The piriformis is one of the most important muscles in your body. When working together, the piriformis and psoas are the muscles that allow us to stand upright, as opposed to being quadruped (on our hands and knees). Additionally, the piriformis laterally rotates your femur (thigh bone) and abducts your leg. This means it moves your leg away from the midline of your body.
Frequently, this muscle can be the cause of pain. Because of it’s location near the sciatic nerve, it can cause significant pain that some may refer to as sciatica. Technically, because the pain comes from a tight piriformis, it is called piriformis syndrome.
Here’s more information on a muscle that’s so important that I decided to write about it first. With this article, I’m beginning a new Sunday series on learning your muscles. Once you learn about your muscles, you will better understand what you’re really doing in yoga poses and Pilates exercises. Plus, if you are in pain or get injured, you will have an idea of what to do to relieve your pain and heal your injury.
The origin of the piriformis is on the front surface of the sacrum. This means it is internal. The insertion of the piriformis is on the greater trochanter of the femur. When you think about your femur (thigh bone), very near the ball on the head of the femur is the greater trochanter. It’s like a little bit of extra bone that sticks up past the ball. That is the spot where the piriformis inserts.
While this information is important, people primarily are interested in the location of the piriformis because of its relationship to the sciatic nerve. In most people, the piriformis lies directly on top of the sciatic nerve. However, in some people, the sciatic nerve runs over or through the piriformis. Therefore, when the piriformis is tight, the sciatic nerve is compressed. This pinching of the sciatic nerve causes a pain that is commonly called sciatica but is also referred to as piriformis syndrome.
Because of its location, the piriformis crosses and affects the sacroiliac (SI) joint and the hip joint. The origin of the piriformis is on the front part of the sacrum. The muscle then moves forward through the body to its insertion. This forward pull holds the sacrum forward in a neutral position (relative to the position of the pelvis).
At the hip, the piriformis is one of 6 deep lateral (to the side) rotators. This means that the piriformis helps rotate your leg to the side, away from the midline of your body. Of these rotators, the piriformis is the most well known, possibly because of its relationship with the sciatic nerve.
Additionally, the piriformis abducts (moves away from the midline) the thigh. Think of taking a step to the side. The piriformis helps you do this. It also helps hold the femur in its socket, particularly when balancing on one leg.
The piriformis, along with the psoas, are the only muscles that connect the leg to the spine. In his book Psoas Release Party!: Release Your Body From Chronic Pain and Discomfort Jonathan FitzGordon says, “The psoas connects the body across the front and the piriformis at the back. These two muscles, when working well, perform as balancing act that allows for successful upright posture. A problem with one of these muscles always involves a problem with the other as well.”
Let’s follow along with FitzGordon’s thought that the psoas and the piriformis affect each other. This means that if you have low back pain, you might think that it’s coming from a tight psoas, but that may not necessarily be the case. It could mean that your tight piriformis is restricting the movement and function of your psoas and, therefore, creating your pain. So, the piriformis could be a component to low back pain.
However, the primary dysfunction of a tight piriformis is piriformis syndrome, which is a sciatic pain that begins in the buttocks and frequently travels down the back of the leg. This can be a shooting pain, or a numbness or tingling. Luckily, this type of sciatica is easily treated with stretching.
Additionally, because of its origin on the sacrum, a tight piriformis can result in a misaligned sacrum. As someone who has this happen periodically, I can tell you that it makes any activity involving your tailbone weird. For example, sitting down or sleeping on your back feels weird. It might not necessarily be painful, but it just feels wrong and uncomfortable.
A less severe result from a tight piriformis is that you might stand with your feet turned out.
Restoring or Maintaining Health
Personally, I love to release my tight piriformis my rolling on The Orb, tennis balls, or a lacrosse ball. I like how I can position my body on the ball and roll to get a deep massage of this muscle. Plus, if the piriformis is not the only culprit for my pain, I can normally find release for other tight muscles around it.
For more information, I recommend “The Piriformis Muscle” by David Keil. He has a wonderful yoga anatomy book that I enjoy. That book is called Functional Anatomy of Yoga. Here is a link to buy it on Amazon. When you buy this book through this link, I earn a small commission.
Another book that I find helpful is The Concise Book of Muscles by Chris Jarmey. I used lots of information from his book while writing this post. The link I have provided is to an updated version of the book I have. It appears to be a very thorough update, although I have not personally looked through the whole book.
Although his book has more to do with the psoas, I also recommend Psoas Release Party! by Jonathan FitzGordon to get a better understanding of the relationship between the psoas and piriformis.
What do you do when your piriformis is hurting? Let us know in the comments below.
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