I’m not referring to your nagging wife or lazy husband.  This is all about pain in that muscle tucked in behind the Glutes… the Piriformis, and someone in the world of the wise has named it the Piriformis syndrome.

The Piriformis Syndrome effects countless numbers of people daily, and doctors refer to it as neuropathic entrapment.  That means that a muscle deep under the gluteal area called the Piriformis is tight or inflamed which decreases the performance or flow of the largest nerve in the body (the sciatic), which passes behind it.  Sometimes, it goes through the muscle.  Tightness in the Piriformis  will cause pain can be in or around the muscle, and along  the sciatic nerve, usually in the back of the thigh, and possibly all the way down into the foot. Shooting pain along the sciatic nerve distribution is called sciatica.  Pain can also be referred up into the lower back region.

If you have pain walking uphill or up stairs, along with pain after prolonged periods of sitting, it’s quite possible you have a dicky Piriformis.

Where is it?

The origin of the muscle is the front the sacrum.  The sacrum is that triangular shaped bone at the base of the spine between the two hip bones, forming the pelvic girdle. The Piriformis Muscle then goes through the greater sciatic foramen (that’s a hole in the pelvis) before it blends into its tendon and inserts onto the top of the Femur at the Greater Trochanter ( hip bone).

The sciatic nerve travels through the greater sciatic foramen (that hole I told you about) behind the Piriformis Muscle.  In about 15% of the population, the sciatic nerve goes through the Piriformis muscle. It’s no surprise then that those within that 15% would be much more likely to experience Piriformis syndrome. Regardless, a tight and/or inflamedPiriformis will eventually lead to a condition known as Sciatica.

Function?

The function of the Piriformis is to abduct and laterally or externally rotate the femur. Abduction of the thigh means to move the leg out to the side away from the body. Lateral (a.k.a. external) rotation means to rotate the hip such that your toes are pointed out to the side instead of forward.

Runners, cyclists, and weightlifters usually experience the condition. Another cause is sitting for prolonged periods with the hips abducted and externally rotated. This can occur at one’s desk, but it is also very common while driving for long periods of time.

Treatment:

Stretching is good.  Deep tissue massage is  also invaluable in treating Piriformis Syndrome.  Undoubtedly, the best  technique is an active release. It’s a very precise technique that’s used to remove any adhesions that might have formed within the Piriformis or between it and the Sciatic Nerve.

A deep tissue massage can help if the therapist is familiar with the anatomy of the deep gluteal muscles.  If you’re experiencing the symptoms of Piriformis Syndrome or tight Gluteal muscles, make a booking and feel the difference Remedial Massage can make.  With any massage however, it’s advisable to wear comfortable underwear that’s not too tight.

The Gluteal group of muscles consists of three  muscles: Gluteus Maximus, Gluteus Medius and Gluteus Minimus.  “Gluteus” is from the Greek and means rump.  “Maximus” is the largest of the muscles and “Minimus” the smallest.  The role of the Gluteus Maximus is different from the Medius and Minimus muscles because of their attachment points.

The Gluteus Maximus is the largest and most posterior of the group, and is the big overlaying muscle in the buttocks.  It originates at the posterior Sacrum, Ilium and the superior gluteal line of the ilium, and attaches to the gluteal tuberosity of the femur and the iliotibial tract.  This muscle contracts to swing the upper leg backward, and is heavily used during swimming and squatting.

The Gluteus Maximus extends the femur at the hip and laterally rotates the extended hip. The Gluteus Maximus is used mostly for power as in going upstairs, jumping, rising from a sitting position, climbing or running.  I think it’s one of the hardest working muscles of the body.

The Gluteus Medius and Minimus muscles are located below the Maximus, and all three are referred to as ‘the Glutes’.

When these and other butt muscles are tight and visually pleasing to the opposite sex, there is the possibility of adverse effects on the body elsewhere in the body.

Sciatic Pain:

The Piriformis is often involved in Sciatic pain.

The   Piriformis  Muscle is a short, small muscle that is located deep in the buttock region. It functions to rotate the thigh, and helps to stabilise the hip joint during walking. This muscle lies next to a major nerve (the Sciatic Nerve) and blood vessels.

The Sciatic Nerve starts at the Lumbar vertebrae 4 and 5, (L4 and L5) passes through a notch in the hipbone under the Piriformis muscle and travels down the leg.

In most people, it passes under the Piriformis Muscle, and in others, it passes right through it.

If the Piriformis is tight for whatever reason, it can compress the Sciatic nerve causing pain to the lower back, buttocks or the legs.  This is a condition known as Sciatica.

Pills may provide temporary relief but they don’t address the cause.

Often, a simple remedial massage technique can make the symptoms of sciatic pain just disappear without the need for anti-inflammatory tablets or other treatments.

If you’ve ever visited a remedial therapist and mentioned that you have a sore back, sore legs, sore knees and or feet and he or she doesn’t at least mention working on or releasing your butt muscles, then question their qualifications.

The therapist may have to consider that the patient has limited time, but those muscles are very significant.

If the therapist doesn’t understand their implications for the rest of the body, he or she may not be as qualified as you think.

For obvious reasons, some people are dubious or uncomfortable about having their buttocks massaged.  Other people will say it’s “just magic” because if it’s done professionally with no embarrassment ,they’ll only feel the tight spots disappearing and realise how much better they are going to feel later.

At the end of the day however, whether or not you want the therapist to massage your buttocks is up to you.  Just bear in mind, your “nice tight butt” is not just something you sit on.  It’s a range of vital muscles that can have various impacts on the rest of your body.

Not massaging the buttocks… in other words, just massaging a sore back means the therapist may just be treating the symptom of the problem, not the cause or an important contributing factor.  With any massage however, it’s advisable to wear comfortable underwear that’s not too tight.