It’s Meet Your Muscle Monday!
Introducing Piriformis! This one starts on the rear surface of the triangular bone at the base of your spine called the sacrum and reaches across your pelvis and attaches to the top of the femur. When it contracts, it makes the leg ‘laterally rotate’ (what you would do to show someone the inside of your leg)
This muscle is important to know because it is a common culprit for pain referring to the buttocks and down the rear thigh from a condition commonly known as ‘Sciatica’. The body’s largest, strongest and longest nerve, the sciatic nerve runs behind the piriformis in 87% of the population (sometimes right through it, sometimes both), providing sensory and motor innervation for the hamstrings, lower leg and the foot. Sciatica is a general term describing several conditions affecting the nerve, but it helps to know that sometimes it’s just a contracted Piriformis pushing on or squeezing the nerve and causing pain that can be relieved through therapy, heat and stretching. This will not only relieve the pain, but make your legs more responsive in both movement and sensation.
A contracted Piriformis is often the result of trigger points (bundles of taut muscle fibers) that commonly occur at the origin beside the sacrum or beside it’s insertion at the top of the femur. These will create a deep ‘butt ache’ at the site of the trigger point and a diffuse deep ache down the back of the thigh to above the knee. One can get trigger point therapy from a massage therapist and/or heat and stretch these trigger points themselves.
To stretch this muscle, try one of the two positions in the above picture. I prefer the ‘leg in front’ version. Some of you may recognize this from yoga, a practice that pays a lot of attention to ‘opening the gate’ of the hips.
Guidelines for stretching:
Duration is more important than intensity. A muscle needs to be coaxed out of it’s contracted position. Going into the stretch too deeply too early will just create a guarding response. Make it a rule to hold each position for a minimum of 90 seconds, breathing deeply and allowing each exhale to take you deeper into the stretch. You may feel the muscle jump or twitch. This is a good sign of the trigger point releasing. Let your body weight deepen the stretch and let your breath do the work.
Once your piriformis has returned to it’s regular length, be mindful of your habitual postures. Sitting cross legged a lot can keep your leg in a ‘laterally rotated’ position and lock the muscle into a contracture. Even your ankles being rotated outwards while sleeping on your back can shorten the muscle. Be aware of your foot position while walking. Toes pointed outwards while using your leg and gluteal muscles will condition them to work in a shortened position. Also, check your foot while driving. Try to keep your toes pointed up rather than out to keep your muscle operating at it’s natural healthy length. For the guys, if you have a thick wallet in your back pocket, sitting on it regularly will tighten this muscle and cause pain as well.
Hope you’ve enjoyed getting to know the “Pesky Piriformis” and creating a greater understanding and awareness of what’s going on inside your body. Next muscle, next Monday!
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