. So, if one of the muscles becomes too tight it can pull on the hips enough to change the alignment, and then the other muscles within the area can become affected as well.

Q: What are the symptoms associated with piriformis syndrome?

KH: Symptoms include pain—usually a dull ache—in the glutes, low back, and/or the side of the hip, and the pain can travel all the way down the leg.

Q: How can it impact a person and an active lifestyle?

KH: Piriformis syndrome is very uncomfortable to deal with, as there can be constant pain during activity or even just while sitting. This ailment is commonly seen in runners and those who sit for prolonged periods of time.

Q: How is it diagnosed?

KH: Piriformis syndrome is usually diagnosed based on the symptoms. Other tests can be used to rule out disc herniation, which can have similar symptoms to piriformis syndrome.

Q: What can people do in the gym and on their own to help prevent or reverse piriformis syndrome?

KH: This is what has worked for me and my clients:

• Tennis ball massage on the low back, hip and glutes – regularly!
• Strengthening the muscles involved: leg lifts work wonders but may aggravate the pain initially which is why we use the tennis ball to release the pain with massage.
• Lots of core work (front planks, side planks, etc.).

These things can be done daily and should be done using a lot of reps (at least 20 or more). Typically, the whole body needs to be addressed with strength conditioning for the best results.

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This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your primary care physician.