The Pain that Follows you Around – The Piriformis

I have now massaged quite a number of you after your races and I hope that I’ve helped you with a speedy recovery. Perhaps the most common niggle that I see after the Run Through races is a pain or tightness in the glutes or hamstrings. On massaging this, I find that the root of this pain is rarely from these muscles themselves, but instead the piriformis. It’s an incredibly persistent pain and sticks right behind you wherever you go!

The piri-what?

The piriformis. Nothing to do with spicy chicken. Nor the twirl done by ballerinas. The piriformis is a narrow muscle that is deep in your buttocks. It runs from your sacrum horizontally to your hip joint, underneath the gluteus maximus. So basically it stretches all the way across your behind. It is an important muscle for rotating the hips and also for running.

What causes this pain in the bum?

Running, especially hills, as well as sitting for prolonged periods at a desk or driving, can cause the tightening of the piriformis and pain can be experienced as a deep ache in the buttocks. The sciatic nerve is located very close to the piriformis (in fact, in some people it actually passes through the muscle). When the piriformis becomes tight it swells and puts pressure on the sciatic nerve which runs all the way down the leg. Pain can radiate into the thigh, down the leg as far as the calf. Pain can be felt as far down as the feet and also in the lower back.

What can be done about it?

Sports massage can really help promote blood flow to the piriformis as well as ease the tightness. If the tightness is causing a lot of discomfort then the sports massage should be carried out about once a week. Once on the mend, a monthly massage should help prevent the injury from coming back.

A tight piriformis can also be caused by overuse so make sure that if you’re increasing your mileage, you do so gradually. A good warm up is crucial and this is what runners seem to be especially bad at doing. High knees and hip openers are good for this. Footwear is important too – running with tired shoes is a asking for injuries to happen. Cool down stretches are vital. Stretching and using a foam roller or tennis ball on the tender muscle can all help but there are also some very effective stretches you can do without tools. The best stretches for the piriformis are those where the hip is flexed and rotated inwards. Here are a couple of examples: