Back pain is an incredibly common complaint. In fact, if you go through life without experiencing back pain you are in the minority i.e. it is abnormal! However, a smaller group of people suffer “sciatic” symptoms as a component of their presentation. These symptoms may include:
- Buttock and Leg Pain
- Sensations Changes – pins and needles, numbness
- Muscle Weakness
Whilst these symptoms are often caused by the more common injuries – such as a herniated disc or irritated facet joints a percentage may be caused by “piriformis syndrome”. To give you more information about this cause of sciatic pain this article will discuss background information on the condition, the relevant anatomy and of course the most appropriate rehabilitation exercises.
What Is Piriformis Syndrome?
Piriformis syndrome is a cause of approximately 6 – 8% of low back pain presentations (Fishman et al., 2002; Kirschner et al., 2009). Piriformis syndrome, sometimes known as “Runner’s Bum”, occurs when the piriformis muscle is shortened or spasms as a response to trauma or overuse (repeated episodes of microtrauma) (Hopovian et al., 2010). This tightness can cause ‘entrapment’, compression or irritation of the sciatic nerve – and may result in pain within the ‘sciatic area’ and other sciatic symptoms (Fishman, 2003).
Anatomy and Muscular Contributions to Piriformis Syndrome
Sports medicine professionals will agree that there are a number of muscles around the lower back and hips that may contribute to the development of piriformis syndrome. This includes tightness/reduced flexibility and active trigger points in the:
- Piriformis muscle
- Gluteal muscles
As well as tightness, piriformis syndrome is also contributed to by reduced strength and control in a number of the back/pelvic muscles. These include:
- Gluteal muscles – particularly the ‘external rotators’
- Core muscles
So, what can be done about this condition?
Foam Roller Exercises for Piriformis Syndrome
The most appropriate exercises are those that target the myofascial structures of the:
The videos below displays all of these components:
Piriformis Syndrome Releases
Should I Do Anything Else For Piriformis Syndrome?
Yes! Unfortunately, the foam roller is only one component of the successful rehabilitation of piriformis syndrome. To fully resolve this complex problem you should also undertake:
- Regular Hip Stretching (gluteals, piriformis, adductors)
- Gluteal, pelvic and core strengthening exercises
- Be guided by your physiotherapist – who can take you through all of this including a full rehabilitation program
Hip External Rotator Strengthening For Piriformis Syndrome
Core/Transversus Abdominis Training Exercises
What Size Will Be Most Useful?
Given that you are going to cover a medium to large sized area and i.e. the hip and gluts, the best foam rollers for this condition would be:
Fishman, LM.; Dombi, GW.; Michaelsen, C.; Ringel, S.; Rozbruch, J.; Rosner, B.; Weber, C. (Mar 2002). “Piriformis syndrome: diagnosis, treatment, and outcome–a 10-year study.”. Arch Phys Med Rehabil 83 (3): 295-301
Fishman, LM, Shaffer, M F (2003). “The Piriformis Syndrome is Underdiagnosed”. Muscle and Nerve 83: 626-629
Hopayian, K.; Song, F.; Riera, R.; Sambandan, S. (Dec 2010). “The clinical features of the piriformis syndrome: a systematic review.”. Eur Spine J 19 (12): 2095-109
Kirschner, JS.; Foye, PM.; Cole, JL. (Jul 2009). “Piriformis syndrome, diagnosis and treatment.”. Muscle Nerve 40 (1): 10-8
Photo Credit: WikiCommons