The piriformis is a strap of pear-shaped muscle running across your backside deep to the much larger (and more celebrated) gluteus maximus. It is small but mighty especially when it is unhappy. Poor piriformis is often plagued with tightness or overuse/overstrain due to its size, geography, and general work performance. An unhappy piriformis can be at the root of your sacro-iliac, sciatica, and pelvic pain. Poor hip, knee, and/or foot alignment in stance and gait are major contributing factors in this scenario. So let’s take a closer look “behind” the scenes.
Originating along the anterior surface of the sacrum, the piriformis traverses and gives padding to the posterior pelvic wall before its insertion on the greater trochanter of the femur. It acts as a muscular bed for the sacral plexus (bundle of nerves – literally) and proximal sciatic nerve. Other duties of the piriformis include stabilizing the hip joint by steadying the head of the femur in the acetabulum, stabilizing the sacro-iliac joints through approximation or compression, laterally rotating an extended hip, and abducting a flexed hip. That is a lot of work for such a little muscle! No wonder it is easily overwhelmed!
So how do you know if your piriformis is unhappy? Do you have a pain smack dab in the center of your butt? Do you have pain near your sacrum on either side? Does the pain radiate into the posterior thigh? Do you stand and walk like a duck (or a dancer) with your toes pointed out? Do you stand and walk with pronated (unsupported arch) feet and kissing knees? If yes to any of these, then you might just have an issue with the piriformis tissue.
Here are some Yoga Tune Up® poses that feature and awaken the piriformis as well as address lower extremity alignment:
Tune Up Tadasana
½ Happy Baby to Playing the Violin Minivini
Leg Stretch #3
So many people show up to yoga with sciatica issues and knowing more about that pesky piriformis is very helpful. Love the half happy baby mini vini! Great article. Thank you!
It’s always so interesting to see how intimately related hip tension and back pain are, especially because hips can hold so much emotional memory and back pain (a la dr. Sarno) can too. So many people come into my classes complaining of all sorts of “back pain” and point everywhere from their head to their butts when showing me where it hurts. It’s a process to start to parse what exactly people mean and what could be going on. The piriformis is another big piece of the puzzle.
As a long time sufferer of Piriformis Muscle Syndrome, I would note too that that this can come on suddenly and out of no where after an intense day at the gym doing lower back exercises, or just doing a hard yoga class. I came to Yoga Tune Up because of this very chronic and excruciatingly painful condition, I was really worried that I had done something serious, and after recurrence upon recurrence I no longer wanted to continue to take low grade muscle relaxers at night. I’ve been doing Leg Stretch #3 and other counternutating movements to help me keep it open and flexible. IT WORKED! Great source of information for folks here, and could save them a trip to the Emergency Room.
I’ve known fr the last several months that it’s been my Piriformis that’s been giving me so much grief. From Plantar Fasciatis to my lower back pain and right outer hip tightness, but I never saw the connection. I must admit this is a bit troubling since both my parents have knee replacements, and through yoga practice I am hoping to avoid this scenario. Thank you for the insight and the poses.
Pain due to piriformis dysfunction, or as a like to say, pain due to a “pain in the butt,” has the ability to radiate though your hips, knees, legs, calves and feet. An easy way to begin addressing the pain is to use the Yoga Tune Up balls to stimulate the feet, therefore hydrating the connective tissue not only in your feet but up your body into your legs, hips and even your piriformis. Something as simple as rolling the ball under each foot, up and down and from side to side – imagine you are painting the entire sole of your foot with the ball as your brush- for 1 minute on each foot every day is the beginning to a self-care/no routine.
This just shined a light on how to help my boyfriend who has flat feet and is experiencing pain in the but! I will definitely suggest these exercises to help relieve what may be causing this pain! Now I know a little more about the deeper muscles within the pelvis and hip area. Always learning!
My, isn’t it remarkable that a small muscle like piriformus can be responsible for so much and yet until today I had not officially met her. I definitely have poor knee, hip and foot alignment on my left side – (a muscular adaptation to left kidney removal and major cutting on that side as a child)? or perhaps I was born with a compromised left sacral muscular structure along with the non-functioning kidney, which led to left knee injury and arthritis in base of 1st metatarsal (left big toe). Who knows which comes first? Who cares?! The goal is to heal, to eradicate pain, and to have more stability.
I look forward to learning more about “poor piriformus,” and helping her to grow into “well loved stable piriformus!”