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Piriformis Syndrome - What is it and What to do about it!

Writer's picture: katieperronedptkatieperronedpt

TLDR:  Piriformis - what a pain in the butt!  Literally though.  The piriformis muscle is a crucial muscle that plays a role in your hip mobility and stability, and it sits above the sciatic nerve.  When it gets tight, injured, or irritated, it can bump into the nerve and cause sciatica symptoms, including pain down the leg and pain in your low back too.  There are specific exercises that can be completed to help to manage piriformis syndrome and to help to prevent it from happening again!  Get evaluated by a physical therapist to determine if this is what you are dealing with and to find out what exercises are best for you!  While there are some exercises that are “typical” to be prescribed to help you to feel better from piriformis syndrome, you want to meet with your physical therapist to find the ones that will work best for you and what you are dealing with!  


Also - quick update for LWL! We now have products for sale that you can purchase right in the office at the time of your appointment! You never have to buy anything from us - it’s just there if you want to and you want to grab it then, and not have to go and buy it elsewhere!  


 Understanding Piriformis Syndrome

Being a PT for the last 10 years, I have come across so many clients suffering from a condition known as “piriformis syndrome” - it’s actually something I have dealt with too!. This occurs when the piriformis muscle, located in the buttocks, spasms and causes pain in the buttocks and down the leg, mimicking sciatica.  It can also cause low back pain.  Often, people think they are dealing with low back pain alone or sciatica because of a different injury - and really, it’s the piriformis that’s the issue.  We used to say in PT school “Before physical therapy, I was a pain in the butt - Piriformis”.  Anyways, correct diagnosis of this syndrome is critical to help you to feel better!


So what is Piriformis Syndrome? Great question!

As a start: the piriformis muscle plays a crucial role in hip movement (rotation, and abduction (moving your hip away from the center of your body) and stabilization! It runs from the sacrum (your tailbone) to the top of the femur (so across your butt on a diagonal). You have this muscle on both sides. Piriformis syndrome is when the piriformis muscle becomes tight, injured, or inflamed, and then may press against the sciatic nerve, leading to discomfort. Symptoms may include butt pain, difficulty sitting, and radiating pain down the leg and sometimes low back and hip pain.


Piriformis syndrome can be caused by a lot of different things!  Here are some of the (not all of them) the things that can cause piriformis syndrome!

- Overuse: Activities that involve repetitive hip movements, such as running or cycling, can lead to muscle tightness.

- Injury: Any type of injury or trauma to the butt where the piriformis is located can irritate the piriformis muscle.

- Posture: Poor posture, especially during prolonged sitting, can contribute to tightness in the piriformis.

- Anatomical Variations: In some individuals, the sciatic nerve may pass through the piriformis muscle, making it more likely to become compressed and cause symptoms.


Despite there being many different things that can cause piriformis syndrome, the good news is, that we can help it to feel better!  First, you definitely want to get evaluated by your physical therapist and officially figure out what is going on!  Get evaluated and find out what caused your symptoms, what is provoking them still and making them worse and what can make them feel better!  After the evaluation, you will get a customized program that focuses on stretching and strengthening the hip and back to help to relieve symptoms.  Your PT should also include specialized and specific manual therapy to help you to feel better and manage your symptoms!


If you go on the internet, there are a lot of different exercises and stretches that will probably pop up for you to complete for your piriformis syndrome - and they may seem like they may help, and they may or may not. I can’t stress enough how important it is to NOT only rely on the internet or any influencers to help you to manage the symptoms you are having.  Talk to your PT and get specific exercises and recommendations for what you are dealing with!  While there are some basic exercises that can be used generically to help piriformis syndrome - it still does not mean they are right for you!  The cause behind why you are experiencing piriformis syndrome in the first place is crucial to know so you can get specific exercises for your specific symptoms! In general you do want to stretch and strengthen your hip muscles, and core muscles - both front and back - to help to manage this - your PT can help you to have the best ones for you!


Not having a specific program and going only based on the internet recommendations and influencers could potentially make you worse!  We have to make sure that we know what your specific symptoms are and what your lifestyle and activities are like!  This will help you to have the best exercises for you and to learn if there are any activity modifications or anything else that can be done to help you to manage and improve the symptoms that you are having!   


Piriformis syndrome is a manageable condition, and with the right treatment approach and the right professionals helping you through that treatment approach, you can find relief!  And you can prevent them from happening again!  And you don’t have to not do the things that you love - you can still do everything you want to do - we just have to get you to that point so that you are doing them without symptoms!  Sometimes we need to modify activities and positions during the day temporarily to help to improve symptoms but it won't be forever! Look back at the possible causes of your symptoms - depending on what the cause is will help us to determine what we need to do to help you to feel better!


Don’t just live with your symptoms and your pain!  You can get rid of that pain and you can live your life to the fullest without these symptoms and without worrying about them coming back! If you don’t have a PT yet, reach out today and we can help you out!

At your PT appointment your PT will: complete a full evaluation of strength, range of motion, mobility, and joint mobility and determine any movements or anything else that causes you pain or discomfort; they will assess your specific symptoms; talk to you about your day to day life and activities and learn about what things (movements, interventions, positions or anything else) that cause the symptoms to increase and that help them to decrease; discuss any other interventions and other things you have attempted to help you to feel better that have not helped yet (or even did help)! They will take you through a whole treatment following the evaluation - that will include hands on, manual muscle therapy to help to relieve symptoms, and specific exercises that are personalized to you and your symptoms to help you to improve strength and flexibility appropriately and to get rid of your symptoms! You will be given exercises to do at home before your next appointment as well!


This PT appointment will help you to get set up for the best success and to help you to feel better and to get rid of those symptoms! Don't wait - if you are having any of these symptoms reach out!


LWL February 2025 UPDATE!

Our quick update for LWL this month: We celebrated our 4 year anniversary this year! We can't thank you enough for all of your continued support and trust in your care and your health journey! We are so grateful to be a part of your journey and healing!  We also have a new shelf set up in the waiting room of our office!  We have some products that you can buy - if they are appropriate for you and for your care and recovery!  Some of the products that we have include:  Kinesiotape, Lacrosse balls (for myofascial release), Biofreeze, Ice packs, pain patches, and Resistance Bands!  We will be adding some LWL swag too! Stay tuned for our monthly updates!


If there is anything specific that you would like to learn about, comment or email me and I am more than happy to talk more about it! If you are a small business owner or know somebody who is and who would like to be a part of LWL’s blog in the future, reach out to us and we would love to feature you!


If there is anything specific that you would like to learn about, comment or email me and I am more than happy to talk more about it! 


Thanks for being here!


Follow us on Instagram for tips and tricks and all of our updates, and if you have any questions or need help with any injuries or pain or preventing injuries email us at livewithoutlimitspt@gmail.com!  And let us know if there is anything else that you would like us to talk about in our blog and our Instagram/Facebook posts!  





  • Dr. Katie

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