It is a common occurrence that people believe the root cause of their problem is piriformis syndrome. But is it piriformis syndrome or something else? To better understand the source or cause, we must first know more about what exactly is going on.
To begin with, the piriformis is a small accessory muscle that assists hip function. Basically, it is a helper muscle. Its primary function is to assist with hip rotation. The sciatic nerve runs either run above or under this muscle and in very rare instances runs through the piriformis. This muscle sits deep under the gluteus maximus and is routinely blamed for buttock pain. This happens because it is easy to name names and assign blame without a thorough examination.
Often people are told this muscle is the culprit based on location or palpation alone. What you have to understand is that in order to “palpate” or push on the piriformis, you first must push through the gluteus maximus. And so if there is pain with palpation, which muscle is really the issue?
Next, looking at hip motion in both sitting and on belly can assess for tightness of the piriformis muscle. Limitations in motion or muscle length may be an indicator of a problem. After that, testing out hip rotation strength can test if the piriformis is sensitive. And finally, looking at how a person is able to contract and move the gluteus maximus is important.
In many cases, the piriformis may be “sensitive” to testing because the gluteus maximus is not pulling its weight. If for example, when lying on your belly you lift the leg up and it causes your pain. But then when you do the same thing only contract your butt muscles 1st and the pain is no longer there…the gluteus maximus is more likely the source of the pain.
And…what about the sciatic nerve, could that be a source of pain? Yes, it could. A series of nerve testing carefully performed after everything else was looked at could indicate an issue. This is done at the end to make sure that if it is the source that is does not get too irritated and limit the scope of a good exam.
Does any of this sound like you?
Curious what exactly is causing that pain in your butt (literally)?
If so, then click on this link HERE to request a call to discuss your pain, what it is stopping you from doing, and what you would like to accomplish.