The running effects of piriformis syndrome

What is piriformis syndrome in running?
Piriformis syndrome is a very common complaint with runners. The piriformis is one of the small muscles deep in the buttocks that rotates the leg outwards. It runs from the base of the spine and attaches to the thigh bone (femur) roughly where the crease in your bottom ends.

The sciatic nerve runs very close to this muscle and sometimes (in about 15% of people) it runs through the muscle. If the muscle becomes tight it can put pressure on the sciatic nerve and cause pain in the buttock, which can radiate down the leg.

What can cause the piriformis to strain or tighten up during running?
Overuse, an uneven running gait, or even problems in the lower spine can cause problems. A common cause though is a tight adductor muscle with an abductor muscle (on the outside of the hip) not working properly. The end result is the piriformis acting as an abductor (lifting the leg to the side) and making it work harder than it would normally and so becoming strained and tightening up.

What can you do to prevent this in your running?
Stretching the piriformis muscle in conjunction with a strengthening programme can help. In addition to the piriformis muscle itself, other muscles around the pelvis should also be stretched. These include adductor muscles, hip flexors and gluteus muscles.

As a general rule hold stretches for 30-40 seconds, repeat three times and try to do this up to five times a day. A good strengthening exercise is the ‘dog leg’ exercise where you go down on hands and knees and lift the leg up to the side like a dog. Repeat these 20 or so times and have a good stretch afterwards. The muscles will stretch a lot easier after they have been worked.

Heat applied in the form of a hot water bottle or hot bath can also help relax the area. Do not apply heat if you suspect a recent tear or strain of the muscle.

What can a sports injury professional do to help my running?
Ultrasound and deep massage techniques, combined with stretching and muscle energy techniques, can really help in relaxing and stretching the piriformis. It might take a couple of treatments but a good masseur can reach the parts you cannot reach yourself. It is also important to get yourself checked out for lower spine problems and proper running gait.

This is a common problem among runners, which can be easily treated. It is important to not only look at your running style and habits, but your habits in every day life which often have more bearing on this type of injury than your training. For example, sitting poorly in a chair all day or having to drive long distances can aggravate many problems. Keep active and mobile and do not allow muscles that need to be used, to tighten-up and adaptively shorten.

Remember to continue to stretch the muscles long after you feel you have recovered from this running injury or you may find it returns.