The piriformis muscle is a small muscle located in the deep layers of the hip and pelvis complex.
It’s primary job is to externally rotate the femur (turn the leg outwards)
The reason why this little muscle can be related to sciatica is that the sciatic nerve actually pierces and travels through this muscle to make its way down the leg.
A shortened or overly lengthened resting position of the muscle can affect how the sciatic nerve glides, causing possible compressions and roadblocks that would cause pain and numbing sensations in the butt or down the leg.
Some may think the simple solution is to stretch the muscle, but it’s not that simple.
The behavior in which the muscle responds and contracts may be a result of hip and pelvis orientation, changing the leverage a muscle will have.
The piriformis may be preventing the hip from gaining more internal rotation or be compressing it with greater external rotation leverage.
Either way, the hip is going to behave differently as the leg flexes and extends based on it’s initial resting orientation. This will also translate into how well the sciatic nerve will glide during leg movements.
So what’s the solution to resolving this butt pain?
It’s not as simple as it may seem because there is no clear cut way. There are multiple ways based on the pelvis orientation and muscle behavior.
Perhaps the hip joint needs to have internal rotation restored to decompress the piriformis muscle, and clear up space towards the back side of the pelvis.
Another way would be to restore external rotation to gain more leverage in the priformis during contractions.
Or, restoring the dynamic movements of the pelvis itself can be the answer.
Having a skilled eye and trained movement professional can help you rule out causes and narrow down what your specific needs are.
Thinking you need more help?
Schedule a Free Discovery Call with a PT, and we can guide you through options and see if you are appropriate for treatments.
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Dr. Peter Dionisopoulos is the owner and founder of Dynamic Performance & Rehab. He has a Doctorate in Physical Therapy and enjoys to help active adults maintain their lifestyle and provide natural solutions to their pain.